Frequently asked questions

Where do I go?
Where will I see the Consultant?
How long will the appointment last?
What happens during the consultation?
What happens if I need an MRI/CT/X-ray/Injection?
What is an MRI?
What is A CT Scan?
What if I need an injection?
What if an operation is planned?
I am insured, what should I now tell my insurance company?
What are the fees and will I be covered by insurance?
I am paying for my treatment myself. Will I need to provide a credit card?
Who do I contact if I have problems after the operation? 
Outcome scores
 

 Where do I go?

For private appointments go to the main reception of the Spire Hospital in Bristol and they will direct you to the Outpatients Department. The same applies to the Nuffield Hospital. For Weston the private clinic is called  the Waterside Suite.

Please go to the hospitals page for directions  

 Where will I see the Consultant?

A nurse will show you to a seat near your Consultant's consulting room. Mr Harding will call you into his consulting room when he is ready to see you. Ideally, all clinics run on time but sometimes there may be delay due the nature of consultation times being variable or other issues outside Mr Harding's control.

 How long will the appointment last?

Appointments will last for as long as they need to  - more complex problems need longer appointments as do first presentations to the clinic. Sometimes, X-rays are requested and this can prolong the time in the clinic - depending on how busy the X-ray department is.

 What happens during the consultation?

Mr Harding will take a full medical history from you and ask you about your current symptoms. In most cases he will perform an examination of your spine and limbs. It may therefore be useful to wear appropriate clothing if this is required.  

He will ask you questions about whether you take any medication or suffer from any illnesses. (It may be an idea to take your medication along or write down the name if you are taking any). Likewise, if you have an extensive previous medical history relating to your spine or any previous correspondence that you have (or imaging) it is always useful to bring it along.

Normally, the next stage is to go through any further investigation or treatment that may be required and then to organize this.

 What happens if I need an MRI/CT/X-ray/Injection?

Mr Harding will fill out a card (or online if possible)  for the X-ray Department, instructing them as to which investigation you require.

You can then make an appointment directly with the X-ray Department to pop back and have your scan, at a convenient time for you.

The results will be sent directly to Mr Harding following your scan. He will inform you when you need to make a follow up appointment and this can be made as soon as you have a date for your scan/injection. Often, if possible, in urgent cases an appointment straight after a scan is requested (although the radiologists report will not be available) to facilitate early diagnosis and treatment.

 What is an MRI?

MRI (Magnetic Resonance Imaging) is a technique that has been used since the early 1980’s to get an internal picture of specified areas of the body.

The MRI scan uses magnetic and radio waves, meaning that there is no exposure to damaging forms of radiation.

You will lie in a large, cylinder shaped magnet that uses radio waves 10,000-30,000 times stronger than the earths magnetic field. The magnet sends differing radio waves through the tissues in the body to show up what types of tissues are present. As it does this, the particles in the cells of the tissues bounce. As they move back into their original place, they send out a radio wave of their own. A specialized computer then turns these waves of energy into a picture of the types of tissues present in the area of the body being scanned. Different types of tissues emit differing signal strengths, bones usually look dark on the scans and fatty tissues look much brighter.

The MRI scan provides such a detailed picture of your body, it is possible for your Consultant to see if there are any little growths or abnormalities in the area being scanned. As the MRI scan is like a very defined photograph of the internal workings of your body, if you need an operation your Consultant will then use your MRI scan to guide him to the correct area of the problem.

In the Spine, the MRI is useful at ruling out any serious underlying problems and looking at the discs, nerves and joints in your spine. It cannot show the position of the spine when you are standing up (which is very important) and so standing xrays are often needed for this.

 What is A CT Scan? 

A CT or CAT scan is a special type of xray. Much like an MRI scan, a specialised computer will collate the results from the different x-ray beams and create a picture of the density of your tissues in the form of a cross-section through your body. Beams that have passed through less dense tissue, such as the lungs, will be stronger, whereas beams that have passed through denser tissue such as bone, will be weaker. CT involves radiation like X-rays and is therefore used sparingly.

In the spine CT is often used to evaluate the bony anatomy more clearly which is not seen well on an MRI.

Sometimes a CT Spect scan is requested which has to be done at Southmead Hospital as a private patient. The combines a bone scan with a CT and can give additional information regarding sources of pain - particularly in patients with previous surgery. Like CT, it does involve radiation and may take a number of hours to complete.



 What if I need an injection?

This is usually done in the xray department by a radiologist  (usually Dr Watura or Dr Rajayogeswaran)  or by Mr Harding himself in the operating theatre – it depends on the patient and the injection. The injections are used to help in confirming a diagnosis and often also help the patient. Diagnostic injections either numb an area or the spine e.g. facet joint, nerve root, pars defect with local anaesthetic – if this takes away your pain then it is likely to be the problem. Steroid is often also injected to help give a longer term benefit, although how long this works for is very variable. In one type of rarely used  injection called a discogram, the aim is to identify a source of pain by injecting fluid into the disc and this may be (deliberately) uncomfortable and has no therapeutic benefit. It is for diagnosis only and if positive suggests the disc is the source of pain.

 What if an operation is planned?

The reasons will be clearly explained and if you are insured you will be given codes to hand to your insurance company. In most cases, Mr Harding will give you a date in the clinic. Sometimes it is necessary to go away and weigh up the pros and cons of surgery and then you can contact his PA with a decision thereafter.

If you decide to proceed with an intervention you will be asked to contact his PA, who will arrange your operation with you. If you are insured, please provide insurance details. In many cases you will be required to attend a pre-operative assessment and details will be sent to you regarding this. If you are not insured an exact cost for an inclusive package will be arranged.  

For details of individual operations please consult the Treatment page on this website

 What are the fees and will I be covered by insurance?

Treatment fees vary depending on complexity of surgery, but in most cases insurance companies cover the costs. As a guideline, unless there is a prior agreement with the insurance company WPA rates are used for surgery to standardise costs. These fees have not increased or changed considerably in a number of years despite rising costs of providing private healthcare, including rising premiums, and are freely available online.

Consultation fees vary from £150 to £250. If you are insured your insurance company will be billed directly but you will be liable for any excess. Payment is expected within 30 days if you are liable and will be pursued. The hospital is independent of Mr Harding and any bill received by Mr Harding is independent of hospital charges. The hospital will swipe your card for any charges incurred by them but this will not cover Mr Harding's fee. Mr Harding operates independently from the hospital and pays charges to hospital for consulting and administration.

If you wish to pay via BACS then
 please use the following:

account name: Mr I J Harding
sort code: 40-47-58
a/c: 73893545



 
I am insured, what should I now tell my insurance company?

You should inform your insurance company (before you attend for a consultation) that you are planning to see a Consultant. Often, they will issue you with a claim form that you will need to fill out. It may be necessary to obtain a formal GP referral, although Mr Harding does not require this and is quite happy to see self referrals or contact your GP himself.

Some parts of a claim form may need to be completed by the Mr Harding. If this is the case, take it with you to your initial consultation or post it to his PA afterwards.

Insurance companies may also need other details such as the time and date of the operation, which implants are used and who the anaesthetist will be (normally Dr Richard Dell FRCA) and length of stay at the hospital. We can provide you with all this information.

 I am paying for my treatment myself. Will I need to provide a credit card?

If you have an operation, the hospital will collect the fees. This is called an ‘inclusive care package’. They will collect the full amount and pay the surgeon and anaesthetist on your behalf. One follow-up consultation is included in this price. Any subsequent consultations will be billed for.

 Who do I contact if I have problems after the operation?

You can contact the nurses at the hospital. Alternatively, you can call the PA (0117 973 4073), during working hours, who will either offer you a follow-up appointment, or if it’s an urgent issue, contact Mr Harding on your behalf to ask his advice.

Outcomes  


If you are having surgery, you will be given a patient related outcome questionnaire to complete. This is important to monitor your progress and give an overview of Mr Hardings practice overall. Data is collected and stored on the secure British Spine Registry. At intervals following treatment you will be contacted via email to complete further forms. Thank you for you help with this.