No. However, it would be beneficial to have a referral letter, if possible, to have more information about your child’s health, before the appointment. Hence, we would recommend having your GP’s letter, unless it is difficult/inconvenient to get this or if you expressly wish not to do so.
We would recommend you consider doing the following:
- Place a reminder in your planner/mobile, with the date and time of the appointment you have booked
- Plan your journey. Allow extra time for traffic and to find parking. Visit the hospital’s website for travel options and nearby parking options
- Bring all your child’s health records including any forms you have been asked to complete by the doctor
- Bring any/all medications your child is currently taking with you
Food/drink for your child, as some appointments can be long
Sri believes in having in-depth information about your child and his/her circumstances. This information will enable him to carry out a holistic assessment and recommend appropriate interventions, offer advice/support, and signpost you to the necessary resources.
Therefore, we will need completed Background Information Sheets to help us do the above. Sri thoroughly recommends you to email/post these completed forms to his secretary before the appointment, wherever possible. Sri can than peruse all this information to save you time and to help you maximise the value of the appointment with him.
Neurodevelopmental disorders, by their very nature, are likely to have an impact on the child’s behaviour and functioning, both at home (social settings) and at pre-school/school (educational settings). Having/finding all the pieces of the jigsaw puzzle will help Sri develop a complete picture of your child’s needs, requirements, strengths, and abilities.
Obtaining a complete picture of your child will help him offer you a comprehensive and robust management plan with advice regarding educational, behavioural, environmental, and medical interventions, individually tailored, to build upon your child’s strengths and to address any weaknesses.
Yes. You can request a chaperone be available during your appointment when you check-in at the reception on your arrival or when you meet Sri at the start of the consultation.
Fortunately, Sri comes across something like this infrequently. In such a scenario, Sri’s advice would be to direct them to his website https://www.drsrigada.co.uk/, for them to know more about his experience and qualifications. Point to the fact that Sri has served in the NHS in the field of Neurodisability for 20+ years and he is the Editor of the book that is used by doctors in his speciality in the UK and worldwide. Sri keeps himself academically active and up to date. They can find more information about his expertise in section Medicolegal + Expertise.
The school should feel free to get your child independently assessed, should they disagree with Sri’s diagnosis. You need to be a ‘pleasantly persistent parent’ and be an advocate for your child’s needs. Handle these discussions calmly and respectfully. You should consider contacting your Parent Partnership service offered by your local LEA, to find out about your rights and the way forward. Also, request them to put what they say in writing. You also have the right to appeal against any decision you disagree.
The clinic letter you receive from Sri will be a detailed and comprehensive summary of your child’s overall strengths, weaknesses, and needs. The letter will also have a detailed management plan for a future course of action.
Sri would recommend you:
- Carry this letter with you to all NHS appointments. This will reduce duplication and will help professionals to serve you better. This would also save valuable time and resources for NHS & yourselves by reducing the duplication of history taking, tests, referrals, and could reduce your wait to access certain services.
- Share a copy of the letter with your child’s therapists, so that they know your child’s diagnosis, which will help them in planning their assessment and therapy.
- Share a copy of the letter with your child’s teacher and the school’s SENCO coordinator. This will help them to understand your child’s needs and to apply for/request additional resources from the local authority, undertake an EHCP assessment, and more, if applicable.
- Read the information about/signposting to relevant sources of information and support that are written in the letter
- Use copies of the letter as evidence and information for applications for Disability Living Allowance, housing support, respite, and other benefits and allowances.
- Review the management plan recommended by Sri once every term or every 6-12 months to check whether your child is on the expected path of progress and is improving
- Doing all the above will empower you with the necessary information and enable your child to achieve his/her potential and excel.
The GMC (General Medical Council) of the UK recommends that it is good medical practice to share a copy of the medical report with the child’s General Practitioner (GP) in every case. With the way the health services are organised and delivered in the UK, your General Practitioner (GP) will be the first port of call for all the medical and health-related information on your child. Your General Practitioner/GP surgery would also be the gateway to access any further tests, investigations, repeat medications, or follow up in the NHS or the independent sector.
Therefore, it is in the best interests of your child for your GP to have the complete and full picture of your child’s health and needs. Hence, we request the email address along with full postal address of your GP when you make initial contact with our service. I have always encouraged all the parents of children I have served thus far to share a copy of my medical report with their GP.
On extremely rare occasions a request is made to me not to share their child’s report with their GP. It is your right to decide whom to share or not to share your child’s medical report with. In such a case I will do my best to comply with your request. However, it is important for you to note that, I have professional duties to fulfil, and by law I am mandated to share copies of medical reports with your GP/GP surgery if there are any concerns regarding a child’s safeguarding or wellbeing, even when there is explicit parental request from you not to share.
Cost + Funding + Payment +
Neurodisability appointments/assessments are both time and resource-intensive. They are quite different from a General Paediatric assessment. The tariff for a new Neurodisability appointment in my clinic in the NHS was £680+ for a new patient (1-1.5 hr appointment), and £450+ (for 1 hour) follow-up appointment, until 2019. As you will experience, my assessments are detailed, thorough, and comprehensive. A new neurodevelopmental assessment with me takes 5-6 hours of work, including a 2-hour face-to-face appointment. Joint assessments for two or more conditions takes even more time.
Moreover, in independent practice, a considerable proportion of fees is taken up by hospital clinic room rent, dictation, transcription, billing, administration, professional indemnity, training, travel, and various other practice overheads. The costs quoted to you are also in line with my professional qualifications, experience, expertise, and the time taken.
You may be able to use my clinical report to apply to claim Disability Living Allowance and other benefits for your child, where applicable. Please also refer to our ‘cost letter’ and the ‘welcome letter,’ which my secretary would have sent to you for additional information.
You can also use Sri’s clinic letter to apply to claim Disability Living Allowance and other benefits for your child, if applicable. Sri will be able to give you more information about this at your appointment on request.
Please also look under Fees+Payments for more information.
Yes, if you are self-funding. As mentioned above, Neurodevelopmental and Neurodisability assessments are time and resource-intensive, with many practice overheads. Hence, we do require full payment 48 hours before the appointment. More importantly, pre-payment will help us better serve you by allowing us to read and prepare your child’s case before your meeting.
Moreover, pre-payment frees up our time in billing/invoicing, sending reminders, etc. Pre-payment also reduces no-shows and helps us use our resources efficiently to serve other clients and contain our costs and charges.
For clients with private health insurance, we will need written confirmation from your insurer regarding your policy number and their authorisation code for the invoiced amount, before you book your appointment. My insured clients should note that they will be liable to pay any fees their insurer declines to pay.
Most private health insurance companies cover for Neurodevelopmental assessments and Neurodisability consultations. However, some insurance policies may have exclusions for conditions such as Autism or ADHD in the policy. In the majority of clients who contact us, a neurodevelopmental disorder is suspected but not yet confirmed. Therefore, if you request your insurer to assess your child’s difficulties, then most insurers would agree to fund for an evaluation.
There are well over a dozen medical conditions that can present as Autism or ADHD. Unless a child undergoes a thorough assessment, one cannot be sure of a diagnosis. Therefore, please work with your insurer to bring to their attention this fact and request an authorisation number for a consultation/assessment to investigate your child’s difficulties and needs.
You and your insurer can find interesting articles on ASD, ADHD, Dyspraxia, Differential Diagnosis and much more on my website: https://www.drsrigada.co.uk. For more information, your insurer can also refer to the book I have edited titled ‘Oxford Handbook of Community Paediatrics, published by Oxford University Press https://www.amazon.co.uk/Community-Paediatrics-Oxford-Specialist-Handbooks/dp/0199696950/.
Depending on your policy, some insurers will require more information about what a neurodevelopmental assessment would involve? If they request this information, then please direct them to https://www.drsrigada.co.uk/the-10-aspects-of-a-neurodevelopmental-assessment/.
You and your insurer can find more information under the section ‘Your Journey’ on my website https://www.drsrigada.co.uk/
I am in a fortunate position as a great majority of parents, patients, professionals and medical and legal experts accept my diagnosis I make and the medical opinion I provide. This is because they can see my medical credentials, my track record, and my self-discipline of keeping myself up to date with the latest evidence and literature. Moreover, my detailed and exhaustive medical report demonstrate the detailed reasoning in my reports linking issues and facts in a given child with the medical opinion I have given.
However, on rare occasions I do come across a parent who disagrees with my diagnosis or a lack of diagnosis i.e., my inability to arrive at a diagnosis they have in mind. One should remember that my whole and sole duty is to the child I have seen and not to the person, parent or the insurance company which has funded this appointment. I am obliged to act in the best interests of a child at all times. Consequently, on occasions if a given child does not meet the full criteria for a medical condition, then I would be unable to formalise a medical diagnosis but would still be able to list the child’s difficulties and needs and give advice and strategies on how best to address. I also on rare occasions come across a parent who has come to see me because the school or the services recommended them to get an assessment for their child because of concerns they have. Consequently, if the child meets the full criteria for a given diagnosis or a medical condition then I have a duty to give a diagnosis to the child whilst still appreciating and understanding that a parent does not fully agree with me or appreciate the diagnosis I have made.
In such a scenario the first thing to do would be for you to express your feelings and opinions to me. Doing so would enable me to take time and go through with you in detail the reasoning for me arriving or not arriving at a given diagnosis. At all times I will be treating you with dignity and respect. I will listen to your concerns fully even though on occasions I may find it clinically impossible to agree with you.
After doing the above, if you still remain dissatisfied with the diagnosis or the lack of diagnosis in your child, then I would suggest you seek a second opinion. You could do so by either discussing my medical report or diagnosis with your General Practitioner, your insurers or any professional or a family member. You are within your rights to seek a second opinion for your child. I would and fully appreciate your decision to do so.
Follow-Up + Therapist +
Sri appreciates how valuable your time and resources are. Therefore, he makes all efforts to minimise the need for a follow-up appointment. Hence, he requests you to complete and send all the required forms before the date of the appointment. Doing so would ensure that the time in a face-to-face meeting is used effectively for an interview, assessment, tests, and drawing up a management plan.
In addition to the above, he has allocated longer consultation time (45 mins vs 30 mins in NHS) and far longer assessment time (2 hours in independent practice vs 60-90 mins while in NHS practice). He has taken these steps so that he can complete a comprehensive assessment of your child and explain his management plan to you in detail, further minimising the need for a follow-up.
However, in some clients, due to the complexity of the presenting conditions, a further appointment would be required to:
- Complete the assessment or
- Have a specific report from a professional/therapist or
- To score the test items completed and/or
- To have more time to answer your questions.
Moreover, the diagnoses Sri makes are life-long diagnoses. And some clients require due care and monitoring by a paediatrician either in NHS or in private.
Neurodisability conditions are complex, multi-faceted, and multi-dimensional affecting many aspects of your child’s functioning. Hence, for some children, an assessment report by professionals such as a Speech Therapist/Occupational Therapist/Physiotherapist or a Psychologist becomes essential to complete the diagnostic workup and to help recommend the required interventions to address your child’s needs adequately.
In such cases, Sri will advise you to see a relevant professional. Be confident that with Sri’s experience in his field of practice of over 20+ years, he will recommend you necessary professional when and where required and not routinely.
Treatment + Prescriptions +
Melatonin is a recommended medication by NICE & British National Formulary for Children with sleeping difficulties. Sri has prescribed Melatonin for his patients in the NHS and Private for over 13+ years. Many GPs are happy to give repeat prescriptions once a Consultant Paediatrician has assessed the child and has recommended its use. However, a child needs to be under follow up by a paediatrician while using this medication.
Melatonin is indicated to address sleeping difficulties in children with Autism Spectrum Disorder, Learning Disabilities, children with Delayed Sleep Phase Syndrome, etc. according to NICE. However, like many other medications used in children, the manufacturer did not obtain a license for its use in children. Hence some GPs are reluctant to give repeat prescriptions. You can share the following link with your GP, for their information:
Sri will also be happy to complete and sign a ‘Shared Care Protocol’ if your GP requests explicitly.
Privacy + Confidentiality + Security +
Sri understands that he has a responsibility to protect and respect your privacy and look after your personal data.
For clarity, we may be both the data controller and data processor for your personal data under certain circumstances. Sri’s practice is GDPR compliant and is also registered with the Information Commissioner’s Office.
You have the right to make a complaint about how we process your data to the Information Commissioner: https://ico.org.uk/concerns/.
Yes. Sri’s newsletter will contain useful information such as tips, strategies, or advice on the management of conditions such as ASD, ADHD etc. His prospective clients will automatically receive a copy of the newsletter electronically. You can see a sample of the articles and videos he has produced and shared on this website. They will have the option to unsubscribe from this anytime and through any of his newsletters.
However, you do not have to be his client to receive this. Please complete the minimum required details such as your name, surname, occupation, and your email ID on our website to receive this newsletter. These details will not be shared with any third parties.
Your feedback +
Any feedback you give will be welcomed and would be much appreciated. Your feedback will help us improve the services we offer. You can email your suggestions to Sri’s secretary or write to him personally at any of the hospitals he works at or request a call from Sri.
Your feedback on your experience of using our service is particularly important to us. Sri believes in having your feedback, helps him to plan the services he and his team provide. Your feedback would help us change, improve, or modify our services wherever required. Sri believes in continuous learning. Moreover, he uses your reviews to carry out an annual audit of the services he provides. Furthermore, your feedback would be a service to other patients.
In addition to the above, feedbacks are essential for health professionals. Therefore, Sri has made it easy for you to leave your review by registering himself with independent and 3rd party organisations, and by providing you with the direct weblinks to help you offer your feedback.
Sri would be incredibly grateful if you could leave your feedback on any of the below links:
Many thanks for your time and effort in leaving feedback 😊.
I can assure you that I and my team do our fullest to provide you a service with care, compassion and clinical competence. Consequently, most patients are happy and satisfied with the service they have received, however, on rare occasions unknowingly and unintentionally some systems and processes may not have worked either as I and my team intended or as you had expected.
In such a case the first thing I would respectfully urge you to do, is to pick up the phone and speak to my secretary to convey your displeasure. I shall then get in touch with you, firstly to listen and understand fully the reasons behind your dissatisfaction and then come up with whatever I could do to help resolve the issues. In the highly unlikely event that you still feel dissatisfied following our discussion and our meeting, then you can request my secretary to send you the Complaints Policy.