Appointments are made via Martin Holt’s secretary and can be for clinics at
The BMI Alexandra Hospital, Cheadle on Monday morning, Wednesday evening, Friday morning and afternoon.
The Spire Regency Hospital Macclesfield on Friday late afternoon/early evenings.

Advantages of having private health care include being able to have your treatment with the surgeon of your choice and having tests and treatment in both a timely manner avoiding NHS waiting lists and at times that are more in keeping with your personal commitments. Martin Holt has worked with private patients for 20 years and can advise you with regard to timings of your operation as it often the case that certain treatments can be deferred for events such as weddings, examinations, interviews or other important social activities in line with a patient’s personal diary.

It is usually the case that your operation can be arranged in a couple of weeks from the decision that surgery is needed. Apart from emergency procedures private hospitals require patients to have a preoperative assessment which is arranged in the ten days prior to surgery this is to make sure that where possible potential problems can be detected and managed safely for all patients.

Prior to your attendance you will be sent a letter of engagement and outpatient fee structure which is a legal requirement as from 2018. This letter will also confirm that Martin Holt is recognised by all of the Medical Insurance companies.

If you have Private Medical Insurance please check before your first attendance with Martin Holt that you are covered for the initial Consultation and investigations such as radiographs and MR scan. It may be that radiographs, (X-rays) MR scan, CT Scan, blood tests or an injection of steroid will be recommended for you in which case it be would advantageous for you to have confirmation in advance of the extras that are covered by your policy as nowadays your Medical Insurance pol-icy may be personalised.

Martin Holt accepts self pay patients. Self pay patients will be sent the same letter of engagement with the same outpatient fee structure as for Medically Insured patients. On request patients will be advised by the relevant hospital of the charges for tests and investigations as these are not part of any outpatient consultation. If surgery is required then the hospital will arrange for a self pay patient to have a quote for their operation which will include the hospital costs, the anaesthetist fee, Martin Holts surgeons fee together with a free post operative out patient appointment and if the surgery dictates a number of physiotherapy sessions, as detailed in the quote.

In the event that following your appointment with Martin Holt tests and investigations are arranged then a follow up appointment is made by yourself at the main reception desk for the date agreed between you and Martin Holt in keeping with the date the results will be available. In the unlikely event that the results are not available at the time of your next appointment efforts will be made to notify you in advance. However, if you have not been contacted in advance, no charge will be made for that appointment without the results and a further appointment will be arranged with you.

Physiotherapy may be required and this can be arranged either at The Alexandra or Spire Regency Hospitals. Sometimes patients have a preferred Physiotherapist or would like to have their physio-therapy in their own city or nearer to home. This is not a problem as Martin Holt can communicate both via yourself and directly to the physiotherapist of your choice to optimize your treatment.

The time off work is dependant on the particular operation and also on how a patient progresses afterwards with physiotherapy together with their occupation.

As a guide if the occupation is office based then the time off work is approximately two weeks, if the occupation requires driving then it can be of the order of four weeks. If the patient works on tools or their occupation requires full return of safe function required such as airline pilots then the time off work may be of the order of six weeks. Please note that these are approximations and patient re-sponses vary with more specific information being available on your patient friendly GHOST. While these are the usual periods of time off work but there are many factors to be taken into considera-tion which all patients respond differently.

All arthroscopic operations done by Martin Holt can be done as day case procedures. This means that you arrive at the hospital, are admitted, have your operation and are discharged so that you are able to return home on the same day. It is however important that you have someone at home who is staying the night with you if this is not the case then you may have to have an overnight stay in the hospital in which case please contact your Insurance company to gain an authorisation code for this postoperative overnight stay because without their authorisation you could be liable for the additional charges as too will self pay patients.

This is an operation which is done through an open incision which allows the surgeon access to remove insert or fix bone with implants such as those used for joint replacement operations or fracture fixation. An open operation is not a keyhole (arthroscopic) procedure.

Sometimes. It is more common for patients to stay overnight after an open operation as these tend to be longer procedures and therefore there may be longer postoperative monitoring required necessitating an overnight or longer stay. Most insurance companies recognise that particular procedures are not day case (such as joint replacement procedures) and the authorisation code for the procedure will recognise that this is not day case surgery but if in doubt please contact your insurance company for verification.

The dressings are kept on for approximately ten days arrangements and can be made, before your discharge by the admission ward, for their removal together with sutures where necessary with the hospital or your GP practice.

Most patients do not have sutures after an arthroscopic operation but for those that do have one or two stitches for the little portals and for those patients with operations which require formal incisions such as for joint replacement surgery or after trauma operations the wound is closed by Mr Holt with a special technique using an absorbable suture material which does not require removal as it is absorbed over time by the body. Occasionally the suture appears to take longer to get absorbed in these cases just the little knot can be trimmed at the time of your post operative outpatient appointment with Martin Holt.

Yes. Mr Martin Holt is recognised by all medical insurance companies including AXA PPP, BUPA, BUPA International, AVIVA, Simply Health, Vitality health, Prudential, April.

Yes. My Consultant anaesthetists are Dr Roger Smith, who is also a specialist Intensive Care Consultant and is my colleague at my NHS practice at Wythenshawe Hospital and Dr Alan Ashworth who is also a Consultant Cardiac Anaesthetist. Both Dr Smith and Dr Ashworth are recognised by all medical insurance companies.


Yes.

If you have medical insurance then according to your policy you may require a letter of referral. If you are self pay no letter of referral is required by Martin Holt but a GP letter of referral can contain additional information such as your past medical history and medications which can help in the management of your problem.

Martin Holt’s fees are £245 for the initial Consultation and £175 for any follow up Consultations with a 15% reduction on these fees for self paying patients for payments received within two weeks of the date of invoice for the Consultation. These fees do not include X-Rays, scans or blood tests etc which will be billed separately by the Hospital.

All arthroscopic operations are day case procedures. Joint replacement surgery and some trauma procedures may require postoperative observation and may not be day case procedures.

There are many types of medical insurance policies and Martin Holt does not have access to the information regarding your own specific policy. Patients are given a code for their procedure which can be used to check with their insurance company as to whether they are eligible for an overnight stay. Some medical insurance companies will only pay for overnight stays following operations such as joint replacement surgery or major trauma. Please check before your operation and get an authorisation code for any overnight stay from your medical insurance company before your operation otherwise you could be charged by the Hospital.

Driving is restricted until such a time as a patient can safely control a car which depends on the operation and the rate of recovery for each patient after the procedure. It is really important to realise that it is not the just ability to drive a car, changing gear etc it is the ability to drive a car safely so that if (say) a four year old boy suddenly runs out after his football appropriate safe, swift and appropriate steering is completed without danger to the little boy or any other traffic. Driving down the motorway at 70mph one handed is not safe driving.

Using the elephant test can help as a guide as to when a patient may be able to progress with driving. The patient sits on their bed and points at the corner of room’s ceiling and then points to the opposite corner of the room and back again in the time it takes to say “one elephant two elephant”. This test can be used as a guide following both shoulder and elbow surgery. Upon completion of the elephant test it is reasonable for a patient to try manoeuvring their vehicle such as a three point turn in the driveway. These are useful guides but at the end of the day any patient considering returning to driving should only do so is they feel that they are safe and their arm can be used such that they would be able to pass their driving test.

Most but not all operations will be followed by postoperative physiotherapy.

This can be arranged on the day of your operation at the hospital venue or if you prefer your physiotherapy can be with a physiotherapist of patient’s choice. Choosing to have your physiotherapy with a physiotherapist of your choice such as one who is based nearer to your home is not a problems but if this is the case then the physiotherapy appointment will have to be organised by the patient themselves.

When indicated most physiotherapy begins within 2-4 days of the procedure. All surgeons have different opinions as to when physiotherapy should begin. Mr Holt bases his treatment programs for patients on over twenty years of experience in treating patients with shoulder and elbow problems and his regimes can be more accelerated and differ to those of than some of his Consultant colleagues therefore it is important to follow the instructions given at the time of surgery.

The details and specific information as to the exercises required or restricted will be given to you on the day of your operation.

Yes, this is a very good way to proceed as they will have examined you before and will have knowledge of your preoperative status. Mr Holt welcomes the opportunity to refer you back to your original treating physiotherapist after your operation as this can be beneficial to the patient’s overall recovery.

All chartered physiotherapists will be able to take on your postoperative physiotherapy be it shoulder or elbow surgery elective or trauma. There is a well established communication between Mr Holt and hospital physiotherapists and also with many physiotherapists based in the community so it is not a problem for Mr Holt to communicate with your chosen physiotherapist to optimise your postoperative treatment. The specific information as to the exercises required and any restrictions will be given to you on the day of your operation which can then be given to your physiotherapist. Any changes during your post operative phase will be advised where necessary to both yourself and your physiotherapist. For those patients who are out of the Manchester and Cheshire regions Eg Liverpool, Leeds and London please give Mr Holt the relevant details of your chosen physiotherapist.

On the day of your operation you will be seen by a hospital physiotherapist. They can arrange for your physiotherapy to be at the hospital (either the Alexandra BMI or the Spire Regency Macclesfield according to your operation venue). The appointment time will be given to you prior to your surgery or before you are discharged after the operation according to the procedure and pathology. Physiotherapy is usually arranged to be with 2-4 days of the operation

Yes you can select a physiotherapist of your choice in which case please can you book an appointment to start within 2-3 days from the operation. The specific information as to the exercises required or restricted will in the first instance be given on the day of your operation.


What happens on the day of my operation?

This will vary between Martin Holt's two hospitals, The BMI Alexandra and the Spire Regency:

 

BMI Alexandra Hospital

On the day of your operation please make sure that you have nothing to eat or drink from 0730 as your operation will be in the afternoon and six hours is the recommended period to be nil by mouth for a safer anaesthetic. Ideally a piece of toast and a cup of tea - not a fry up!

Please arrange for a lift from the Alexandra Hospital after the operation because you will not be allowed to drive following an anaesthetic usually for twenty four hours. The majority of Martin Holt’s patients have day case surgery and so are home the same day as the operation.

After checking in at reception around 1030-1130 on the morning of your operation you will be shown to your room on the ward where you will be seen by the nursing staff for your baseline observations to be checked which will include your blood pressure and they will document any medications you take regularly.

Martin Holt will meet you around midday when once again he will go through the procedure and the consent for your operation. Your arm, corresponding to the side of the procedure, will be marked and he will answer any questions you have which may have arisen since the last time you met and discussed your operation.

It may be that you would wish for a partner, relative or friend who is with you on the day of your operation, to be told of the details of your operation after the procedure in which case please tell Martin Holt before the operation so that this can be formalised with all parties otherwise the operation remains confidential in line with GDPR This is important for students over 18 whose operations may have been arranged by their parents who will obviously be concerned.

A physiotherapist will see you before your operation if physiotherapy is required and arrange an appointment usually in the first post operative week according to the procedure. If you have already arranged a physiotherapist then the details of the procedure and the physiotherapy required will be given to you to pass on to the physiotherapist of your choice and an update will be sent the physiotherapist at the time of your postoperative outpatient appointment.

The operation will be in the afternoon, the time of your operation will be decided by several factors some of which will be determined by the anaesthetic review of not only yourself but also that of the other patients on that day’s operation list.

You will be seen by one of my anaesthetic colleagues usually Dr Roger Smith or Dr Alan Ashworth both of whom are able to provide you with an anaesthetic block where indicated for either your shoulder or elbow surgery. The block is an injection of local anaesthetic into the nerves around the top of the shoulder near the neck which numbs the arm. This block can be very effective at reducing the post operative pain with some patients preferring to just have a block for their operation instead of a General Anaesthetic in which case the patient is awake throughout the procedure but not feeling any pain because of the block. A patient who has a block can sit up and watch their arthroscopic operation on the same screen as Martin Holt who will discuss relevant parts of the operation with the patient. Other patients while wanting to stay awake prefer not to watch but listen to music on their head phones. Many patients don’t want to be awake preferring to go to sleep with a general anaesthetic for their operation even so these patients can also get an anaesthetic block to help with their postoperative pain.

The duration of the block varies between patients. The arm usually remains anaesthetised after the operation for 6-12 hours but in some patients it can be more than 24 hours before the effect of the block fully wears off. The block can give very good pain relief and it also stops the muscles of the arm working and so it is important to wear the sling until the arm has recovered from the block.

In some cases your arm will be in a sling for only a couple of days. For other procedures the sling may be retained for a number of weeks the duration of use of the sling will be explained to you according to the procedure.

If you want pictures of your arthroscopic procedure then this can be arranged but please ask in advance on the day of surgery.

Martin Holt will see you after the operation and discuss the findings and procedure. Sometimes the effect of the general anaesthetic is such that you will not remember everything which is explained at the time but there will be further opportunities for you to have questions answered.

After the operation you will have the opportunity to have something to eat, it will have been at least 6 hours since you last ate!

Before leaving the ward you will be given an appointment date and time for your post operative out patient review, in most cases this is on the Friday a couple of weeks after the operation.

It is important that you are aware that in the unlikely event you have any problems post operatively you get in touch with the ward via the Alexandra Hospital Switchboard and they will arrange for you to be contacted by Martin Holt.


Spire Regency Hospital

On the day of your operation please make sure that you have nothing to eat six hours before your operation as this is the recommended period to be nil by mouth for a safer anaesthetic. The specific time to begin ‘nil by mouth’ varies according to the day you have been listed for surgery but you will be advised by Mr Holt beforehand.

Please arrange for a lift from the Regency Hospital after the operation because you will not be allowed to drive following an anaesthetic usually for twenty four hours. The majority of Martin Holt’s patients have day case surgery and so are home the same day as the operation.

After checking in at reception on the day of your operation you will be shown to your room on the ward where you will be seen by the nursing staff for your baseline observations to be checked which will include your blood pressure and they will document any medications you take regularly.

Martin Holt will meet you before the operation when once again he will go through the procedure and the consent for your operation. Your arm, corresponding to the side of the procedure, will be marked and he will answer any questions you have which may have arisen since the last time you met and discussed your operation.

It may be that you would wish for a partner, relative or friend who is with you on the day of your operation, to be told of the details of your operation after the procedure in which case please tell Martin Holt before the operation so that this can be formalised with all parties otherwise the operation remains confidential in line with GDPR. This is important for students over 18 whose operations may have been arranged by their parents who will obviously be concerned.

A physiotherapist will see you before your operation if physiotherapy is required and arrange an appointment usually in the first post operative week according to the procedure. If you have already arranged a physiotherapist then the details of the procedure and the physiotherapy required will be given to you to pass on to the physiotherapist of your choice and an update will be sent the physiotherapist at the time of your postoperative outpatient appointment.

The time of your operation will be decided by several factors some of which will be determined by the anaesthetic review of not only yourself but also that of the other patients on that day’s operation list.

Operations under a block allowing the patient to be awake are only possible with my anaesthetist Dr Smith or Dr Alan Ashworth at the BMI Alexandra Hospital.

If you want pictures of your arthroscopic procedure then this can be arranged but please ask in advance on the day of surgery.

Martin Holt will see you after the operation and discuss the findings and procedure. Sometimes the effect of the general anaesthetic is such that you will not remember everything which is explained at the time but there will be further opportunities for you to have questions answered.

After the operation you will have the opportunity to have something to eat, it will have been at least 6 hours since you last ate!

In some cases your arm will be in a sling for only a couple of days. For other procedures the sling may be retained for a number of weeks the duration of use of the sling will be explained to you according to the procedure.

Before leaving the ward you will be given an appointment date and time for your post operative review, in most cases this is on the Friday a couple of weeks after the operation. It is important that you are aware that in the unlikely event you have any problems post operatively you get in touch with the ward via the Spire Regency Switchboard and they will arrange for you to be seen or contacted by Martin Holt.

Before leaving the ward you will be given an appointment date and time for your post operative out patient review, in most cases this is on the Friday a couple of weeks after the operation.

It is important that you are aware that in the unlikely event you have any problems post operatively you get in touch with the ward via the Spire Regency Switchboard and they will arrange for you to be contacted by Martin Holt.

Before leaving the ward you will be given an appointment date and time for your post operative review, in most cases this is on the Friday ten days after the operation. It is important that you are aware that in the unlikely event you have any problems post operatively you get in touch with the ward via the Alexandra switchboard and they will arrange for you to be seen or contacted by Martin Holt.