Walk-in walk-out hernia clinic offers shorter waiting times and faster recovery


Mr Raj Bhutiani set up the pioneering clinic
Mr Raj Bhutiani set up the pioneering clinic

Referral information

Please book your patients directly onto the operating list on the date the patient requests. The patient makes only one visit to the hospital for both consultation and treatment on the same day.

1. This clinic is suitable for patients with primary inguinal hernia, umbilical, para umbilical hernia, epigstric hernia and small incisional hernia and who are able to be treated under a local anaesthetic.

2. Please book all suitable patients directly on to my clinic by faxing your referal to 020 8963 8878. If the patient is booked onto my clinic via NHS choose and book they will end up with an additional pre-assessment appointment.
Please ask your nurse to take MRSA swabs on the day the patient is booked on the list.

Please click here to see the full set of referral guidelines
Please click here to download information for patients attending the clinic

3. To contact Mr Bhutiani (pictured) please call 020 8869 2614 or 077621 37050

Patients choose operating date and have only one appointment

Waiting times for patients needing a hernia repair are shorter than ever before, thanks to a pioneering ‘walk-in walk-out’ hernia clinic at The North West London Hospitals NHS Trust.

This clinic, a first for the NHS, means patients can choose the date of their operation and make only one visit to the hospital for both their consultation and surgery. This clinic has been running at Central Middlesex Hospital for the past three years and has treated around 600 patients, reducing the waiting time from 18 weeks to four.

The clinic was set up by Mr Raj Bhutiani, a consultant general surgeon at the Trust.

Talking about the clinic, he said: “My desire to set up the clinic came from seeing frustrated patients who had waited months for their surgery when their condition had been instantly diagnosed by their GP. I simply thought there has to be a way to make the service better for patients.”

Patient testimony

Mr Ernest Stokes has recently had his hernia repaired in Mr Bhutiani’s clinic.

Mr Stokes said: “I enjoy ten pin bowling and walking and having the hernia was stopping me from doing the things I enjoy. My GP referred me to Mr Bhutiani and within four weeks I had an appointment to go and see him.

“Mr Bhutiani inspires complete confidence and the service was very efficient, I was home within six hours of arriving at hospital. I have been recovering now for two weeks and I am already able to enjoy walks outside without the discomfort I previously suffered. I hope to be bowling again very soon”.

Inguinal hernia repair is one of the UK’s most common surgical procedures with over 80,000 being performed every year in England alone and can only be treated through surgery.

What’s different?

The main advantage to this clinic is that patients do not have to attend a number of outpatient appointments prior to surgery. GPs can directly refer suitable patients to Raj's operating list via the choose and book system.

Mr Bhutiani said: “This direct contact between the GP and consultant cuts out the many tiers of administration which used to make waiting times longer and lead to unnecessary and repeated pre-assessment clinic visits to outpatient departments. To ensure patients are suitable to attend the clinic we have developed a concise set of referral guidelines for GPs, along with a thorough clinical assessment for each patient.

“Patients can choose a date that suits them. The procedure is done as a day case, so it is not dependent on the availability of hospital beds. This makes the chances of operations being cancelled extremely low and has reduced the ‘do not attend’ rate by 42 per cent.

“The procedure is performed under a local anaesthetic, which is much safer for our elderly patients who may have additional health problems. As patients do not have to be in the hospital, any risk of getting an infection is significantly reduced.”

The success of this clinic has saved the Trust nearly £70,000 in the first year. If a significant majority of these hernias are repaired in this clinic, there is a potential to save more than £700,000 a year.