Private neurology in Edinburgh: assessment, headache and spinal care

Neurology is one of the specialties listed on the Nuffield Health Edinburgh page, which also lists cardiology, dermatology, ophthalmology, haematology, orthopaedics, pain management and urology. Diagnostic imaging is described as available alongside outpatient appointments, which suits an assessment that may need a scan.

The hospital is on Colinton Road. Lothian Buses routes 10, 27, 38 and 45 serve it, Waverley and Haymarket are a short taxi ride away, and parking is free once your number plate is validated at reception. It says referrals are preferred but not mandatory, which is useful for someone whose GP has not yet written, though the consultant will want a good history of the symptoms.

Since the page does not name specific neurological clinics, ask whether the consultant offers the particular service you need, for example a headache assessment or a movement disorder review, and whether any electrical tests such as nerve conduction studies are done on site.

Spire's Edinburgh treatment page groups spinal surgery, back decompression, scoliosis correction, nerve pain treatment and headache treatments under neurology, and has a separate spinal surgery heading covering laminectomy, discectomy, spinal fusion and microdiscectomy. Its main page also names respiratory medicine, men's health and a breast clinic, but not a general neurology clinic, so this is mostly a spinal-and-pain offer.

The group runs from Murrayfield on Corstorphine Road, with free parking and a short walk up a steep driveway from the bus stop, and from Shawfair Park by the Sheriffhall Park and Ride, a five-minute walk. The listing is shared between the two, so ask which site hosts a spinal clinic and operating list.

MRI and CT scans are listed for the group, which matter for spinal and nerve-root problems.

NHS Lothian's Department of Clinical Neuroscience brings neurology, neurosurgery and neurophysiology to 50 Little France Crescent, EH16 4TJ. It describes three inpatient wards, a programme investigations unit, operating theatres, diagnostic services and outpatient clinics, with neurology outpatients also seen at St John's Hospital in Livingston and Roodlands Hospital in Haddington. The Anne Rowling Regenerative Neurology Clinic provides specialised research and clinical services for neurodegenerative disease, and paediatric neurology is delivered in the children's hospital.

For private patients, the implication is that complex, emergency or inpatient neurological care usually runs through this department, even when the first outpatient consultation was private. A good private neurologist will say so plainly and explain how a transfer would happen.

Headache and migraine make up a large part of outpatient neurology. The consultation aims to separate common patterns from rare warning features and to review medicines, including overuse of painkillers. Other frequent reasons are tingling and numbness, which may be a trapped nerve or neuropathy, tremor, blackouts, memory worries and suspected epilepsy.

Tests are chosen carefully. An MRI of the brain can look for structural causes, an EEG records electrical activity, and nerve conduction studies assess peripheral nerves. Many people have a normal result, which can itself be informative, and the consultant should explain what has been excluded.

• Migraine and other headache disorders

• Numbness, tingling and nerve pain

• Tremor and movement problems

• Blackouts and suspected seizures

• Back pain with leg symptoms needing spinal assessment

Keep a symptom diary for a fortnight before attending; it helps more than most tests.

• Whether your insurer needs a GP referral before neurology.

• Which tests will be carried out on the day and which later elsewhere.

• Whether a spinal surgeon and a neurologist are both involved when the problem could be either.

• What happens if the tests show something that needs NHS neurosurgery.

• How the report reaches your GP.

NHS inform sets a 12-week standard for a new outpatient appointment and six weeks for eight key diagnostic tests, with an 18-week overall referral-to-treatment standard. Neurology waits vary and should be checked with NHS Lothian or Public Health Scotland. Suspected stroke or other emergencies bypass outpatient queues entirely and go through 999.