Appointment Guide and Booking Terms
We look forward to welcoming you to Midland Skin.
This guide explains how to prepare for your appointment, what your appointment does and does not include, how prescriptions, investigations and procedures are arranged, the fees that may apply, and the rules concerning payment, insurance, late arrival, cancellation and non-attendance.
The guide also explains how advice is provided after an appointment, how clinical records and additional work are handled, and the standards that apply when using our services. Please read it carefully before booking and retain it for future reference.
How booking works
Step 1
Choose your initial assessment consultation
- Choose the appointment that best suits your needs from the list below. Every treatment starts with an initial assessment. Some minor procedures may be available on the same day where arranged in advance.
Step 2
Book and prepay your initial assessment
- All services are offered by prepayment.
Step 3
Attend your initial assessment
- Your clinician assesses your condition and discusses what happens next — treatment, tests, a prescription, or reassurance that nothing needs doing.
Step 4
Book your treatment, if recommended
- You will receive a care plan if a procedure has been recommended, which outlines the fees. Treatment is booked as a separate appointment and requires prepayment. The assessment fee is not deducted from the cost of treatment.
Step 5
Review consultation
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A review consultation checks your progress, goes through any results and decides whether treatment should be continued, changed or stopped. Review consultations are listed under “Seen us before” below.
Which appointment do I need?
Initial assessment appointment types
Every treatment starts with an initial assessment. We offer several types of initial assessment depending on your concern. Medical advice is only provided during a booked consultation:
- Initial dermatology assessment – for one concern affecting the skin or nails, including a rash or skin lesion. If you have several separate problems, please tell us when booking.
- Extended initial dermatology assessment – for eczema, psoriasis, complex or long-standing skin problems or second opinions.
- Children’s dermatology assessment – for skin, hair or nail problems in children and young people.
- Mole check or mole assessment – for review of one or more moles, or a full skin check where this has been booked in advance.
- Hair loss or scalp assessment – for hair thinning, hair loss, scalp inflammation and related concerns.
- Acne assessment – for acne diagnosis, management and treatment planning.
- Acne scar assessment – for evaluation of established acne scarring. If active acne is present, an acne consultation will usually be required first.
- Scar assessment – for surgical, injury and burn scars, keloid and hypertrophic scars (including keloids caused by acne), chickenpox scars, stretch marks, scars from self-harm and children's scars.
- Specialist skin surgery assessment – required before planned specialist surgery for a cyst, lipoma, skin lesion, suspected skin cancer or another surgical concern.
- Oculoplastic assessment - required for assessment of surgical eyelid concerns
- Laser assessment – for concerns treated with lasers or energy-based devices e.g facial redness and thread veins, port wine stains, BBL and IPL, resurfacing for lines, sun damage or texture, laser removal of leisions or moles.
- Sofwave assessment – with an aesthetic practitioner, for Sofwave skin tightening.
- Online consultations - for selected concerns.
Important information before you book
- What your consultation fee covers - The consultation fee covers reserved clinician time, assessment and independent professional advice. The outcome may be a treatment recommendation, a different option, further investigation, postponement or no treatment.
- One concern per appointment - Each appointment is booked for a specific concern and a fixed amount of time. If you have additional or unrelated concerns, please let us know in advance as these may require a longer an additional consultation.
- Questions after your appointment - After your appointment, our administrative team can help with practical matters. Where a question requires further clinical assessment, consideration of new information or a change to the agreed plan, a review appointment is usually required.
- Separate charges - Review appointments, investigations, medication, procedures and other requested administrative or clinical work are charged separately.
- Not a deposit - The consultation fee is not a deposit and is not deducted from a later treatment fee. You are under no obligation to proceed with treatment.
- Booking for a specific treatment - Booking an assessment for a particular medicine, procedure or treatment means that the clinician will assess whether it is suitable as part of their broader assessment. It does not reserve or guarantee that treatment.
- Cancellations and changes - Appointments must be cancelled or changed by 10:00 am on the preceding working day to qualify for a refund or transfer of the payment.
- Private medical insurance - Patients using private medical insurance remain responsible for authorisation, excesses, shortfalls and charges not paid by their insurer.
- Photographs and chaperones - Clinical photographs are a mandatory part of care, and a trained medical assistant is present throughout consultations to support the clinician and act as chaperone.
- Not an emergency service - Midland Skin is not an emergency or out-of-hours medical service.
Accepting the booking terms
Before an appointment is confirmed, you will be asked to confirm that you have read and accepted this Appointment Guide, our fees and the applicable Terms and Conditions. If another person books or pays on your behalf, they must ensure that you have received and understood the booking information. The patient and the person responsible for payment must not assume that a family member, insurer, employer or other third party will settle charges unless this has been confirmed in writing.
What your appointment includes
The purpose of an initial assessment
An initial assessment is an exploratory, time-limited consultation for the concern booked. The clinician will usually discuss your history, examine the relevant area, provide a specialist opinion where possible, consider whether investigations are needed and explain suitable next steps.
The appointment provides a defined period of clinical assessment and advice. Some concerns can be resolved at the first visit, while others require investigations, monitoring or a review before a final diagnosis or treatment plan can be confirmed.
Consultation fees and treatment fees
The consultation and any subsequent treatment are separate, stand alone professional services and are charged separately.
The consultation fee covers the clinician’s reserved time, examination, assessment and independent professional advice. Its purpose is to understand your concerns and goals, consider the diagnosis and assess which options are appropriate and likely to benefit you while also addressing limitations, risks and alternatives.
The consultation fee is not a deposit and is not deducted from any subsequent treatment fee. Keeping the consultation and treatment fees separate means that you are under no obligation to proceed with treatment. You may take time to consider the advice, decide not to proceed, decide that no treatment is the right option for you or seek another opinion.
We welcome patients who have researched their options or have a particular treatment in mind. Your concerns, preferences and desired outcome are an important part of the consultation. Booking an assessment for a particular treatment means that the clinician will assess your suitability for it; it does not guarantee that it will be recommended or provided.
Following assessment, the clinician may advise that:
- the treatment you are considering is suitable;
- a different treatment may better meet your needs;
- further assessment, investigation or preparation is required;
- treatment should be postponed;
- no treatment is necessary or advisable; or
- another service or provider would be more appropriate.
Treatment decisions are made through discussion between you and the clinician. You are free to accept or decline the options discussed. The clinician must also exercise independent professional judgement and will not provide treatment that they consider unsuitable, unsafe or unlikely to offer a reasonable benefit.
The consultation fee remains payable for the assessment and professional advice provided, whether or not a final diagnosis can be confirmed at the first appointment and whether or not treatment is recommended, booked or undertaken.
If you decide not to proceed with an examination or another part of the assessment needed to provide safe advice, the clinician will explain how this limits what can be concluded. If you leave before the appointment has finished, the fee remains payable for the reserved appointment time and professional assessment provided.
Discussing more than one concern
Your appointment time is reserved for the concern you described when booking. Please tell us before booking if you would like to discuss more than one concern. We can advise whether a longer appointment or separate appointments are required. Each appointment carries its own fee.
Adding another concern to your registration form, mentioning it during the appointment or sending it by email does not automatically allow sufficient time for it to be assessed during the same appointment. The clinician will decide what can be considered properly and safely within the time available. Concerns that cannot be assessed properly within the available time will require another appointment.
Further appointments may be required
It is not always possible to address everything in one visit, especially where a concern is complex, the diagnosis is uncertain or more than one problem has been raised. Accurate diagnosis and safe treatment may require investigations, monitoring, a treatment trial, expert input or one or more review appointments.
Please take the likely cost of review appointments into account when choosing private medical care. We cannot reliably confirm before the initial assessment whether further appointments will be needed.
Fees and payment
Midland Skin is a private, pay-as-you-go medical practice. An indication of our fees for common services is available on our fees page.
Separate fees may apply for:
- initial assessments and review consultations;
- blood tests, biopsies, skin swabs, scans, X-rays and other investigations;
- steroid injections, laser treatment, surgery and other procedures;
- medicines and pharmacy charges;
- repeat prescriptions;
- review of substantial records outside the standard appointment time;
- additional letters, reports, forms or correspondence; and
- other clinical or administrative work requested by you.
Additional work requested after an appointment
A copy of the standard consultation note is included in the consultation service. Bespoke letters, insurer forms, employer or university letters, legal reports, retrospective forms, detailed summaries, review of extensive records, repeated replacement documents and non-standard correspondence are separate services.
Where additional work carries a fee, the work will not begin until the scope and fee have been confirmed and payment has been received or another arrangement has been agreed. Payment for a letter or report is for the clinician’s time and independent opinion; it does not guarantee wording or a conclusion requested by the patient or a third party.
Outstanding balances
Fees become due when the booked appointment or requested service has been provided. Please raise any billing query promptly so that it can be reviewed and explained.
Outstanding balances must be paid before further appointments or additional administrative work can be arranged.
We do not charge for correcting a clinic administrative error or considering a genuine request to correct inaccurate personal data. Any statutory rights remain unaffected.
Private medical insurance
Services available through insurance
We offer services under private medical insurance for skin lesions requiring diagnosis and for suspected or confirmed skin cancers only. We do not offer hair loss or trichology services, acne assessment or treatment, scar assessment or therapy, laser treatment, cosmetic procedures, routine adult medical dermatology consultations such as general rash assessments, or children’s services under private medical insurance.
If you are unsure whether your concern is suitable for an insured skin lesion or suspected skin cancer appointment, please see your GP or contact your insurer before booking.
Authorisation and policy cover
It is your responsibility to contact your insurer before every appointment and confirm that your policy is current, the clinician and facility are recognised, the condition is covered, the correct authorisation has been issued, and any required GP referral is in place.
Insured appointments are available only to patients with an active policy from Bupa, AXA Health, Vitality or WPA. We do not work with any other private medical insurers.
Insurer authorisation is not a guarantee of payment. You remain personally responsible for any excess, shortfall, benefit limit, excluded service, invalid authorisation, insurance policy misinterpretation or amount your insurer declines to pay. Further appointments cannot be booked while an insured or self-funded balance remains overdue.
If valid insurance details have not been supplied by the required time, the appointment may be cancelled or converted to self-funding. Any applicable late-cancellation charge remains payable by you rather than your insurer.
Accurate information and coding
You must not provide false or misleading information about your symptoms, referral, diagnosis or insurance cover. Deliberately doing so may result in cancellation, personal liability for all fees, withdrawal of clinic services and referral to the insurer or another appropriate organisation.
Midland Skin will not alter symptoms, diagnoses, procedure descriptions, billing codes, dates or clinical records to obtain insurance cover. We will provide accurate information only. If the insurer does not cover the service on that basis, you must either proceed as a self-funding patient or cancel within the applicable cancellation period.
Changing from self-funding to insured care
If you book or receive a service as a self-funding patient, that service will remain self-funded. We cannot retrospectively convert the appointment or treatment to an insured service, submit a retrospective claim to your insurer, or refund fees on the expectation that your insurer may pay at a later date.
You should proceed on a self-funding basis only if you are prepared to remain responsible for the full cost. Any reimbursement you later seek from an insurer or other third party must be arranged directly by you and does not affect the amount payable to Midland Skin.
If you wish to use private medical insurance for future care, you must tell us before booking and obtain any required authorisation in advance. Insurance cannot be applied retrospectively to services already booked or provided on a self-funding basis.
Cancelling or changing your appointment
Cancellation deadline
We must receive notice by 10:00 am on the working day before your appointment if you wish to cancel or change it and receive a refund or transfer of your deposit or prepayment.
A working day means Monday to Friday, excluding bank holidays. The deadline for a Monday appointment will normally be 10:00 am on the preceding Friday. If that Friday is a bank holiday, the deadline will fall on the preceding working day.
A cancellation or change takes effect when it is received through the contact method stated in your booking confirmation. You are responsible for checking that your request has been sent to the correct address or number.
Late cancellation and non-attendance
If notice is received after the deadline, or if you do not attend, the deposit or prepayment is non-refundable, any unpaid appointment fee remains payable and a new payment will be required before another appointment can be booked. This also applies to insured appointments, as insurers do not normally pay late-cancellation or non-attendance charges.
Consultant time, clinical staff and facilities are reserved specifically for each patient. After the deadline, there is usually insufficient time to offer the appointment to another patient, while the clinic continues to incur the cost of providing the reserved service. The reason for a late cancellation does not normally alter those costs, so the policy is applied consistently. The clinic does not routinely waive the charge because of work commitments, travel disruption, illness, childcare difficulties or other personal circumstances.
Reminders and contact details
Appointment reminders are provided as a courtesy. Failure to receive a text, email or telephone reminder does not remove your responsibility to attend or cancel within the required timeframe. You are responsible for providing accurate contact details and checking booking confirmations, including junk or spam folders.
Remote appointments
A remote appointment may be treated as missed if it cannot proceed because you are unavailable, cannot be contacted, do not have a suitable connection or private setting, or have not supplied photographs or information requested in advance. If the failure is caused by Midland Skin’s systems, we will offer a replacement appointment or refund as appropriate.
Repeated changes
Where sufficient notice is given, a payment may be transferred to a replacement appointment subject to the booking terms. Repeated changes may require the original booking to be cancelled and a new payment made. We will confirm this before processing the further change.
If Midland Skin cancels
If Midland Skin cancels your appointment, you will be offered a replacement appointment or a refund of the amount paid for the cancelled service. Your statutory rights are unaffected.
Preparing for your appointment
Registration and medical information
You will be asked to complete a registration form. Please complete it fully and accurately, as it forms part of your medical record.
Provide details of current and previous medical conditions, allergies, current and recent medicines, previous treatment, relevant pregnancy or contraception information and your GP. Please bring an up-to-date medication list and any relevant records.
Incomplete, inaccurate or withheld information may prevent the clinician from completing a safe assessment or prescribing treatment. If an appointment cannot be completed because required information was not supplied despite being requested, the appointment fee remains payable.
Clothing, make-up and remote-consultation photographs
It may be necessary to examine a wider area of skin. Please wear clothing that can be removed easily where appropriate. If your face is being assessed or treated, please attend without make-up or arrive in good time to remove any make-up before your appointment time.
For a video or telephone consultation, clear and focused photographs must be supplied when requested. Remote advice may not be possible if the images are unclear, incomplete or do not show the relevant area adequately.
Sending information before your appointment
Reports, photographs, notes, correspondence from other doctors and blood results sent before the appointment will be filed in your record so they are available to the clinician during your appointment. They are normally reviewed during the booked consultation and are not reviewed in advance.
Sending information does not create an obligation for the clinician to provide advice before the appointment. Information sent after the appointment may require a paid review if it changes the history, raises a new question or requires the clinician to reconsider the assessment or plan.
If you submit more than one standard A4 report or letter, or other substantial material, please tell us before booking. Additional review time and a further fee may be required.
Records from other providers
Please bring relevant reports and results obtained from other clinics, hospitals or healthcare professionals. If you have substantial materials please advise the clinic in advance so additional review time can be purchased.
If you ask Midland Skin to obtain records on your behalf, an administrative fee applies and you must complete any necessary consent or data-release process. We cannot guarantee that another provider will release information or that it will arrive before your appointment. Some organisations may take 28 days or longer to respond. If important records are unavailable, the clinician may be unable to complete the assessment or recommend treatment safely, and a further appointment may be required.
Access, interpreters and children
Access to the clinic
Please review our Access Statement before booking. Our clinical rooms are accessed by stairs and are not suitable for patients who cannot climb stairs independently.
Please contact us before booking if you have mobility, sensory, communication or other access requirements. We will discuss whether a reasonable adjustment, remote consultation or alternative service may be appropriate. Not every assessment or procedure can be provided remotely.
Professional interpreters
If you cannot communicate sufficiently in English for a medical consultation, please inform us when booking. Where an interpreter is required for safe and accurate communication, a suitably qualified professional interpreter will be arranged and an additional fee will apply.
Relatives, friends and children cannot normally act as medical interpreters. They may not understand complex medical terminology, may unintentionally omit or alter information, and may make it inappropriate to discuss confidential or sensitive matters. If you have not told us in advance that an interpreter is required and the consultation cannot safely proceed, the appointment may need to be rebooked and the fee may remain payable.
Children attending the clinic
The clinic accepts patients under the age of 18 where an appropriate service has been booked. Unless the appointment is for the child, please do not bring children with you. We do not have childcare facilities and clinic staff cannot supervise children.
If an appointment cannot proceed because an accompanying child cannot be safely supervised, the appointment may need to be rebooked at your expense.
Attending your appointment
Arriving on time
Please arrive in time to complete any required registration or pre-appointment checks. Appointments run to a fixed schedule.
If you arrive late, the clinician may have less time available and the appointment will still finish at its scheduled end time, as the next appointment booked after you will still need to be commenced on time. The full fee remains payable.
If you arrive more than 10 minutes late, the clinician will usually be unable to see you without delaying the patient booked after you. The appointment will be treated as missed, the fee or prepayment will not be refunded and a new appointment must be booked and paid for.
Please allow sufficient time for traffic, parking and finding the clinic.
How your appointment is delivered
Appointments at Midland Skin are delivered by a clinical team rather than by the doctor working alone.
A trained medical assistant may meet you before the clinician. The medical assistant may confirm your identity and registration information, check that required forms have been completed, confirm relevant medicines or allergies, take the clinical photographs required for your medical record, and prepare you and the clinical room for examination or treatment.
This preparation is part of Midland Skin’s normal appointment pathway. It does not replace the clinician’s assessment. The clinician remains responsible for diagnosis, clinical decisions, prescribing and the management plan.
Bringing someone with you
You may bring one partner, relative or friend for support. They must be present at the beginning of the appointment. We cannot extend the appointment or repeat substantial parts of the consultation because an accompanying person arrives late.
The clinician may ask to speak to you alone for part of the consultation where this is necessary for confidentiality, safeguarding or an accurate medical assessment. An accompanying person must not record, interrupt or prevent the consultation from proceeding.
Medical assistants and chaperones
A trained medical assistant is present throughout consultations, examinations and procedures at Midland Skin. The medical assistant supports the clinician, assists with the safe and efficient delivery of care and acts as the clinic’s trained chaperone.
Their role includes assisting during the consultation, examination or procedure; supporting your comfort and dignity; helping with equipment, clinical photography and practical aspects of care; ensuring clinic procedures are followed; and acting as an impartial witness.
Medical assistants are members of the Midland Skin clinical team and are required to maintain patient confidentiality. A partner, relative or friend may attend for support where appropriate, but cannot replace the clinic’s medical assistant or chaperone.
The medical assistant’s presence is a standard part of how services are provided at Midland Skin and is a condition of care. Consultations, examinations and procedures are not carried out with the clinician and patient alone. If you do not accept this arrangement, Midland Skin will not be able to provide the appointment and you should cancel your appointment in the cancellation period. If you decline the medical assistant’s presence after attending, the appointment may be unable to proceed and the fee will remain payable because the clinical team and appointment time have been reserved.
Our Chaperone Policy is available on request.
When an appointment cannot continue
The clinician may stop or decline to continue an appointment where safe assessment is not possible, required information is withheld, reasonable clinical requirements are refused, or behaviour is abusive, threatening, intimidating or persistently disruptive.
Where the appointment cannot be completed because of the patient’s or accompanying person’s conduct or failure to follow a requirement explained in advance, the fee remains payable. This does not apply where the appointment cannot proceed because of a failure by Midland Skin.
What to expect from your consultation
How medical advice is provided
We only provide medical advice during a booked face-to-face or remote appointment, or through a formal clinical process specifically arranged by the clinician. We do not provide consultations through routine email correspondence, social media messages or photographs sent without request. Please only submit clinical photographs when we have asked you to do so and through the method specified by the clinic.
Administrative staff cannot diagnose a condition, interpret results, advise whether a symptom is serious, change medication, override a clinician’s decision or promise that a particular prescription or procedure will be provided.
Realistic expectations
We understand that skin and hair concerns can be distressing. Your concerns, goals and treatment preferences are an important part of the consultation. The clinician will consider them alongside the diagnosis, available evidence, likely benefit, risks, limitations and alternatives.
A consultation or treatment cannot guarantee a diagnosis, cure or particular result. Outcomes vary, improvement may be partial or temporary, and some conditions are long term, recurrent or difficult to treat.
For some concerns there may be limited or no reliable evidence for treatment, or the option you are considering may not be one we provide. The clinician may advise that no treatment is required, that the likely benefit does not justify the risk, that treatment should be delayed, that psychological or other medical support should be considered first, or that another provider would be more appropriate.
Your choices after the consultation
You are free to accept or decline any recommendation and are under no obligation to proceed with treatment at Midland Skin. You may take time to consider the advice or seek a second opinion from another appropriately qualified clinician.
If you would like the clinician to reconsider the assessment or plan, new and relevant information will be considered. Where further clinical discussion or reassessment is required, a review appointment may be needed.
Clinical photographs and consultation technology
Clinical photographs
Clinical photographs are taken as a standard and mandatory part of care at Midland Skin.
They are used to document the condition being assessed, support diagnosis and treatment planning, record the area before treatment and monitor change over time. The photographs form part of your confidential medical record and provide an accurate visual record of the condition at the time of your appointment.
A trained medical assistant will usually take the photographs before you see the clinician. Further photographs, and occasionally video, may be taken during the consultation or treatment where required.
Photographs are limited to the relevant area wherever possible and are stored securely with your medical records. They are not used for advertising, social media, teaching or publication without separate and specific permission.
By booking an appointment, you confirm that you understand that clinical photography is a required part of the service. If you do not agree to clinical photographs being taken for your medical record, Midland Skin will not be able to provide the consultation, procedure or treatment.
If you refuse clinical photography after attending, the appointment may be unable to proceed and the fee will remain payable because this requirement was explained before booking and the clinical team and appointment time have been reserved.
AI-assisted clinical note-taking
Midland Skin uses Heidi, a secure clinical note-taking tool, to assist with documenting consultations so that the clinician can focus on the patient. The software may create a real-time transcript or draft note. The clinician remains responsible for reviewing and approving the final medical record.
Audio is not retained by Midland Skin as part of the medical record. Under our current service arrangements, consultation data is processed and stored in the UK with encryption and access controls. Access is limited to the Midland Skin clinical team and Heidi acting as our contracted processor. The information is used to support your care and clinical record, not for Midland Skin marketing or unrelated product training.
The use of clinical note-taking software is part of our standard consultation process. Please raise any concern before the appointment so that we can explain the process and confirm whether an alternative documentation arrangement is available. If you do not agree to the standard documentation process and a safe alternative cannot reasonably be provided, we may be unable to offer the consultation.
Investigations and results
Why tests may be needed
Investigations may be required to assist diagnosis, assess whether treatment is suitable or monitor treatment safety. These may include blood tests, skin swabs, biopsies, scans or X-rays. They may be carried out on the same day or at a separate appointment.
Investigation fees are additional to the consultation fee. Current prices are available on our fees page. The clinician may not be able to confirm what is required until you have been assessed.
Receiving and discussing results
Results will be communicated by the method the clinician considers appropriate. A brief written notification may be provided where no further discussion is required.
Where a result requires detailed interpretation, further assessment, a treatment decision, discussion of options or consideration alongside new symptoms or information, a review appointment will be required. The clinic will explain when this is necessary and any applicable fee.
You are responsible for ensuring that your contact details remain accurate and for attending any review requested. Important or urgent results will be managed according to clinical need, but Midland Skin is not responsible for delays caused by incorrect contact details or failure to respond to contact attempts.
Prescriptions and medications
New prescriptions
Medication is prescribed only following an appropriate clinical assessment and where the clinician considers it safe and suitable at that time.
Please do not assume that a particular medicine will be prescribed because you requested it, previously took it, were told about it by another person, or received a recommendation from another clinician, online provider or overseas clinic.
The clinician may require examination, medical records, blood tests, pregnancy testing or other monitoring before prescribing. The consultation fee remains payable if a prescription is not issued.
Medicines started elsewhere
Before Midland Skin can take over prescribing for a medicine started or recommended elsewhere, the clinician must carry out an independent assessment and be satisfied that the diagnosis is sufficiently established, the medicine remains appropriate, relevant records are available and any required monitoring can be completed safely. Where these requirements cannot be met, you may be advised to continue treatment with the original prescriber.
Receiving and paying for medication
Most private prescriptions are sent to an independent online pharmacy, which will contact you with the price and arrange delivery. You pay the pharmacy directly.
Private medicines are not charged at NHS prescription rates and NHS exemptions or prepayment certificates do not apply. Some bespoke medicines are ordered through the clinic and may require payment in advance.
Duration of prescriptions
The quantity of medication prescribed is intended to last you until the next required clinical assessment. At your review appointment, your clinician is professionally obliged to reassess your condition, response to treatment, medication use, side effects and review any monitoring requirements before deciding whether the medication should be continued, adjusted or stopped.
Interim prescriptions
In exceptional circumstances, the clinic may consider issuing a short interim supply to cover a limited and unavoidable gap between the end of the medication already supplied and an arranged review appointment.
An interim prescription is not a routine continuation of treatment and cannot be used to replace, postpone or avoid an agreed review appointment.
More information is available on our interim prescriptions page.
Requests are normally assessed within five working days. Where approved, the prescription is usually raised or dispatched within five working days after payment and receipt of any required information.
A request may be declined where a clinical review, blood test or other monitoring is needed. Please request medication in good time. Urgent or last-minute repeat prescriptions cannot be guaranteed, and interruption caused by a late request is not the responsibility of the clinic.
High-risk medications and blood monitoring
Monitoring requirements
Examples of high-risk medications include isotretinoin, methotrexate, ciclosporin, JAK inhibitors and biologic treatments. These medicines require structured clinical review and blood monitoring.
Treatment will not begin or continue until all required blood tests, pregnancy-prevention requirements where applicable, monitoring appointments and follow-up reviews have been booked, paid for and completed within the required timeframe.
Monitoring for high-risk medication must be arranged through Midland Skin unless the clinician has expressly agreed an alternative in advance. We do not routinely accept GP-arranged monitoring because tests may be incomplete, results may not reach us or may arrive too late for safe prescribing.
If you cannot commit to the required monitoring, we will not initiate or continue treatment. High-risk medication is prescribed only at a booked consultation.
Other blood tests
Where the clinician has agreed that a routine blood test unrelated to high-risk medication monitoring may be performed elsewhere, you must arrange it in sufficient time, normally allowing at least one to two weeks, and ensure full and required results are available before the relevant appointment. A further appointment may be required if the result is incomplete or delayed.
Annual reviews and existing-patient status
Under Midland Skin’s prescribing policy, patients normally require a clinical review at least once every 12 months before further prescriptions can be issued. Some medicines and conditions require more frequent review.
If you have not attended Midland Skin for more than 12 months, you will lose your existing patient status, and normally be booked for a new initial assessment at the applicable fee because your health, diagnosis and treatment needs may have changed.
Treatments and procedures
Deciding whether treatment is suitable
We welcome patients who have researched a procedure or have a particular treatment in mind. Booking a surgical, laser, injectable or energy-based assessment means that the clinician will assess whether that treatment is suitable for you; it does not guarantee that it will be recommended or performed.
Your concerns, preferences and goals will be considered alongside the diagnosis, medical history, alternatives, likely benefit, material risks and your ability to follow the required preparation and aftercare. The outcome may be the treatment you are considering, a different option, further assessment, postponement or no treatment.
The decision will be discussed with you. You are free to accept or decline the recommendation, and the clinician will only provide treatment that they consider appropriate, safe and likely to offer a reasonable benefit.
Same-day procedures
In selected cases, a same-day procedure may be possible where arranged in advance. It cannot be guaranteed and may be deferred if the diagnosis is uncertain, consent requires more time, records or investigations are needed, the procedure is more complex than expected or there is insufficient clinical capacity. Full service commitments are provided on the linked page.
Procedure fees
Procedure fees are additional to the consultation fee. The final price may depend on the number, size, location or complexity of the areas treated and is provided only after assessment. Our price schedule is available here for indicative prices.
Procedures for insured patients
Insured patients normally require separate pre-authorisation before treatment, so same-day procedures are not usually possible. The consultation and procedure may also need to take place at different facilities depending on insurer requirements.
Aftercare and complications
The aftercare included with a procedure will be explained in the procedure information and booking confirmation. This normally includes written aftercare instructions and clinical triage where you report a possible complication. Some procedures include a planned review, while others do not.
Possible complications will be clinically triaged and managed according to need. Additional appointments may carry a fee where they involve further assessment, treatment, concerns unrelated to the procedure or review beyond the aftercare expressly included in the procedure fee. Urgent concerns may require NHS urgent or emergency care rather than waiting for the clinic to respond.
Review appointments and advice between visits
When a review may be needed
A number of patients attending for an initial assessment will subsequently require one or more review appointments. Many skin and hair conditions require ongoing assessment. A review may be required to assess progress, discuss a result, adjust medication, monitor side effects, consider a new symptom, complete an assessment or plan a procedure.
A review may be needed within days, weeks or months. Reviews are separately chargeable, and we cannot reliably predict before the initial assessment how many will be required.
Administrative questions
A brief administrative query may be answered without a clinical appointment. This includes confirming an appointment time, checking whether a document has been received, confirming where an approved prescription was sent or correcting a clinic administrative error.
Questions requiring clinical judgement
Some questions arising after an appointment require further clinical judgement and cannot be answered safely as an administrative email. A review appointment will normally be required for:
- new symptoms, changes in the condition or a new concern;
- interpretation of photographs, results or information received after the appointment;
- requests to start, stop, change or extend treatment;
- medication side effects or questions about whether treatment remains suitable;
- requests for a new prescription or reconsideration of a prescribing decision;
- clinical questions raised after the consultation that were not discussed during the appointment;
- further explanation where this requires the clinician to review the history or reassess the advice; or
- a request to reconsider the assessment or plan.
A brief clarification may sometimes be provided without another appointment where the clinician considers this appropriate. Where a further assessment or treatment decision is required, the clinic will explain that a review appointment is needed and confirm the applicable fee.
Please refer to the review appointments for further details.
Medication review during procedure appointments
If you are attending for a procedure, injectable or laser treatment and also require a dermatology assessment or medication review for other ongoing care, please contact the office beforehand to add a review consultation. It cannot be added informally during the procedure appointment without additional time and a separate fee.
Letters, records and response times
Your clinic note
For medical consultations, it is our standard practice to send a copy of the clinical note. This is a contemporaneous summary of the history provided, observations made, assessment and recommendations. It is not intended to be a word-for-word transcript of every sentence spoken.
Clinic notes are usually sent by secure email within seven days. A separate password may be sent for security. If you do not provide an email address, the note may be sent by post. Please contact us if it has not arrived within seven working days.
Communication with your GP
We encourage patients to consent to a copy being sent to their GP because private diagnoses, prescriptions, investigations and treatments may affect wider healthcare. Your care may be compromised if your GP is not informed. Where consent and accurate GP details have been provided, the clinic note will normally be sent to your GP within seven working days.
Correcting factual errors
Clinical notes are formal contemporaneous medical records. They will not be retrospectively rewritten or deleted solely because there is disagreement with a clinical opinion.
If you believe there is a factual inaccuracy, please tell us as soon as possible, preferably within five working days. We will consider the request and, where appropriate, make a dated correction or addendum while preserving the original entry and audit trail. Later requests will still be considered in accordance with applicable data-protection rights.
Clinical records and reports must reflect the information available at the time and the clinician’s independent findings and opinion. They cannot be amended to support wording or a conclusion that is not supported by the clinical record.
Additional letters and reports
Additional reports or letters for an employer, university, insurer, solicitor or another organisation are separate services. Please contact us in advance to discuss what is required. Fees are available in our fee schedule.
We may decline a request that falls outside the clinician’s expertise, requires an unsupported opinion or is disproportionate to the available information. Payment is for the time spent preparing an independent report and does not guarantee a conclusion requested by the patient or recipient.
Response times
Administrative enquiries are normally answered within three working days. A response may take longer where clinical input or record review is required, the clinician is not working, information is awaited from another provider or the request is complex.
Where a request requires assessment or clinical advice, you will be asked to book a review consultation. Please arrange appointments, blood tests, monitoring and prescriptions in good time. Urgent non-emergency appointments and last-minute prescribing cannot be guaranteed.
Urgent and emergency care
Midland Skin is not an emergency or out-of-hours medical service. Emails, website messages and telephone messages are not continuously monitored and must not be used for urgent medical problems.
For urgent help, contact your GP, NHS 111, an urgent treatment centre or Accident and Emergency. Call 999 where there is an immediate risk to life or serious harm. Do not delay seeking urgent care while waiting for a response from Midland Skin.
Plan review appointments, monitoring and blood tests in good time to avoid interruption to treatment. The clinic cannot accept responsibility for interruption caused by a patient failing to arrange required care or request medication within the stated timescales.
Feedback, conduct and clinic policies
Feedback and complaints
We welcome feedback, positive and negative, and are keen to hear any suggestions you may have. You can speak to a member of staff or contact us in writing.
You can find out more about making a complaint here and review our Complaints Policy here.
Midland Skin is regulated by the Care Quality Commission. You can also provide feedback to the CQC.
Standards of behaviour
Patients, visitors and staff are expected to communicate respectfully. Abusive, threatening, discriminatory, intimidating, dishonest or persistently disruptive behaviour will not be accepted.
Serious or repeated breaches may result in termination of a call, removal from the premises, cancellation of an appointment, limits on methods of contact, withdrawal of non-emergency clinic services, removal from the clinic register or referral to the police or another appropriate organisation. Where clinically appropriate, reasonable notice and information about alternative care will be provided.
Please review our Zero Tolerance Policy.
Terms and conditions
This Appointment Guide should be read together with Midland Skin’s full Terms and Conditions. Where those terms contain more detailed provisions, those provisions will apply.
Privacy policy
Please review our Privacy Policy.
What Our Clients Say
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