Types of Service

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

Terms and conditions

Some of the terms and conditions have altered slightly from January 2014 this year. Please note terms are 30 days net and no longer 60 days net.


(Updated January 2017)

A growing number of patients find that paying regularly into a scheme can be expensive. Many opt to pay themselves. It is important that a patient selecting this service understands how it works. This is a form of ‘pay as you go’. You can seek an initial appointment for which you pay a set fee. X-rays, tests and any treatment is NOT included in the consultation which is divided into two sections; first contact and follow up for one fee. This may give anywhere from 40-60 minutes consulting time. I will provide you with a quotation of costs although initially can only estimate your surgery until our business office provides this in writing and I have the results of x-ray tests.

Self-pay patients can now take advantage of inclusive second consultation costs. Your second consultation (non treatment) follow up visit is built into the  new patient fee of £230.00. This allows you to return to see me inclusively for three months so you are not rushed.  This offers good value and is highly competitive.  The consultation can be taken as a telephone consultation if this is more convenient.

Examples of costs

A tariff is provided covering costs for private care. The surgery costs are only a smaller percentage of the full package. A hammer toe operation costing £289 -350 for example may cost you around £2300 once the hospital costs have been included.

A typical cost of an imaging guided injection into a single joint would cost £100 for the consultant and £300 to the hospital in addition to the consultation fee.

Financing your care at our hospital – opens up alternative options for private care

Spire Little Aston Hospital provides advice on finance. To make your treatment more affordable, you may be eligible for a medical loan. Spire Hospital has teamed up with specialist medical loans company First Medical Loans for one-off treatment at Spire Hospital. Low cost APR loans are available over 10 months or longer. Details are available tel. 0845 6341199 or apply at www.spirehealthcare.co.uk/finance

Mr Tollafield cannot offer advice on this service as it is independent from his practice and he is not qualified to offer financial advice.

Why self-pay?

Many patients tell us that funding yourself allows more control of their finances. Finding out the cost of your care allows you to budget and in many cases the costs of treatment are not as high as you might imagine. Although Mr Tollafield does not offer direct advice over finance he is able to put you in touch with our friendly business office to discuss your options.

You pay the first consultation and receive a summary of the treatment based on any tests (ultrasound, X-rays, bloods etc).

You pay for tests unless these are included as being necessary in your surgery.

When you have surgical treatment, physiotherapy, nursing and admission will be taken into consideration as well as anaesthetist and podiatric surgeon’s fee. This will be your fixed cost quotation. ALWAYS ensure you have a free quotation before booking surgery.

We can reserve a treatment slot for a limited period without obligation. After surgery you will have the cost of your first consultation included in the cost of treatment. Thereafter you will pay reasonable fees based on the frequency of visits required.

Problems that might occasionally arise within the fixed cost term are set by the hospital’s scheme. Infection, wound management delaying progress, will be covered at no extra cost only if they are related to treatment at our hospital. This part of the package should give you some peace of mind.

For further information click on terms and conditions

Insurance Schemes

There are a number of methods of funded care through a medical insurer or medical society or health fund. Patients should make an appointment after checking with their provider scheme first.

Please ensure you have an authorisation code. Some insurers will not pay unless the referral has come from a GP. Referral by a chiropodist or podiatrist may not be accepted. Podiatric surgery is recognised by most insurers but because they will not know the difference between a podiatrist and a podiatric surgeon the two can become confused. Few companies cover orthotics / orthoses / appliances and this includes walker boots. Remember to check first but also ensure that you tell the insurer that you are seeing a consultant who only undertakes foot surgery and will provide you with a code.

Mr Tollafield adheres to the advisory fees recommended by your insurer and will not add more to the bill. Local anaesthetic codes are not charged for and he does not bundle case costs together to inflate invoices. In some cases it is necessary to admit you for an overnight stop. You must check with your insurer first before agreeing your surgery to ensure you do not have to pay.You will be responsible for any shortfall in cover not provided by your insurer. These must be paid for by patients and regrettably late payment will be subject to additional charges which are clearly stated on invoices and statements and now within the Introductory information sheet.

AXA PPP are the only insurer who do not cover planned overnight admission for podiatry foot surgery. Mr Tollafield will not provide such treatment in the rare situation where admission is likely. During 2014 my admission overnight was around 1-2%. Majority of foot surgery is undertaken on a day care basis.

For further information click on terms and conditions 

NHS ‘Choose and Book Patients’

UPDATED (January 2017)

This service is limited. The service relating to NHS patients is  governed by NHS commissioning and covers adult patients only.  GP’s must agree to all referrals and  approved for funding. There are rules that allow patients to be treated at Spire Little Aston Hospital and the hospital must follow such guidelines. Mr Tollafield is not the only consultant to provide this service which is limited to surgical management.

Please contact Mr Tollafield’s our NHS desk Miss Amie Firestone, or Mrs Helen O’Reilly on 0121 580 7295 for follow up queries.


Ganglia, cysts and corns and callus.

Complex foot surgery is not covered

Unstable diabetic and thyroid disease.

Patients over body weight index (BMI) of 40

Multiple foot problems cannot be treated under one referral.

Patients with complex medical health should be treated in a general NHS hospital.

Spire Little Aston Hospital does not operate as an emergency or trauma centre.

Physiotherapy care is not provided before surgery if it is needed so you would have to return to see your own GP for this to be arranged. Only approved surgical treatments are allowed and all NHS options are followed as closely as possible.

NHS provision is subject to availability.


Provision of treatment responsibility

Only treatment requested by your GP can be carried out. I can provide advice for your GP on biomechanics as part of a consultation but the hospital do not dispense any appliances or orthoses.

Once you have been see you will be given an operation date, usually at your first consultation if this is required. This date will be between 12-18 weeks from the date of referral. We can extend your treatment (if you have other commitments beyond the 18 weeks inline with patient choice

If you cannot reasonably accept two dates offered you will need to be discharged back to your GP for a new referral.

The date provided is provisional until the consent has been signed. Patients failing to return for follow ups may be cancelled or discharged. DO make sure that you return to make an appointment after your imaging request (i.e x-ray, ultrasound or other investigations). WE do not send out reminders, this is your responsibility. The dates booked under this provisional basis may change until confirmed at you final pre-surgery visit.

Some treatments can be purchased where they are not covered under the NHS. This may include some foot appliances that may help you. Treatment of heel pain by Extra-corporeal shock wave is not available as an commissioned NHS option.

Some of the more expensive surgical implants may not be available to NHS patients.

Our patients enjoy being treated at Spire Hospital Little Aston but we do not offer the same lengthier consultations that private clients enjoy. Some of the flexibility toward care may be different although the quality remains very high. During periods May-June and September-October, Mr Tollafield takes breaks from practice and so undue waiting times may appear. Our private cliental will have priority during these periods but you are able to select other consultants offering the same service.

Complaints or concerns

These should be addressed via the NHS office at Spire Little Aston Hospital. We hope that we can meet all care sensitively and effectively. Any concerns may involve going back through the NHS. Of course wherever possible Mr Tollafield, as with other consultants, will do their best to deal with immediate concerns.

You will be given an operation date usually at your first consultation if this is required. The date is provisional until the consent has been signed at a revisit. Patients failing to return for follow ups will experience delays. The dates booked under this provisional basis may change until confirmed at you final pre-surgery visit.

Value for Money

It is the intention of this practise to deliver a quality service with value for money. A new section called Treatment Centre was developed in 2014  to provide material only for registered patients.  Appliances and orthoses are not available on the NHS at Spire Little Aston Hospital and insurers do not cover such modalities. It is not my practise to press patients for custom made prescription devices but to save money where we can. This is a family practice established since 1998 and my business is about giving you impartial quality advice.

Why use podiatric surgery in the private sector?

There are distinctive differences that my service can offer over the traditional NHS service. Personalised with faster diagnostic options and good integration with other hospital services for your convenience.

So why use me and why use Spire Little Aston Hospital?

Private practice is designed to offer treatment on demand without unreasonable delays and when you need it. If you cannot book to see Mr Tollafield as a private (self pay or insured patient) please contact Mr Tollafield’s secretary who will try to guide you. Alternatively you can contact the outpatient manager who will be pleased to help as well.

If you have a problem following treatment you can expect support from our resident medical doctor (RMO) or outpatient nurse. Mr Tollafield can be contacted outside working periods. This exists for all patient categories.

There are times when Mr Tollafield is away from work for courses, examining, attending essential meetings or personal events. If any inconvenience arises we will provide you with an early return even if this is on an unscheduled day.

When away Mr Tollafield will arrange for emergency cover with orthopaedic colleagues and he will see you at the earliest opportunity thereafter. After surgery a 24/7 service for post operative care exists.

The hospital provides excellent parking facilities. You will be seen in our modern and aesthetic surroundings which do not have the intense traffic associated with a general hospital. The staff are smaller in number and know Mr Tollafield’s practise well and can offer aid more effectively.

Physiotherapy is fully integrated into our support services.

Why is the private sector so expensive?

It is right that you know how costs are made up. Publication of baseline fees has become a now a legal requirement from 2017. Different consultants may charge different fees. The surgeon broadly takes 1/5th of the total cost of a surgical treatment. The time spent with patients is usually twice as long as most equivalent consultations. On the basis of cost per minute this represents good value.

A fee is made up of the following components:

  • Hospital costs and charges
  • Professional costs
  • Education – keeping up to date
  • Other statutory costs
  • Production of quality personalised clinical information

In order to work at consultant level and practise surgery involves many years where the cost of education (in podiatric surgery) is borne by the specialist as a junior. Remuneration is commensurate with the time it takes to become skilled.

When you undertake to see a consultant podiatric surgeon at your GPs recommendation you are entitled to expect

  • Good quality advice
  • The benefit of good training sustained for life of the career
  • Experience of over 10 years post graduate training
  • Appraised ability.
  • That he keeps up to date
  • Is willing to spend time with you and understand you
  • Audited practise

The modern consultant has to maintain numerous standards. To remain in practise certain requirements must be maintained from our income.

Reassurance in the care that you receive


The cost of consultation allows adequate consulting time, provision of information and explanation with access to our hospital practise. New cases can expect up to 40 minutes for a consultation depending upon need. A follow up appointment is often necessary to discuss tests and discuss management.

Many people seek information, others reassurance and second opinions while the main group desire to have treatment delivered efficiently in comfortable surroundings.

Letters to your GP, short reports, and notes to companies concerning holiday insurance are included in the consultation and treatment fees. Legal reports that are NOT part of a medical report on past treatment and life insurance will incur charges. All patients can receive a copy of their letters to GP without charge on request. While Fitness Notes (replacement of sick notes) will be provided on discharge, I will help you with work return issues wherever possible.

Simple tests before consultation

Simple tests such as blood pressure and urine testing, weight, are requested to provide information about key health status. Some of these tests are charged by the hospital and are conducted by nurses. Services that support consultants include laboratory and imaging (x-rays etc) are always additional to the consultant’s fees. Basic tests include an x-ray or an ultrasound scan. More detailed tests may require an electrocardiogram (for operative treatment), MRI, CT and bone scans.

Clinical notes

A history of your treatment is kept on a database which is protected by password and firewalls. Only factual data is retained to assist audit. Audit is the process of review of past treatment to understand how results are achieved or causes of poor results for learning. Mr Tollafield is registered with I.C.O. (Information Commissioners’ Office) as part of data protection. The system is registered to the Society of Chiropodists and Podiatrists. You are entitled to see this information on request.

Thanks for reading: Types of Service. Consulting Foot Pain – Mr David Tollafield, Birmingham