Leg Circulation Assessment

Consultant-led · Same-day ABPI & duplex · CQC-registered

Leg Circulation Assessment in Kingston upon Thames, London & Surrey

If your legs feel heavy, ache when you walk, swell at the end of the day, look discoloured, feel cold, or you have visible varicose veins or a wound that is not healing, you are right to want it looked at.

KONCEPT® runs a consultant-led leg circulation clinic that works out what is going on, explains it to you in plain English, and points you at the right next step. Same-day Ankle-Brachial Pressure Index (ABPI) and venous and arterial duplex ultrasound make sure the answer is based on evidence, not guesswork.

  • CQC registered clinic
  • GMC Specialist Register, Vascular Surgery
  • Same-day ABPI & duplex ultrasound
  • Written plan before you leave
  • Clear referral pathway

At a glance

Leg circulation assessment at KONCEPT®

Service

Consultant-led

First visit

ABPI + duplex

Consultation

30 to 45 min

Initial consult

from £325

Verified statistics

Leg circulation by the numbers

Drawn from NHS, NICE, the British Heart Foundation, the European Society for Vascular Surgery and peer-reviewed UK prevalence studies. Every figure links to its citation in the References section at the bottom of this page.

What “poor circulation” actually covers

~30%

UK adults have varicose veins, a venous-side circulation problem

NHS[1] · NICE QS67[3]

~20%

UK adults aged 60+ have peripheral arterial disease (PAD)

NICE NG147[4] · ESVS[5]

~450,000

UK adults estimated to be living with lymphoedema

Moffatt LiMPRINT[6]

20-50%

of DVT patients develop post-thrombotic syndrome within 2 years

Kahn SR et al.[7]

What ABPI and duplex add

Same-day

ABPI and duplex ultrasound on the first visit where clinically indicated

NICE NG147[4] · ESVS[5]

Mandatory

ABPI before any compression therapy, to rule out significant arterial disease

NICE NG147[4] · ESVS[5]

Non-invasive

duplex is painless, takes 20-30 min per leg, no needles, no contrast

NICE QS67[3]

Background

What “poor circulation in the legs” actually means

“Poor circulation” is a phrase patients use, not a single diagnosis. The job of a leg circulation assessment is to find out which of the leg’s three circulations is affected, and how. Each one has its own symptoms, tests and treatments[1][3][4][5]:

  • Venous circulation carries blood back to the heart. Problems here cause varicose veins, ankle swelling, skin changes around the ankle, post-thrombotic syndrome after DVT, and venous leg ulcers.
  • Arterial circulation delivers oxygenated blood from the heart to the legs. Problems here (peripheral arterial disease) cause cramping leg pain on walking, cold feet, slow-healing wounds and, in severe disease, rest pain or gangrene.
  • Lymphatic circulation drains fluid back from the tissues. Problems here cause persistent swelling that does not improve overnight (lymphoedema), particularly after cancer treatment or with primary genetic disorders.

The three can overlap (mixed venous-arterial, lipo-lymphoedema, diabetic foot with all three) which is why a structured assessment matters.

Symptoms

Symptoms patients describe

The most common patient phrases are:

Sudden, severe or one-sided symptoms (sudden leg swelling, sudden severe pain, sudden colour change of the foot, a black toe) need urgent medical assessment rather than a planned private consultation. Contact NHS 111 or your nearest Same Day Emergency Care.

Where to go next

Symptom-to-service router

Symptoms point us toward different parts of the vascular service. Use this as a guide while you book, your consultant will confirm the diagnosis at assessment.

Disproportionate fat in the legs that is tender and resists weight loss

Lipoedema clinic

Not sure which page applies? Book a leg circulation assessment and we will route you.

Assessment

How we assess at KONCEPT®

Our work-up is built around what international vascular guidelines recommend at first contact[3][4][5]:

  1. A 30 to 45-minute consultation with a Consultant Vascular Surgeon on the GMC Specialist Register.
  2. Detailed history, including the pattern of symptoms, walking distance, ankle swelling, skin changes, diabetes, smoking history, cardiovascular risk factors, any prior DVT, family history.
  3. Examination of both legs in standing and lying positions, with documentation of varicose veins, skin changes, foot pulses, capillary refill and limb circumference at standard reference points.
  4. Ankle-Brachial Pressure Index (ABPI) to screen for peripheral arterial disease.
  5. Venous and / or arterial duplex ultrasound on the same visit where clinically indicated.
  6. Written summary, diagnosis, plan and quote before you leave, with a copy sent to your GP with your consent.

Where the assessment shows a problem we do not treat on site (iliac vein stenting, peripheral revascularisation, lymphatic surgery, complex wound surgery), we set up the specialist referral and stay involved for the second opinion and post-procedure follow-up.

Scope

What we cannot find at the first visit

To be straight with you, a single leg circulation assessment is not a complete cardiovascular work-up. It will not:

If we find anything that needs onward attention, we tell you and route you. Where the issue is outside our scope, we say so clearly.

After the visit

What happens after the assessment

Most patients leave with one of the following[3][4][5]:

A copy of the consultation letter and any imaging report is sent to your GP with your consent.

First visit

What to expect at your first appointment

For full pre-care and post-care instructions, see our Patient instructions page.

Pricing

Self-pay pricing

  • Initial vascular consultation with duplex ultrasound: from £325 (one leg) or £495 (both legs)
  • ABPI is included in the consultation where clinically indicated
  • Any onward treatment, compression or referral is priced separately on the pricing page

You receive a written quote before any treatment is booked.

Full pricing for every treatment →

See patient pre-care & post-care instructions →

Insurance

Private medical insurance

Vascular assessment is recognised by most major UK private medical insurers when there is a clinical indication. Cover for ongoing treatment depends on what is found and what your policy includes. Recognition at KONCEPT® is at both clinic and consultant level, and cover is expanding.

Call 020 8129 1011 with your insurer and policy details and we will come back to you within one working day with confirmation, before any appointment is booked.

Read more on the Insurance & access page →

Your consultants and team

Your consultants and team

Leg circulation consultations at KONCEPT® are carried out by one of our Consultant Vascular Surgeons, both on the GMC Specialist Register for Vascular Surgery and both Platinum BUPA Consultants. They hold substantive NHS consultant posts at St George’s University Hospitals NHS Foundation Trust and see private patients here on a practice-privileges basis.

FAQs

Frequently asked questions

What is “poor circulation” in the legs?

“Poor circulation” is a patient phrase, not a single diagnosis. It can mean a problem in the veins (varicose veins, post-thrombotic syndrome), the arteries (peripheral arterial disease) or the lymphatic system (lymphoedema), and the three can overlap. The job of an assessment is to find out which is affecting you.

What are the signs of poor circulation in the legs?

The most common signs patients describe are heaviness or aching at the end of the day, ankle swelling, cramping calf pain on walking that is relieved by rest, cold feet, visible varicose veins, discoloured skin around the ankle, slow-healing wounds, numbness in diabetes, restless legs at night, and itching or burning.

What is ABPI?

The Ankle-Brachial Pressure Index (ABPI) is a simple, non-invasive test that compares the blood pressure at the ankle with the blood pressure at the arm. An ABPI of 0.9 or below confirms peripheral arterial disease. ABPI is also essential before any compression therapy.

What is duplex ultrasound?

Duplex ultrasound combines a standard ultrasound image with a flow measurement. It maps the leg veins and arteries, identifies reflux (failed valves), and detects narrowing or blockage. It is painless, takes 20 to 30 minutes per leg, and uses no needles or contrast.

Do I need a GP referral?

For self-pay, no, you can book directly. Most insurers also allow direct booking. A small number still require a GP referral letter, we will confirm what your insurer needs when you enquire.

What if my issue is urgent?

If your symptoms are sudden, severe or one-sided (sudden swelling of one leg, sudden severe pain, sudden colour change of the foot, a black toe), seek urgent NHS medical assessment rather than booking a private clinic appointment. KONCEPT® is a planned, consultant-led clinic and not an emergency service.

Will I get a diagnosis on the day?

In most cases, yes. The consultation, ABPI and duplex on the same visit are usually enough to confirm what is going on. Where further imaging is needed (CT angiography, MR angiography, MRV / CTV for iliac vein assessment, lymphoscintigraphy), we set up the specialist referral.

How long is the appointment?

The first appointment is 30 to 45 minutes with a Consultant Vascular Surgeon. Plus ABPI and duplex on the same visit. Allow 60 to 90 minutes for your visit including arrival, reception and the scan.

Does private medical insurance cover the assessment?

Most major UK private medical insurers cover vascular assessment where there is a clinical indication. Call 020 8129 1011 with your insurer and policy details and we will check with your insurer before any appointment is booked.

What if you find something serious?

We tell you in plain English, write a clear letter to your GP and arrange the right onward referral, urgent or routine. Many problems in this clinic are common and treatable. We will be straight with you about what we find.

Can the same scan check the deep veins for a DVT?

A standard venous duplex can detect a deep vein thrombosis. If you have a current suspected DVT, the safer route is the NHS DVT pathway (your GP or Same Day Emergency Care), because the diagnostic timeline is shorter and urgent treatment is on-site. Where you have had a prior DVT and want a planned post-DVT review (post-thrombotic syndrome), see Post-thrombotic syndrome.

How do I prepare?

Wear loose clothing. Bring a list of current medications, any prior vascular notes or imaging reports, and your most recent blood-pressure or cholesterol readings if you have them. Avoid heavy walking or exercise just before the visit if your symptoms are exercise-related, we want to be able to reproduce them.

Locations

Locations we serve

Surrey catchment also includes Esher, Cobham, Weybridge, Walton-on-Thames, Oxshott and Hampton.

Related vascular services

Related services

Ready to book?

To book a leg circulation assessment with one of our Consultant Vascular Surgeons, or to discuss your case, get in touch.

Email info@konceptmedicalclinic.com · Visit 46-48 Wood Street, Kingston upon Thames, KT1 1UW · See full self-pay pricing →

Regulation and standards

KONCEPT® Medical Clinic is registered with the Care Quality Commission (CQC) for the regulated activities provided at our Kingston upon Thames premises. All consultants are on the General Medical Council (GMC) Specialist Register for Vascular Surgery and remain personally accountable to the GMC under Good Medical Practice. Public information on this page is written to be factual and verifiable in line with the Committee of Advertising Practice (CAP) Code and Advertising Standards Authority (ASA) rules for medical advertising.

References & evidence

References and evidence

Claims about prevalence, the venous / arterial / lymphatic framework, and the role of ABPI and duplex on this page are drawn from NHS, the British Heart Foundation, NICE, the European Society for Vascular Surgery, the LiMPRINT UK prevalence study and the AHA PTS Scientific Statement. Each source is linked for verification.

3
NICE Quality Standard

National Institute for Health and Care Excellence

Quality Standard QS67, Varicose veins.

NICE, August 2014, last updated 2019

nice.org.uk/guidance/qs67

4
NICE Guideline

National Institute for Health and Care Excellence

Peripheral arterial disease, diagnosis and management (NG147).

NICE, December 2020

nice.org.uk/guidance/ng147

5
ESVS Clinical Guideline

Wittens C, Davies AH, Bækgaard N, et al.

Management of Chronic Venous Disease, Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).

European Journal of Vascular and Endovascular Surgery 2015, 49(6), 678-737

doi.org/10.1016/j.ejvs.2015.02.007

6
UK Prevalence Study

Moffatt CJ, Keeley V, Franks PJ, et al.

Chronic oedema, a prevalent health care problem for UK health services (LiMPRINT).

International Wound Journal 2017, 14(5), 772-781

pubmed.ncbi.nlm.nih.gov/27928889

7
AHA Scientific Statement

Kahn SR, Comerota AJ, Cushman M, et al.

The post-thrombotic syndrome, a Scientific Statement from the American Heart Association.

Circulation 2014, 130(18), 1636-1661

pubmed.ncbi.nlm.nih.gov/25246013

8
RCS Good Practice Guide

Royal College of Surgeons of England

Consent, Supported Decision-Making, A Guide to Good Practice.

RCS England, 2018

rcseng.ac.uk/…/consent

Last clinical review: Dr Maryam Attarzadeh, Medical Director (GMC 7193218), 2026-05-28. Next review due: 2026-11-28. Statistical claims are re-verified every 6 months, or sooner if peer-reviewed evidence changes.