Visible varicose veins, aching, ankle swelling, skin changes around the ankle
Varicose vein treatmentLeg Circulation Assessment
Service
Consultant-led
First visit
ABPI + duplex
Consultation
30 to 45 min
Initial consult
from £365
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 coversFirst-visit
ABPI and duplex ultrasound on the first visit where clinically indicated
Mandatory
ABPI before any compression therapy, to rule out significant arterial disease
“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]:
The three can overlap (mixed venous-arterial, lipo-lymphoedema, diabetic foot with all three) which is why a structured assessment matters.
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.
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.
Visible varicose veins, aching, ankle swelling, skin changes around the ankle
Varicose vein treatmentCramping calf pain on walking, cold feet, slow-healing wounds
Claudication & PADPersistent leg or arm swelling, particularly after cancer or surgery
Lymphoedema treatmentDisproportionate fat in the legs that is tender and resists weight loss
Lipoedema clinicAn open wound on the leg or foot that has not healed in 2 weeks
Leg ulcer treatmentDiabetes and any foot symptom, including numbness or a wound
Diabetic foot servicePersistent symptoms in a leg that has had a DVT
Post-thrombotic syndromeSmall surface vessels for cosmetic reasons (legs or face)
Thread vein treatmentNot sure which page applies? Book a leg circulation assessment and we will route you.
Our work-up is built around what international vascular guidelines recommend at first contact[3][4][5]:
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.
ScopeTo 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 visitMost 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 visitFor full pre-care and post-care instructions, see our Patient instructions page.
You receive a written quote before any treatment is booked.
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 teamLeg 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 BUPA-recognised, fee-assured 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.
“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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Surrey catchment also includes Esher, Cobham, Weybridge, Walton-on-Thames, Oxshott and Hampton.
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.
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.
Peripheral arterial disease (PAD), context for “poor circulation”.
National Health Service
nhs.uk/conditions/peripheral-arterial-disease-padPeripheral arterial disease.
BHF
bhf.org.uk/…/peripheral-arterial-diseaseQuality Standard QS67, Varicose veins.
NICE, August 2014, last updated 2019
nice.org.uk/guidance/qs67Peripheral arterial disease, diagnosis and management (NG147).
NICE, December 2020
nice.org.uk/guidance/ng147Management 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.2015.02.007Chronic oedema, a prevalent health care problem for UK health services (LiMPRINT).
International Wound Journal 2017, 14(5), 772-781
pubmed.ncbi.nlm.nih.gov/27928889The post-thrombotic syndrome, a Scientific Statement from the American Heart Association.
Circulation 2014, 130(18), 1636-1661
pubmed.ncbi.nlm.nih.gov/25246013Consent, Supported Decision-Making, A Guide to Good Practice.
RCS England, 2018
rcseng.ac.uk/…/consentLast 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.