Frequently Asked Questions – Vasudev Shanbhag

How do I get referred?

We accept referrals from your Insurance Company or your GP. Although it is helpful to have a GP letter, self paying patients do not have to have one. We always copy the GP into our correspondence following the consultation so that your medical records are up to date.

It is important to check with your insurance provider to check if you need a referral in the form of a letter from your registered doctor.

How much does a consultation cost?

A new patient consultation costs £225 and a follow-up consultation will cost £150.
Steroid Injections cost £90 in addition to the consultation costs. The Hospital will charge a separate amount for the injection, please check at each hospital.

Will I need tests or scans?

Additional tests may be needed to aid in an accurate diagnosis of your condition:

X-rays: To visualise your bones.
Ultrasound: To assess tendons, ligaments, and sometimes nerves.
MRI: For detailed images of soft tissues and complex problems.
CT: to look at more complex bone or joint problems.
Nerve Conduction studies- electrical testing of your nerves to diagnose compression on your nerves- like in some cases of Carpal Tunnel Syndrome.
In case of Insured patients, a pre-authorisation is needed in most cases.

Is physiotherapy necessary after surgery?

Post-operative exercises and therapy may be needed after surgery. This would be tailored to your specific surgery and your needs, working collaboratively with qualified, experienced Hand Therapists.

Day Case, In-Patient – what does it mean?

A day case patient means that you will go home on a day of your operation. Please remember to arrange some transport home, either a relative or a friend can drive you home. After hand surgery, you will not be able to drive yourself.
An In-patient needs to stay at least for one night in the hospital.

What is a difference between Local, General or Regional anaesthetic?

Local anaesthetic is an injection in the specific area which will be operated.
If you have regional anaesthetic, your entire arm will be numb. This type of anaesthetic can take a few hours to wear off after the operation but you will be allowed to go home usually 1-2 hrs after the operation.
General anaesthetic is when you are asleep during the whole of the operation. This type of anaesthetic is very rare in hand surgery.

All these choices will be discussed at your consultation.

What are normal, expected post-operative changes?

Aching and throbbing of the hand and swelling and bruising are all common. If local anesthetic has been injected at the time of surgery, it may be a day before sensation improves. Discomfort is improved by elevation, and anti-inflammatories. It may not be possible to get rid of all pain in the immediate days after surgery. Bruising may take about 2 weeks to go away. In the time after surgery, pain is normal. Swelling is normal. Stiffness is normal. Scarring is normal. Duration of those symptoms is determined by the injury, the type of surgery and the location of the surgery.

What if you experience worries or concerns following your surgery?

At St Joseph’s Hospital and at Nuffield Hereford Hospital, before you go home, you will be given contact details if you have got any problems out of office hours. During office hours you can contact our nurses at the respective hospital.

When can I return to work?

This depends on the degree of complexity of your surgery and the demands of your job. This should be discussed with Mr Shanbhag.