Terms of Business 2022

Mr Rafid Al-Mahfoudh FRCS

Consultant Neurosurgeon & Complex Spinal Surgeon


Nuffield Health Brighton Hospital                                                                                        

Warren Road
East Sussex BN2 6DX
Private  secretary  07501 703075
Fax:  01273 962021

Email address: secretary@spineandbrain.co.uk

all correspondence to Nuffield Brighton


Consultation Fee

My fee for an initial consultation is £320 and my fee for any follow-up consultation is £210.

For patient’s who have had recent scans or consultations, my initial consultation fee is £350 to allow for a longer appointment in order to explain the investigation findings and discuss management options. The clinic appointment will be 50 minutes to allow for this.

For patient’s who are requiring a second opinion or patient’s who have a complex spinal history, my initial consultation fee is £400.

Following your consultation, you may need certain tests (such as blood tests or imaging, for example an X-ray, MRI or CT scan) to help me diagnose your condition.  If the test is undertaken by the clinic or hospital, and not by me, the fees for those tests will be determined by the clinic or hospital and charged to you, or your private medical insurer, separately.

If there are any fees which I will charge in relation to any of the tests I advise that you have, I will let you know what those will be.

A nominal administration fee of approximately £30-80 will be charged direct to patients for the
organisation and transfer of previous records and scans due to the time required to organise
transfers and obtain relevant approvals. Payment can be made over the phone by debit card.
Alternatively, a bank transfer can be made with a screen shot sent to confirm transfer.

I reserve the right to charge in full for non-attendance to consultations.

For self-pay patients having a surgical procedure, the first postoperative follow up is included in the price of the procedure, however follow up after that is not included and chargeable at our standard follow up rates outlined above.

Insured Patients

Insurance companies will be invoiced directly following consultation, unless specifically requested not to by the patient in advance of the consultation.  Should this be the case, the patient will need to settle the invoice and a receipt will be issued in order to claim reimbursement from the insurance company.

Any shortfall or policy excess is the responsibility of the patient.  Payment can be made over the phone by debit card and a receipt will be issued.  My secretary will telephone you within 7 days of notification of excess/shortfall in order to facilitate payment if not already made.

Please contact your insurer before your consultation to check the terms of your policy, particularly the level and type of outpatient cover you have, including any reimbursement limits on your individual consultation fees.  It is the responsibility of the patient to ensure they have enough cover and/or funds available in advance of treatment.  In the event of non-payment by the insurance company, the patient is responsible for outstanding fees.

I am recognised by the following private medical insurers:  AXA PPP (and their subsidiaries), Aviva, WPA, Cigna and Vitality.

Bupa patients

I am currently no longer registered with Bupa whilst reimbursements are being negotiated but I am
happy to see Bupa patients as self pay patients. This fee may then be able to be claimed as a
reimbursement from Bupa or alternatively other patients have contacted Bupa to come to an
agreement to cover my fees direct, whereby we can invoice Bupa directly once negotiated by the
patient. If such a request has been put in and refused after a complaint, patients can choose to
contact the Financial Ombudsman as it should be within patient’s right to choose their own clinician
if they have health insurance rather than being allocated a specific consultant without choice.

My practice may need to contact your insurance company regarding your procedure, payments or passing on your relevant health records.

Uninsured Patients

Uninsured private patient fees are payable prior to the consultation.  Payment can be made over the phone by debit card and a receipt will be issued.

All efforts will be made to provide accurate fee estimates in advance of surgery.  Self-paying patients who require surgery are required to pay their fees to the hospital concerned in advance of surgery.  This package fee will include hospital, surgeon and anaesthetist fees where appropriate, plus one follow-up consultation fee.

By agreeing to consult with me privately, you agree to be bound by these terms.

Failure to make payment may result in the matter being referred to P&J CDS, debt collection agents, whose charges will be added to and payable with the invoice debt or passed to the Small Claims Court which could result in a County Court Judgement affecting your credit rating.

Clinic appointments/investigation results

We will endeavour to be in touch with you to organise a clinic appointment/follow up but you will be responsible for contacting the practice if you haven’t heard from us (to organise a clinic appointment or discuss the results of an investigation we have requested for you).

After your appointment we will send you a copy of your clinic letter. The letter will usually be addressed to your GP to ensure they are updated.

Worsening of symptoms

If you have a neuro-spinal condition and your condition deteriorates neurologically while you are awaiting a review or follow up, then it is your responsibility to inform us. In urgent situations with rapid worsening of neurological function or new symptoms or out of hours, then this should be addressed through the emergency services as we cannot provide this service privately.

With lumbar pathology (e.g. lumbar stenosis or a lumbar disc prolapse) this would include red flag symptoms such as bowel/bladder dysfunction, bilateral leg pain/numbness/weakness, saddle numbness and progressive neurological weakness.

In cord compression cases (e.g. cervical myelopathy or thoracic myelopathy caused by either a disc or a tumour) this would include a deterioration in neurological function such as walking or hand function.

The same would apply postoperatively if you develop an urgent worsening function then you should inform us, however the emergency department is the best place to deal with urgent conditions and we ask that you attend through there in the unlikely scenario that you develop these symptoms or if we advise you to do so.

Obtaining, storing and sharing your clinical information and data handling

Any relevant patient history, documentation and imaging will be obtained directly from hospitals,
GP surgeries and healthcare centres etc when a consultation has been booked in order to effectively
treat patients. In booking a consultation consent is given to obtain all previous medical records and

Sensitive patient information will be emailed to patients via an encryption service such as
Proofpoint or Egress which has been recommended by the Spire network of private hospitals. In
booking a consultation consent is given to sending patient information in this way. For further
details on Egress please see below:

My practice may need to contact your insurance company regarding your procedure, payments or
passing on your relevant health records.

Following your consultation, I may write to your GP, copying relevant health practitioners to
ensure appropriate involvement of relevant health professionals involved in your care.

Patient data will be stored on clinic computers and Bluespier, a clinical software system and saved
for 30 years.

For all additional correspondence required for third parties, such as holiday insurance companies
and workplace occupational departments, there will be an administrative fee applicable.

Patients may be asked to sign a form at the visiting hospital confirming they have been informed of
consultation and other fees.

NHS transfer requests

Patients who request to be transferred from my private practice to the NHS agree to all data and
information obtained from the private practice consultations to be stored by the relevant NHS Trust,
their data being therefore accessible to all permitted NHS clinicians and administrators.

Upon a patient’s request to transfer hospital or at the end of care if the patient would like their care
to be provided by another healthcare provider, such as the NHS, an administration fee of £20-50 in
order to transfer all scans and relevant medical records is chargeable.

Quality Information

You can compare independent information about the quality of private treatment offered at the
hospital and other private healthcare providers from the Private Healthcare Information Network
(PHIN) website: www.phin.org.uk.


Mr Rafid Al-Mahfoudh owns S&B Diagnostics who own the Dantec Keypoint Focus EMG system
held at Nuffield Health Brighton Hospital. Mr Al-Mahfoudh may refer you for an EMG, Nerve
Conduction Studies or SSEPs to this company if this is needed as part of your clinical care. You
can request to be referred to another provider of this service, this will not affect your care in any

British Spine Registry

The British Spine Registry was set up by the British Association of Spinal Surgeons in 2012 to
monitor the outcome of spinal procedures, collecting valuable data to better understand procedures,
techniques and the patient’s experience.

We would be most grateful if you would agree to take part in this research, usually by email. If you
are not on email, the questions can be completed by telephone with my secretary.

You will be asked to complete a few questionnaires that will be sent to you at varying
intervals. This can be over a few years to monitor long term outcomes.

These should not take more than a few minutes to complete and will ask you about your pain
levels, and the benefits, or otherwise, of any procedures that you have had undertaken.

Your consent will be requested, and if you do not consent to take part or would like your data
removed at any time, then this is perfectly acceptable, however we would appreciate
your cooperation with this research.

For more information on their Privacy Policy please visit the below link:

If you do not agree to participate in the spine registry, then please communicate this to us direct.

Mr Rafid Al-Mahfoudh
Consultant Neurosurgeon & Complex Spinal Surgeon