Frequently Asked Questions

Pectus excavatum is a condition where the breastbone (sternum) grows inward, creating a sunken or hollow appearance in the chest. It's one of the most common chest wall deformities, affecting roughly 1 in 300 to 400 people, and tends to become most noticeable during puberty. In some cases it can affect breathing and heart function, but for many people the main impact is on confidence and wellbeing, particularly in teenagers and young adults.

A vacuum bell is a non-surgical device used to treat pectus excavatum. It works by using suction to gradually lift the sternum outward over time. It's worn for a prescribed number of hours each day, and treatment typically takes place over months or years depending on the individual. Vacuum bells are most effective in younger patients whose chest wall is still developing, but can be beneficial for adults too. Fiona will be able to advise whether it's likely to be appropriate for you.

No. This is a private service, run independently by Fiona Roy. Fiona works with NHS England and helps support the charity Pectus Matters to improve access to pectus care nationally, but Pectus Care with Fiona is a separate, self-funded service for people who are unable to access treatment through their local NHS trust.

No, you don't need a referral to get in touch. However, Fiona will ask whether you've discussed your diagnosis with a doctor as part of the screening process. If you haven't, she may recommend you do so before proceeding.

Yes, as long as appointments can be conducted in English. Fiona works with clinicians internationally, including in Australia, and vacuum bell devices can be posted abroad — postage costs would apply. If you're based outside the UK, please mention this in your screening form.

Fiona Roy is a HCPC registered orthotist with over 22 years of experience in paediatric orthotics and more than 10 years of specialist pectus work. She is also a student mentor and works with NHS England and helps support the Pectus Matters charity.

No. Submitting the screening form simply starts a conversation. Fiona will review your details and let you know whether a consultation may be appropriate. There is no charge at this stage, and you are under no obligation to book an appointment or proceed with treatment. You can step away at any point.

If something isn't right, please contact us directly in the first instance — we'd always rather resolve a concern informally and quickly. We aim to acknowledge complaints within 5 working days and provide a full response within 20 working days. If you remain unhappy after raising a concern with us, you can contact the Health and Care Professions Council (HCPC), which regulates Fiona's professional practice, at hcpc-uk.org.

Full Package: £1,200 — includes the vacuum bell device (delivered direct to you), virtual fitting appointment, 3-month review, 6-month review, 12-month review, and email support throughout.

Device and Fitting: £800 — includes the vacuum bell device and virtual fitting appointment; follow-up sessions available at £50 each.

Support Only: from £100 — for patients who already have a device or are sourcing one independently. Initial consultation £100, follow-up sessions £50 each.

There is no charge for completing the screening form.

The full £1,200 package includes:

• Vacuum bell device delivered to your door
• Virtual fitting appointment
• 3-month review
• 6-month review
• 12-month review
• Email support throughout

Yes. If you already have a vacuum bell device or are sourcing one independently, the Support Only option is perfect for you. Initial consultation is £100, and follow-up sessions are £50 each. You don't need to purchase a device through us, but clinical support is available whenever you need it.

The 6-month and 12-month reviews are both included in the full £1,200 package. After that, further follow-up sessions are available at £50 each if you need them. There is no obligation to book — Fiona provides written guidance after each session so you can self-manage, but support is available whenever you need it.

The all-inclusive package fee is due before the virtual fitting appointment. There is no charge at the screening stage — you will only be asked to pay once you have agreed to proceed.

We currently accept payment by bank transfer. Payment details will be provided when your appointment is confirmed. If you have difficulty with this method, please let us know and we will try to accommodate you.

We understand that £1,200 is a significant sum for many families. Some families have successfully used crowdfunding or charitable grants to help cover treatment costs. Trees of Hope is a UK charity that supports families fundraising for medical treatment their child can't access on the NHS — they may be able to help if your child is under 18. Platforms such as GoFundMe have also been used by families in similar situations. Our Support page has more information.

We ask for at least 48 hours' notice if you need to cancel or reschedule. Cancellations with less than 48 hours' notice may not be eligible for a refund, though we consider each case individually and will try to be flexible where circumstances are unavoidable. If Fiona needs to cancel at short notice, we will offer an alternative appointment or a full refund.

Unfortunately, we are unable to accept returns or offer refunds once a device has been dispatched. Vacuum bell devices are custom-fitted to your clinical measurements and come into direct contact with the skin, which means they fall under the hygiene exemption to standard consumer return rights. If you believe your device is faulty or was not as described, please contact us immediately and we will do everything we can to help.

Devices are dispatched from a UK-based supplier. International delivery may be available — postage costs and delivery times will be confirmed before any order is placed. Any applicable customs or import charges for your country are the responsibility of the recipient.

Yes, it is possible to purchase a vacuum bell device independently. We understand that cost is a real barrier for some people, and we're not here to discourage anyone from exploring their options. However, we would encourage anyone doing so to seek clinical guidance — ideally from an orthotist or clinician with experience in pectus excavatum — before and during use. Using a vacuum bell without proper fitting or supervision can lead to incorrect sizing or technique, which reduces effectiveness and may cause discomfort or injury. If you'd like clinical support alongside a self-sourced device, please do get in touch to discuss your options.

Usage protocols vary depending on age, severity, and individual response to treatment. Fiona will put together a personalised treatment plan that sets out how long and how often to use the device. Total treatment duration can range from months to years — Fiona will give you a clearer indication at your first appointment once she has reviewed your case in full.

Yes. A significant proportion of people seen by this service are children and teenagers, often with parents or guardians involved throughout. If you're completing a screening form on behalf of a child, there's a section for parent or guardian details. Fiona has over 22 years of experience in paediatric orthotics and is well used to working with young people and their families.

Treatment length varies significantly depending on age, severity and how consistently the vacuum bell is used. Fiona will be able to give you a clearer picture at your first appointment once she's reviewed your case.

Fiona will be upfront with you if she feels this service isn't the right fit. She'll explain why and wherever possible point you towards other options, including Pectus Matters, which offers information and support to people across the UK.

NHS provision for pectus excavatum is inconsistent across the UK. Some NHS trusts have established pathways for vacuum bell therapy; others do not. Whether treatment is available to you often depends on where you live — a situation sometimes described as a postcode lottery. Pectus Matters provides information and advocacy to help people navigate the NHS and understand what may be available in their area. Our Support page has more information.

Any information you share with Fiona is handled in accordance with UK GDPR. Health data is treated as special category data and stored securely. It is not shared with third parties except where necessary to provide your treatment. Please see the Privacy Policy for full details.

Records are retained for the period required by Fiona's professional body and indemnity insurer, after which they are securely deleted. The exact retention period will be confirmed in the Privacy Policy once finalised.