Terms and conditions

Foot Pain Consultant Birmingham - Podiatric surgical services at Spire Little Aston Hospital


The following information is provided to ensure the best harmony between patient and clinician. The points below should help to guide  your treatment. These conditions will only be summarised in introductory information issued at the initial consultation for private and self-funding patients. The  information below deals with all the terms and conditions associated with Podiatric Surgical Services and ‘Consultingfootpain’. Podiatric Surgical Services is part of Busypencil Case Communications Ltd and registered with Companies House (2015).

Chiropody is an outmoded title and does not mean or reflect the service provided at Spire Hospital Little Aston. The name has been retained by The Society of Chiropodists & Podiatrists as some practitioners prefer to include this as part of their care package for older clients and the regulator still persists in using this old title nearly 1/4 century after degrees in podiatry replaced chiropody diplomates. Patients should consult a chiropodist or podiatrist for routine problem before seeking a consultant Podiatric Surgeon to ensure all conservative management is provided first. At Spire Hospital Little Aston we have Podiatrists who work from the physiotherapy department (PERFORM).


The relationship between a patient and the consultant is special. In this case as a podiatric surgeon Mr Tollafield will do all he can to provide effective treatment. You are entitled to know any fee structure before embarking on treatment.

He does need to know if you are being treated by someone else, if you have allergies, if you take any prescribed medication, recreation drugs, alcohol or smoke. The success of treatment lies as much in the hands of a patient as it does the person carrying out surgery.

Mr Tollafield is governed by the Health Care Professions Council (HCPC) and his professional body (The Society of Chiropodists & Podiatrists) to provide patients with quality care. This is not the same as the GMC (doctor’s council) who have no jurisdiction in Mr Tollafield’s practice. (Refer to quality assurance).

Data protection

Patient data is held on a database ‘PASCOM-10’ which assists with audit and quality assurance (see QA). All patients are entitled to see information held about them and know that this is held securely with protocols laid down by the hospital and the Podiatry body, The Society of Chiropodists and Podiatrists.


These are reviewed each year to reflect the cost of providing a quality service. Fees vary between initial consultation, follow up, outpatient treatment and post treatment/surgery reviews. Each fee is based on consulting time which is often longer than many other consultant services. Current  fees are made available and follow the recommendations of the Competition and Marketing Authority (CMA) guidelines for 2017. My secretary (Tuesday, Wednesday) will be able to advise you further or you can use david.tollafield@spirehealthcare.com (replies only on Wednesday, Fridays)

Split fees

The hospital (Spire Hospital Little Aston) and (Podiatric Surgical Services) are entirely different even though we work together. Bills from one do not affect the other as do shortfalls. Do not contact the hospital to find out if you owe anything to me, you must contact my secretaries to ensure you are aware of any unpaid statements (see Jackie Ravenhill for financial / after care costs and invoices).

Podiatric surgery

Podiatric surgery is not the same as orthopaedics. Mr Tollafield is not a medical doctor and does not hold out that he is, or holds a medical qualification assuming medical entitlement of the title doctor. Do bear in mind his initials are D and R and have nothing to do with being a doctor but more a fluke on the birth certificate! He holds out that he is qualified to perform foot surgery and uses the title podiatric surgeon to avoid confusion with the term podiatrist where a narrower scope of practise is offered. Podiatric surgeons offer diagnostic assessment and elective surgery under general and local anaesthetic, but do not deal with emergency trauma care.

Inappropriate referrals

Mr Tollafield holds no responsibility for a referral generated by another person, GP, specialist or member of the public where such a referral would be unsuitable for treatment. He holds the discretion to discount your fee as entitled. He does not provide the services that a podiatrist would do although can advise on such services.

If you do not wish to have surgery but seek conservative care and none is advised, he will still charge you for his time and expertise. (See value for money).

In the event of an appointment being made and not cancelled, you may be charged up to 75% of the consultation fee. You will need to claim this back from the party who advised you to see Mr Tollafield. Refer to above inappropriate referrals.

Failed appointments

Any person booking an appointment will have deemed to agree to pay for his contact time. When failing to attend, your liability to receive a charge is not removed. Naturally Mr Tollafield is sensitive to sudden unexpected genuine events. Cancellations earlier than 8 hours will be charged for at 20% of the consultation. This will be added to your next visit and cannot be claimed by your insurer.

Self pay

All self pay patients must understand what they will receive for their money. The initial consultation is £190.00 and follow up £90.00 (2017). Self-pay patients may take advantage of the inclusive second consultation costs if booked within 60 days of the first consultation totalling £230.00. This represents a saving of £40.00. If you need no further follow up the lower cost will be applied. Fees are settled on each day of attendance.

It is important that your follow up visit supports your first appointment and provides additional information such as planning your next stage once we have test results.

Please refer to any terms in regard to fees charged by Spire. Our hospital will be able to advise you about current consultation fees and fixed cost surgery and treatment packages. The fixed cost or quotation given has some limits and exclusions. You should not sign or agree to self pay surgery or treatment if you do not have the means to pay. You must understand that self pay treatment offers no more guarantee than by any other method of payment for this service. That is to say if the treatment fails, or you have to have revision surgery, then you will have to pay again unless it is re-claimed within the period set down by the hospital.

Settlement of costs

Patients (outpatient visits) must settled  on the day of consultation. Credit card facilities are available for payment. Cheques are accepted supported by a guarantee card but are favoured less.

Insured patients

Your contract for the cost of your care is with myself as Mr Tollafield holds no contract with your insurer. He agrees to undertake healthcare within his expertise at locally agreed fees. Any shortfall in fee settlement is the patient’s responsibility not the consultant’s. Where Mr Tollafield has agreed a fee with your insurer, this will be honoured. If you are not fully insured, have run out of cover due to heavy usage you must pay the shortfall promptly. If you fail to tell your insurer that you are seeing Mr Tollafield or embark on treatment these costs are unlikely to be recovered later and you will have to bear the full cost of money owing. He will advise you of all costs if you are insured on request. Recently  companies have indicated in advance the level of fee paid for surgical treatment.  Mr Tollafield cannot be held responsible for not knowing the terms of all insurance  packages as these vary so widely.

Mr Tollafield does not contact insurers on a patient’s behalf although on occasions his Accounts Secretary ( see ‘ABOUT’) may assist you, provided that you have not defaulted on payment or left it to a final reminder stage. All treatment approvals are down to the patient to have agreed with their insurance scheme provider.Insurance companies do not re-imburse patients for inappropriate referrals and Mr Tollafield does not see referrals or notes until the day of the appointment and therefore cannot be held responsible for late advice.

Settling short falls

You may pay our finance section which can be found in clinic or telephone in using your credit card. If you wish you may pay directly into his bank account saving.  Please call my secretary for the sort code and bank account if you find e-banking easier.

If you know you have insufficient funds before you embark on treatment you are advised not to proceed.

Failure of settlement

Please refer to ‘failed payments’ below which are most often associated with shortfalls. Remember as with any service you are responsible to pay for the expertise and treatment you receive as you would with any product purchased. A contract exists once you make an appointment and attend following a booking.

Fairness and arbitration

Private health care is a business  and debts cannot be ignored and will be collected. Please avoid escalation of a debt. You can use various arbitration methods; Mr Tollafield’s Society, the hospital manager or in extreme cases the HCPC. Mr Tollafield will reimburse those fees considered inappropriate where arbitration finds in favour of the client.

Cancellation of holidays

If you embark on surgery  you will be informed how long recovery may take. Circumstances outside Mr Tollafield’s control cannot be anticipated. If you are travelling by air ‘long haul’ [8+ hours] you may need three months before you are ready or safe to fly if  surgery is complex. If you opt to have surgery and do not tell Mr Tollafield your plans he is not responsible. He cannot write to your holiday insurer to support an invalid claim. DO NOT have surgery if any commitment relies on you being fully mobile.


If you drive after surgery before you have been advised you will invalidate your insurance and may expose yourself to criminal prosecution. He will not be able to support you in the event of a prosecution. You should only drive when it is advised, safe to do so and that you can perform safe stopping methods without pain or distraction. When driving initially you should always plan a short drive first supported by someone who can take over.


Alcohol impairs decision making and is unsafe in the healthcare setting. You will forfeit your appointment and have to meet the costs as if you had attended. No-one will be admitted for any procedure if considered to have consumed alcohol within the hospital.


If your behaviour (or someone attending with you)  is aggressive, or language is used that is offensive and personal to any member of staff who works with Mr Tollafield then you will forfeit your right to be seen. If you become upset or agitated about your treatment you should discuss this objectively and not lose sight of the fact that Mr Tollafield is trying to help you over your concern.

NHS patients

Cannot demand to be seen at a specific time. All surgery will be offered within the dates determined by the hospital panel. Please do not book appointments or try to arrange any social activities around your surgery without first having agreement from the consultant. The responsibility for booking your treatment is down to Mr Tollafield and not his secretary. If an NHS patient has a concern this should be taken up with the appointed officer or Hospital Manager.

After your initial appointment you will usually be sent tests (imaging such as x-rays). You can leave after this appointment but make sure a follow up appointment is made. If you fail to make a follow up appointment, the next stage of your treatment will be delayed even if you have a reserved date for treatment (surgery/injections). Check with our main patient reception (downstairs) before leaving if unsure.

Children cannot be seen at our hospital under the NHS scheme.

Failed treatment

Not all surgery is successful and sometime problems arise. You will made aware of these events on your consent form as list of possible risks. Secondly you will receive what is known as Sheet 40 covering information about surgical risks. This sheet directly relates to the information given on your consent form. Information will also be made available on these WebPages or you will have written information covering the specific treatment.

When children cannot be seen

Mr Tollafield can see any child under the age of 16 years of age if they do not require surgical treatment. Ingrowing nails require a form of surgical treatment and cannot be treated at this Spire Hospital.

Mr Tollafield cannot operate on any patient considered to be a minor (under 16 years of age) at Spire Little Aston Hospital. The hospital do not have paediatric nursing which is a minimum requirement of the Care Quality Commission (CQC).

The reception staff will do all that they can reasonably to warn you that the appointment cannot be acted upon e.g ingrowing toenail treatment or verrucae.


Invoicing and payments

All NEW patients are expected to pay for their first consultation at our main reception unless approved by an insurance company or NHS commissioning when invoices will be dealt through second or third parties. All patients who do not hold approval, or have no authorisation number will have to pay for their consultation or treatment where appropriate.

Payment by credit or debit card is preferred and can be collected at the reception desk and a receipt issued. Cheques and cash can also be collected as forms of payment. You can claim monies back if required. Please contact Geraldine or Mel  if a formal receipt is required.

Returned cheques

Any cheque returned by the bank will incur a charge of £15 for resubmission and refusal to be seen again until this is remedied. To avoid problems you can use on-line banking and transfer funds to account D R Tollafield; Sort code 09-06-66. Account number 41664478 . Please ask my secretary for this information.

Failed payment & charges

Any unpaid amount of the bill submitted that is more than 30 days overdue will accrue interest at 2% above the Bank of England lending rate. The amount outstanding will attract compound interest each month.

Any charges for legal fees will be recovered plus an administration fee of no less than £120 added to the outstanding bill calculated at an amount not less than that paid to courts for collection.


If advised by your insurer these must be paid within 30 days of the original invoice which you will have been sent a copy of. If you have not responded to the final reminder, the whole fee plus costs and interest will be put in the hands of legal collection and you will have to deal with another agency thereafter. Failure of payment will mean discharge from my service.

What to I do if I cannot pay?

If you find that you are unable to pay your bill due please contact Mr Tollafield or Jackie Ravenhill in writing as soon as possible. DO NOT IGNORE reminders. It is better that Mr Tollafield can consider the debt early to mitigate unnecessary escalation of debt problems. There are often ways to assist patients without loss of ongoing treatment but you must be open early on. If the mistake is ours we can remedy this. Often reasons for failure are down to human nature:

  • I thought my insurer would pay
  • I forgot as I had a lot on my mind
  • A recent tragedy happened
  • I did not understand that I had to pay
  • I walked out of the hospital and forgot
  • I forgot to sign my cheque
  • I meant to pop back and pay the shortfall

Hospital services

These are charged independently of Mr Tollafield’s practise and come under the hospital departments such as radiology or physiotherapy for example. (See split-fees above).

Thanks for reading: Terms and conditions. Consulting Foot Pain – David Tollafield, Birmingham

Originally published Aug 3 2013. Last updated December 17th 2016