HEADACHE - MIGRAINE - NEUROLOGY

Frequently Asked Questions

Professor Alexandra Sinclair

01905 971 354

Frequently asked questions

A list of your current medications and a list of the previous medications you have taken for headaches. Copies of your previous brain imaging results (I do not offer a second opinion on brain imaging (MRI and CT) but can arrange this if needed). Letters from previous appointment and from other healthcare professionals. I would advise you send this information at least 2 weeks before your appointment to my secretary (Worcester_neurology@Proton.me).

If this is an appointment for a complex review with lots of medical records, please see below question complex history.

I typically have initial consultation availability within a few weeks. You can see live availability and book online or call the appointment line directly (01905971354) if you would prefer to speak to someone. It you need an urgent slot please contact my secretary to ask for additional availability on 07703 731637 or Worcester_Neurology@proton.me

Your initial 40-minute consultation is an opportunity to discuss your symptoms, medical history and any treatments or medications you have tried previously. I will also talk about your concerns, answer any questions you may have and discuss what you hope to achieve from the appointment.

If clinically appropriate, I can arrange further investigations including blood tests, brain scans or nerve conduction studies.

By the end of your consultation, you will have a personalised treatment plan and a clear understanding of the next steps in your care.

No. You can book a private consultation with me directly. There is no need for a GP referral. With your permission, I can send a summary letter to your NHS GP after your appointment outlining your assessment and treatment plan so it can be added to your medical records.

You can view my live availability and book your appointment online. If you'd prefer to speak to someone, call the appointment line directly (01905971354).

If you need an urgent appointment, please contact my secretary who can advise on any additional availability (Worcester_Neurology@proton.me or call on 07703 731637).

Most patients book a follow-up appointment around 12 weeks after starting treatment so I can review how things are going and optimise your treatment plan. Headache management often evolves over time, and follow-up appointments allow me to make sure your treatment is working well for you and adjust it where needed.

Call the appointment line directly (01905971354) to book.

At present it is not possible to change your appointment online. If you need to cancel or change your appointment, you can do so by contacting the appointment line directly (01905971354) or via the link in your appointment confirmation email or by contacting my secretary (Worcester_neurology@proton.me).

Appointments cancelled with more than 48 hours’ notice will not incur a cancellation charge. Cancellations made within 48 hours of the appointment will be charged at 50% of the consultation fee. Missed appointments (DNA – Did Not Attend) will incur the full consultation fee.

Both options are available. I offer online video consultations as well as in-person appointments at my clinic at Spire South Bank Hospital Worcester.

You can choose the option that works best for you when booking your appointment. If your consultation relates to idiopathic intracranial hypertension, you may need to be seen in person so I can assess your eyes as part of your evaluation. Please contact my secretary with details of your situation and I can advise on the most appropriate appointment type.

Initial consultation

For new patients or returning after 12+ months

£420 for up to 40 minutes

Includes Full symptom and history review coordinating investigations and treatment plan.

Follow-up consultation

For existing patients seen within 12 months

£210 for up to 20 minutes

Includes a review of your current symptoms, investigation results and response to treatment with an updated personalised management plan and medication plan where appropriate.

Brain imaging (MRI and CT scans) and nerve conduction studies incur an additional cost paid directly to the provider.

Procedures:

All procedures require an initial 20-minute follow-up consultation before proceeding. During this appointment, I will review your current symptoms and adjust your treatment plan as needed, confirm that the procedure remains suitable for you and check that there are no new contraindications. I will explain the procedure discuss the expected benefits and potential risks and answer any questions you may have before obtaining your consent.

A further 20-minute appointment slot is then used to perform the procedure.

Please contact my secretary if you need advise booking your appointment (Worcester_neurology@proton.me)

Greater occipital nerve block

Review assessment and consent consultation (20 minutes): £210

Procedure fee: £210

Hospital/clinic facility fee: £345 (this may change over time and, an accurate cost can be obtained from the hospital or my secretary. This is paid directly to the hospital)

Total procedure cost: £555

Migraine BOTOX

First treatment

Initial assessment and consent consultation (20 minutes): £210

Procedure fee: £210

Hospital/clinic facility fee: £420 (this may change over time and, an accurate cost can be obtained from the hospital or my secretary. This is paid directly to the hospital)

Total procedure cost: £630

Second and subsequent treatments

Procedure fee: £210

Hospital/clinic facility fee: £420 (this may change over time and, an accurate cost can be obtained from the hospital or my secretary. This is paid directly to the hospital)

Total procedure cost: £630

Yes. I regularly see patients seeking a second opinion regarding the diagnosis or management of headache disorders.

A second opinion can be helpful if your diagnosis is uncertain, your headaches have not responded to treatment, you have been offered an invasive procedure, or you would like reassurance that your current management plan is appropriate.

To provide the most useful advice I ask that you arrange for copies of any relevant clinic letters imaging reports and investigation results to be sent to my secretary before your appointment. This allows me to review your previous assessments and investigations so that we can make the best use of your consultation.

Please note that if a review of your previous imaging is needed, I can liaise with a specialist neuroradiologist to arrange this at an additional cost.

Following your assessment, I will provide an independent opinion and where appropriate, recommendations for further investigation or treatment. A copy of my report will be sent to you, and with your permission to your GP and any other clinicians involved in your care.

If this is a complex history with lots of medical records, please see below regarding complex history as additional charges may apply.

Yes. I regularly assess patients with complex headache disorders who have accumulated many years of clinic letters, imaging reports and hospital correspondence.

The standard consultation fee includes review of routine correspondence and recent investigations. However, where extensive historical medical records require detailed review before your appointment, an additional complex case review fee may apply. This is charged at my standard hourly professional rate for the time required to review and analyse your records.

If you believe you have extensive medical records that will need to be reviewed, please contact my secretary before booking your appointment. She will be happy to advise whether a complex case review is likely to be required, provide a quotation based on the estimated review time, and explain how to submit your records. To allow sufficient time for review, all relevant correspondence, imaging reports and investigation results should be received at least two weeks before your appointment. Records received later than this may not be reviewed in advance and, in some cases, your appointment may need to be rescheduled.

This additional preparation enables me to gain a detailed understanding of your previous investigations, diagnoses and treatments before we meet. As a result, your consultation can focus on discussing your symptoms, diagnosis and management, rather than spending valuable appointment time reviewing historical records.

A second opinion for idiopathic intracranial hypertension (IIH) is often most helpful when we have access to your previous investigations, imaging and specialist assessments. Please provide as much of your medical information as possible before your appointment so that your history can be reviewed in detail. This should be sent to my secretary at Worcester_Neurology@proton.me

Ideally please send:

Brain imaging reports (for example, MRI or CT scan reports).
OCT (optical coherence tomography) scan summary reports including measurements of the optic nerve and retinal nerve fibre layer (RNFL) thickness.
Lumbar puncture (LP) results including the opening pressure reading and details of the procedure.
Current and previous medications including doses, duration of treatment and side-effects of any treatments.
Previous clinic letters and reports from ophthalmology, neurology, headache specialists or other relevant healthcare professionals.

If your case involves a complex history with a large volume of medical records, additional time may be required to review these documents ,and additional charges may apply. Please see above regarding complex history.

Providing your records in advance helps ensure that your consultation can focus on understanding your diagnosis, reviewing previous investigations and discussing the most appropriate next steps for your care.

Yes. Professor Sinclair can arrange specialist visual testing to assess the optic nerves and visual fields, including investigations for papilloedema.

The available tests are:

Optical Coherence Tomography (OCT) of both optic nerves – a non-invasive scan used to assess the optic nerves and look for evidence of papilloedema. The cost is £190, payable directly to the hospital.
Humphrey Visual Field (HVF) testing of both eyes – assesses visual function and can help identify visual field abnormalities. The cost is £120, payable directly to the hospital.

Professor Sinclair's reporting fee:

Professor Sinclair charges £210 for reporting the results of the OCT, HVF, or both tests.

The hospital charges for the investigations are paid directly to the hospital, while Professor Sinclair's reporting fee is charged separately.

I speak English.

BASH - British Association for the Study of Headache

BASH drug information leaflets for patients

International Classification for Headache Disorders 3rd edition (ICHD-3)

NICE

Migraine Trust

OUCH UK for cluster headache

IIH UK

FND

If you need to cancel or rearrange your appointment, please provide at least 48 hours' notice.

Appointments cancelled more than 48 hours before the scheduled appointment time will not incur a cancellation fee.
Appointments cancelled within 48 hours of the scheduled appointment time will be charged 50% of the consultation fee.
If you do not attend your appointment without prior notice (Did Not Attend (DNA)), the full consultation fee will be payable.

This policy helps ensure that appointment times remain available for other patients requiring specialist care. Thank you for your understanding.