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Experience of your Consultant

Mr Hargrave has over 23 years NHS experience and 16 years experience as a podiatric surgeon. He has held Consultant positions in the NHS since 1998 and has performed over 8000 foot and ankle procedures. He is a recognized surgical tutor, peer reviewer and examiner for the Faculty of Podiatric Surgery, College of Podiatrists. In Norwich he is the lead Consultant for The Norfolk Foot Surgery Centre, proving surgical care for around 1400 patients per year, both privately and NHS. He is frequently called upon to help colleagues with complex surgical cases and lectures widely on a range of foot surgical topics. He continues to expand his field of knowledge with frequent visits to both Europe and the USA to stay abreast of developments in foot and ankle surgery through courses, seminars and conferences.

Peer Review Comments

Podiatric surgeons are required to undergo regular peer review by 2 appointed NHS Consultant Podiatric Surgeons (from the Faculty of Podiatric Surgery, College of Podiatrists):

Charing Cross Hospital; September 2005, Peer Review:

"Mr Hargrave is frequently called on to provide clinical support and guidance for other podiatric surgeons and his clinical reputation is excellent"

"Mr Hargrave is one of the most technically able surgeons within the profession. His diagnostic and surgical skills are respected by his colleagues"

"He was able to display his surgical competence in full on the day of peer review"

The Norfolk Foot Surgery Centre; Norwich Community Hospital, September 2008, Peer Review:

"This is a high standard unit lead by a most competent consultant. An example of how a podiatric surgery unit should be run"

"We were impressed by the standard of the facilities and the level of the service provided. We did not feel that there were any areas of concern with the service or Mr Hargrave"

Surgery

Your surgery will be performed at either a private hospital or private day-case centre. Surgery can be performed under a local anaesthetic at the day-case centre or under general anaesthetic or intravenous sedation at the private hospital. Some patients at hospital will require one or two nights stay, particularly if you have a medical condition that requires monitoring or you haven't got the required home support. You must have a relative or carer to accompany you home after the surgery. For day-case procedures it is very important that you rest for the first 3-days in particular. The vast majority of podiatric procedures allow some weight-bearing even in the early stages, but this should be kept to a minimum e.g. going to the toilet.

Follow-ups

Usually, at least 3 follow-up visits will be required, and these will be at The Harley Street Foot & Ankle Centre at number 9 Harley St. The majority of soft-tissue procedures e.g. removal of neuroma; ganglion etc, will require approximately 7-14 days off work. Where bone procedures are undertaken e.g. hallux valgus (bunion) correction or toe straightening, you may need between 2-6 weeks off work, depending on your progress following surgery (which varies widely).

Driving

For most soft-tissue procedures driving may be permitted following your first visit at 7 days. For bone and joint procedures, usually 4 weeks is necessary before driving is permitted. If you drive an automatic then you may drive if the surgery is to your left foot.

Private Medical Insurance

Mr Hargrave is accredited with all the major insurers e.g. BUPA; AXA/PPP; Standard Life; Norwich Union; Medisure; Cigna; BCWA; Pru Health; Remedi etc. If you are self-funding we will be happy to provide you with a quote for your surgery. Unless you state otherwise we will bill to your insurers as long as you have obtained authorisation for your treatment.

Complications

There is no absolute guarantee that your surgery will be a success. Usually we talk in terms of percentage improvement. The problem/s that you have means your foot is no longer normal. It is certainly not normal to have surgery and therefore your foot cannot ever be completely normal again. Having said this, most patients will be able to lead a full and active life after foot surgery and where deformity has been corrected, the appearance of your foot will improve and you may be able to wear a greater range of footwear. Your Consultant has performed over 8000 foot and ankle procedures, and it is our hope that these experiences and skills will help to rectify your current foot problems. Occasionally, patients do not do well from surgery, for a variety of reasons, often outside of the control of the surgeon or the patient. Very rarely a patient may be left worse off after surgery; although this is extremely uncommon. In these cases further (revision) surgery may prove necessary.

Major Complications are quite rare; here are some known complications: Infection; continued pain and swelling; stiffness; raised scar; DVT (vein clot); recurrence of problem.

Success rates

As reported by our patients from clinical audit; success rates do vary but the majority of foot procedures carry an 80-93% chance of success. Some procedures are known to be less successful e.g. tarsal tunnel release, but in the absence of other curative treatments, the patient may feel that the risk is acceptable. Complications of surgery do not necessarily mean that the final result will be affected.

Recovery/after effects

The total recovery time for foot surgical procedures is actually often rather prolonged. Swelling is the biggest problem as it may take many months to settle and will require patience and compromise in your footwear. Hopefully, you will be able to return to a wider range of footwear and many women are able to wear fashionable court shoes once things settle down. On average patients tell us that it is 8 weeks before they can wear a roomy shoe and 3-months before running activities are undertaken, although swimming and cycling can usually be undertaken much sooner. Some procedures do require physiotherapy and this will be discussed on an individual basis.

If it goes wrong?

Around 5% of patients will have an unsatisfactory result from surgery. This may be due to very rare complications such as bone infection or complex regional pain syndrome. Sometimes the deformity re occurs e.g. bunions, although rarely as bad as the original complaint. If pain and deformity are a problem then revision surgery may prove necessary and can be just as successful as a primary procedure.

To download specific patient information leaflets, including the risks and potential complications of surgery, please click on Patient Information.