A bone density scan with your fracture risk properly calculated — particularly relevant around menopause.
Referred by a GMC-registered GP, results reviewed by the same doctor
Taken at a partner site near you
Results explained in plain English, not just a number
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Bone loss is silent. The first sign is usually a fracture, by which point a great deal of bone has already gone.
DEXA measures bone density directly, and pairs naturally with a menopause consultation — bone loss accelerates sharply in the years after menopause.
Bone mineral density at the hip and spine, reported as a T-score, from which fracture risk is calculated.
A T-score tells you bone density. What you actually want to know is your risk of breaking something in the next ten years — which also depends on age, weight, smoking, alcohol, steroid use and family history.
The results review calculates that properly, because the treatment decision depends on the risk, not the density.
Bone loss accelerates sharply in the years after menopause, and HRT protects against it. If you are considering HRT, knowing your baseline bone density makes that decision better informed.
Consultation, referral to Vista Health, then a results review including a formal fracture risk assessment and a treatment plan where needed.
Avoid calcium supplements for 24 hours beforehand. Do not have a barium study or contrast scan in the week before. Wear clothing without metal zips or buttons.
The T-score compares your bone density with a healthy young adult, and it is what defines osteoporosis and osteopenia.
The Z-score compares you with people your own age, and matters most in younger adults — a low Z-score prompts a search for an underlying cause rather than simply treatment.
This causes a great deal of unnecessary alarm. Osteopenia is a statistical description, not a diagnosis, and most people with it never fracture.
The majority of people with osteopenia do not need medication — they need weight-bearing exercise, adequate vitamin D and calcium, and their fracture risk calculated properly.
Treatment is decided on fracture risk, not on the number alone. That risk is calculated using tools like FRAX, which combine bone density with age, previous fracture, family history, steroid use, smoking, alcohol and rheumatoid arthritis.
Two people with identical T-scores can have very different risks, and therefore very different advice.
A previous fragility fracture — a break from a fall from standing height or less — is a strong predictor of the next one, and often means treatment regardless of the scan result.
It is also frequently not mentioned, because people do not think of a wrist broken on ice as relevant.
Spinal osteoarthritis, previous spinal fractures and aortic calcification all falsely raise the spine reading, which is common in older people and can produce a reassuring number over weakened bone.
Metal implants in the area cannot be measured through, so a different site is used.
We do not perform scans — we refer. And we cannot start most osteoporosis treatment remotely: bisphosphonates need dental assessment beforehand, and injectable treatments need specialist supervision.
Heel ultrasound and other peripheral screening devices, sometimes offered in pharmacies and health fairs, are not diagnostic and cannot be used to make treatment decisions.
High-dose calcium supplements are not the answer either — dietary calcium with adequate vitamin D is preferred, and very high supplement doses carry their own concerns.
NHS DEXA is free where indicated, and the criteria are broader than most people realise: a previous fragility fracture, long-term steroid use, early menopause, low body weight, or a strong family history all qualify.
If any of those apply, ask your GP before paying.
FRAX risk calculation is free and can be done without any scan at all — for many people it settles the question, and sometimes it shows a scan would not change anything.
Osteoporosis medication and the vitamin D that goes with it are prescribed on the NHS, and free vitamin D supplements are available for some groups.
Where you do not meet NHS criteria but have genuine concern, or where a long wait would delay a decision about HRT or treatment.
No calcium supplements for 24 hours beforehand, as they can affect the reading.
No barium studies or injected contrast in the week before — they interfere with the scan.
Wear clothing without metal zips, buttons or clasps, which have to be removed or worked around.
A very small amount — substantially less than a chest X-ray, and considerably less than a day of ordinary background exposure.
It is quick, painless and you stay fully clothed.
Usually not — and this is worth being clear about, because the word frightens people.
Osteopenia means bone density lower than a young adult's. It is not a disease, and most people with it never fracture.
What matters is your calculated fracture risk, which combines the score with age, previous fractures, family history and steroid use. For most people with osteopenia the answer is exercise, vitamin D and reassessment — not medication.
T-score compares you with a healthy young adult, and defines osteoporosis.
Z-score compares you with people your own age, and matters most in younger adults — a low Z-score prompts looking for an underlying cause.
Weight-bearing and resistance exercise, which is the most effective thing available and costs nothing.
Adequate vitamin D and dietary calcium, stopping smoking, and keeping alcohol within limits.
HRT also protects bone, which is relevant for women going through menopause — particularly early menopause.
Not more often than every two years, and often less.
Bone density changes slowly, and an earlier repeat cannot distinguish real change from measurement variation.
Yes, considerably — and it is worth mentioning even if it feels unrelated.
A fracture from a fall from standing height is a fragility fracture, and it is one of the strongest predictors of the next one. It often means treatment regardless of the scan result, and it usually qualifies you for a free NHS DEXA.
No. Peripheral devices offered at pharmacies and health fairs are not diagnostic and cannot be used to decide treatment.
A reassuring heel result should not be relied on if you have risk factors.
Vitamin D, calcium, kidney function and thyroid function — and in men, testosterone, since low levels contribute to bone loss and are often overlooked.
Coeliac disease is also worth considering, because it causes bone loss through poor absorption and is regularly diagnosed this way.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
On this page
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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