• How do I make an appointment?
• Please call the Clinic on (+44) 020 70780302 or email here . Our client coordinator will be ready to assist with your questions and appointment set-up.

• What are your opening hours?
• Mon, Tues, Wed, and Fri from 9.30 am to 5.00pm
• Thursdays from 11.00 and to 7.00pm
• We have other after hours appointments by special request – but please note this may carry a surcharge

• How long will it take to get an appointment?
• You can usually get an appointment within two weeks; however, during busy periods the clinic can develop a waitlist of up to 6 weeks. We recommend that you do not delay calling once you know you may need help with hormonal imbalance, cosmetic work, or simply for your next follow-up appointment.
• If, following your consultation for BHRT and or cosmetic work treatment is recommended or performed, in order to avoid delays in your follow up , we advise that you book the follow-up appointments that will be part of your treatment plan for the next 12 months.

• What is your cancellation policy?
• We require 48 hours of working time to cancel or rearrange your appointment. Please note our working times are from Mon-Fri.
• No show may result in you being charged a fee equivalent to your deposit fee .

• Do you offer a chaperone service at your clinic?
• Yes.Kindly let us know at the time of your booking if you require a chaperone during your consultation.

• Do you offer Interpretation Services at your clinic?
• Yes we offer interpreters via telephone in most languages using Language Line.
• Kindly let us know if you require these services at the time of booking your appointment.

Consultations with Dr Kersh

• • What is the cost of a consultation with Dr Kersh?
  • Cosmetic procedure assessment £250
  • How long does the consultation with Dr Kersh last?
  • Dr Kersh cosmetic assessment consultation can last up to 30 minutes.
  • Would I be able to have treatment on the same day as my consultation?
  • We advise that you take time to think about the information given to you during your consultation with Dr Kersh.
  • We can accommodate other cosmetic treatments on the same day depending on diary availability that day.

Find out more here.

Consultations with Dr Galy

• • What is the cost of a consultation with Dr Galy?
  • Initial appointment up to 60 mins – £450
  • Up to 20 mins review £235
  • Repeat prescription without an appointment (emergency only) – £45
  • Additional time spent outside of appointments e.g. reading written material provided, preparing medical reports –  £80 per 15 minutes
  • Can you provide me with initial advice about blood work for BHRT before my consultation with Dr Galy?
  • Careful consultation and appropriate testing enables us to make a considered diagnosis and recommendations for treatment, so it is very important that we see you in the Clinic first, before we are able to offer this advice.
  • If I live overseas, can I do my follow up consultation by phone or Skype?
  • Yes, the Clinic does both for patients who have commenced treatment.
  • Either can be booked through our receptionist.
  • The costs are the same as in-clinic appointments.
  • You will be required to call the Clinic at the time of your appointment and payment will be taken with credit card prior to the consultation.

Find out more here.

• • If I live overseas, can I do my follow up consultation by phone or Skype?

This really depends on the specifics of your case but a typical schedule of appointments for BHRT is shown below.

• • Initial consultation – 45 minutes. Your doctor will spend time taking a comprehensive history and record of your symptoms. Blood tests and other appropriate tests will be organised at the consultation.
  • 1st follow up – at 1-2 days is complimentary : 10  minutes. You will return to the Clinic to review your test results, and, if recommended, receive a personalised plan of prescription medicine devised specifically for you. The cost of this follow up is included in your initial consultation charge.
  • 2nd Follow up – at 8-12 weeks  weeks : 20 minutes. This consultation at the Clinic will enable your doctor to review your progress with the prescribed medication. Any required adjustments to your medication will be made.
  • 3rd Follow up – at 3-6 months : 20 minutes. Progress will be reviewed and repeat prescriptions will be issued where necessary.
  • Further review – at 6-8 months thereafter  : 20 minutes. This follow-up will entail a full review of progress, where further tests may be required and prescriptions will be issued as necessary.
  • Annual reviews recommended once prescription is steady

Find out more here.

• What is the cost of a consultation with Dr Kersh?
• Cosmetic procedure consultation £250
• What are the costs of treatments at 23MD?
• As each persons needs are individual, we strongly advise a consultation with one of our specialists. Once your needs are determined, we will always  discuss prices in detail with you.
• What is the cost of a consultation with Dr Galy?
• Initial appointment up to 45 mins – £450
• Review appointments up to 20 mins – £235
• Repeat Prescriptions without an appointment – £45
• Additional time spent outside of appointments e.g. reading written material provided – £80 per 15 minutes
• How much do the blood tests cost?
• Blood tests start at £100, for a single hormone.
• Thyroid profile £120
• Female hormone profile from £320
• Male Hormone profiling from £390

• What blood tests do I need for BHRT?
• When you first meet with your doctor, you will be advised which blood tests you need to have.
• The exact tests required will depend on the symptoms that you present with, together with your age and you medical history.

• How much do the blood tests cost?
• Blood tests start at £100, for a single hormone.
• Thyroid profile costs £120, this includes a TSH, Free T4 and a Free T3.
• Male or female hormone profile costs from  £350 this includes Estradiol, Progesterone, Testosterone, Free testosterone, VitD, DHEA, PSA (men), FSH (Women)

• Can I do the blood tests with my GP?
• If your GP is in agreement, yes you can
• Results should be supplied to us in PDF format or
• Please bring printed results along for your consultation.

• How often do I have to have blood tests?
• Blood tests are usually necessary at the time of your first consultation, and by discussion afterwards.
• Thereafter blood tests can then be performed annually or on an as needed basis in discussion with your prescriber.

• When / how do I get blood test results?
• Blood test results are given to you during your follow-up appointment, when your treatment schedule is discussed
• A copy of these tests and a care plan is sent to you after your consultation

• How do I renew my prescription for BHRT?
• During consultations with the doctor at 23MD, patients may be issued with a series of prescriptions for a specified period of treatment.
• Once these prescriptions have been used, the patient is expected to attend for a review consultation in order to receive further medication.
• It is essential that patients meet with their doctor so that their symptoms and levels of medication can be re-assessed, and changes made where necessary.
• We understand that in some exceptional cases patients may require medication before their consultation appointment is due.
• At our discretion, we may prescribe a small amount of medication that takes the patient through to the next consultation appointment.
• We apply a fee of £45 for this service.

• How long is a prescription for BHRT valid for?
• A prescription is valid for 1 month from its date of issue.

• Where do I get my BHRT prescription filled from?
•  If your prescription is for  regulated BHRT  formulas, these prescriptions can be filled in any pharmacy. If you cannot tolerate these regulated versions, your individual prescription will be dispensed by the compounding pharmacy.
• You will need to call the pharmacy after your consultation to order and pay for your prescription and arrange postal delivery.

• What is the cost of the BHRT medicine?
• Bio-identical hormone replacement therapy prescriptions cost an average of £2-£3 per day, subject to your prescribed medication.

• If I decide to start bio-identical hormone replacement therapy, how long will I be on it for?
• The duration of treatment is highly individual and dependent on your personal situation.
• Your treatment plan will be tailored to your needs in consultation with your doctor.
• Coming off hormones in the future may result in reappearance of symptoms that were present prior to staring hormones.

• Will bio-identical hormone replacement therapy help my particular symptoms?
• Bio-identical hormones are frequently effective in resolving and reducing a wide range of symptoms if these symptoms are indeed caused by hormonal imbalances.
• During your first consultation, you can discuss your symptoms with the doctor and how your particular symptoms might be related to hormone imbalances or low hormone levels will be explained.
• Blood tests may be performed if appropriate.
• When the results are available, your doctor will discuss them with you as well as how they may relate to your particular symptoms.
• If these tests show that you have a hormonal imbalance, bio-identical hormone therapy maybe an appropriate treatment for you.
• Your doctor will discuss what might be the most appropriate prescription for you to try meet your needs and resolve your symptoms.

• Are all the hormones you prescribe natural?
• The hormones themselves are not naturally found, except in human bodies.
• The word ‘natural’ is used to refer to the chemical structure of the hormone molecules, rather than the source, with their chemical structure being the same as those produced by your natural glands.
• This means their effects are more consistent with the normal biochemistry of your body than those of synthetic hormones (hormones that do not have the same chemical structure as our own)
• The formulas that we choose to prescribe use ingredients  that have been derived from plant sources

• Where do the bio-identical hormones come from?
• Bio-identical hormones are derived from diosgenin, which is sourced from Mexican yams and then converted into human hormones.
• They need to be prescribed by a doctor
• This prescription can contain medications available on the open market ( regulated or licensed  BHRT) , OR medicines that have to be compounded for each individual patient ( unregulated  or unlicensed BHRT), if such a medicine is not available.
• Whichever is prescribed, licensed or unliscensed, they will always be bio-identical.
• Bio-identical hormone therapy (BHRT) is usually administered in the form of  gels, patches, capsules, creams, or lozenges.

• Is there difference between Body-identical and Bio-identical Hormones
• There is no difference between these 2 groups – other than the name as they both refer to the same type of hormones available
• There is however a difference between these and non-bioidentical ( or non-body-identical) group of hormones, the latter having a different chemical structure to hormones that are found in your glands.
• Is there a difference between the active ingredients used in licensed and unlicensed medicines? Body-identical and Bio-identical Hormones
• There is no difference between the active ingredients used in either licensed or unlicensed medicines.
• Is the manufacturing of Bioidentical Hormones regulated by the Medicines and Healthcare Products Regulatory Agency (MHRA)?
• The MHRA is the UK body that regulates the manufacture of all medicines.
• Regulated ( or liscensed)  Bio-Identical hormones are produced for the market in fixed doses and as separated individual hormones. These are regulated by the MHRA.
• If your prescription involves customising a specific hormone formula for you because of intolerance to market doses, or the required hormone is not available on the market, or compliance issues hinders you from using the regulated hormones, a prescription can be sent to a compounding pharmacy for them to prepare this specific formula to meet your needs. This is regarded as an un-regulated (or unliscensed ) medication. These formulas are not regulated by the MHRA.
• Customised-4-U pharmacy in Northumberland is licensed by The MHRA to compound medications.
• What is an unlicensed medicine?
• The term unlicensed medicine is used to describe medicines that are used outside the terms of their UK licence or those which have no licence for use in the UK.
• They are commonly used in paediatrics, oncology, palliative care and dermatology.
• When can an unlicensed medicine be used?
• Unlicensed medicines may be used where, on the basis of an assessment of the individual patient by their treating physician, it is concluded that, for medical reasons,  it is necessary to do so to meet the specific needs of the patient. For example, prescribing unlicensed medicines may be necessary when
  • there is no suitably licensed medicine that will meet the patient’s need.
  • the dosage specified for a licensed medicine would not meet the patient’s need
  • the patient needs a medicine in a formulation that is not specified in an applicable licence.
  • The prescribing forms part of a properly approved research project.
• Licensed medicines should be prescribed in accordance with the terms of their licence.

• What are the prescribing guidelines for unlicensed medicines in the UK?
• When prescribing an unlicensed medicine both you and your doctor must
  • be satisfied that there is sufficient evidence or experience of using the medicine to demonstrate its safety and efficacy
  • take responsibility for prescribing the medicine and for overseeing the patient’s care, monitoring, and any follow up treatment
  • your doctor should always ensure that you are offered licensed medicines if they are available to meet your needs.

• Will my private medical insurance cover my treatment?
• You will need to check with your health insurer to determine your level of cover.
• Please note that if you are covered by your insurance, you would need to pay the in full at the clinic and then claim this amount from your health insurer.
• Can I have a chaperone present during my consultation?
• If you would like to have a chaperone present in your consultation please inform reception prior to your appointment and this will be arranged for you.
• Are your doctors registered with the General Medical Council (GMC)?
• All the doctors at the 23MD are fully registered with the GMC.
• Is 23MD Clinic registered with The Care Quality Commission UK (CQC)?
• The CQC is the independent regulator that monitors, inspects and regulates health care services to make sure they meet fundamental standards of quality
• The CQC will publish what they find, including performance ratings to help people choose their care providers.
• 23MD is registered for the provision of Medical Services with The CQC.
• What are your ethical responsibilities for the use of medical injectable products?
• At 23 MD, we ensure that we adhere to the ethical use of non medical injectables in accordance with GMC and BCAM guidelines
• We work with each individual patient as their advocate, to make sure their expectations about the outcomes that can be achieved for them are realistic.
• Our doctors and therapists are appropriately trained and highly experienced to practise safely.
• We follow current guidelines or protocols for safe, effective provision of cosmetic interventions.
• We always consider the psychological needs of our patients.
• We do not allow any financial or commercial interests in a particular intervention, or an organisation providing cosmetic interventions, to adversely affect standards of good patient care

• Is the manufacturing of Bioidentical Hormones regulated by the Medicines and Healthcare Regulatory Agency (MHRA)?
• The MHRA is the UK body that regulates the manufacture of all medicines.
• Regulated ( or liscensed)  Bio-Identical hormones are produced for the market in fixed doses and as separated individual hormones. These are regulated by the MHRA.
• If your prescription involves customising a specific hormone formula for you because of intolerance to market doses, or the required hormone is not available on the market, or compliance issues hinders you from using the regulated hormones, a prescription can be sent to a compounding pharmacy for them to prepare this specific formula to meet your needs. This is regarded as an un-regulated ( or un-licensed )  medication.
• Customised-4-U pharmacy in Northumberland is licensed by The MHRA to compound medications.

• What is an unlicensed medicine?
• The term unlicensed medicine is used to describe medicines that are used outside the terms of their UK licence or those which have no licence for use in the UK.
• They are commonly used in paediatrics, oncology, palliative care and dermatology.
• When can an unlicensed medicine be used?
• Unlicensed medicines may be used where, on the basis of an assessment of the individual patient by their treating physician, it is concluded that, for medical reasons,  it is necessary to do so to meet the specific needs of the patient. For example, prescribing unlicensed medicines may be necessary when
  • there is no suitably licensed medicine that will meet the patient’s need.
  • the dosage specified for a licensed medicine would not meet the patient’s need
  • the patient needs a medicine in a formulation that is not specified in an applicable licence.
  • The prescribing forms part of a properly approved research project.
• Licensed medicines should be prescribed in accordance with the terms of their licence.

• What are the prescribing guidelines for unlicensed medicines in the UK?
• When prescribing an unlicensed medicine you and your doctor must
  • be satisfied that there is sufficient evidence or experience of using the medicine to demonstrate its safety and efficacy
  • take responsibility for prescribing the medicine and for overseeing the patient’s care, monitoring, and any follow up treatment
  • your doctor should always ensure that you are offered licensed medicines if they are available to meet your needs.