Hickman lines and PICC lines, by the right hands.
Long-term central venous access for chemotherapy, OPAT antibiotics, TPN and dialysis - inserted by IV nurse specialists and interventional radiologists, under the full NICE care bundle.
Indicative pricing
What private line insertion costs in the UK.
Indicative ranges across UK private providers.
In short
£450–£850, at the bedside under ultrasound.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| PICC line insertion (bedside, US-guided) | £450–£850 | 30–45 min | Same visit |
| Hickman line insertion (IR, LA + sedation) | £900–£1,600 | 60–90 min | Same visit |
| Port-a-cath insertion (IR or theatre) | £1,400–£2,400 | 60–90 min | Same visit |
| Vascath (tunnelled dialysis catheter) | £1,000–£1,800 | 60 min | Same visit |
| Midline insertion (bedside, US-guided) | £350–£650 | 30 min | Same visit |
| Line removal (PICC or Hickman) | £150–£600 | 15–45 min | Same visit |
Prices vary by clinic, by device size and number of lumens, by whether a fluoroscopy suite is used, and by the anaesthetic chosen.
The problem
The right device, the right operator, the right care after.
Vascular access is the quiet backbone of long treatment courses - and the commonest place they come unstuck. We fix all three variables before you commit.
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Not sure which line?
PICC, Hickman, port or midline - each has a right patient. We work through it with you before anything is booked.
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Worried about infection?
Bundle-driven insertion, chlorhexidine skin prep, a Biopatch dressing and community IV nursing - infection risk falls when the whole pathway is tight.
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Want it done properly?
IV nurse specialists at the bedside, interventional radiologists in the suite, fluoroscopy or ECG tip confirmation - no shortcuts.
When it helps
When a Hickman or PICC is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Chemotherapy cycles
Cyclical IV chemo where peripheral veins will not last. A PICC covers a few months; a port suits years of intermittent access.
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OPAT - outpatient IV antibiotics
Six weeks of IV antibiotics for endocarditis, bone or joint infection - done at home through a PICC by a community IV team.
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Long-term chemotherapy or BMT
Leukaemia, lymphoma, bone marrow transplant - a Hickman gives reliable central access for months to years of treatment.
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Total parenteral nutrition (TPN)
When the gut cannot be used, TPN is given centrally - usually via a Hickman or a tunnelled PICC.
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Chronic haemodialysis
Where an AV fistula is not yet ready or not possible, a tunnelled dialysis catheter (Vascath) provides reliable flow.
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Repeated blood products
Recurrent transfusions or plasmapheresis benefit from a stable central line rather than a fresh cannula each visit.
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Difficult peripheral access
Where cannulas fail repeatedly, a midline or PICC removes the daily needle stress and protects remaining veins.
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Red flag: fever with a line in
A temperature, rigors or a red, tender exit site while a line is in situ is not something to sleep on - same-day assessment, blood cultures, and don’t remove the line yourself.
Device types
One name - several very different devices.
What each option actually is - and which fits which therapy.
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PICC line
4–6 Fr single or double lumen, inserted at the antecubital fossa via the basilic, brachial or cephalic vein. Tip in the SVC. Suits one week to twelve months of therapy.
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Hickman (tunnelled cuffed)
7–12 Fr, inserted via the internal jugular or subclavian and tunnelled under the skin to a chest wall exit. A Dacron cuff anchors it and forms an infection barrier. Months to years.
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Port-a-cath (implantable)
A fully implanted reservoir under the chest-wall skin, accessed with a Huber needle when needed. Best cosmesis, lowest maintenance, permits swimming - suits monthly chemo for years.
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Groshong
A PICC or tunnelled variant with a valved tip - no clamps, no heparin flush. Less common in the UK but useful in specific patients.
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Vascath (tunnelled dialysis)
A large-bore tunnelled catheter for haemodialysis or plasmapheresis, used when an AV fistula is not yet mature or not an option.
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Midline
A shorter (~20 cm) catheter with the tip in the axillary or subclavian vein - not central. One to four weeks. A simpler step up from a cannula.
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Removal
PICCs pulled at the bedside once therapy finishes. Hickmans withdrawn with gentle traction after a few months; older Hickmans may need a small cut-down at the cuff. Ports removed in IR or theatre.
Safety and living with a line
What to expect afterwards - honestly.
Central lines are common and safe. The variables worth planning are which device, who is looking after it week-to-week, and knowing which changes need a same-day call.
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Local anaesthetic, sedation where needed
PICCs and midlines are done under LA at the bedside. Hickmans and ports use LA plus light sedation in an IR suite so you are comfortable but not asleep.
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Insertion complications are uncommon
Arterial puncture, pneumothorax (mostly subclavian, 1–2%) and transient arrhythmia during guidewire placement are the main risks. Ultrasound-guided IJ access has brought these right down.
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CLABSI is the main long-term worry
Central line–associated bloodstream infection runs at roughly 1–3 per 1,000 catheter days. Aseptic non-touch technique, chlorhexidine skin prep and a Biopatch dressing all cut the risk.
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Line-related clot happens
Thrombosis affects 5–15% of patients clinically - more with PICCs than with Hickmans or ports. Treated with anticoagulation, catheter-directed thrombolysis, or line removal.
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Occlusion is usually a fibrin sheath
A line that will not flush or bleed back often has a fibrin sheath - in-line urokinase or alteplase clears most of them without removing the line.
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Weekly flush and dressing when idle
PICCs and Hickmans need weekly saline (± heparin, per protocol) and a weekly dressing change. Ports need a monthly access and flush between chemo cycles.
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Swimming, showers and daily life
A Hickman is not designed for full-immersion swimming. Ports permit swimming once healed. Showers with a waterproof cover are fine for most lines after the first week.
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Adhesive dermatitis is common and fixable
A red, itchy patch under the dressing is usually the adhesive, not infection. A different dressing or a barrier film sorts most cases - tell the nurse rather than putting up with it.
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Red flags
Fever, rigors, a red or tender exit site, a swollen arm on the PICC side, or a line that suddenly stops working - call the team the same day. Do not remove the line yourself.
Reading your insertion note
Your insertion note in four parts. Read the last one first.
Whichever device was placed, the note the operator sends you keeps to the same shape.
A quiet reminder
Line-care language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the flush protocol before your first community-nurse visit, just ask.
- 01 Header
Device chosen and indication
Which line was placed - PICC, Hickman, port, Vascath, midline - the size and number of lumens, and the therapy it is for.
- 02 Technique
Access route, tip position, tip check
The vein used (basilic, IJ, subclavian), how the tip position was confirmed (fluoroscopy, ECG guidance, or post-procedure chest X-ray), and the sterile bundle followed.
- 03 Findings
Cuff position, exit site, complications
For a Hickman: cuff depth and exit site. Any first-pass difficulty, transient arrhythmia, or need for a re-site is noted here.
- 04 Impression
Flush regime, dressing plan, review
Read this first: the specific flush protocol for your device, dressing change schedule, who is looking after the line, and when it is due out.
Recognised by major UK insurers
Cover for line insertion is usually included when the therapy it enables is covered - chemotherapy, OPAT antibiotics, TPN.
Frequently asked
Everything we get asked about Hickman and PICC lines.
Quick answers on pain, cost, showering, infection risk and who looks after the line week-to-week.
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What is the difference between a PICC line and a Hickman line?
A PICC is inserted through a vein at the elbow and threaded up to the large vein above the heart - it lives on the outside of your arm and suits therapy from a week to about twelve months. A Hickman is inserted at the neck or upper chest, tunnelled under the skin, and exits on the chest wall with a cuff that anchors it. Hickmans are for months to years of treatment such as long chemo regimens or TPN.
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Does inserting a line hurt?
Not really. PICCs and midlines are done under local anaesthetic at the bedside - a sharp sting, then pressure. Hickmans and ports are done in an interventional radiology suite under local plus light sedation, so you are comfortable throughout. There is usually a day or two of tenderness at the exit site afterwards.
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How much does a private line insertion cost in the UK?
Roughly £450–£850 for a PICC, £900–£1,600 for a Hickman, £1,400–£2,400 for a port-a-cath, and £350–£650 for a midline. Removal is £150–£600 depending on the device.
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Can I have a shower or bath with a line in?
Showers with a waterproof cover are fine for PICCs and Hickmans after the first week. Deep baths and swimming are best avoided with a Hickman - a port, once healed, permits swimming because there is nothing outside the skin.
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Who looks after the line between hospital visits?
A community IV nurse from your local team, usually. Some patients (or a partner) are trained to do their own weekly flush and dressing change - it is very doable and gives you your independence back. Ports need only a monthly access and flush.
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How long can a line stay in?
A PICC will comfortably last twelve months, sometimes longer. A Hickman is designed for months to years. A port can stay in for years - often for the whole treatment course and beyond. The line comes out when the therapy finishes or if there is a problem.
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What if my line gets infected?
Fever, rigors, or a red, tender exit site while a line is in are treated seriously. You will need blood cultures (from the line and from a peripheral vein) and IV antibiotics. Some infections clear with antibiotics through the line; others need the line to come out. Do not remove it yourself.
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Can I still work with a PICC or Hickman?
Most patients do. Office work is fine from day one. Heavy lifting on the PICC-side arm is best avoided. Contact sports and swimming are out with a Hickman. Ports, once the wound has healed, are close to invisible and rarely limit anything.