Appointments for a private assessment at the Priory North London can be made by telephoning my secretary, Chrissy Stylianou, on 020 8920 5611 (direct line) or 020 8882 8191 (hospital). Fax: 020 8447 8138. I am usually available for consultations on Wednesdays and Fridays.

Private consultations may be paid for either personally or by a health insurer. A third party such as an NHS Trust or solicitors may also fund a consultation but only if it has been pre-authorised in writing.

For private consultations, it is preferable to have a referral from your general practitioner. This is not necessary if, for example, you do not have a GP or do not wish your GP to be involved. However if you wish to claim the fees from your health insurer, they will usually require you to be referred by your GP. Furthermore if you wish to take medication, I am reluctant to prescribe without your GP knowing what you are taking. I usually have a waiting list of about 3 weeks to see private patients but will endeavour to see you the same or next day if you  are likely to need admission to hospital (for example if you are feeling suicidal). I do not see patients at weekends. However I start at 8.30am and see one new patient at 6.15pm on Wednesday evenings each week.

Fees

I charge £280 for an initial assessment and £120-£180 for follow up appointments depending on the length of the consultation. These fees are normally recoverable under medical insurance if you have been referred by your GP. My terms will be sent or emailed to you when an appointment is confirmed. Fees for home visits are higher and reflect my travelling time.

I am able to see patients at The Priory on the NHS in rare circumstances with funding from your local Trust or if it is part of the National Specialist Commissioning Team for severe treatment refractory OCD or BDD (see below).

Consulting Rooms

The Priory Hospital North London
Grovelands House
Southgate
London N14 6RA

Click here for directions to The Priory Hospital North London on a “Bing” map or  here for a local map or  download written directions.

I also have a very limited service early morning once a week in Muswell Hill, N10.

Telephone

If you are housebound or live very far away, then it may be possible to do an initial assessment over the telephone, if you can complete the questionnaires beforehand and return them to me beforehand.

Children & Adolescents

I am not a specialist in Child and Adolescent Psychiatry but I do assess adolescents who suffer from OCD, BDD or a Specific Phobia of Vomiting. For children under the age the 12 or for adolescents who have complex problems, I would initially recommend an assessment with Dr Isobel Heyman who sees NHS patients at their OCD clinic at the Maudsley Hospital in London. We also admit young people with severe OCD or BDD to our Adolescent unit who have not been able to make progress as an out-patient (both NHS and private). For this you would need to be referred by a Consultant Child and Adolescent Psychiatrist on the NHS or Dr Heyman.

For children with OCD (under the age of 12) and you are seeking a private appointment, I would recommend seeing Professor Peter Hill (17 Wimpole Street, London W1G 8GB, Telephone 020 7323 1535

What to expect

For an initial consultation, my secretary will email or send you some questionnaires to complete beforehand. This provides a comprehensive picture of your background and information on your problem. I will gain further information during our consultation and usually come to a diagnosis and some understanding of what is keeping your problem going. Occasionally I might recommend some investigations. This will then lead to a discussion of treatment options and the advantages and disadvantages of each. Usually there is a choice of cognitive behaviour therapy or medication or a combination of the two. In severe cases, there is the option of in-patient or day-patient care on a more intensive programme at The Priory North London. For therapy I will usually recommend a colleague as I have a limited private practice and I tend to be quite busy with in-patients or day-patients. Lastly I may provide or recommend some reading. I prefer to see an individual alone first and then if requested see the person’s partner or relatives. Our consultation will normally last about an hour to an hour and a quarter depending on the complexity of the problem. I will then provide a written summary of our assessment and recommendations which can be sent to your GP, Consultant or therapist with a copy to you. You may also withhold consent for a report to be sent to anyone.

Treatment programmes for OCD and BDD

The Priory Hospital North London offers intensive treatment programmes for adolescents or adults with Obsessive Compulsive Disorder (OCD) or Body Dysmorphic Disorder (BDD) as an in-patient or day-patient or occasional out-patients.

In-patient service

The hospital is located in a secluded part of Southgate, North London and set in several acres of private grounds. Individuals with OCD or BDD are normally admitted when they have failed to make progress as an out-patient or their handicap is too severe for out-patient care or for geographical reasons. Alternatively additional diagnoses such as depression or disordered eating may make out-patient treatment more complex. Others may be housebound, have a reversal of their sleep pattern or suffer from obsessional slowness so that attendance as an out-patient has become almost impossible. The programme is also suitable for adolescents. Other problems that our team specialise in include depression, a specific phobia of vomiting, PTSD, borderline personality disorder.

The emphasis is on individuals having a good psychological understanding of how your solutions have become their problem and the implications for overcoming their problems. Once patients are engaged, they are expected to conduct exposure or behavioural experiments at least three times a day and complete their homework diaries and weekly ratings of outcome. In addition, all staff may model exposure or participate in behavioural experiments to help test out a patient’s beliefs.

In-patients with OCD or BDD receive:

• Three individual sessions of CBT with their key therapist
• A specialist nurse therapist who supports your programme
• Group CBT sessions which are specific to OCD or BDD.
• A wide range of other groups for related problems such as depression, low self-esteem or social anxiety.
• Regular monitoring of progress which is used to audit outcome.

Medication is also reviewed. A SSRI or clomipramine or augmentation of a SRI may be offered. CBT may have a better outcome when combined with an SRI than CBT alone in those with moderate to severe impairment but patient’s make the decision whether to combine treatments.

Assessment

An initial assessment for suitability and treatment planning is offered with Dr David Veale and one of the therapy team. This gives an opportunity for a treatment plan to be jointly agreed with the patient prior to admission. If this not possible, then an initial assessment may be conducted as a domiciliary visit or over the telephone. The admission criteria can be provided on request. A formal assessment of response to treatment is completed on the ward within the first 2 weeks. This assessment is focused on the patient’s ability to engage in treatment.

Family therapy

Partners and relatives are encouraged to meet with the therapy team. The team will want to assess their involvement and they will be advised on how best to support a patient’s treatment.

Local involvement

We aim for patients to be able to travel (if necessary with a relative or friend) so they may return home on therapeutic leave as soon as possible at weekends to practice exposure in their own environment. NHS patients must have an identified local care coordinator who can discuss follow up arrangements and attend a CPA meeting with a family member. There should be follow up by a local cognitive behaviour therapist who would preferably act as the care co-coordinator. Alternative follow up arrangements including telephone consultations and day-patient or out-patient care can also be arranged.

Day-patient service

Patients may also be treated on a weekly programme of CBT with the same services as an in-patient.

Teaching

There are attachments for medical students from the Royal Free and University College Medical School. As an in-patent, you do not have to see a student but it is helpful for their training.

Self-help groups

We provide premises for self-help groups for OCD and BDD, which meet once a month at The Priory Hospital, North London. Groups are free of charge. For further information contact OCD Action at 020 7226 4000.

Obtaining NHS funding for treatment at The Priory

It is sometimes possible to obtain NHS funding for in-patient care at The Priory North London but it is difficult to initiate this yourself. Even when you follow the recommended route, it does not guarantee funding and if you are successful, it will not usually happen immediately. The recommended route is:

1. See your GP and seek a referral for an assessment to your local mental health services.
2. Your community mental health team will then assess you and will probably want to attempt treatment locally.
3. If local treatment is unsuccessful then and you have OCD or a related disorder they may consider referral to our NHS service at the Maudlsey Hospital (out-patient service) or at the Anxiety Disorders Residential Unit at the Bethlem Royal Hospital.
4. If you need in-patient care at The Priory North London and cannot be treated as an out-patient or at the residential unit at the Bethlem then your local team may seek funding from your local Primary Care Trust. This does necessarily mean that funding will be successful as there many competing priorities within the NHS and they have a limited budget. In some circumstances it is possible for adolescents or adults with OCD or BDD to obtain funding from the National Specialist Commissioning Team, for severe treatment refractory OCD and BDD. This is funded by the Department of Health (and not your PCT). Again you must be referred by your Community Mental Health Team.

In reality, only those with severe distress and handicap (for example at risk of suicide or being very disabled) obtain NHS funding for in-patient care. The best advice is to work with your local services and if necessary seek advice from the advocacy service at OCD Action.

Legal bit

My private work is conducted through my company, de Coverly Limited, Trojan House, 34 Arcadia Avenue, London N3 2JU. Registered in England & Wales, Registered Number: 7960388.