The below are some frequently asked questions regarding what to expect from an assessment at The Giaroli Centre and what to expect from any ongoing treatment. Further details can be discussed during a phone call with our Referral Manager to discuss your enquiry, please visit www.dr-giaroli.org/enquiries to discuss your enquiry and to arrange a first appointment.

 

What does The Giaroli Centre specialise in?

 

Our centre specialises in neurodevelopmental psychiatric conditions (such as ADHD and Autism) in children, adolescents and adults. Our team are a mixture of medical doctors and other clinicians (see here for further information); whom may suggest medication as part of a patient's ongoing treatment plan. We centre does not offer ongoing talking-based therapies or educational assessments as part of our psychiatric assessments.


 

What does the doctor assess for?

 

Our clinicians assess for whether there is the presence of any psychiatric condition(s) in a patient, and to provide an outline of a suggested treatment plan, which may or may not involve medication. Most assessments are completed over two separate appointments, however depending on a patient's prior history provided, and the case's complexity, an assessment may take place over one appointment, two appointments, or multiple appointments. Under NICE guidelines, for formal assessments of Autism, several different clinicians of different specialities may be involved in providing an assessment over several appointments, involving the diagnostic tools of ADI-R, 3di or ADOS-2. Please speak to us during your initial phone call to discuss your enquiry so that we may provide more relevant information in your particular case.

 

An assessment may lead to one or more psychiatric condition(s) potentially being diagnosed, or potentially no psychiatric condition being diagnosed if in the clinician's opinion there is insufficient evidence of any psychiatric condition(s) being present in the patient at the current point in time.

Are there any differences between each clinician/doctor?

Please see here for the team pages for further information on your particular clinician. Our clinicians are able to tailor each assessment and treatment approach depending on the particular clinical circumstances of each patient. Each clinician/doctor in our team has their own different approach to assessment and ongoing treatment, and that therefore one patient's experience with one clinician of our team may differ from the steps and stages of your child's assessment process with another clinician from our team. Similarly, our clinicians see many patients from within the same family, and that the same clinician may approach the assessment (or ongoing treatment) in a different manner for one patient from the family to another patient (e.g. a sibling) within the same family. 

Will I need to change clinician/doctor when I turn 18 years old?

All of our clinicians are able to provide assessments and treatment for different particular age bands of patients, depending on the clinician's level of expertise and qualifications. For example, a Consultant Child & Adolescent Psychiatrist, may treat adolescents up until the age of 18, but may sometimes not be able to continue providing treatment to a patient after the patient turns 18 years of age, as from 18 years of age and above, is where the expertise of a Consultant (Adult) Psychiatrist generally starts. However, this also depends on the particular clinician's expertise and any additional training they may have undergone. Therefore, please ask the clinician if your child is approaching 18 years of age regarding the clinician's expertise and ability to continue providing treatment to your child after your child turns 18 years of age. 

Our centre aims to be able to provide all adolescents continuity of care for when they turn 18 years of age, hence if the current clinician that your child is with at our centre, is unfortunately unable to continue treatment for your child once your child turns 18, then we will endeavour to arrange a transfer of care for your child to another clinician within our team whom is specifically for adult patients. In such cases, the two clinicians will perform a handover, so that the new clinician is aware of your child's needs. Please visit here to learn more about the age ranges that they provide assessments and treatment for.

What type of clinician can diagnose ADHD?

Our centre follows NICE guidelines (the regulatory guidelines in the UK for healthcare), ADHD can be diagnosed by a Psychiatrist, Paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD. Our centre specialises in the treatment of neurodevelopmental conditions, such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism. All of the clinicians at our centre can diagnose and treat ADHD. Please ensure that you are aware of the particular speciality of any clinician whom you have booked an assessment with, to read more about our team of clinicians, their specialities and clinical backgrounds, visit our dedicated page here.

 

Might I be re-assigned to a different clinician/doctor?


Please be kindly advised that there may be circumstances outside of The Giaroli Centre's control whereby the clinician whom you have booked the assessment appointments with may potentially be no longer able to offer the assessment appointment(s) on the same day/time as you had originally booked, or potentially be no longer able to offer the same modality (face to face or online) or potentially may not be able to offer the assessment appointment(s) at all.

Were this to occur, you would be entitled to a full refund of any monies pre-paid. The Giaroli Centre would also make every reasonable effort to ensure that the assessment appointment(s) can be re-arranged with another suitable clinician within our centre. Please be kindly advised that it may not necessarily be possible to accommodate your preferred date, time, clinician, or modality (face-to-face or online) were this event to occur.

Alternatively, our office may provide you with contact details for other clinicians at other clinics whom you would be welcome to contact to arrange an assessment (or ongoing treatment) with. As our centre is an outpatient service we are unable to assist in any emergency, in the event of any emergency (including self harm or any suicidal attempt) to please take the patient directly to the nearest Accident & Emergency (A&E) Hospital, attend your Local GP for an emergency appointment or dial '999'.

How do I book an assessment?

A phone call will first need to be held with you to ascertain our centre's suitability for the patient concerned, please visit www.dr-giaroli.org/enquiries to arrange a date/time convenient to you, whereby our Referral Manager will phone you to discuss the patient's history, their presenting issue(s) and the desired outcomes. Slots for these phone calls are extremely limited, therefore please follow the instructions on that booking page if you do not see any free slots telephone slots available.

Do I have to prepare anything before the assessment appointment(s)?

  • Any relevant material that you wish the clinician to consider for review must be emailed into us at least 5 business days before any appointment. Failure to do this will mean that the material may not be considered by the clinician for review, or may be considered for review by the clinician, but not yet actually read yet. If you have material you wish a clinician to consider for review, then you will need to book an appointment that is further than 5 business days in advance from the date of booking or emailing us such material.

  • Please ensure that with any material that you send, to only send the most relevant/recent material of any reports that you wish the clinician to consider for review. For example, if your child has had several Educational Psychologist assessments previously, then we kindly advise you to send just the most recent one for the clinician to consider for review.

  • The clinician will not necessarily read any or all material that you send before an appointment, as it is at the clinician's discretion as to which document(s) are most clinically relevant from a clinical perspective. You are however welcome to discuss any particular document during an appointment with the clinician.

  • Depending on instructions given to you at the time of booking the assessment appointment(s) you may be required to email us specific previous reports for the patient.

  • You must complete our online Client Registration Form, failure to do this may mean that one or all of the assessment appointment(s) are cancelled. A link to this will be sent to you after you book the assessment appointment(s).

What happens during the assessment appointment(s)?

  • Each clinician at our centre has their own approach to assessments, and may tailor their approach depending on the patient's clinical presentation.

  • What happens at the assessment appointment(s) depends on several factors, such as the age of the patient, whom accompanies them to the assessment appointment(s) and any background information that has been provided to the clinician beforehand (if so).

  • During assessment appointment(s) the clinician will be observing the social interactions between the patient, clinician and anyone else present. The clinician will also be asking various questions around the patient's prior medical history (both physical health and mental health), their presenting issue(s) and desired outcome(s). These questions may be directed to both the patient and/or their caregiver(s) present during appointment(s). Any questions asked directly of a patient will be age-appropriate.

  • If you (or your child) wish to speak privately with the clinician, please indicate this to the clinician at the start of the appointment.

  • There are not necessarily any specific tests/questionnaires or activities that you (or your child) may be asked to complete during an assessment, the assessment appointment(s) are mostly conversational in style.

  • Some vital measurements, such as height, weight, blood pressure and pulse rate, may be taken by the clinician. If any of your assessment appointment(s) are online, then the clinician may request that you arrange these vital measurements for the patient to be taken by yourself (if you are comfortable), or for you to arrange them to be taken at the patient's General Practitioner (GP) or the patient may visit your local pharmacy to obtain them.

Who attends the assessment appointment(s)?

The patient themselves must attend. If the patient is a child, then they must attend regardless of how young they are. If you wish to discuss anything private with the clinician during any appointment, please indicate this to the clinician at the start of the appointment and please ensure that there is someone else accompanying you whom is able to safely mind your child outside of the consulting room (if the appointment is held in-person), or whom can safely mind your child in another room away from the computer screen (if the appointment is being held online).

 

In addition to the patient, you are welcome to bring any other family member, relative or friend for support. Please be mindful that their attendance at the appointment may result in them being privy to sensitive information that the clinician may discuss with you. If the patient is under 18 years of age, they must be accompanied by an adult; and that adult must be someone whom is able to provide the clinician a reliable account of the child's early developmental history; failure to adhere to this requirement may result in an assessment appointment being cancelled and the full appointment fee being due.

Do I need to complete anything after a first appointment of an assessment?

As part of an assessment, the clinician may request via email for some questionnaire(s) to be completed after the first appointment. The clinician may request these questionnaire(s) to be completed yourself, the patient (depending on their age) and potentially 3rd parties, such as the patient's school teacher(s). If the clinician would like any 3rd parties to complete such questionnaire(s) then please be kindly advised that you are responsible for onforwarding any such questionnaires and ensuring their timely completion. If you do not believe that such questionnaire(s) will be completed in time for the patient's next appointment of the assessment then you are welcome to contact our office to move the patient's next appointment to a later date, however please ensure we receive at least 3 clear business day's notice prior to that appointment, as otherwise the full fee for the second appointment of the assessment will still be due.

What happens after receiving a diagnosis?

 

For any part of the treatment plan that involves medication, our centre is able to provide ongoing review appointments to monitor the patient's progress, wherein any suitably required prescriptions may be provided.

For any part of the treatment plan that does not involve medication, our centre can provide the contact details for other clinicians at other clinics whom may be able to offer any such non-pharmacological aspects of the treatment plan. If so, please be advised that you will need to arrange any such (separate) treatments directly with those other clinics and clinicians outside of our centre and to enquire with these other clinicians and clinicians as to their fees and insurance coverage.

What if I do not receive a diagnosis?

Any diagnosis given, or not given, is at the sole discretion of the clinician involved. Sometimes an assessment outcome may be 'inconclusive', as the clinician is not able to give (or not to give) a diagnosis for a particular condition, as the clinician may simply not have been provided enough evidence (either from yourself, or from the young person, or from 3rd parties such as teacher(s)) during the assessment process to support either position, or perhaps the evidence that has been supplied to the clinician during the assessment process is contradictory.

Contradictory evidence may happen for example, if there are differing opinions from different people whom have completed any questionnaires as part of the assessment process, such as any school teacher(s) along with caregiver(s). Depending on the condition(s) that the patient is being assessed for, contradictory evidence from questionnaires such as this, may lead to a diagnosis being inconclusive at that point in time. If this were to be the case, you are welcome to request a further 30 minute appointment with the clinician to present or discuss any further supplementary evidence that can be presented, and that was not already made available to the clinician at the time of the original assessment appointment(s). Please note that any such additional 30 minute appointment is chargeable, please visit our fees page here.

What factors inform a diagnosis?

Depending on the particular psychiatric condition(s) involved, a diagnosis may be formed from many factors, with each factor's weighting on the impact of the outcome of the assessment depending on the particular circumstances of the patient and the particular condition(s) involved.

 

For example, some of these factors may include:

  • direct clinical observation of the patient during assessment appointment(s);

  • patient history (of a medical, social, educational or other nature) as informed by the patient's caregiver(s) or the patient directly during assessment appointment(s) or other sources;

  • patient history provided by yourself (or others) to the clinician in written reports;

  • outputs from any questionnaire(s) completed during the assessment process, which may have had inputs from the patient's caregiver(s), 3rd parties (such as teacher(s)) and the patient themselves;

  • other relevant 3rd party information made available to the clinician during the assessment process.

How often will review appointments be needed?

 

For ongoing treatment plans, particularly those involving medication, the clinician will require periodic appointments in order to safely monitor and discuss the patient's progress and to adjust any aspects of the treatment plan as may be necessary. The frequency of such review appointments depends on the particular complexities of each individual patient's case, they may be as often as once a month (or more frequently) for several months during any particularly sensitive periods, such as when medication is being first started or a dosage is adjusted. Or a review appointment may be required only every 6 months (or potentially longer) if a patient is very stable on their medication.

 

The frequency of review appointments required depends on many factors, such as the patient's clinical needs, the diagnosis involved, the patient's level of risk and the patient's progress. Review appointment frequency may also depend on other risk factors for a patient, such as any cardiovascular conditions, other medications they may be taking (psychiatric or otherwise) and lifestyle factors of the patient and their support environment. Please speak to the clinician during an appointment for further information on the review appointment frequency that they will require in order to safely monitor the patient's progress. Our appointment fees can be found at www.dr-giaroli.org/fees.
 

Can my GP take over prescribing with a Shared Care Agreement?

If medication is part of the treatment plan, then once the patient has been stabilised on a particular medication programme (in terms of specific medications and dosages) you may request your assigned clinician at our centre, to write to your General Practitioner (GP) to negotiate a Shared Care Agreement (SCA). It is up to the discretion of both our clinician and your GP as to whether they will mutually agree to this. If an SCA is agreed between them, then your GP could potentially take over the ongoing issuance of relevant repeat prescriptions, however nonetheless your GP and our clinician, will both require the patient to still see our clinician for a review appointment at some specified frequency, this may be every 3 months, 6 months, 9 months or 12 months (or other frequency) or a different arrangement, depending on what your GP and our clinician agree too.

What report(s) or letter(s) will I receive?

  • A bespoke letter will be written by the clinician following any appointment and sent to you via secure email. Please allow 3 to 4 weeks following an appointment to receive this.

  • 1st appointment of 60 minutes, the letter will be 1.5 to 3.0 pages long. All subsequent assessment appointment(s) or review appointment(s): 1.0 to 1.5 pages long. Note, in cases of a formal diagnosis of Autism, whereby additional assessment(s) are required such as ADOS-2ADI-R / 3Di-sv, the resulting diagnosis letter will be substantially longer.

  • The patient's relevant medical history, presenting issues, and any diagnosis and treatment plan, will not necessarily be within the one letter from your clinician, but rather, will be across each letter from each stage of the assessment process, as our assessments are carried out over more than one appointment in the majority of cases.

  • Much more detailed advice on how to manage a diagnosis in you (or your child's) specific situation can be discussed during subsequent appointment(s) to the assessment appointment(s), as can any further revisions of a treatment plan be discussed at subsequent appointment(s) after the assessment appointment(s).

  • You are welcome to on-forward any of our letters or reports to any 3rd parties such as a school, university or employer. Due to data confidentiality, we will not be able to do this on your behalf.

 

What if I need to cancel an appointment?

  • As long as we receive at least 3 clear business day's notice, there will not be any charge. If we do not receive enough notice, then the full appointment fee is due. The time of day that your appointment is on does not matter, as our policy is 3 clear business days and not a "72 hour" policy.

    • ​If your appointment is on a Monday (regardless of time), we require notice by no later than 9am the previous Wednesday 

    • If your appointment is on a Tuesday (regardless of time), we require notice by no later than 9am the previous Thursday

    • If your appointment is on a Wednesday (regardless of time), we require notice by no later than 9am the previous Friday

    • If your appointment is on a Thursday (regardless of time), we require notice by no later than 9am the previous Monday

    • If your appointment is on a Friday (regardless of time), we require notice by no later than 9am the previous Tuesday

    • If your appointment is on a Saturday (regardless of time), we require notice by no later than 9am the previous Wednesday

    • If your appointment is on a Sunday (regardless of time), we require notice by no later than 9am the previous Wednesday

What if I don't agree with the outcome of an assessment?

  • We encourage our clients to raise any questions, issues or complaints that they may have regarding the assessment process, with the clinician directly during an assessment appointment itself ideally, or if not then via email. A direct line of communication with the clinician regarding anything you may not be satisfied with helps ensure that if there are any misunderstandings or further insights that you or the clinician can offer one another, then they can be addressed by mutual dialogue and discussion.

  • If for any reason you still feel that after raising any assessment related issue with the clinician that your issue has not been resolved effectively, then you are welcome to submit feedback to us vis our online form here, you may also view our Complaints Policy here if you wish to make a complaint.

What if I forget an appointment?

  • Depending on your preferences, our system may send an appointment confirmation email and an appointment confirmation email to the registered email we hold for the patient; and potentially also an appointment confirmation text to the mobile phone number we hold for the patient. Our system may also send a courtesy appointment reminder email and a courtesy reminder text prior to the appointment too. The doctor and our office are not responsible for these confirmations being blocked by any Spam/Junk filters or denied by your mobile phone provider. Please kindly ensure you check your Junk/Spam email folders. If you are in doubt regarding the date/time/modality of an appointment, please contact our office.

  • If the patient fails to attend an appointment, it will result in the full appointment fee still being due.

How does the patient receive medication?

  • Should medication be a suitable part of a patient's treatment plan, then the assigned clinician at our centre may provide you with a prescription for the relevant medication(s) as and when they are safely required. Any prescription may be either handed to you during an in-person appointment, or posted to your home address, or alternatively the medication itself may be delivered to you via our central London partner pharmacy, Zen Pharmacy. Our centre receives no incentives (financial or otherwise) from Zen Pharmacy.

  • As we are a private health provider (and not part of the NHS), you will need to directly pay the relevant pharmacy for the cost of any medications pertaining to prescriptions written by our doctors.

  • All repeat prescriptions must only be submitted via our website at: www.dr-giaroli.org/prescriptions and incur a £25 administrative charge (rising to £50 from Monday 10 October, 2022).

 

What are your opening times?

 

Our admin office is open from 9am to 5:30pm from Monday to Friday, excluding Bank Holidays. Our team of clinicians hold appointments in-person at our two clinics on Harley Street in Central London as well as remotely via online technologies. Our clinicians themselves offer appointments ranging from approximately 8am to 8pm from Mondays to Saturdays; depending on each clinician. Please enquire if you require further availability specifics for your particular clinician.

Will my child's school be involved?

  • School feedback can be important during an assessment for a young person, though this depends on each patient's particular circumstances and which diagnosis the clinician may be potentially considering.

  • However, due to data confidentiality, our centre will not directly interact with your child's school during an assessment, though the clinician may ask you to onforward to you child's teacher(s) some questionnaire(s) that they may want your child's teacher(s) to complete.

  • You are also welcome to email the clinician any other school reports or school material that you wish the clinician to consider for review regarding your child. The clinician will not necessarily read any or all documents that you provide, though you are welcome to arrange an appointment if there are any particular documents you wish to discuss in detail.

  • You are welcome to on-forward any of our clinician's letters to any 3rd parties such as a school, university or employer. Due to data confidentiality, we will not be able to do this on your behalf.

My child is applying for an Education Health & Care Plan (EHC Plan)
 

  • Our clinicians are professionally and ethically bound to only provide material in a letter or report that is factual and specific to the clinician's clinical opinion of a patient. You are welcome to request any particular information be amended or added to a clinician's letter, however any amendments are at the clinician's sole and final discretion.

  • Our centre does not directly specialise in medico-legal reporting for EHC Plan applications nor tribunals; however we work with a law firm partner and can provide you a referral to them if you require. If you are considering applying for an EHC Plan, or challenging an EHC P outcome, please be aware that you may require this additional specialist legal assistance.

Will I be able to speak to or email my assigned clinician anytime?
 

  • Many of our clinicians work both within the National Health Service (NHS) and at The Giaroli Centre. Therefore, please be advised that your clinician will not be able to immediately respond to any particular email you may send them. Our clinician's diaries are organised by their Personal Assistant, whom you are welcome to email (email details will be provided to you upon an assessment being booked) or telephone their Personal Assistant on our centre's main phone number.

  • If you wish to hold a telephone call with the clinician, please kindly contact our administrative office to arrange a review appointment. Please be advised that review appointments are chargeable, visit here to read about our fees.

What happens if there's an emergency?

  • If the patient encounters an emergency situation (such as self harming behaviour or suicidal thoughts), please be advised that as our centre is an outpatient service that we cannot provide any emergency service, and in any such circumstances you will need to immediately attend your nearest Accident & Emergency (A&E) Hospital, attend your local GP for an emergency appointment, or dial '999' within the United Kingdom.

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