NEW PATIENT ENQUIRIES

Please contact us directly by email or contact the office on 0751 735 8453 in order to leave a message. Please let us know briefly about your inquiry so we can decide what is the best way forward. If I am able to help, we can then book an appointment and we will send you a questionnaire and a consent form to be completed before the assessment. If I am not able to help, we will try to direct you to the relevant service. 

Is this the right service for you?

Is your child unable to engage in an assessment /review for any reason?

Does your child have eating difficulties and he/she is such low weight that his/her physical health is compromised?

Is your child experiencing hallucinations or delusions(odd beliefs)?

Is your child actively abusing alcohol and /or narcotics beyond recreational use?

Is your child actively suicidal with the intent to act on these thoughts or likely to become actively suicidal soon?

Is your child self-harming beyond superficial cuts/burns?

Does your child have a severe learning disability?

Is your child displaying aggressive behaviour requiring or that has required police involvement? Are forensic services or social services involved with your child?

If any of the above conditions apply to your child, it may be that we are not the right service to support you. Please get in touch if you have any questions.

ASSESSMENT

At your first visit, I will conduct a thorough review of the current difficulties. I focus on helping everyone to feel at ease in a safe space and give them the opportunity to express themselves.  I engage children in a creative, gentle, friendly way and use toys and art materials in the process.

The assessment may last from 2 to 4 sessions. In some instances, for example, where ASD and ADHD are being considered, additional specialised assessments may be recommended. It may also be helpful to contact the child or young person’s school to gather more information to help complete the assessment. We will discuss not only any mental health concerns and social, emotional, cognitive development but also the patient’s physical health, family and social life, schooling and lifestyle choices in detail. I may organise physical health checks and investigations such as blood tests or psychopharmacogentic testing.

If you are concerned about your teenager and he or she is not willing to attend an appointment, I recommend that I meet with parents first and we can discuss the best strategy.

By the end of the assessment, I will offer my preliminary impressions, and we will discuss a management plan including treatment options. I will write a summary of my assessment.

TREATMENT

I will tailor your treatment to your individual needs and choices. This may include psychiatric reviews, psychological therapies for individuals and/or families, prescribed medication or referral to other professionals. I work closely with GPs, psychologists, psychotherapists, family therapists, pediatricians, speech and language therapists, occupational therapists, dietitians and other professionals.

In the U.K. healthcare system, the GP. holds the overall view of a patient's health, and it is important that they are aware of the assessment so they can continue to support the patient appropriately. With your permission, I will write to your/your child’s GP about my assessment and treatment.

PAYMENT

Fees

Initial appointment (55 minutes)     £500

Follow-up appointments                  £300 (50 minutes), £180 (30 minutes)

Assessment summary and GP letters are free of charge. When appropriate, a letter will also be sent to the referrer free of charge.

The initial consultation fee is payable at the time of booking to confirm the appointment. Follow-up appointment fees must be paid 48 hours in advance of the appointment.

Prescriptions issued outside the consultation will cost £40 for regular and £70 for controlled drug prescriptions.

Other miscellaneous services such as filling forms, telephone/email correspondence etc. requiring more than ten minutes of time, will cost £90 per fifteen-minute interval.

I am registered with insurances including BUPA Global, BUPA UK, WPA, AVIVA. I am not registered with AXA or Vitality.

Full details of your insurers must be made available prior to the appointment. If you have private medical insurance, please contact your insurer before your consultation. Please note that even if someone else is paying your bill or you have private medical insurance, you are responsible for paying any charges that they do not pay.

Also note that for BUPA UK patients the follow-up appointment is 25 minutes, in line with the tariff paid by BUPA UK.

The above fees are different for ASD and ADHD assessments. Please see below for details.

If you are self-paying you will receive invoices and receipts from Xero, which is the accountancy software I use, and you will have the option to pay either by PayPal or you can make a bank transfer.

CANCELLATIONS AND NON-ATTENDANCE

If you are unable to make your appointment please provide at least 48 hours notice (this does not include weekends).  If sufficient notice (48 hours) is not provided, then the full consultation fee will be charged.

MEDICAL RECORDS RETENTION AND DISCLOSURE

I keep complete medical records, which include personal and sensitive data. The medical records are stored electronically and encrypted in transit and at rest. 

You are entitled to review your medical record at any time unless I feel that by viewing your records, your emotional or physical well-being will be jeopardized. If you wish to view your records, I recommend that we review them together to minimize any confusion or misinterpretation of medical terms. Time spent collecting, printing, copying, and summarizing the medical record will be charged the appropriate fee. Information will be provided to you within 30 calendar days.

Your information is kept for the time necessary to provide the service requested, however outside of this I will hold your medical records for a period of up to 20 years following the end of assessment and/or treatment to comply with the recommendations of the Information Governance Alliance with regards to mental health records. After this date, all data will be securely deleted unless requested otherwise.

CONFIDENTIALITY

The security of your sensitive information and confidentiality is of utmost importance to me. I follow General Medical Council’s guidelines on confidentiality and sharing information. Please read the following documents for the details.

https://www.gmc-uk.org/-/media/documents/consent---english-0617_pdf-48903482.pdf

https://www.gmc-uk.org/-/media/documents/0_18_years___English_1015.pdf_48903188.pdf

There are exceptions to this confidentiality, where disclosure is mandatory when anyone is at risk.

https://www.gmc-uk.org/-/media/documents/protecting-children-and-young-people---english-1015_pdf-48978248.pdf

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/confidentiality

COMMUNICATION

I send all sensitive information using encrypted emails. The forms will be sent to you electronically or via email. I use an email encryption service called Egress. You will be able to reply to me and send me documents using Egress. Egress meets the GDPR compliance for data protection.

Emails are checked intermittently and please do not send any urgent enquiries via email. Please call 07517 358453 if you would like to leave a message or send an email to us at info@esracaglar.com.

I do not provide a service for medical emergencies. If there is an emergency, please contact emergency services.

COMPLAINTS

I take complaints very seriously. When patients complain, they are dealt with courteously and promptly so that the matter is resolved as quickly as possible. If you wish to make a complaint you can do so verbally to me or email info@esracaglar.com.

ASSESSMENT OF NEURODEVELOPMENTAL DISORDERS 

We carry out assessments of Autism Spectrum Disorders and ADHD (Attention Deficit Hyperactivity Disorder) to children and adults up to the age of 25.

Autism Spectrum Disorders

Autism is defined by having difficulties with social communication and restricted or repetitive behaviours, activities or interests. ASD is a neurodevelopmental condition, meaning that these difficulties would have existed since early childhood although can often become clearer over time.  

Autistic traits appear on a spectrum, meaning that people are affected in different ways and to different degrees.

Assessment

Prior to the first consultation, you will be asked to fill in pre-assessment forms. Following the first consultation, we will send you further ASD specific forms to complete. With your permission, school will be contacted to receive feedback.

The assessment outline:

-        First consultation is usually held with parents or the patient. This session takes about 50 minutes. We discuss current concerns and developmental history.

-        We carry out the ADOS (Autism Diagnostic Observation Schedule) with the patient in the second meeting. Perla Toledo will be present during the consultation. She is a graduate member of the British Psychological Society and is ADOS trained. This session takes about 60 minutes for younger children and about 1 1/2 hours for older children and young adults. This is a face to face appointment.

-        A further meeting may be necessary before a conclusion can be reached.

-        With your permission, we will liaise with other professionals working with the patient if this is appropriate. A school meeting can be arranged.

-        Finally, there will be a 30-minute feedback session where preliminary impressions and recommendations are discussed.

-        There will be a 30-minute feedback session where preliminary impressions and recommendations are discussed.

After the assessment, you will receive a comprehensive written report including the diagnosis and any further assessment recommendations if relevant. The report will be sent to you within 3 weeks of completing the assessment and receiving all questionnaires.

 Fees:

The ASD assessment costs £2900. This does not include extra-sessions required to assess co-morbid conditions if appropriate.

ADHD (Attention Deficit Hyperactivity Disorder) and ADD

Children and adults having ADHD can present as inattentive, impulsive and hyperactive. ADHD is a neurodevelopmental condition, meaning that these difficulties would have existed since early childhood although can often become clearer over time.  

Assessment

Prior to the first consultation, you will be asked to fill in pre-assessment forms. Following the first consultation, we will send you further ADHD specific forms to complete. With your permission, school will be contacted to receive feedback.

The assessment outline:

-        The first consultation is usually held with the parents or the patient to discuss current concerns. This session lasts for up to 50 minutes.

-        At the second consultation, I carry out Qb Check and a mental state examination. Qb Check is an objective test that involves motion-tracking system and computerized tasks that require continuous attention and impulse control. As a result, the tests provide data on all core signs of ADHD, that is, hyperactivity, impulsivity and inattention. This consultation lasts up to an hour.

-        With your permission, we will liaise with other professionals working with the individual if this is appropriate. A school meeting can be arranged.

-        Finally, there will be a 30-minute feedback session where preliminary impressions and recommendations are discussed.

After the appointment you will receive a comprehensive written report including the diagnosis, treatment plans, and any further assessment recommendations if relevant. The report will be sent to you within 3 weeks of completing the assessment and receiving all questionnaires.

The ADHD assessment costs £1500. Please note that the assessment may require extra sessions if there are co-morbid conditions. These are not included in the fee.

We also offer stand alone Qb Check. This costs £350.

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