Urgent rib injuries seen same day · routine appointments within 24–48 hours 020 7459 4367 WhatsApp info@marcoscarci.co.uk
For referrers

Refer a patient

For GPs, emergency and acute medicine teams, physiotherapists, osteopaths, sports and exercise medicine clinicians, and solicitors’ case managers. One secure route, a prompt reply, and a plan you can act on.

Page last updated September 2026

Two minutessecure online referral, no account needed
Attach imagingletters and scans go with the referral
Same-visit imagingCT, dynamic ultrasound or MRI where it changes the plan
A written plandiagnosis, treatment, rehab, and who does what
Three ways to refer

One secure route, and a phone line for the urgent ones

New patients are usually seen within a week, and acute rib fracture cases sooner. Clinic letters go to the referrer and the patient. NHS referrals to the thoracic surgery service at Hammersmith Hospital, Imperial College Healthcare NHS Trust, go through the NHS e-Referral Service in the usual way.

Who to refer

When a chest wall opinion changes the plan

Acute (days)

  • Three or more rib fractures, or any displaced fracture
  • Any rib fracture in a patient over 65particularly on anticoagulants or with COPD, heart failure or frailty
  • Flail segment, or fractures with respiratory compromise
  • Sternal fracture
  • Pain not controlled within 48 to 72 hours on standard analgesia
  • Rib fractures in an athlete or manual worker who needs a defined return plan
  • Chest wall injury with a normal X-ray but persistent focal paincartilage injuries do not show on X-ray

Persistent (weeks to months)

  • Chest wall pain more than six to eight weeks after injury
  • Suspected non-unioncrepitus, a step, or a lump at an old fracture
  • Clicking, popping or slipping lower ribsslipping rib syndrome
  • Chronic anterior chest wall pain labelled costochondritis that has not settled
  • Chest wall pain with a completed, normal cardiac and gastrointestinal work-up
  • Burning, band-like pain suggesting intercostal neuralgiaincluding post-surgical and post-herpetic
  • Xiphoid tenderness, chest wall lumps, bulges that appear on straining, and chest wall shape concerns
What to include

Enough to triage — a short referral is fine

A short referral is fine. If the case is urgent, a phone call is better than a perfect letter.

What happens next

From referral to a written plan

Acknowledgement

From the practice, with an appointment offer.

Same day

Consultation

History, hands-on chest wall examination, review of imaging. Where imaging will change the plan — thin-slice CT with 3D reconstruction, dynamic ultrasound, MRI for stress fractures — it is arranged on the same visit wherever possible.

Within a week

Diagnostic or therapeutic nerve block

Under ultrasound guidance, where indicated.

Same visit

A written plan to you and the patient

Diagnosis, treatment, rehabilitation, and who does what.

After the visit

Rehabilitation goes back to you. Referring physiotherapists and osteopaths keep their patients; the plan is written to be delivered locally, with direct access to the practice for questions.

What the practice offers

Diagnosis and treatment under one chest wall service

Diagnosis

  • Specialist chest wall examination
  • Thin-slice CT with 3D reconstruction
  • Dynamic chest wall ultrasound
  • Ultrasound-guided diagnostic intercostal nerve blocks
  • Assessment of chest wall lumps, including image-guided biopsy

Treatment

  • Surgical stabilisation of rib fractures (rib plating), acute and delayed
  • Non-union repair and resection
  • Slipping rib syndrome surgery
  • Costal cartilage repair
  • Sternal fixation and xiphoidectomy
  • Intercostal nerve decompression and neurectomy
  • Chest wall hernia repair
  • Excision of chest wall lumps
  • Rib flare and pectus assessment
Where patients are seen

Five private hospitals, plus NHS care at Hammersmith

Private consultations and surgery at the Cromwell Hospital, the Wellington Hospital, the London Clinic, HCA Elstree and Imperial Private Healthcare. NHS care at Hammersmith Hospital. Video consultations are available for follow-up and for patients travelling from outside London.

Mr Scarci is recognised by the major UK private medical insurers. Self-pay consultation and procedure fees are available on request from the practice.

Cromwell HospitalThe Wellington HospitalThe London Clinic HCA ElstreeImperial Private HealthcareNHS · Hammersmith
Referrals from other clinicians

The most useful thing a surgeon can do is confirm the diagnosis

Ruling out the things that will not respond to rehabilitation — a non-union, a separated cartilage, a slipping rib, or a trapped nerve — is where a chest wall opinion earns its place.

Physio & osteo

Physiotherapists & osteopaths

Refer directly, without a GP letter for private patients. Your patient comes back with a diagnosis, imaging, and a plan that includes what to load and when. For athletes, return-to-sport planning is done jointly with club and team clinicians.

Legal

Solicitors & case managers

Treating-clinician referrals after road traffic accidents and accidents at work, through the same routes. Treatment reports and imaging are provided promptly for case management. Expert witness instructions go to the medicolegal practice, not this page.

Teaching

Talks & teaching

Practice-based sessions for GP practices, physiotherapy teams and sports clubs — rib fractures in older adults, slipping rib syndrome, and chest wall pain that outlasts the tests. Arranged through the practice.

Mr Marco Scarci, consultant thoracic surgeon
Your surgeon

Mr Marco Scarci

MD(Hons) · FRCS(Eng) · FCCP · FACS · FEBTS · Consultant Thoracic Surgeon, Imperial College Healthcare NHS Trust

Mr Scarci holds an NHS consultant post at Hammersmith Hospital, Imperial College Healthcare NHS Trust, and runs a chest wall practice across London’s leading private hospitals. He has performed more than 5,000 procedures at consultant level since 2011 and treats rib and chest wall injuries every week, from acute trauma to the long-standing pain that other tests have failed to explain.

20+years as a consultant thoracic surgeon
5,000+procedures at consultant level
170+peer-reviewed publications
Read the full biography
Pages you may want to send patients

Plain-English pages to pass on

Refer in two minutes

Secure, no account needed, and imaging can be attached. For urgent cases, call the practice directly.