A nail does not leave a hole. It leaves a tear: a ragged slot with torn edges and rubber shoved sideways, often at an angle to the surface rather than square to it. Try to force a repair stem into that and it seats against nothing, because the walls it is meant to grip are not there. Which is why the first tool that goes into the tyre is a reamer.
The reamer cuts the damage back to a clean round hole of a known diameter, so the stem has parallel walls to bond to along its whole length. It also tells you something. If the reamer keeps going and the hole opens out far wider than expected, the object did more damage on its way in than the entry point suggested, and that is often the moment a repair becomes a replacement. Better to learn that at the kerb than a month down the road.
A train to catch is a hard deadline in a way that most things are not. You cannot negotiate with a timetable, and a puncture found twenty minutes before you meant to leave the house in the Brunel University area does not care. School run in Hillingdon Heath or 1am in the Brunel University area, we answer the same. Christmas Day in the Brunel University area, any day in Cowley: the line is open. An UB8 address in Cowley and one in Hillingdon are the same round.

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Stuck between a fast dual carriageway on one side and congested town roads on the other, there is nowhere sensible around here to be dealing with a puncture yourself. The work happens wherever the car has ended up, which is usually a side street or a car park. What decides the outcome is the state of the damage, not the address.
A tyre on a car off the Oxford Road had a neat entry point and a badly torn path underneath it. Once it was opened up the damage sat outside anything that could be repaired.
A screw picked up near Uxbridge town centre had gone in square and clean. Reamed, filled and patched, the tyre was back on the car and balanced inside the hour.
A driver in Hillingdon had a soft tyre and somewhere to be. The damage was central and shallow, so the repair went ahead and they got away roughly on time.
It is counterintuitive and it is the standard method. A torn hole gives the repair nothing to bond to. Cutting it back to clean rubber at a known size is what makes a permanent seal possible at all.
Then the damage was worse than the outside showed, and there is a size limit past which a repair is not permitted. You get told immediately and a replacement comes off the van instead.
Almost always, and it comes out from the outside first so the path it took can be seen. Occasionally something has broken up in there, which is another reason the casing gets inspected from within.
No. Being quick means arriving sooner. Every part of the procedure still happens, because the steps that get dropped under pressure are the ones that decide whether the repair lasts.
Sometimes, if they are far enough apart and both sit inside the repairable band. If they are close together the repairs would overlap each other and the tyre gets replaced instead.
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