Frequently Asked Questions
Professor Mo Imam is an experienced Orthopaedic trauma, upper limb and sports surgeon, appointed as a consultant in the NHS and a Professor in the Smart Health Academic Unit in London leading research on the uses of Artificial and Machine intelligence in surgery. Mo covers all aspects of shoulder, elbow, hand and wrist surgery and has a particular interest in elite sports injuries and looks after many athletes.
Mo consults and operates at several private hospitals.
Lauren, Sam and Lorraine are his secretaries and will help you find a suitable location. (Please call Tel: 020 3384 5588 or email [email protected])
Please check the clinics’ section to find the most suitable location for you.
Prof Imam is happy to receive referrals from a variety of sources. However, you should check with your insurance company whether you require a referral letter from your GP. If you wish to make an appointment, call Tel: 020 3384 5588 or email [email protected]
Waiting times for a routine non-emergency private referral is usually less than two weeks. We will do our best to accommodate Emergency injuries on the same day service.
A referral letter from either your GP or physiotherapist is required. This may have already been sent directly to the hospital. You might need to bring your insurance number and authorisation code for the consultation.
The standard new patient consultation lasts up to 20-30 minutes. Some conditions are straightforward, and a thorough explanation, including demonstrations with anatomical models, can take only 10 minutes. Some complex needs can take much longer, and Prof Imam has usually identified these patients and made allowances for extra time. Follow up appointments last up to 10 minutes but can vary from a few minutes to 20 – 30 minutes. Either way, Prof Imam hopes that enough time has been given to explain the issues involved fully at the end of the consultation.
Your insurance company usually covers the consultation fees as they are within the standard guidelines. Please discuss matters further with our secretarial team if you have any queries regarding this.
Conditions that affect bone, such as fractures and arthritis, often need x-rays. An x-ray will be done on the same day and the results discussed with you by Prof Imam. Most Insurance companies cover x-rays as part of the initial authorisation, but please check first.
Scans (MRI, CT, and ultrasound) are expensive, and the insurance companies almost always require authorisation. Scans are usually performed on a separate day, and a follow-up appointment is needed to discuss the results. On the day of the scan, we recommend patients making a follow-up appointment for a week, by which time the radiologist will have had time to review the images and write a report.
The steroid lasts 24 hours before it is gone from the system.
It is simply a potent anti-inflammatory to reduce inflammation and allow healing of the tissues. Therefore, the duration of pain relief depends on the amount of healing and the effect of any aggravating activities (which is difficult to predict). Thus, the injection may ‘last’ anywhere between a few days and forever.
Overall, 80% of people do not require further treatment and make a good recovery. This is why we review patients at 4-6 weeks after the injection because if the injection does not work, we usually know in that period.
There is no rule about the number of cortisone injections a person can have. Still, there are some concerns with repeated cortisone injections to one area of the body: The cortisone injections are not helping. Suppose one or two cortisone injections into one region do not help a problem for a sustained period. In that case, it is unlikely that more cortisone injections will be of any benefit. Repeated cortisone injections are not healthy for tissues. Small amounts of cortisone in the body are probably reasonable, but repeated injections can cause damage to tissues over time. Sometimes this is of little concern. For example, if a patient has severe knee arthritis, and a cortisone injection every six months helps significantly, the number of injections probably does not matter too much.
On the other hand, if a patient has shoulder tendonitis but an otherwise healthy shoulder, the number of injections should probably be limited to prevent further damage to these tendons.
So, what is the bottom line?
No hard and fast rule says how many cortisone injections can be given over time. However, cortisone injections can have side effects, and repeated use of cortisone injections should be done with caution. Patients should understand that there are reasons not to use cortisone injections, even if they may help some symptoms. Because of this, most orthopaedic surgeons will limit the number of cortisone injections they will offer to a patient.
Noises in the joints, such as popping, cracking or clicking, can disturb and cause concern. Often, these noises are not indicative of any underlying problem. Such noise often persists for years without any real problem developing. If there is no pain with cracks or clicks, you can assume the soft tissue in a joint is causing it. Noises that are associated with pain may indicate damage to the surfaces of the joint. Such cracks and clicks may be due to tears in the labrum of the shoulder, which may snap over the other structures as the arm moves. Similar soft tissue problems can occur anywhere in the body.
The decision for surgery is not always easy and adequate time will be offered to ensure you understand what is involved. Once you have decided on surgery, you will have consented to the operation and an OPCS code. A suitable date will be determined in a clinic or arranged with one of my secretaries.
Consent is an essential part of the surgical process. It is the process in which the patient and surgeon can discuss the planned surgery in detail and be fully aware of the risks and benefits. It is usually performed in the outpatient department at the time of initial consultation. A signed document outlining the procedure, risks and benefits is filed in the notes, and a copy is retained for the patient. Would you please check common consent forms in the downloads section.
The OPCS code will represent a particular operation. It will consist of a capital letter followed by four numbers. For example, a carpal tunnel decompression operation will have the OPCS code A6510. Your surgeon should give you the code once a decision has been made to perform surgery. Occasionally multiple OPCS codes are required for one operation, representing two or more different procedures being performed in the one operation. Once you have been given the OPCS code, you should inform your insurance company to obtain authorisation.
Due to the COVID19 pandemic, the number of face-to-face clinic appointment slots have been reduced to protect patients and clinic staff by allowing social distancing and reducing the need for patients to travel and be exposed to hospital and clinic environments. We offer video surgical consultations for self-isolating patients, unable to or don’t want to travel and would recommend video consultation as the default first consultation.
During a video consultation, we can review any existing documents you have, take a thorough history and do some clinical examination of your shoulder and elbow and order necessary investigations. As long as you have a smartphone, tablet, laptop or PC with a webcam, speakers and microphone, we can do your video consultation. If there is a need for physical examination or outpatient treatment such as injections, we will offer you a face-to-face consultation.
After a video consultation, you and your GP will be sent a letter confirming the consultation’s details just as we do during a face-to-face consultation. Our video consultation slots are 20- 30 minutes long, but they may be shorter for some follow-up appointments.
If you are insured, please make sure your insurance company has authorised your appointment with us. Most insurance companies are allowing video surgical consultations. We will need you to send us your insurance details and authorisation code. If you have a referral letter from your doctor or therapist or any other relevant clinic letters, reports or documents, please send those to us by email before your appointment to review them. If you have had scans or x-rays at another UK hospital, please let us know so we can have them transferred before your appointment so they can be reviewed. If you have had scans or x-rays, abroad let us know to make arrangements to see how best they can be viewed.
Please test out your computer or phone equipment before your consultation and choose a quiet room for your consultation with a light source in front of you so we can see you. The room you choose needs to be private and large enough for you to be examined.
Video consultations have several benefits for patients:
• No need to travel or use public transport
• Reduced exposure to hospitals and other patients
• Ability to see each other face-to-face without the need for masks
• Patients no longer limited by geography, so even patients outside of London have access to surgical opinion
There are some limitations to video consultations, including the reliance on software, technology, and internet/mobile phone signals which may disrupt the talk. Some conditions, such as shoulder instability or neurological disorders, may not be thoroughly examined by video. If there is a need for further examination or outpatient treatment such as injections, we will arrange your post-investigation follow-up appointment as a face-to-face appointment.
We will be conducting our video consultations via Microsoft Teams, Zoom, and others. You will get an email invitation to join your meeting, and you will need to keep this on the device you will be using for your consultation. We will require you to download the Microsoft Teams app or desktop software to the device you will be using before your appointment.
If we determine that X-rays or scans are needed during your video appointment, we will discuss this with you and then order these electronically. You will then receive an appointment for your Xray or scan from the imaging centre or clinic, and we will be able to review these with you at your follow-up consultation. If you are insured, please ensure that your insurance company has given authorisation for your imaging.
These terms describe the amount of time spent in the hospital.
A Day case operation is performed, and the patient is allowed home on the same day. The patient is usually given a private room or day case cubicle.
An In-patient is kept in overnight following surgery. This may be for various reasons such as co-existing medical conditions, social circumstances, more careful observation required etc.
The level of surgery and length of stay may dictate what you should bring. All patients may require to wait a few hours before the operation. It is advisable to bring a book, laptop or a tablet to help pass this time. Newspapers/Magazines will be provided. We would recommend a pair of slippers and a bathrobe. Patients staying overnight may wish to bring wash bags and toiletries.
Local anaesthetic involves injecting a solution around where the operation is to be performed whilst you are entirely awake. It is usually injected in the operating room. The area takes 5-10 minutes to become numb. The surgeon will not start the operation until satisfied the anaesthetic has worked.
Regional anaesthetic (Blocks) involves injecting the same solution in the neck or armpit to anaesthetise the whole arm whilst the patient is still awake. This usually takes 30 – 40 minutes.
General anaesthetic involves putting the patient to sleep for the duration of the operation. At the end of the operation, either local anaesthetic is injected into the wound to provide post-operative pain relief or the anaesthetist has performed a block.
Prof M Imam would perform all private operations. Occasionally for complex cases, he is assisted by another experienced surgeon.
Prof Mo Imam will check that you are comfortable and in a satisfactory condition to leave the hospital. You will be followed up in the outpatient’s department either by a nurse, therapist, or Mo. If there is a simple bandage, this is reduced after two days by the nurse clinic. Patients may be seen for mobilisation or splinting by our experienced therapists after surgery. Mo Imam usually uses absorbable sutures, and these do not need removing. The first appointment after surgery varies depending upon the type of surgery but is generally at 6-8 weeks postoperatively.
Scars around the shoulder can cause concern, particularly for ladies wearing thin strap tops and swimwear. Generally, surgical wounds are made in the natural skin lines, known as Langer’s lines, so scars should heal very well. It usually does take up to one year for a scar to disappear, but this can be improved with Silicon Gel application. For more information, see the Patient Information section
Complications are fortunately quite rare in upper limb surgery. However, they still can occur. The close post-operative attention that you will receive from the nurses, hand therapist and Prof Imam would hopefully identify any problems early so that they can be rectified. You are free to call Prof Imam at any time through the main hospital telephone for genuine emergency problems. Calls of a non-urgent nature should be made during office hours with one of our secretaries.
Yes, we accept private healthcare insurance from almost all the top providers such as Aviva, AXA, Bupa, Bupa International, Cigna, Vitality and more.
Our clinics are based in London and Surrey. Please check the clinics section
Our team offers general consultation, trauma and upper limb surgery, regenerative medicine, physical therapy, orthopaedic medicine and surgery, pain management, sports medicine, health and wellness.
Yes, we offer virtual consultations as an option to all our patients, as well as aftercare and ‘rehab from home’ programmes.
Yes, we pride ourselves in taking time to get to know and understand our patients. We do not want to miss any important details that could lead to a misdiagnosis. Bring/Upload your report and scans, and our doctors will analyse each case individually.
Yes, we will always try to repair damage caused by failed surgeries using cutting edge technology and modern techniques for maximum effect.
Yes when ever appropriate, we follow the family and friends test; whenever appropriate we will opt for the non-operative option!
At all clinics, please inform us in advance if you will require special assistance. We have disability access to the clinics in all locations.
We are able to organize interpreter services, but you should let us know in advance in order that this can be arranged. We can also arrange accommodation and make travel arrangements as necessary. Please call us to discuss your requirements.
If you have seen Prof Imam or a team member previously, within the last year and you want to book an appointment about the same condition, you should book a ‘follow up appointment’ with this consultant. If it has been over a year since you saw a team member, or you would like to see them about a different condition, or if you have not seen this consultant before, please book a ‘new consultation’.
If you are claiming on your health insurance, you may need a referral letter from your health practitioner or GP. We advise you to contact your insurer to confirm whether you are covered for the consultation and any subsequent treatments. If your GP or physio has referred you, you can call us to book an appointment.
Accordion You can refer yourself to see Prof Imam, however if you are claiming through your health insurance, they may require you to have a GP referral prior to authorising your consultation and treatment. If you are paying for your treatment yourself, you can refer yourself directly by contacting one of our clinics or Prof Imam office. Content
If you have had previous scans (MRI, CT or X-Ray) related to your condition, please bring these along to your consultation. Please also bring any copies of letters from your GP or specialists.
Prof Imam will listen to you carefully, assess what is wrong, and then design a step-by-step treatment and recovery plan that’s right for you. He or a team member may request further investigations to assist in the diagnosis such as an MRI, Ultrasound, X-Ray and/or blood tests which can be done in clinic on the same day.
If you have had investigations, it is likely you will need a follow up consultation. During this appointment, Prof Imam will discuss with you the results from your consultation and diagnostic investigations. Professor Imam will recommend the most appropriate treatment for your condition which may be discharging you, referring you on to another health professional, booking you in for further treatment or follow up, or an immediate nursing appointment in clinic. If surgery is indicated then He will explain the whole procedure to you and what to expect afterwards.
If you cannot attend an appointment for any reason, please inform us as soon as possible in order for us to offer that appointment time to another patient. We reserve the right to charge for a cancellation less than 24 hours in advance. Late arrival may result in your appointment being rescheduled for later in the day or another day so please get in touch with our appointments line should you need to rearrange your appointment time.
Nearly all insurance companies do not cover the cost of additional treatments such as orthotics or splints fitted by our nursing team. Please speak to your doctor or nurse to obtain the costs for any additional tests, investigations or treatments.
If Prof Imam has referred you for a scan, we can usually perform this on the same day. The imaging department at all clinics is open during the clinical days. We also offer a comprehensive out of hours service for any urgent referrals.
We ask that our patients arrive at least 15 minutes prior to each scan to ensure that there is sufficient time to complete the screening process and to make sure it is safe to do your exam. If you cannot get to your appointment on time you should call as soon as possible. We will attempt to provide you with an alternate slot the same day, if there is one available.
If you are having an MRI scan or X-ray, please notify us if you have a pacemaker or any other metallic implant or device. You should also let us know if you think you may be pregnant. You may eat and drink normally before and after the scan unless you have been told otherwise. All instructions will be on your appointment letter, please read it carefully.
There are very few risks from having an X-ray as these examinations involve relatively low doses of radiation, which compare to natural background radiation. The use of X-rays is subject to strict regulations and are assessed on the principle that the risk of having the X-ray outweighs the risk of not having the examination. Female patients who are, or might be pregnant, should tell the radiographer who will decide if special precautions need to be taken.
Following your scan, the images will be carefully interpreted by one of our affiliate experienced musculoskeletal Consultant Radiologist who is an expert in their field. He or she will prepare a report for your consultant, which will be ready within 24 hours. Your consultant will discuss the results with you.
We or the hospital might require your card details, even if you are insured, as many insured patients will have an excess or shortfall to pay. We would recommend that you contact your insurer to find out what is covered under your policy.
We analyse the data to audit and evaluate the care we give. It gives us a greater understanding of the benefits and risks of the treatments we provide, giving us an opportunity to improve and develop these as required. Although we may publish our results or share information with our health partners, this will involve aggregated, anonymous data only and it will not be personally identifiable. Amplitude, the company which runs the process for use, also runs some national orthopaedic registries and, with a patient’s permission, their data may be passed to them.
The information is securely stored by Amplitude. Their data centre is ISO 270001 certified which means that the information they store is secure. Although we require personal information such as your name and date of birth, this is only so that we are able to link the questionnaires answered to the treatment that is given. Under no circumstances will any personally identifiable data will be passed to any other parties without your permission.
If you have private medical insurance, you will need to contact your insurer to confirm whether you are covered for your consultation and imaging appointments and whether you will need a GP referral. You should do this prior to seeing Prof Imam or a team member. Your insurance company will provide you with an authorisation code which you will be required to provide when booking your appointment, along with your policy or membership number. Please bring your pre-authorisation code for your consultation and/or treatment, along with your policy or membership number. All of this information can be attained from your insurance company.
If you have insurance through an overseas insurer, you will be required to pay on the day of your appointment and then claim back from your insurance company. However, if you present a letter of guarantee with all the correct details, we may be able to deal directly with your insurer.
If you are paying for yourself, you will be asked to settle the full cost of the consultation, any diagnostic imaging services or treatement procedures as soon as possible. We request card details from all our patients when registering for an appointment, in order to facilitate an easy and accurate payment process. An invoice will be generated and emailed to you post appointment, at which point we will process payment with the card details provided.
If you live overseas and are travelling abroad to the UK to receive treatment, you will be asked to pay at the end of their appointment and receipted invoices can be provided.
Our team will be able to provide an estimated total cost of treatment, which will include hospital and anaesthetist fees, in addition to the consultation fee. The consultant surgeon/anaesthetist fees will be the same but there might be some variability on the procedure costs among different hospitals.
Clinical outcomes are defined as a “change in health likely to be due to a medical/clinical intervention or series of interventions”. They can be measured by examining the impact treatment has on things that people care about, such as how much pain they are feeling, and their ability to carry out activities. The change is measured by collecting information from patients before and after treatment. This information is put into context by also collecting details about a patient’s general health, his/her age and gender, and their level of physical activity.
Unless we systematically measure clinical outcomes, we cannot be sure what effect our treatments have. Amplitude allows us to audit and evaluate the treatment we give and to determine the standard of care we provide. It helps us identify any problems or undue complications; we can then take action to prevent these happening again. In the long term, evaluating the outcomes of treatment provides evidence of its benefits, risks and results. Patients and clinicians can use this information to determine which treatment would be best for their condition.
It is not a legal requirement to collect clinical outcomes but we believe it is an important part of ensuring the highest standards of treatment and it is part of our commitment to providing excellent care.
Patients are invited to complete different questionnaires ─ both before and after treatment. How often and exactly when they are completed after treatment will depend on the type of condition you are being treated for. We ask our patients to complete questionnaires themselves without including our own assessment of them as this often provides a more accurate picture of how they really feel. After all, whether you are happy with the outcome of your treatment is more important than whether we are!
No, certainly not. We don’t insist patients complete the questionnaires, although we do encourage all our patients to do so. The greater the number of patients completing questionnaires, the more accurate and insightful the results and findings will be. This will then benefit future patients.
The questionnaires can be completed online. Patients receive an email from us before their first appointment with a link to the Amplitute patient portal. If this is not convenient, the initial questionnaire can be completed in the clinic before your first appointment. Patients who would prefer to complete the questionnaire in the clinic are asked to arrive at least 15 minutes before their scheduled appointment time. If you need help completing the questionnaire, please ask the clinic staff – they will be pleased to help in any way they can. We use different types of questionnaire, each measuring different elements of your health. Some questionnaires are also referred to as ‘PROMS’ (Patient Reported Outcome Measures).
These scores measure factors directly related to the problem you have, such as a hand or shoulder condition. They are used throughout the world and have been developed specifically to detect and measure changes in musculoskeletal conditions. Although you may feel that not all the questions apply to you, it is important that you still answer them if you can. Patients are invited to complete this type of score questionnaire before their first appointment and at various stages after treatment. Sometimes patients may be asked to complete a different score questionnaire once a diagnosis has been made.
This form gathers information about your condition as well as your general health and activity levels. It helps us to evaluate the effect of your treatment in more depth, for example by showing that the outcome is better if surgery is done at a specific time after an injury, or when patients are in good health. We appreciate that you may be asked these questions again during your consultation – this is because the surgeon likes to hear about these matters directly from you.
The EQ-5D is a very short, simple online measure of general health developed by an international health outcomes organisation. It allows us to measure any changes in a patient’s general health and wellbeing.
We analyse the data to audit and evaluate the care we give. It gives us a greater understanding of the benefits and risks of the treatments we provide, giving us an opportunity to improve and develop these as required. Although we may publish our results or share information with our health partners, this will involve aggregated, anonymous data only and it will not be personally identifiable. Amplitude, the company which runs the SCORES software, also runs some national orthopaedic registries and, with a patient’s permission, their data may be passed to them.
The information is securely stored by Amplitude software. Their data centre is ISO 270001 certified which means that the information they store is secure. Although we require personal information such as your name and date of birth, this is only so that we are able to link the questionnaires answered to the treatment that is given. Under no circumstances will any personally identifiable data will be passed to any other parties without your permission.