We are happy to accept self-referrals. Patients can fill in our on-line form or ring the Centre to arrange an appointment (020 7251 3322). This makes it easier for patients to be seen and lessens the burden on GPs. We welcome GP referrals too. Referrals may also come from other healthcare professionals including Occupational Health, Neurologists, and ENT specialists and practice nurses.
Whatever the referral route, we work closely with the patient’s GP and send assessments and recommendations following each appointment (although we respect that occasional patients do not want information shared with their doctor).
Here are the most frequently asked questions from doctors about referring patients to The National Migraine Centre.
1.What kind of headaches do we see?
We are happy to see patients with any kind of headache. In practice most of these will turn out to be migrainous. It is important to us that any headache may be referred as many patients have an incorrect diagnosis at presentation (for instance cluster headache diagnosed as migraine). We see a significant number of patients with Medication Overuse Headache and can successfully wean them off the offending medication(s) and on to more suitable therapies. A small number of patients do not have headache but may have complex migraine aura (for example vertigo, paraesthesiae, acute or persistent visual aura but without headache) and benefit from an accurate diagnosis.
2.Who can be referred?
Patients from the UK or overseas can be seen at the centre regardless of their eligibility for NHS treatment. We are also happy to treat patients who wish to be seen privately. Certain health insurance plans cover consultations here (e.g. BUPA).
Patients come to us from across the UK (and indeed the world). We may advise individuals on specialty headache services closer to home.
3. How much does it cost?
As a medical charity we rely substantially on patients donating to cover the cost of their consultation. Please make patients aware of this when you refer them. We will always do our best to accommodate patients with financial difficulties, especially for urgent problems such as cluster headache attacks, but we are not a wealthy charity and have very limited resources for pro bono work.
We do charge a missed appointment fee to reduce wasted appointment slots.
4.What qualifications do our doctors hold?
All our specialists are fully qualified doctors registered with the General Medical Council. Our doctors are mainly GPs or Consultant neurologists with specialist training in headache. A number of other specialists (for instance ophthalmologists and gynaecologists) have at various times worked with us. We try to maintain continuity of care with the specialist who first sees each patient.
5.Why would I refer my patients to the Clinic?
Many GPs and other doctors find headache a common and difficult problem to manage and we aim to support practitioners to diagnose and manage their patient. We can:
• See patients considerably more quickly than the NHS, and your patient will be seen by a doctor with a specialist interest in headache (not necessarily the case in NHS neurology clinics).
• Give a confident clinical diagnosis
• Advise on any investigations or other steps required (brain scans are not usually required or recommended, occasional basic blood tests may be useful, esoteric tests almost never)
• Recommend an evidence based package of care
• Support and monitor patient progress during treatment
You can hear some of our patient feedback here.
6.How to refer?
Patients can contact us directly to make a suitable appointment.
From the referring doctor we appreciate:
• A brief referral letter outlining in the clinical issues.
• A list of current and past medication with dates and doses is invaluable
• Encourage your patient to complete a headache diary prior to their appointment (downloadable from our website here)
7.Can patients self-refer?
We accept patients who self-refer although encourage them to inform their GP and preferably obtain information on relevant past medication prior to their attendance. Completing a headache diary is invaluable to the assessing doctor. A report will be sent to the GP unless the patient specifically requests otherwise.
8.How does a consultation work?
• Patients attend for a first 40-minute consultation during which a history is taken and any necessary physical examination made. Based on this our doctor will (usually) make a firm diagnosis and discuss management options with the patient.
• Following the consultation a report is sent to the GP and the patient. The Clinic doctors work closely with GPs and are very happy to discuss any aspect of your patients care.
• Follow up appointments last 20 minutes. Most patients are seen 2 or 3 times in the clinic, which is sufficient to allow them to take control of their headaches and “get their life back”. Follow up appointments can be arranged as telephone reviews and there is a fixed charge for this.
• Patients who we have seen may contact us at any time in the future to seek further advice.
It is at the discretion of the GP to prescribe any suggested medications. As a charity the National Migraine Centre cannot issue NHS prescriptions, but on occasion we may give private prescriptions if there is an urgency to start treatment (most of the drugs we are likely to recommend are inexpensive).
Some of the drugs we recommend for migraine and cluster headache are not licensed for these conditions, but our recommendations are firmly evidence based, in line with the British Association for the Study of Headache’s Guidelines and with NICE and SIGN guidance and other expert pathways.
Apart from medication, management of lifestyle factors and understanding of the nature of the condition is an important part of our strategy, so that part of the consultation is to empower patients to self-manage their headaches.
Most patients are managed by conventional drug treatments and lifestyle changes. For patients with chronic migraine we additionally can carry out Botox treatments (we will normally ask your support to access NHS funding through an Individual Funding Request).
We are also able to perform Greater Occipital Nerve Blocks that can give short to medium term relief to patients with migraine and cluster headache.
There is a charge for therapies that involve injections.
Overwhelmingly headaches are diagnosed on the basis of a careful history and physical examination. When investigations are required we will request that the patient’s GP organises these. We are not looking for elaborate or obscure tests. Most patients do not require brain scans and we tend to dissuade patients from seeking them (unless there is a clinical suspicion of relevant secondary headache).
We would be grateful for your cooperation if we do make such a request and are very happy to discuss it with you.
12.Where are you located?
The National Migraine Centre is located in West London at:
226 Walmer Road,
We are a 10 minute walk from Latimer Road or Holland Park tube stations. Details about how to get to the Clinic are available on our website at the contact us page.
13.Where can I get further information about how to treat headache patients?
Our website provides general information on migraine and other headaches and their possible treatments. A number of references to publications on migraine are also provided. In addition you will find links to national and international migraine sites with information that may be of use to medical professionals and patients.