Cardiology entry point: consultant, GP, ECG or A&E

You have a flutter, a pressure that comes and goes, a family history you have started to take seriously, or a printout from a watch that says your heart skipped. Search results then offer four doors at once: a consultant cardiologist, a GP, a standalone ECG, or A&E. Those are not interchangeable. Picking the wrong door is how people sit in a booked clinic with a symptom that needed an ambulance, or how they leave with a tracing and still have no idea what it means.

The cardiology entry point at Medical Express Clinic is a consultant visit with Prof Darrel Francis at 117a Harley Street. That is not the same as a GP appointment, it is not the same as a resting ECG booked on its own, and it is not an emergency department. This article is about which of those four is yours.

When is it 999 or A&E?

Call 999 or go to A&E for a life-threatening emergency.

NHS guidance is plain. For the heart, that includes severe chest pain, sudden severe breathlessness, collapse, or any symptom that makes you think you may be having a heart attack. NHS.uk describes pain that feels tight or like squeezing, pain that spreads to the arms, neck or jaw, severe difficulty breathing, collapse, and chest pain with sweating, sickness, light-headedness or shortness of breath.

A booked Harley Street slot cannot do that work. If you are reading this while the pain is on, stop reading and call 999. Do not drive yourself if you think it is a heart attack.

NHS 111 is the route NHS.uk names when symptoms are urgent but not life-threatening, or when you are not sure whether 999 is required. You can check symptoms online, or call 111. A private cardiology diary is not a substitute for that public emergency system.

When is a GP the right person?

A new chest symptom that is not an emergency, or a routine look at cardiovascular risk, often belongs with a GP. A GP can take a history, examine you, check blood pressure, and decide whether an ECG on the day, blood tests, or a specialist referral would help, separate from a heart health panel.

This clinic is consultant cardiology. That is a different appointment from the GP service in the same building. Wanting a specialist does not make a GP the wrong doctor. If you have not yet had anyone take a basic history of a new, milder symptom, a GP is often the person who can do that without you having already decided you need a consultant.

A GP can also write the letter you later bring to Prof Francis. If a referral letter already exists, bring it with you. Do not use a cardiology booking as a way of skipping a GP when the problem is a cough, a fever, or a medicine review. Those remain GP work.

When is a standalone ECG enough?

A resting ECG is a tracing of the heart's electrical activity at rest. At this clinic it can be booked online on its own, Monday to Friday between 10:00 and 17:30. That booking exists for people who already know they want that recording today, because a GP asked for one, an occupational form named it, or they have been told to obtain a tracing before a later review.

A tracing is not a consultation. It does not take a history, it does not examine you, and it does not decide whether you need a Holter monitor, a stress test or an echocardiogram. If the only thing you need is the recording, the standalone booking is the honest one. If what you want is someone to interpret symptoms, the ECG on its own will leave you with a printout and the same question you arrived with. The clinic explains how that standalone report will be shared when you attend.

When is a consultant cardiologist the visit?

For a heart symptom or a cardiovascular risk review that you want a cardiologist to hold, the usual first consultant visit is a consultation with Prof Darrel Francis, Consultant Cardiologist, GMC 4062833, at 117a Harley Street. He leads this service. You do not need a diagnosis before you arrive. You do need to be sure you are not in the 999 category, and it helps to know whether a GP has already seen the same problem.

People come with palpitations that have been going on for weeks, with breathlessness on stairs that is not sudden and severe, with a cholesterol result and a family history, with a previous ECG that nobody has talked through, or with a letter from a GP who thinks a cardiologist should look. Those are consultant questions rather than screening packages or A&E.

Medical Express Clinic has practised at 117a Harley Street since 1984 and is CQC-registered. Prof Francis sees you in that building. When a longer investigation is needed, it is coordinated through a nearby diagnostic centre, and the report comes back into your cardiology care rather than being left as a file you have to interpret alone.

What does the Harley Street consultation cover?

The visit includes a detailed medical history, a cardiovascular risk assessment, a physical examination, and a management plan. Prof Francis starts with what is happening, your history, and any results you already have. Symptoms and risk factors are discussed in the room. He then decides whether examination and further tests would help.

If a test would change the plan, it is explained before it is arranged. That is the point of seeing the consultant rather than shopping for a scan. A Holter, a treadmill, a blood-pressure monitor worn for a day, or an ultrasound of the heart each answers a different question. Ordering the wrong one wastes time and still leaves the original worry untouched.

Appointments are arranged according to clinical need and current availability. Call the clinic on 020 7499 1991 if you need to know what the diary currently looks like.

Which tests can be arranged after review?

When a further investigation is clinically appropriate, the clinic coordinates it nearby. That can mean a resting ECG after the consultation when it is indicated; Holter monitoring, a portable rhythm recording typically worn for 24 to 72 hours; an exercise stress test on a treadmill; ABPM, which is 24-hour ambulatory blood pressure monitoring; or echocardiography, which is ultrasound of the heart's structure and function.

Fees are discussed before those tests are arranged. A fuller list sits on the clinic's fees page, and those figures can change. How soon a report is ready varies by investigation. The consultant interprets a recording or scan alongside your history, examination and other results.

Is screening this appointment?

Well Man screening at this clinic is not a substitute for a cardiology consultation. Screening looks for risk in people who feel well. A consultant visit is for a heart concern you want a cardiologist to assess. Mixing them up is how people leave a screening with a cholesterol number and still have palpitations nobody has taken a history of.

What should you bring?

Bring any referral letter, previous results and a medication list, because letters or traces you already hold save time on facts that are already known. If a watch, a home blood-pressure machine or a previous hospital discharge mentioned a finding, bring that paperwork rather than reconstructing it from memory. You do not need a referral to request the consultation, but a letter that exists should still travel with you.

What helps beforehand?

Decide which of the four doors you are walking through before you book.

• Severe pain, sudden severe breathlessness, collapse or suspected heart attack is 999, not Harley Street.
• Urgent symptoms that are not life-threatening can go to NHS 111.
• A new milder chest symptom or a routine risk review often starts with a GP.
• The standalone ECG is for when the recording is the thing you already know you need.
• The consultant visit is for a heart concern you want Prof Francis to assess.
• If you already have results, put them in a single envelope or a single email so the history does not start from zero.
• If a GP has already examined you, say so.
• If nobody has, be honest about that too, because the consultation will then have to do more of the groundwork.
• Book the ECG on a weekday between 10:00 and 17:30 if that is the only thing you need.

What should you avoid?

Do not sit on severe chest pain because you have a clinic appointment later in the week.

• Do not treat a wearable alert as a diagnosis, and do not treat a clear ECG as a promise that palpitations cannot return.
• Do not book Well Man screening because you wanted a cardiologist, and do not book a cardiologist because you wanted a GP to look at a cough.
• Do not arrive without letters you already hold.
• Do not assume every further test happens in the same room.
• Longer recordings and scans are arranged nearby after clinical review.
• If you do want the consultant cardiology visit, the details sit on the cardiology clinic page, or you can contact the clinic on 020 7499 1991.

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