cancer and palliative care directory

St. Helens and Knowsley Hospitals NHS Trust

Cancer & Palliative Care

Service Directory

Fourth Edition – April 2007

CONTENTSProduced by Cancer Services Version Four April 2007

NHS

1. INTRODUCTION.....................................................................................4

2. CANCER MANAGEMENT TEAM...........................................................5

2.1 SUSPECTED CANCER REFERRALS.....................................................6

2.2 MDT POLICY............................................................................................7

2.2 MDT POLICY............................................................................................8

2.3 SERIOUS DIAGNOSIS FAX...................................................................19

3 ONCOLOGY..........................................................................................21

3.1 LILAC CENTRE......................................................................................21

3.2 CLINICAL TRIALS TEAM......................................................................23

4. SITE SPECIFIC PATIENT SERVICES..................................................24

4.1 CANCER SERVICE – Breast.................................................................24

4.2 CANCER SERVICE – Colorectal..........................................................26

4.3 CANCER SERVICE – Gynaecology.....................................................28

4.4 CANCER SERVICE – Haematology.....................................................30

4.5 CANCER SERVICE – Head & Neck......................................................31

4.6 CANCER SERVICE – Lung...................................................................32

4.7 CANCER SERVICE – Skin....................................................................34

4.8 CANCER SERVICE – Upper Gastrointestinal.....................................35

4.9 CANCER SERVICE – Urology..............................................................37

5. PALLIATIVE CARE..............................................................................39

5.1 PALLIATIVE CARE - Hospital Specialist Palliative Care Team.........39

5.2 PALLIATIVE CARE - Willowbrook Hospice........................................47

5.3 PALLIATIVE CARE - Macmillan Clinical Nurse Specialist Palliative Care - Community..........................................................................................51

Produced by Cancer Services - Version Four (April 2007)

- 1 -

5.5 PALLIATIVE CARE - INTEGRATED PALLIATIVE HOME CARE TEAM – HENRIETTA PROJECT..............................................................................55

6.0 EXTENDED SERVICES........................................................................57

6.1 EXTENDED SERVICES - HOSPITAL BASED PAIN TEAM................57

6.2 EXTENDED SERVICES - Chaplain/Pastoral Care...............................59

6.3 EXTENDED SERVICES - Department Of Nutrition and Dietetics......61

6.4 EXTENDED SERVICES - The Speech & Language Therapy Service68

6.5 EXTENDED SERVICES – SUPPORT Smoking Cessation..................69

6.6 EXTENDED SERVICES – ICCP (Integrated Cancer Care Programme)72

7. SUPPORT GROUPS.............................................................................74

7.1 SUPPORT GROUPS - Local Support Groups/Services.....................74

7.2 SUPPORT GROUPS - Local Bereavement Support...........................78

7.3 SUPPORT GROUPS - National Support - General..............................79

7.4 SUPPORT GROUP - National Support – Site-Specific.......................84

8. Amendment Form..................................................................................92


- 2 -

1. INTRODUCTION

Welcome to the fourth edition of St Helens & Knowsley Hospitals NHS Trust, Cancer & Palliative Care Service Directory. This Directory has been produced to build on existing communication links between primary and secondary care. The Directory contains vital information about the multidisciplinary teams responsible for cancer care at St Helens & Knowsley Hospitals.

There are seven sections, with the first five giving details of cancer and palliative care services at St Helens & Knowsley Hospitals, Willowbrook Hospice and Primary Care. The sixth section covers a range of extended services, which may be accessed by cancer or palliative care patients. The last gives details of relevant local and national support groups.

Inevitably teams change and Directory details become dated and inaccurate. To maintain what we believe is a crucial dialogue between health professionals, the directory will be subject to quarterly amendment to maintain its accuracy, future editions will be available electronically on our Intranet site:nww.sthkhealth.nhs.uk/cancer services.

To ensure subsequent editions of the Directory are complete, please inform me of any additions or amendments directly.

Your assistance is appreciated.

Anita CorriganLead Nurse/Manager - Cancer Services0151 430 [email protected]


- 3 -

mailto:[email protected]

2. CANCER MANAGEMENT TEAM

There is a lead team within St Helens & Knowsley Hospitals, comprising of a lead clinician and lead nurse/manager, who work in close collaboration to deliver on the strategic and operational agenda for cancer services at a local level.

Lead Clinician

The lead clinician is responsible for the clinical organisation, development and delivery of cancer care across the cancer unit. The lead clinician is a representative voice for medical colleagues relating to all aspects of cancer service provision. Communication is a fundamental part of this role.

Contact details: Dr Rani ThindTel: 0151 430 [email protected]

Lead Nurse

The lead nurse is responsible for providing leadership and direction for all nurses involved in cancer care, to develop cancer-nursing practice in line with local, regional and national priorities. The aim is to facilitate a comprehensive and integrated approach to cancer service delivery and improve the patient’s experience throughout their cancer journey.

Contact details: Anita CorriganTel: 0151 430 [email protected]

Lead Manager

The lead manager works closely with individual cancer teams and key stakeholders to develop cancer teams and services to meet national cancer standards and the targets set out in the National Cancer Plan.

Contact details: Anita CorriganTel: 0151 430 [email protected]


- 4 -




2.1 SUSPECTED CANCER REFERRALS

St Helens & Knowsley Hospitals NHS TrustUrgent Suspicious Cancer Referral Pro-forma

Patient Details GP Practice Details (stamp) Surname: Practice Name:

Address:

Postcode:Telephone:Fax: Email:

First Name:

Age/DOB:

Address: Postcode: Contact Number:Evening Telephone:

Mobile:

Referring GP:

New NHS number: Decision to refer date: / /

Hospital number (if known): First language:Interpreter required? Y / N

Please tick the Speciality for which you are requesting a Two-week wait appointment:1Gynaecology 2Lung (x-ray to be done prior to referral) 3Haematology 4Head & Neck 5Urology 6Testicular 7Upper GI 8Breast 9Brain 10Lower GI 11Skin 12Sarcoma

State clinical reason for suspicion of cancer - See Referral Guidelines – Include any investigation results and any other relevant information.


- 5 -

FAX THIS FORM WITHIN 24 HOURS OF YOUR DECISION TO REFER TO:UROLOGICAL 0151 430 1901 GYNAECOLOGICAL 0151 430 1043

ENDOSCOPY 0151 430 1892ALL OTHER CANCER REFERRALS 0151 430 1629


- 6 -

10SKIN -Urgent ReferralMelanoma - Pigmented lesion which have >=1 of the following features: Growing in size Changing shape Irregular outline Change in colour Mixed colour Itch/ bleeding InflammationNB Melanomas are usually 5mm or greater at the time of diagnosis, smaller lesions may appear in early melanoma.Squamous Cell Carcinoma (SCC)Slow growing, non-healing lesions with a significant induration on palpation with documented expansion over 1-2 months. Patients diagnosed SCC from a biopsy undertaken in general practice immuno suppressed patients following organ transplant have a high incidence of SCC which can be unusually aggressive and metastasize . Strongly recommend referring these patients via two week rule.Characteristics of SCC Evidence of chronic skin damage eg solar keratosis/old burn scar Crusting/non healing lesion Documented expansion Inflammatory response.

1GYNAECOLOGY-Urgent Referral Pelvic mass not obviously fibroids or

pregnancy Post menopausal bleeding not on

HRT Suspicious cervical lesion Persistent post-coital bleeding Smear suggesting malignancy

2LUNG-Urgent Referral to a Chest Physician: Chest x-ray suggestive or suspicious

of lung cancer (including pleural effusion and slowly resolving consolidation)

Persistent haemoptysis in smokers/ex-smokers over 40 years of age

Sign of superior vena caval obstruction (swelling of face/neck with fixed elevation of jugular venous pressure)

Stridor (consider emergency referral)

3HAEMATOLOGICAL – urgent referral Blood count/film reported as

suggestive of acute leukaemia or chronic myeloid leukaemia.

Lymphadenopathy (> 1cm) persisting for 6 weeks

NB. Cervical lymphadenopathy/ un-resolving neck masses persisting for > =3weeks, referral to the Head & Neck team is recommended Hepatosplenomegaly Bone pain associated with anaemia

and a significantly raised ESR (or plasma viscosity)

Bone x-rays reported as being suggestive of myeloma

Constellations of 3 or more of the following symptoms (+/-fatigue) night sweats weight loss itching breathlessness bruising recurrent infections bone pain.

4Head & Neck – urgent referral >=6 weeks hoarseness any 1 of the following lasting >=3

weeks: ulceration of mucosa, oral swellings, dysphagia, unressolved neck mass

uniltareal nasal obstruction with purulent discharge

unexplained tooth mobility without peridontal disease

cranial neuropathies orbital masses

The level of suspicion is further increased if the patient is a heavy smoker or heavy alcohol drinker and is aged over 45years and male. Other forms of tobacco use (chewing Betel, Gutkha, Pan) should also arouse suspicion

5UROLOGICAL - Urgent Referral Macroscopic haematuria in

adults Microscopic haematuria in

adults over 50 yrs – excl UTI Swelling in the body of the

testis – refer to consultant Solid renal masses found on

imaging An elevated age specific PSA

in men with a ten year life expectancy

A high PSA (>20ng/ml) in men with a clinically malignant prostate or bone pain

Any suspected penile cancer Recommended that PSA test, in aysmptomatic men should only be performed after full counselling and provision of written information.

6UPPER GI-Urgent Referral any age Dysphagia Dyspepsia with >=1 of the

following alarm symptoms: Weight loss, proven

anaemia vomiting >55 years Dyspepsia >=1 of

the following "high risk" features:

Onset of dyspepsia less than one year ago

Continuous symptoms since onset

Dyspepsia combined with >=1 of the following risk factors:

Family history of upper GI cancer in more than 2 first degree relatives

Barrett's oesophagus Pernicious anaemia Peptic ulcer surgery over 20

years ago Known dysplasia, atrophic

gastritis, intestinal metaplasia

Jaundice Upper abdominal mass

7BREAST - Urgent Referrals Patients with a discrete lump

in the appropriate age group (eg age > 30)

Signs which are highly suggestive of cancer such as: ulceration, skin nodule, skin distortion, nipple eczema, recent nipple retraction or distortion (< 3 months

8Brain tumours – urgent referral Subacute progressive

neurological deficit developing over days to weeks eg weakness, sensory loss, dysphasia, ataxia.

New onset seizures characterised by >=1 of the following: focal seizures, prolonged post ictal focal deficit (>1hr), status epilepticus, associated inter-ictal focal deficit.

Headache, vomiting & papilloedema

Cranial nerve palsy eg diplopia, visual failure incl. Optician defined visual field loss, unilateral sensorineural deafness.

Consider urgent referral for: recent onset non-migrainous headaches, present for >=1 month, accompanied by features of raised intra cranial pressure eg woken by headache; vomiting; drowsiness. (Exclude depression and somatisation disorder – brain tumour unlikely)

9LOWER GI - Signs & Symptoms of predictive value of bowel cancer

Any age

• persistent increase in frequency of bowel function or looseness of stools for 6 weeks

• definite palpable right sided iliac fossa mass

• definite palpable rectal tumour

• suspicious barium enema

Aged 40>

• bleeding persistently without peri-anal symptoms (eg soreness, discomfort, itching, lumps, prolapse, pain)

• dark blood mixed with stools

• unexplained iron deficiency anaemia (Hb <11g/dl in men or <10g/dl in postmenopausal women)

• abdominal pain only if severe, colicky and in association with weight loss or decreased appetite

10SKIN -Urgent ReferralMelanoma - Pigmented lesion which have >=1 of the following features: Growing in size Changing shape Irregular outline Change in colour Mixed colour Itch/ bleeding InflammationNB Melanomas are usually 5mm or greater at the time of diagnosis, smaller lesions may appear in early melanoma.Squamous Cell Carcinoma (SCC)Slow growing, non-healing lesions with a significant induration on palpation with documented expansion over 1-2 months. Patients diagnosed SCC from a biopsy undertaken in general practice immuno suppressed patients following organ transplant have a high incidence of SCC which can be unusually aggressive and metastasize . Strongly recommend referring these patients via two week rule.Characteristics of SCC Evidence of chronic skin damage eg solar keratosis/old burn scar Crusting/non healing lesion Documented expansion Inflammatory response

11Sarcoma – urgent referral Soft tissue mass with

>=1 of the following: Size > 5 cms, painful,

increasing in size, deep to fascia, recurrence after previous excision.

Radiological suspicion of a primary bone tumour based on evidence of bone destruction, new bone formation, soft tissue swelling and periosteal elevation.

2.2 MDT POLICY

1.0 Introduction

1.1 As a prerequisite for Cancer Peer Review, the Trust is required to have an agreed operational policy in place for each cancer multidisciplinary team (MDT). The policy aims to ensure that the MDT is an integral part of the cancer patient’s management.

1.2 Following consultation with all MDT Lead Clinicians (as documented below), the policy was approved on 14/03/05 at the Trust Cancer CommitteeMr G. Cawdell Lead Clinician – GynaecologyMiss L. Chagla Lead Clinician – BreastMr R. Green Lead Clinician – SkinDr J. Hendry Lead Clinician – LungMr I. Khan Lead Clinician – Upper GIMr R. Kiff Lead Clinician – ColorectalDr C. Littlewood Lead Clinician – Palliative CareMr A. Massey Lead Clinician – UrologyDr G. Satchi Lead Clinician – Haematology

2.0 Scope of Policy

2.1 To describe the process and requirements of an effective MDT, ensuring

All patients with a new diagnosis of cancer have their treatment plan discussed by the appropriate MDT

Prompt effective decision making, to prevent delays in the patients journey

Teams comply with the site-specific quality measures identified within the Cancer Services Manual of Cancer Standards 2004.

This is a generic document that applies to all cancer MDT’s in the Trust. It is intended for adjustment by the various MDT’s to reflect their local practices.

3.0 Terminology and definitions

3.1 The Cancer Multidisciplinary Team (MDT) is defined as a group of staff from different health care disciplines, who meet together at a given time (whether physically in one place, or by video/teleconferencing) to discuss a given patient and who are each able to contribute independently to the diagnostic and treatment decisions about the patient.


- 7 -

3.2 The (2004) Cancer Services Standards define the objectives of an MDT as follows:

To ensure that designated specialists work effectively together in teams such that decisions regarding all aspects of diagnosis, treatment and care of individual patients and decisions regarding the team’s operational policies are multidisciplinary decisions.

To ensure that care is given according to recognised guidelines (including guidelines for onward referrals) with appropriate information being collected to inform clinical decision making and to support clinical governance/audit.

To ensure that mechanisms are in place to support entry of eligible patients into clinical trials, subject to patients giving fully informed consent.

4.0 MDT Constitution

4.1 There should be a single named lead clinician for the named MDT who should then be a core team member, agreed by the lead clinician of the Trust.

4.2 The lead clinician of the MDT should have agreed the responsibilities of the position with the lead clinician of the Trust. (Appendix 1)

4.3 The MDT should be listed as part of the services of a named locality of the network.

4.4 The core membership of an MDT will vary between teams and must be adjusted to reflect Cancer Services Standards, NICE guidance and local practice. Membership will generally include:

MDT Lead Clinician Consultant medically qualified core member(s) other than in imaging

and histopathology. Oncologist(s). Clinical Nurse Specialist/nurse representative Radiologist Histopathologist Palliative Care representative MDT Co-ordinator Any additional members at the discretion of the MDT Lead. A core team member will be nominated as having specific

responsibility for users' issues and information for patients and carers.

4.5 The MDT should agree cover arrangements for each core member, agreed by the lead clinician of the MDT


- 8 -

4.6 The core imaging specialist member(s) of the MDT should regularly report on imaging of the primary cancer site or sites of the MDT.

4.7 The MDT should have at least one core nurse member who should have enrolled in, or be undertaking, or have successfully completed, a programme of study in their specialist area of nursing practice which has been accredited for at least 20 level III CAT points.

4.8 The MDT should have at least one core nurse member who should have enrolled in, be undertaking, or have successfully completed a course/module in communication skills, which is accredited for CAT points. This may be either standalone or as part of specialist programme.

4.9 The lead clinician and the core nurse member/s will have agreed a list of responsibilities. (Appendix 2)

4.10 If applicable, the MDT lead clinician will agree the names of members of the extended team for named roles in the team, if they are not already offered as core team members.

5.0 MDT Terms of Reference

5.1 Meetings should take place as directed by the Cancer Services Standards, or more frequently dependant on workload. As a minimum, fortnightly meetings should take place to ensure the patient’s journey is not adversely affected. A record of core members' attendance will be maintained.

5.2 Core members or their arranged "cover" should attend a minimum of 51% of the meetings.

5.3 The core MDT, at their regular meetings, should agree and record individual patient's treatment plans. A record should be made of the treatment plan. The record should include: The identity of patients discussed. The multidisciplinary treatment planning decision (i.e. to which

modality(s) of treatment - surgery, radiotherapy, chemotherapy, hormone therapy or supportive care or combinations of the same, they are to be referred for consideration).

5.4 For patients requiring a treatment planning decision before the next scheduled meeting, the consultant lead will discuss the patient with the relevant core/extended team member (i.e. consultant colleague, oncologist , palliative care) and jointly agree a management plan. The agreed management plan will be documented in the case notes. All patients will be discussed retrospectively at the next scheduled meeting.

5.5 Besides the regular meetings to discuss individual patients, the team should meet at least annually to agree the following:


- 9 -

Local protocols and guidelines for practice Adoption of national/network guidelines Review MDT compliance with Cancer Services Standards Agree and ensure representation on the relevant CNG, with regular

feedback to the team.

6.0 MDT Co-ordination

6.1 The list of patients to be discussed at a forthcoming meeting is held by the MDT Co-ordinator. Any member of the core or extended MDT may add patients to the list, although this should be discussed with the site-specific surgeon/physician beforehand to ensure responsibility for any clinical decision made by the MDT is agreed.

6.2 The MDT Co-ordinators frequently review all pathology reports to identify cancer patients. If a patient is identified via this route the MDT Co-ordinator has the authority to add these patients to MDT lists.

6.3 The cut-off time for adding patients to the list is as follows: For a morning meeting - cut-off midday previous working day For a lunchtime meeting – cut-off close of day previous working dayThis ensures the MDT Co-ordinators have time to find all notes and x-ray films before a meeting, and for these to be reviewed by MDT members. The Core Team Radiologist and Histopathologist will be informed of those patients on the list, in order to review films/slides in advance of the MDT meeting.

6.4 For patients added to the list after the cut-off time, notes and films must be provided by the ‘adding’ clinician.

6.5 The chair of the meeting will ensure discussions are focused, ensuring all core members of the MDT are able to contribute.

6.6 Following MDT discussion, a core team member will record the management decision be in the patient’s case notes.

7.0 Primary Care Feedback

7.1 The MDT will inform the patient's general practitioner (GP) after a patient is given a diagnosis of cancer. The agreed generic proforma will be completed and faxed to the practice by the end of the following working day.The MDT will audit this process on an annual basis.

7.2 The MDT will provide information to referring general practitioners on the appropriateness of urgent suspected cancer GP referrals.


- 10 -

8.0 Patient experience

8.1 Each MDT will identify a single named key worker for each individual patient receiving treatment/care directly from the team. The name of the current key worker will recorded in the patient's case notes. The responsibility for ensuring that the key worker is identified should be that of the nurse MDT member(s). (Appendix 2 & 3)

8.2 The key worker for each individual patient will ensure that the patients and/or carers receive written contact information to access the MDT to discuss problems or concerns.

8.3 The MDT will offer patients the opportunity of a permanent record or summary of at least a consultation between the patient and the doctor at which the treatment options of their diagnosis were discussed.

8.4 The MDT will undertake an annual survey of its patients' experience of the services offered by the team.The survey should at least ascertain whether patients were offered: A key worker. The MDT's information for patients (written or otherwise). The opportunity of a permanent record or summary of a consultation

at which their treatment options were discussed.The survey results will be presented and discussed at an MDT meeting, with at least one action point arising from the survey agreed and implemented.

8.5 The MDT will provide written material for patients and carers which includes:

Information specific to that MDT about local provision of the services offering the treatment for that cancer site.

Information about patient self-help groups if available and complying with the network quality criteria.

Information about the services offering psychological, social and spiritual/cultural support, if available.

Information specific to the MDT's cancer site or group of cancers about the disease and its treatment options.

8.6 There should be a checklist in each patient's case notes addressing whether the patient has been offered: A key worker. The MDT's information for patients (written or other formats). The opportunity of a permanent record or summary of a consultation

at which their treatment options were discussed.

9.0 Network requirements

9.1 The MDT should send a team member as a representative to at least two thirds of the site-specific clinical network group (CNG) meetings.


- 11 -

The representative should feedback CNG discussions to the MDT on a regular basis.

9.2 The MDT should abide by the agreed specified network-wide clinical guidelines for the cancer site.

9.3 The MDT should abide by the agreed network-wide referral guidelines

9.4 The MDT should abide by the agreed imaging guidelines for the diagnosis and assessment of that cancer site.The guidelines should address: Imaging modalities. Their specific indications.

9.5 The MDT should abide by the agreed pathology guidelines for the diagnosis and assessment of that cancer site. The guidelines should address: Laboratory and histopathology/histochemical investigations. Their specific indications.

9.6 The MDT should collect the minimum dataset (MDS), as agreed by the site-specific clinical network group (CNG).

9.7 The MDT should participate in at least one network-wide audit project. The MDT should present the results of a completed network-wide audit project to the site-specific clinical network group (CNG)

9.8 The MDT should abide by the agreed network approved list of clinical trials.

10.0 Data Collection

10.1 The MDT should have started to record the MDS in an electronically retrievable form.

10.2 Measured over the complete calendar year prior to the peer review visit, the MDT should ensure that the hospital's number of separate patient returns to the cancer registry for the MDT's cancer site(s) should be at least 95% of the hospital's 'average' return.

10.3 Measured over the complete calendar year prior to the peer review visit, the MDT should ensure that the hospital's number of separate patient returns to the cancer registry for the cancer site(s) of the team should be at least 95% of the new cancer patients discussed by the team in the same period.

10.4 The Cancer Support Team will provide each MDT with a monthly report identifying pre-defined data items including Cancer Waiting Times Performance.


- 12 -

11.0 Service Improvement

11.1 The lead clinician of the MDT should nominate one of the members of the core or extended team as the person responsible for ensuring that service improvement is integrated into the functions of the MDT.

11.2 The MDT should carry out process mapping covering the key stages of their patients' journey i.e.:a) From the receipt of the referral of a new patient to their point of

referral on for each of the possible options for first definitive treatment; and:

b) In the case of a surgical, first definitive treatment, to the point of admission for surgery.

From the completed process mapping the MDT should produce a report containing an action plan (AP) for service improvement, which addresses patient waiting times.

The report including the AP should be agreed by the MDT lead clinician, the service improvement lead of the CNG and the network service improvement lead.

From the AP, at least one action point for service improvement addressing patient waiting times should have been agreed with the service improvement lead for the CNG and the network service improvement lead, as being of first priority for implementation, and should then have been implemented.

Data, addressing patient waiting times, from the relevant part of the patient journey should have been collected before and after implementation, and compared.

Following receipt of the MDT's process mapping report, the network service improvement lead should decide whether capacity/demand study is required for any part of the patient journey. If this is required, the MDT should have completed the required study and the results used as a basis for part of the service improvement AP.

11.4 The MDT will offer patients ‘booking’ at three key stages of their cancer journey:-

Booking Two-week wait referrals should be able to choose to pre-book their appointment.

New patients who are suspected of having cancer should be able to choose and pre-book the date of their first diagnostic test.

Patients who require an elective admission/outpatient treatment for first treatment should be able to choose and pre-book their admission date.

12.0 Clinical Governance

12.1 It is a national requirement that an MDT discusses all patients with a new diagnosis of a cancer. Each MDT must therefore ensure the team discusses all patients within their remit at least once, and that treatment decisions are clearly recorded in the patients notes.


- 13 -

Appendix 1 – Role and Responsibilities of MDT Lead Clinician

Role: Ensure that all objectives of MDT working (as laid out in Manual of Cancer

Service Standards, 2004) are met

Ensure that MDT members work effectively together, such that decisions regarding all aspects of treatment/care of individual patients and decisions regarding the team's operational policies are multidisciplinary decisions

Ensure that care is given according to recognised guidelines (including guidelines for onward referrals) with appropriate information being collected to inform clinical decision-making and to support clinical governance/audit.

Ensure mechanisms are in place to support entry if eligible patients into clinical trials, subject to patients giving fully informed consent.

Responsibilities:

Overall responsibility for ensuring that MDT meeting and team compliance meet Peer Review Quality Measures.

Ensure attendance levels of core team members are maintained, in line with Quality Measures.

Ensure the target of 100% of cancer patients discussed at MDT is met.

Provide link to Network Site Specific Group (NSSG), either by attendance at meetings or by nominating another team member to attend. Engage in the work of the NSSG in developing cancer services, policies and standards

Lead on, or nominate radiology lead for service improvement.

Organise and chair MDT annual team meeting examining functioning of team and reviewing operational policies, and collate any activities that are requires to ensure optimal functioning of the team (e.g. training for team members).

Ensure MDT’s activities are audited and results documented..

Ensure that the outcomes of the meeting are clearly recorded and clinically validated and that appropriate data collection is supported.

Ensure target for communicating MDT outcomes to primary care is met.

Meet regularly with Cancer Management Team, colleagues from Trust and locality, participating in discussion on trust-wide Cancer Services and Strategy.

Signed ……… Date ………….. Signed ……...………………….. Date ……………….MDT Lead Clinician Dr Thind, Cancer Services Lead Clinician


- 14 -

Appendix 2 – Role and Responsibilities of MDT Core Nurse Member/s

Role:

Contribute to the MDT’s compliance with the quality measures for site-specific teams (as laid out in Manual of Cancer Service Standards, 2004) are met.

Contribute to effective MDT working, such that decisions regarding all aspects of diagnosis, treatment and care of individual patients and decisions regarding the team's operational policies are multidisciplinary decisions.

Ensure that care is given according to recognised guidelines (including guidelines for onward referrals) with appropriate information being collected to inform clinical decision-making and to support clinical governance/audit.

Responsibilities

Contributing to the MDT discussion and patient assessment/care planning decision of the team at their regular meeting. Ensuring the at MDT meeting and team meet Peer Review Quality Measures.

Providing expert nursing advice and support to other health professionals in the nurse’s specialist area of practice

Utilising research in the nurse’s specialist area of practice.

Involvement in clinical audit

Contributing to the management of the service

Specific responsibility for user issues and information for patient and carers

Lead on patient communication issues and co-ordination of the patients pathway for patients referred to the team – acting as a key worker or responsible for nominating the key worker for the patient’s dealings with the team.Key Worker Role: To promote clinical continuity for patientsKey Worker Responsibilities- To orchestrate assessments to ensure patients’ needs are elicited- Ensuring care plans have been agreed with the patient- Ensuring findings from assessments and care plans are communicated to

others involved in a patient’s care- Ensuring patients know who to contact when help or advice is needed,

whether the ‘key worker’ or other appropriate personnel- Act as an administrative contact (during normal working hours i.e. 09.00-17.00,

Monday-Friday) for patients and professionals. The key worker will ensure that patient’s and those providing care are given contact information in writing (i.e. name and telephone number).

- Managing transitions of care

In circumstances where the Palliative Care Team (HPCT) are involved, there has to be an agreement made between the Site-Specific Clinical Nurse Specialist (SS-CNS) and the HPCT member negotiating the' key worker' for that specific episode of care. The individual patient’s current issues and specific problems or concerns need to be taken into account. This will take the form of:


- 15 -

- Advice from HPCT to SS-CNS on a particular situation, e.g. on symptom control, where the SS-CNS remains the key worker.

- Joint consultation by HPCT and SS-CNS where, on patient's agreement,SS-CNS continues to be the key worker.

- Joint consultation by HPCT and SS-CNS where, on patient's agreement,HPCT becomes the key worker.

Signed ……………..…………… Date ………….. Signed ……...………………….. Date ……………….MDT Lead Clinician Site Specific – Clinical Nurse Specialist


- 16 -

Appendix 3 - Clinical Nurse Specialist Protocol

Initial contact with a newly diagnosed cancer patientIntroductionAs a prerequisite for Cancer Peer Review, the Trust is required to have an agreed operational policy in place for each cancer multidisciplinary team (MDT), ensuring each MDT identifies a single named key worker for each individual patient receiving treatment/care directly from the team. The responsibility for ensuring that the key worker is identified should be that of the nurse MDT member(s).

Scope of ProtocolTo describe the role of the site-specific nurse specialist on Initial contact with a newly diagnosed cancer patient

Terminology and DefinitionsFor St Helens & Knowsley Hospitals, the site-specific clinical nurse specialist will perform the role of the ‘key worker’. The Clinical Nurse Specialist title will be used rather than ‘key worker’.

Protocol Initial contact will be made at time of diagnosis in clinic/ward setting or by the end of the

next working day by telephone. In the absence of the Nurse Specialist, it is the responsibility of the clinician informing the patient of the diagnosis to provide the Nurse Specialist and patient with contact details.

On contact the patient and/or carer will receive the Nurse Specialist’s name, contact details and hours of work.

The patient and/or carer will receive written/verbal information regarding the role of the Nurse Specialist i.e.

- To orchestrate assessments to ensure patients’ needs are elicited- Ensuring care plans have been agreed with the patient- Ensuring findings from assessments and care plans are communicated to

others involved in a patient’s care- Ensuring patients know who to contact when help or advice is needed,

whether the ‘key worker’ or other appropriate personnel*- Act as an administrative contact (during normal working hours i.e. 09.00-

17.00, Monday-Friday) for patients and professionals. The key worker will ensure that patient’s and those providing care are given contact information in writing (i.e. name and telephone number).

- Managing transitions of care

The Nurse Specialist will provide written material for patients and carers which includes:

- Information specific to that MDT about local provision of the services offering the treatment for that cancer site.

- Information about patient self-help groups if available and complying with the network quality criteria.

- Information about the services offering psychological, social and spiritual/cultural support, if available.

- Information specific to the MDT's cancer site or group of cancers about the disease and its treatment options.


- 17 -

2.3 SERIOUS DIAGNOSIS FAX

PRACTICE PROTOCOLSERIOUS DIAGNOSIS FAX BACK

Introduction

During the baseline assessment of cancer services in primary care throughout St Helens PCT, it was highlighted that patients were attending surgery following a cancer diagnosis before the GP has been informed of that diagnosis. Developments are being progressed in secondary care to provide GPs with this communication within 24 hours of diagnosis.

PROTOCOL

This protocol is to be used when a serious diagnosis fax is received within the practice.

A named member of the reception staff for each practice should be responsible for dealing with the serious diagnosis fax.

A second named member of the Primary Health Care Trust should be identified to cover for holidays and sickness absence etc.

The named member of staff should inform the relevant GPs of the diagnosis and treatment plan (registered GP and/or the GP the patient normally sees).

Either by showing them the serious diagnosis fax.

By informing the GP by telephone.

If the GP is unavailable due to sickness absence or holiday then the Locum and/or principle GP of the practice should be informed of the diagnosis and treatment plan.

The serious diagnosis fax (or copy) should be placed within the patient’s record/notes.

The patient’s record/notes should be Read coded with the appropriate diagnosis (Read codes to be provided).


- 18 -

St. Helens and Knowsley HospitalsNHS Trust


- 19 -

NHS

Cancer Diagnosis – 24 hour communication

Speciality

Dear Doctor ………………………………………… Date ……………………

RE: Addressograph

Your patient was seen in clinic today by:……………………………………………………….

Diagnosis ………………………………………………………………………………………….

The patient has been told:……………….………………………………………………………

………………..……………………………………………………………………………………..

The plan of treatment is as follows: …………………………………………………………….

………………………………………………………………………………………………………

New medication commenced: …………………………………………………………………..

Investigation / procedures planned …………………………………………………………….

………………………………………………………………………………………………………

………………………………………………………………………………………………………

Additional information (ie referred to palliative care……………………………………………………………………………………………………………………Appointment details ………………………………………………………………………………

A detailed letter will be sent to you in the near future. However, if you have any queries in the meantime please do not hesitate to contact me.

You will need to update your cancer register with this information.

Yours Sincerely,

(Name Telephone Number Bleep Number)

Whiston Hospital, Warrington Road, Prescot, Merseyside, L35 5DR

3 ONCOLOGY

3.1 LILAC CENTRE

St Helens & Knowsley Hospitals provides a local outpatient chemotherapy service for haematology and oncology patients. In addition to elective chemotherapy the Unit operates an open door access policy for known haematology/oncology patients, with emergency assessment, telephone advice and triage. The Unit also facilitates out-patients procedures including: Bone marrow biopsy Hickman/PICC line placement and care Pleural/ascitic tap Whole unit venesection Intravenous infusions including:

- iron - immunoglobulin - bisphosphonates - monoclonal antibody - blood and platelet transfusions.

The Lilac Nurses are qualified and trained to care for patients with cancer. They aim to make treatment as tolerable as possible and to minimise side effects associated with chemotherapy treatment. They work closely with all team members, to help provide continuity of care.

Based within the Lilac Centre is a counselling and complimentary therapy service. This service is open to patients and carers during and post treatment. Both staff and patients can make referrals to the service and all therapies are conducted in a safe and confidential environment.


- 20 -

Team Members Role Contact Details Monday to Friday9 – 5

Barbara Jost Unit Manager 0151 430 1687Ruth Jackson Chemotherapy Sister 0151 430 1687Karen Pocock Chemotherapy Nurse 0151 430 1687Holly Donaghy Chemotherapy Nurse 0151 430 1687Philip Walker Chemotherapy Nurse 0151 430 1687Maureen Scotton Chemotherapy Nurse 0151 430 1687Janet Davies Receptionist 0151 430 1614Deborah Kilshaw Receptionist 0151 430 1614Janice Ashton Health Care Assistant 0151 430 1687Gill Levey Counselling Manager 0151 430 1687Shirlie Deveney Assistant Counselling Manager 0151 430 1687Dawn Porter Research Practitioner 0151 430 1147

Bleep 1148Jeanette Ribton Oncology Nurse Specialist 0151 430 2269

Bleep 0014Raphael Kawonga Haematology Staff Grade 0151 430 1825

Bleep 1826Dr M Abbas Oncology Staff Grade 0151 430 1995

Bleep 0227Peter Smith Oncology/Haematology

Pharmacist0151 430 1514Bleep 1514

Laura Evans Oncology Dietician 0151 430 1201Bleep 0208

Elaine Smith Haematology Secretary 0151 430 1825Denise Ambage Haematology Secretary 0151 430 1825Lisa Ryan Haematology Secretary 0151 430 1825Sandra Clegg Oncology Secretary 0151 430 1910

OUT OF HOURS CONTACT INFORMATIONOut-patient Advice Ward G5 – 0151 430 1560In-patient Advice Surgical/ Medical On Call Team.


- 21 -

3.2 CLINICAL TRIALS TEAM

Team Members Role Contact Details Monday to Friday9 – 5

Dr E Marshall Consultant Oncologist 0151 430 1910Jenny Almond Merseyside & Cheshire Cancer

Research Network Manager0151 482 7804

Dawn Porter Research Practitioner 0151 430 1147Bleep 1148

Sarah Simpkin Clinical Trials Nurse 0151 430 1147Bleep 1147

Michelle Harvey Clinical Trials Data Clerk 0151 430 1147Jeanette Ribton Oncology Nurse Specialist 0151 430 2269

Bleep 0014


- 22 -

4. SITE SPECIFIC PATIENT SERVICES

4.1 CANCER SERVICE – Breast

Core Multidisciplinary Team Members

Role Contact Details Monday to Friday9-5

Miss L. Chagla Lead Consultant 0151 430 1607Mr R. Audiso Consultant Breast

Surgeon0151 430 1079

Dr S. Desmond Consultant Radiologist 0151 426 1600Ex2491

Dr O. Harris Consultant Radiologist 0151 430 1185Dr E. Gradwell Consultant Pathologist 0151 430 1827Dr S. Kelly Consultant Pathologist 0151 430 1839Dr H InnesDr R Sripadam

Clinical Oncologist Clatterbridge Centre for Oncology0151 334 4000

Sue McNicholas Breast Care Specialist Nurse

0151 430 1908

Chris Bebb Breast Care Specialist Nurse

0151 430 1908

Louisa Mahon Breast Care Nurse 0151 430 1908Jill Atherton MDT Co-ordinator 0151 430 1061

Extended Multidisciplinary Team Member

Role Contact Details Monday to Friday 9-5

Colette Murray Palliative Care Cancer Nurse Specialist

0151 430 1953

Chris Jonkers Breast radiographer 0151 430 1185Rob Rosser Clinical Psychologist 0151 430 1654Mr K. Graham Consultant Plastic

Surgeon0151 430 1262

Mr R. Alvi Consultant Plastic Surgeon

0151 430 1401

Dr LynnGreenhough(Alder Hey Hospital)

Clinical genetic/genetics counsellor

Marie Curie centre Physiotherapist/ Lymphoedema

Mr A. Ray Associate Specialist 0151 430 1528Dr R. Thind Consultant Radiologist 0151 430 1265Dr M. Pinto Consultant Pathologist 0151 430 1731Dr N. Hasan Consultant Pathologist 0151 430 1190Sarah Simpkin Trials Nurse 0151 430 1147Nina Agnew Warrington Screening 01925 230923


- 23 -

OUT OF HOURS CONTACT INFORMATIONOut-patient Advice Via GP/NHS Direct. If urgent local A&E

Department.G5 Ward if Chemotherapy related.

In-patient Advice Ward H4 or via Surgical On Call Team.G5 Ward if Chemotherapy related.

Non-urgent Advice Breast Care Nurses Answer Phone Service.OUTPATIENT CLINICSConsultant Clinic Type Day SiteMiss Chagla Breast New patients Wednesday AM Burney Breast

UnitMiss Chagla Breast Revisits Wednesday PM Burney Breast

UnitMr Audisio Breast New patients Tuesday PM Burney Breast

UnitMr Audisio Breast Revisits &

new non-urgentThursday PM Burney Breast

UnitMr Audisio Breast Revisits Friday AM Stephenson

HouseMr Ray Breast New patients Monday AM Burney Breast

UnitMr Ray Breast Revisits Friday PM Burney Breast

UnitDr Innes Breast New patients

and Revisits.Friday AMWednesday PMAlternate Monday AM

Stephenson House

Dr Innes Breast New patients and Revisits.

Tuesday PM St Helens

OUTPATIENT CLINICSNurse Specialist

Clinic Type Day Site

Sue McNicholasOr Chris Bebb

Breast Prosthetic Clinic

Tuesday PM Whiston

BREAST SCREENING/RECALL

Dr R. Thind Breast Screening Assessment

Monday AM Whiston

Dr O. Harris Breast Screening Assessment

Monday AM Whiston

Dr S. Desmond

Breast Screening Assessment

Monday AM Whiston

Multidisciplinary Team Meeting held, every Friday at 13.00Venue: Post Graduate Centre


- 24 -

4.2 CANCER SERVICE – Colorectal

Multidisciplinary Team Members


Mr R. Kiff Lead Clinician 0151 430 1529Mr D. Maitra Colorectal Surgeon 0151 426 1600

Ext. 2339Mr M. Scott Colorectal Surgeon 0151 430 1911Dr J McLindon Physician

Gastroenterologist0151 430 1281

Dr E Marshall Medical Oncologist 0151 430 1910Dr Whitmarsh Clinical Oncologist Clatterbridge Centre

for Oncology0151 334 4000

Dr A. Evans Consultant Radiologist 0151 430 1265Dr. S. Kelly Consultant Pathologist 0151 430 1839Helen Carroll Colorectal Nurse

Specialist0151 430 1078

Angela Fitzgerald-Smith Colorectal Nurse Specialist

0151 430 1685

Paul Ratcliffe MDT Co-ordinator 0151 430 1061

Extended Multidisciplinary Team


Carolyn Swash Stoma Nurse Specialist 0151 430 1221Debbie Maddox Specialist Palliative Care

CNS0151 430 1274

Laura Evans Dietitian /nutritionist 0151 430 1201Tony Ellis Clinical geneticist /

genetics counsellorSocial Worker 0151 430 1201


Department.G5 Ward if Chemotherapy related.

In-patient Advice D2 Ward or Via Surgical On Call Team.G5 Ward if Chemotherapy related.

Non-urgent Advice Colorectal Nurse Specialists’ Answer Phone Service.


- 25 -

OUTPATIENT CLINICSConsultant Clinic Type Day SiteMr Kiff Colorectal

Cancer/GeneralTuesday AM Whiston

Mr Kiff Colorectal Cancer/General

Friday AM St Helens

Mr Maitra Colorectal Cancer/General

Wednesday AM Whiston

Mr Maitra Colorectal Cancer/General

Thursday AM St Helens

Mr Scott Colorectal Cancer/General

Thursday AM Whiston

Mr Scott Colorectal Cancer/General

Friday PM St Helens

Dr Marshall Oncology (Chemotherapy)

Monday AM Whiston

Dr Marshall Oncology (Chemotherapy)

Thursday AM Whiston

Dr Whitmarsh Oncology (Radiology) Monday AM WhistonENDOSCOPY SESSIONSMr Kiff Wednesday PMMr Maitra Alternate Friday PMRapid Access Friday PM

Multidisciplinary Team Meeting held, every Monday at 13.00Venue: X-ray Seminar Room


- 26 -

4.3 CANCER SERVICE – Gynaecology



Mr G. Cawdell Lead Clinician 0151 430 1663Vacant Medical Oncologist Clatterbridge Centre


Dr J Zekri Clinical Oncologist Clatterbridge Centre for Oncology0151 334 4000

Dr J. Kirwan Gynaecology Oncologist Women’s Hospital0151 702 4265

Dr N. Hasan Consultant Histopathologist

0151 430 1824

Dr O. Harris Consultant Radiologist 0151 426 1600Ext.2491

Diane Dearden Clinical Nurse Specialist 0151 426 1600 Ext. 2348

Jill Atherton MDT Co-ordinator 0151 430 1061


Role Contact details Monday to Friday 9-5

Colette Murray Specialist Palliative Care CNS

0151 430 1274

Sarah Simpkin Clinical Trials Nurse 0151 430 1147Dr M. Abass Oncology Staff Grade 0151 430 1910Gill Levey Psychosocial /

psychosexual counsellor0151 430 1687

Maria Embleton Staff Nurse 0151 426 1600


Department.In-patient Advice H4 or Via Gynaecology On Call Team.

G5 if chemotherapy related.Non-urgent Advice Gynaecology Oncology Nurse Answer Phone

Service.


- 27 -

OUTPATIENT CLINICSClinic Type Day SiteGynae-Oncology Alternate Monday AM *WhistonRapid Access Pelvic Mass Wednesday AM *WhistonRapid Access Post-Menopausal Bleeding

Tuesday PM H1,Whiston

Rapid Access Post-Menopausal Bleeding

Wednesday PM H1,Whiston

Rapid Access Post-Menopausal Bleeding

Friday PM H1,Whiston

Vulvoscopy Alternate Wednesday PM

HI, Whiston

*Clinics take place in Maternity and Gynaecology Unit

COLPOSCOPY SESSIONSColposcopy Monday am/p.m. H1, WhistonColposcopy Tuesday am/p.m. H1, WhistonColposcopy Thursday am/p.m. H1, WhistonColposcopy Thursday am/p.m. H1, WhistonColposcopy Friday am/p.m. H1, Whiston

Multidisciplinary Team Meeting held alternate Mondays at 09.15 prior to Oncology ClinicVenue: X-Ray Seminar Room


- 28 -

4.4 CANCER SERVICE – Haematology



Dr G. Satchi Lead Clinician 0151 430 1887Dr J. Tappin Consultant Haematologist 0151 430 1292Dr T. Nicholson Consultant Haematologist 0151 430 1825Dr R. Kawonga Staff Grade –

Haematology0151 426 1600 Ex 2473Bleep 1826

Jeanette Ribton Oncology Nurse Specialist

0151 430 1687Bleep 0014

Angela Madigan Haematology/Oncology Macmillan CancerNurse Specialist

0151 430 4111Bleep 4111

Sr. I Kearney Ward Manager – G5 0151 430 1560Sr. B. Jost Unit Manager – Lilac

Centre0151 430 1687

Dawn Porter Trials Practitioner 0151 430 1147Bleep 1148

OUT OF HOURS CONTACT INFORMATIONOut-patient Advice Via Switchboard to Consultant on-callIn-patient Advice G5 Ward

OUTPATIENT CLINICSConsultant Clinic Type Day SiteDr G. Satchi Anti-

coagulationMonday AM St Helens

Dr G. Satchi Anti-coagulation

Tuesday PM Whiston

Dr G. Satchi Haematology Wednesday AM WhistonDr G. Satchi Haematology Thursday AM St HelensDr J. Tappin Haematology Wednesday AM WhistonDr J. Tappin Haematology Friday AM WhistonDr T. Nicholson Haematology Wednesday AM WhistonDr T. Nicholson Haematology Friday AM Whiston

Multidisciplinary Team Meeting held weekly on Wednesday at 14.00Venue: X-ray Seminar Room.

Joint MDT with North Cheshire Hospitals 1st Wednesday of the month 15.00Venue: X-ray Seminar Room.


- 29 -

4.5 CANCER SERVICE – Head & Neck



Mr Nandapalan Consultant Otolaryngologist

0151 430 1598

Mr Daud Consultant Otolaryngologist

0151 430 1573

Mr Jones Consultant Otolaryngologist

0151 529 5248

Dr Husband Medical Oncologist Clatterbridge Centre for Oncology0151 334 4000

Dr Hasan Consultant Histopathologist

0151 430 1190


Department.In-patient Advice D2 Ward

OUTPATIENT CLINICSConsultant Clinic Type Day SiteMr Daud ENT Monday AM Whiston HospitalMr Daud ENT Friday PM Whiston HospitalMr Nandapalan ENT Tuesday AM Whiston HospitalMr Nandapalan ENT Thursday PM Whiston HospitalMr Jones ENT Tuesday PM

2nd, 4th & 5th Whiston Hospital

Dr HusbandMr Jones

Head & Neck Tuesday PM1st & 3rd

Whiston Hospital

Multidisciplinary Team Meeting held at University Hospital Aintree


- 30 -

4.6 CANCER SERVICE – Lung


Role Contact Details Monday to Friday9 – 5

Dr. J. Hendry Respiratory Physician –Clinical lead for Lung Cancer

0151 430 1899

Dr. P. Stockton Respiratory Physician 0151 426 1600 Ex 2638

Dr S Twite Respiratory Consultant 0151 426 1600 Ex 2638

Joanne Brown Lung Cancer Clinical Nurse Specialist

0151 430 1367

Pauline Murphy Lung Cancer Clinical Nurse Specialist

0151 430 2326

Carol Dawson Lung Cancer Clinical Nurse Specialist

0151 430 2326

Robert Case Specialist Palliative Care CNS

0151 430 1274

Dr. J. Wide Consultant Radiologist 0151 426 1600Ex 2485

Dr N. Mohsin Consultant Radiologist 0151 426 1600Ex 2485

Dr A. Dar Consultant Histopathologist

0151 430 1827

Dr E. Marshall Consultant Oncologist 0151 430 1910Mr. Shackcloth Thoracic Surgeon 0151 228 1616Dr. Z. Malik Consultant Oncologist Clatterbridge Centre


Lorraine Price MDT Co-ordinator 0151 430 1061

Extended Multidisciplinary Team Members

Role Contact details Monday to Friday 9-5

Dr Littlewood Palliative Care physician 0151 430 1347Pool member Social WorkerRob Rosser Clinical Psychologist 0151 430 1634Jane Shepherd Chaplain/ pastoral care

worker0151 430 1657

Willowbrook Hospice Bereavement care worker 0151 430 8736


Department.In-patient Advice Ward F2, G16, C1 or Via Medical On Call Team.Non-urgent Advice Lung Cancer Nurse Answer Phone Service.


- 31 -

OUTPATIENT CLINICSConsultant Clinic Type Day SiteDr Hendry Lung Shadow

ClinicThursday am Whiston Hospital

Dr Stockton Lung Shadow Clinic

Thursday am Whiston Hospital

Dr Marshall Cancer Clinic Monday am Whiston HospitalDr Marshall Cancer Clinic Thursday am Whiston HospitalMr Soorae Thoracic Surgery

Clinic1st and 3rd

Tuesday p.m.Whiston Hospital

Dr Z Malik Oncologist Radiotherapy


BRONCHOSCOPY SESSIONS

Alternate Monday p.m. Dr Stockton H2, Endoscopy Unit

Tuesday am Dr Ridyard H2, Endoscopy Unit

Wednesday p.m. Dr Hendry/Dr Corless H2, Endoscopy Unit

Multidisciplinary Team Meeting held every Thursday morning, at 08.30Venue: Brandreth Suite

Pre-thoracic Surgery MDT Meeting alternate Tuesdays, at 14.00. Venue: Hackworh Suite

X Ray MDT Wednesday 12.30 – 14.00Venue: X-Ray Seminar Room


- 32 -

4.7 CANCER SERVICE – Skin


Role Contact Details Monday to Friday

Mr Green Consultant Plastic Surgeon 0151 430 1664Mr Hancock Consultant Plastic Surgeon 0151 430 1044Dr Curley Consultant Dermatologist 0151 430 1507Dr Herbert Consultant Radiologist 0151 426 1600

Ext. 2265Dr Marshall Consultant Oncologist 0151 430 1910Dawn Porter Clinical Trials/Research

Practitioner0151 430 1147Bleep 1148

Tom Crowe Dermatology Nurse Specialist

0151 430 1953

Chris Hunt Dermatology Nurse Specialist

0151 430 1482

Dr Gradwell Consultant Pathologist 0151 430 1827Dr Husband Consultant Oncologist Clatterbridge Centre



Department.In-patient Advice Holbrook UnitNon-urgent Advice Dermatology Nurse Specialist Answer Phone

Service

OUTPATIENT CLINICSConsultant Clinic Type Day SiteMr Green *Skin Cancer Tuesday PM Whiston HospitalDr Curley Skin Cancer Tuesday PM Whiston HospitalDr Marshall Skin Cancer –

OncologyTuesday PM 1st & 3rd

Whiston Hospital

*Note – although patient’s with Skin Cancer are mainly seen at this clinic they can be seen by other consultants at clinics in Whiston & St Helens

Multidisciplinary Team Meeting held 1st & 3rd Tuesday in the month at 12.30 Venue: Burns & Plastics Seminar Room


- 33 -

4.8 CANCER SERVICE – Upper Gastrointestinal

Multidisciplinary TeamMembers

Role Contact DetailsMonday to Friday 9-5

Mr Khan Lead Clinician 0151 430 1239

Mr A. Li UGI Surgeon 0151 430 1528

Ms Chagla UGI Surgeon 0151 430 1607

Mr Kanwar UGI Surgeon 0151 430 1528Dr Preistley Physician Gastroenterologist 0151 430 1252

Dr Marshall Medical Oncologist 0151 430 1910

Dr Meek Consultant Radiologist 0151 430 1589

Dr Kelly Consultant Histopathologist 0151 430 1824

Paul Madigan Nurse Consultant Gastroenterology

0151 430 1599

Laura Evans Oncology Dietician 0151 430 1381

Kathy McDermott Chest Physiotherapist Bleep 1188

Barbara Ashall Upper GI Nurse Specialist 0151 290 4143Bleep 2600

Peter Smith MDT Co-ordinator 0151 430 1061

Dr Littlewood Consultant in Palliative CareMedicine

0151 430 1347

OUT OF HOURS CONTACT INFORMATION

Out-patient Advice Via GP/NHS Direct. If urgent local A+E DepartmentLilac Centre 0151 430 1687

In-patient Advice Ward D3 0151 430 1440Ward G5 – if chemotherapy related

Non-urgent Barbara Ashall CNS Answer Phone service 0151 290 4143


- 34 -

ENDOSCOPY SESSIONS

Dr Francis Monday amMiss Chagla Alternate Monday p.m.Paul Madigan Tuesday/Thursday p.m.Mr Khan Alternate Wednesday p.m.Mr Kanwar Alternate Monday a.m. and every

Friday a.mMr Memon Alternate Wednesday p.m.Dr Turner

OUTPATIENT CLINICS

Consultant Clinic Day Site

Ms Chagla UGI/GEN Alternate Monday am

Whiston

Mr Li General Monday am St Helens

Mr Li UGI/Gen Tuesday pm Whiston

Mr Khan UGI/Gen Wednesday am Whiston

Mr Khan General Friday pm St Helens

Dr Francis Gastro Tues/Thurs pm Whiston

2 week rule Rapid Access Friday pm Whiston

Multidisciplinary Team Meeting held every Thursday 08.30Venue: X-Ray Seminar Room


- 35 -

4.9 CANCER SERVICE – Urology



Mr Massey Lead Consultant Urologist 0151 430 1976Mr Gana Consultant Urologist 0151 430 1907Mr Khattak Consultant Urologist 0151 430 1907Dr Marshall Medical Oncologist 0151 430 1910Dr Malik Clinical Oncologist Clatterbridge Centre

for Oncolgy0151 334 4000

Dr Meek Lead Radiologist 0151 426 1600 Ex 2492

Dr M. Pinto Lead Histopathologist 0151 430 1731Sue Charles Nurse Specialist 0151 430 1076Nancy Chisholm Nurse Specialist 0151 430 1898Nerys Williams Nurse Specialist 0151 430 1076Julie Keith MDT Co-ordinator 0151 430 1061



Claire Littlewood Consultant in Palliative Care

0151 430 1058

Dennis McComas Senior Nurse Specialist 0151 430 1898Lorna Evans Dietitian 0151 430 1201Mary McBirnie Urology Sister 0151 426 1600

Ex 2528Ann Caton Urology Sister 0151 426 1600

Ex 2528Carolyn Swash Stoma Nurse 0151 430 1221Dr Clark Clinical Oncologist

(testes patients + bladder patients who required chemotherapy treatment only)

Shirlie Deveney Assistant Counselling Manager

0151 430 1687


Department.In-patient Advice A1 Ward / D1 Ward or Via Urology Surgical On Call

Team.Non-urgent Advice A1 Ward / D1 Ward Monday – Friday 9 am – 4pm

Urology Nurse Specialist Answer Phone Service.


- 36 -

OUTPATIENT CLINICSConsultant Clinic Type Day SiteMr Massey Urology Tuesday pm Whiston HospitalMr Massey Urology Thursday pm St Helens

HospitalMr Gana Urology Wednesday am St Helens

HospitalMr Gana Urology Friday am Whiston HospitalMr Gana Urology 1st Wednesday

pmNewton Hosptial

Mr Khattak Urology Monday AM Whiston HospitalMr Khattak Urology Thursday PM Whiston HospitalNursing Team Rapid Access

Haematuria ClinicMonday am& Alternate Thursday pm

A1 Ward

Nursing Team Prostate Assessment Clinics

Monday pmWednesday am& Alternate Thursday pm

A1 Ward

Mr Gana Flexible Cystoscopy Lists

Thursday am A1 Ward

Mr Massey Flexible Cystoscopy Friday am A1 WardDennis McComas

Flexible Cystoscopy Tuesday am A1 Ward

DennisMcComas

Flexible Cystoscopy Wednesday pm A1 Ward

Sue Charles Stable Prostate Cancer Clinics

Monday pm St Helens Hospital

Sue Charles Stable Prostate Cancer Clinics


Sue Charles Chemotherapy Intravesical Immunotherapy

Friday pm On the district

Multidisciplinary Team Meeting held weekly on a Monday at 11.45 – 12.15Venue: X-Ray Seminar Room


- 37 -

5. PALLIATIVE CARE

5.1 PALLIATIVE CARE - Hospital Specialist Palliative Care Team

Team Members Role Contact Details Monday to Friday9-5

Dr C Littlewood Consultant in Palliative Medicine

0151 430 1347

Dr J Wiseman Consultant in Palliative Medicine

0151 430 1347

S.P.R. (Rotational every 12 months) Dr Jenny SmithMrs Jan Leatherbarrow Team Leader, Specialist

Palliative Care CNS0151 430 1347

Robert Case Specialist Palliative Care CNS

0151 430 1274

Mrs Collette Murray Specialist Palliative Care CNS

0151 430 1953

Ms Debbie Maddox Specialist Palliative Care CNS

0151 430 1274

Miss Claire Johnston CNS – Heart Failure/ FCP Facilitator

0151 430 1274

Mr Andrew Dickman Pharmacist Pager: 07654661703Or 0151 430 1274

Mrs Jackie Bruce P.A. to Dr Littlewood 0151 430 1058Mrs Josie Dold Team Secretary 0151 430 1274Mrs Denise Delaney Team Secretary 0151 430 1274Mrs Simone Taylor Data Entry Clerk/

Admin Assistant0151 430 1274

OUT OF HOURS CONTACT INFORMATIONOut-patient Advice Via GP or Community NurseIn-patient Advice Via Willowbrook Hospice

Nurse in Charge 0151 430 8736.Non-urgent Advice Answer Phone Service.

Multidisciplinary Team Meeting held weekly, every Wednesday, at 14.00Venue: Palliative Care Office

The Hospital Specialist Palliative Care Service adopts the concept of shared care with other health professionals, aiming to ensure a quality of service and improved quality of life for patients within St Helens & Knowsley Hospitals. The service is aimed at patients with specialist needs relating to life limiting disease and is based on need and not diagnosis. The service provides:


- 38 -

Specialist support from diagnosis for the patient and family, psychologically, spiritually and socially.

Advice on pain and symptom control for patients, relatives and staff.

Liaison between hospital and hospice and regular contact with the Specialist Palliative Care Community Nursing Team is maintained.

Education is provided both formally and informally, and is available to hospital staff.

Support and advice for staff, in their difficult and sometimes complex role of caring for patients with advanced disease.

ReferralsReferrals to the Specialist Palliative Care Team should be made with:

The full agreement of the patient.

The full knowledge of the doctor and nurse undertaking the patients care and management.

Referral forms can be found in Web Communities under Specialist Groups ‘Specialist Palliative Care http://nww.sthkhealth.nhs.uk/palliative_care.

Fax referral 0151 430 1925, or contact direct.

A Secretary/answer phone will take messages until a Team member is available to return your call.


- 39 -

http://nww.sthkhealth.nhs.uk/palliative_care

PROTOCOL - How do I use the Referral Form?

This 2-sided protocol is to enable Specialist Palliative Care (SPC) Teams within St Helens & Knowsley to standardise and unify practice with respect to (SPC) patient referrals. This protocol was designed and developed collaboratively by the St Helens & Knowsley Integrated Care Network. The aim of the (SPC) referral form is to enhance and develop the exchange of patient referral information across Hospital, Community and Hospice settings. Please note the revised (SPC) referral forma replaces all previous referral forms as at 5th April 2004.

To this end please note the following points as well as the ‘Reasons for Referral’ table on side-2, as they apply within each of the (SPC) referral form headings:

Patient Details: Please provide at least one of the following as they relate to your

SPC team NHS number, Hospital ID and Hospice ID At the D.O.B (Date of Birth) please complete as follows: 2 digits to

represent day of month; 2 digits to represent month and 4 digits to represent year of birth. e.g If Patient born on the 12 June 1967 this would be 12 06 1967.Plaese note this convention is applicable to all date data-fields within the (SPC) referral form.

Please provide were possible Ethnicity/Religion – if this is unavailable insert NA at appropriate data-field

Carer Details: Within the ‘Is the Patient Living Alone’ data-field please tick at

the appropriate box. (N = No, Y = Yes and NK = Not Known).

Involved Professional Details:

Community Contact: Within the PCT data-field please tick at the appropriate PCT. Within the ‘DN’ (District Nurse) data-field please insert the name of

the DN involved with the patient. This will aid communication between SPC & Community professionals.

History of illness: Within ‘Disease Stage’ please tick at the appropriate box Within ‘Disease Management’ please tick at the appropriate box Within ‘Is Patient Aware of Referral’ please tick at the

appropriate box

Details of Understanding and Medication: Please use free-text were appropriate.


- 40 -

Page 1

Reasons for referral: Please note the guidance at the top of this section and complete as

appropriate. Within the ‘Where is Patient Presently?’ data-field please tick as

appropriate Except at Hospital (Ward) – please insert hospital name and ward as appropriate.

Service Required: Tick as appropriate for the (SPC) required Tick as appropriate which patient service is required at Willowbrook

HospiceReferrer Details:

Please state your designation i.e. Consultant, Community Nurse Specialist, Hospital Doctor etc...

Your signature shall confirm approval of patient’s GP or Consultant.If (SPC) Referral is More Urgent:

Please contact relevant service by telephone


- 41 -

Page 2

Reason for Referral Role of the Health Care Team with Advice and Support from Specialist Palliative Care Team as needed

Criteria for Direct Patient Contact by Specialist Palliative Care Team in conjunction with Ward Team

Pain Control Assessment, investigation, diagnosis.Initiate treatment according to Trust formulary.World Health Organisation pain ladder.Monitor and document effect of treatment (at least daily)

Uncontrolled/escalating pain

Any Other Symptoms

Assessment, investigations, diagnosis.Initiate treatment, evaluate and document outcome (at least daily)

Incomplete symptom control.Unacceptable side effects.Complex multiple problems.

Psychological Support for Patient +/- Family

Basic psychological support.Review and document outcome.

Complex psychological and spiritual support.

Patient Dying Identify the patient is dying.Assess and address symptom, psychological and spiritual distress.Use of Care Pathway for the Dying Patient.

Specialist support to achieve symptom control, psychological and spiritual support.

Information/Communication

Provide information about diagnosis and current condition, patient/family needs.Up-date as necessary.Document discussions.

Difficult communication issues.i.e. denial, collusion, complex family dynamics.

Discharge/Placement

Discharge planning to commence at time of admission as per Hospital Policy.

Facilitate rapid discharge to enable patient to die at home.Initiate Hospice Transfer.

(Adapted from Referral Criteria RLUH Palliative Care Team, March 2002)


- 42 -

Reasons for Referral Table

ACCESS TO PALLIATIVE CARE OUT-PATIENT CLINICS

WHEN & WHERE?

MONDAY WEDNESDAY THURSDAY FRIDAYHeld at:WILLOWBROOKHOSPICE (p.m.)

WHISTON (p.m.)COPD – Monthly(commencing 19.04.04)

WILLOWBROOKHOSPICE (p.m.)Community linked

NEWTON COTTAGE(alternate Wednesdays)

WHISTON (a.m.)Stephenson HouseBrandreth SuiteParallel clinic toDr. E. MarshallOncology/Lung Cancer

WHISTON (a.m.)Stephenson HouseBrandreth SuiteParallel clinic toDr. A. FlavinOncology/Breast Cancer

Dr C.M. Littlewood

Dr. J. Wiseman Dr. C.M. Littlewood Dr. C.M. Littlewood

HOW TO REFER?

Referrals for WHISTON clinics - by formal letter toDr C.M Littlewood, c/o Palliative Care Team, Whiston Hospital

Tel: 0151-430-1058 Jackie Bruce, P.A/Supervisor Fax: 0151-430-1925 General Office

Referrals for HOSPICE clinics – by formal letter. Referrals will be put into next available clinic with Dr. C.M. Littlewood or D. J. Wiseman.Tel: 0151-430-8736 Paula Younger, Medical Co-ordinatorFax: 0151-493-1006 General Office

NOTE: Patients initially attending Whiston clinics may be linked into Hospice services, as felt appropriate.


- 43 -

Draft Version 2.0 - Page 1 SPC Referral Form March 2004

Referral for Specialist Palliative Care Services

Patient Details Carer DetailsNHS Number: Name of Carer:Hospital ID: Hospice ID: Relationship to Patient:Title: Forename(s): Carer Tel:Gender: Surname: Is Patient Living Alone? Y NAddress: Involved Professional

Community ContactPCT:GP Name:GP Surgery:GP Tel:

Postcode: DN Name:Tel: Hospital Contact DetailsAge: D.O.B Hospital Consultant:Ethnicity: Religion: Hospital Dept:History of Illness (Please include Diagnosis. Secondary Site – Relevant Treatment)Diagnosis:

Date of Diagnosis:Spread/Complications:Disease Stage EARLY ADVANCED Disease mang’t CURATIVE NON-

CURATIVECurrent Treatments: Past Treatment:

Is Patient Aware of Referral: Y NDetails of Understanding for Patient/CarerPatients Understanding of Diagnosis: Carers Understanding of Diagnosis:

Current Medication Previous Medication (State Reaction/Poor response)

1. 1.2. 2.3. 3.4. 4.5. 5.6. 6.7. 7.8. 8.9. 9.10. 10.


- 44 -

Referral for Specialist Palliative Care Services 2NHS Number Hospital ID Hospice ID

Reason(s) for ReferralPlease state the main problems that have led to the request for SPC assessment. Include relevant information on physical symptoms (including mobility), carer’s needs, psycho-social/spiritual issues and different ethical needs as appropriate:

………………………………………………………………………………………………………..

……………………………………………………………………………………………………….

……………………………………………………………………………………………………….

……………………………………………………………………………………………………….

……………………………………………………………………………………………………….

Where is Patient Presently? Home Hospital (Ward)

N/Home R/Home

Service Required ( Please FAX referral to appropriate number)Hospital Palliative Care TeamFax (0151) 430 1925

Referral to MEDICAL OUT-PATIENT CLINIC FORMAL LETTER ONLY TO:Dr LittlewoodConsultant in Palliative Care Medicine,Whiston HospitalPrescot L35 5DRTel: 0151 430 1274

Referral to MEDICAL OUT-PATIENT CLINIC FORMAL LETTER ONLY TO:Dr Wiseman Consultant in Palliative Care MedicineWillowbrook HospicePrescot L34 2QTTel: 0151 430 8736

Community Palliative Care TeamFax (0151) 289 8776Willowbrook HospiceFax (0151) 493 1006

If you think this Referral requires ‘OUT-OF HOURS’ Service – Please see details below

Referrer DetailsPrint Name Designation:Date of Referral Signature:Referrer Tel No: (Signature Confirms Approval of Patient’s

GP or Consultant).

If More Urgent: 9.00 am – 5.00 pm Monday to Friday

WILLOWBROOK Office Use Only:DATE REFERRAL Received ……………..DATE of INTIAL CONTACT ………………..DATE of INTIAL ASSESSMENT ……………DATE of ACCEPTANCE …………………….

TO BE COMPLTED ON ORGINAL FORMACCEPTEDREFUSED on OTHER GROUNDS (e.g. too unwell)CANCELLED (e.g. died)

Date ………….. Signature …………………..

Hospital Palliative Care Team: Tel: 0151 430 1274Community Palliative Care Team:Tel: 0151 431 0156OUT-OF-HOURS SERVICE

Willowbrook HospiceTel: 0151 430 8736All referral will be reviewed within 24-48 HOURS


- 45 -

5.2 PALLIATIVE CARE - Willowbrook Hospice

Willowbrook HospicePortico LanePrescotMerseysideL34 2QT

Telephone: 0151 430 8736Fax: 0151 493 1006Willowbrook Hospice is an independent charitable organisation providing specialist palliative care services for the adult population of St Helens and Knowsley Boroughs. Willowbrook Hospice aim to enhance the quality of life, and relieve the suffering of patients with cancer, and other life threatening illness, by providing quality Specialist Palliative Care for those in need, and support for their carers. We are a NO smoking hospice.

Specialist Palliative Care In-Patient ServiceCurrently we have nine In-Patient beds. There is no restriction on visiting times and families are encouraged to take an active part in the care of their loved ones if they wish. Staff at the Hospice are always available to offer advice and support whenever it is needed.

Referral Criteria For patients with advanced, progressive, incurable, malignant and non-

malignant disease who have complex physical, psychological, spiritual, and social or carer needs.

Where the above patient and / or family needs are unable to be met by health professionals in the current care setting and may be met by a specialist palliative care service.

Where the current health professionals require the support and advice of the specialist palliative care service.

Discharge Procedure

Preparation for the discharge of our patients begins on their admission. Willowbrook Hospice is for short periods of treatment only. Patient care is reviewed regularly and future care planned as necessary.

Services provided include: -

In-patient care9 beds for assessments, symptom control, rehabilitation and terminal care.

Outreach ServicesDay therapy providing up to 10 places on a given day and time. Services offered include: Key worker system - each patient is allocated a key worker to ensure

consistency of care.


- 46 -

Complementary Therapies: Aromatherapy / Massage / Guided Visionary / Reiki / Reflexology Relaxation therapy Physiotherapy / Exercise Programmes /Breathlessness Groups /

Anxiety Management Group activity Craft classes Bereavement support Medical review

The Day Therapy Team consists of:

Team Leader – responsible for Complementary and Creative TherapiesSisterStaff NurseSenior Physiotherapist Therapy AssistantChaplaincy Team

Out patient Service

Patients who require initial or follow up appointments can be seen within the out patient facilities at Willowbrook Hospice. Medical Clinics are held at the Hospice weekly, in addition to medical clinics at Whiston Hospital and Newton Community Hospital.Request for appointments are received from Hospital Consultants, General Practitioners or Nurse Specialists via a letter or referral form. Physiotherapy and complementary therapy may be accessed via the outpatient service. Also referrals are accepted from any member of the multi-professional team. Individual or family visits can be arranged to offer a consultation with a doctor.

Carers Support Service – Family Support Co-ordinator

A Carers’ Support Service is offered at Willowbrook Hospice, as part of our Philosophy of Care. The service aims to provide personal advice, comfort, empathy and support to patients’ carers and relatives including: Offering comfort and support to carer's and relatives of patients attending

the Hospice in the anticipatory and post bereavement stages. Trying to ensure the current physical, psychological, social and spiritual

needs are met in order to minimise any future harmful effects on health. Facilitating expressions of grief and discuss the grieving process. Advising on available resources and provide practical help when needed. Aiding recovery and assist in resolution.

EducationProduced by Cancer Services - Version Four (April 2007)

- 47 -

Education is a major part of our work. Willowbrook Hospice aims to offer co-ordinated, multi-professional educational programmes, to all members of staff providing Palliative and Specialist Palliative care within Knowsley and St Helens.

The Hospice is committed to supporting education and training. Services available include: Raising awareness of the role of Willowbrook Hospice and Hospice

services. Involvement within, local organisations, societies, clubs and other groups in

the local community. Clinical placements for medical under-graduates, student nurses’, other

staff undertaking specialist courses, and overseas visitors, as appropriate. A resource centre on specialist palliative care for multi-professional staff

and carers. Providing speakers to inform, educate local organisation – societies, clubs,

schools and other community organisations. Committed to the on going development of staff in-house training.

Referral

The Hospice accepts referrals from the patients’ General Practitioner, Hospital Consultant, or any member of the multi-professional team.In no case will contact be made with the patient without the express prior permission of the patient’s General Practitioner nor without the patient being aware of their diagnosis and that Hospice involvement has been requested. Referrals should be made on the Hospice Referral Form by letter or fully completed single assessment documentation.


- 48 -

Medical TeamTeam Members RoleDr Jenny Wiseman Consultant in Palliative MedicineDr Anthony Thompson Assistant Medical Director

Clinical Team

Mrs Chris Haywood Head of Clinical ServicesMrs Margaret McConaghy

Team Leader for In-Patient Services

Lucy Scriven Team Leader for Outreach Services

Chief Executive

Neil Wright


- 49 -

5.3 PALLIATIVE CARE - Macmillan Clinical Nurse Specialist Palliative Care - Community

Community Clinical Nurse Specialists Palliative CareWillowbrook HospicePortico LanePrescotMerseysideL34 1QTTelephone: 0151 431 0156Fax: 0151 289 8776

The service compliments those services provided by the Primary Health Care Team and other providers/agencies. A key principle is that the specialist nurse seeks to work with these other teams/professionals equipping them with the required skills and knowledge.

Referral CriteriaThe Community Macmillan Clinical Nurse Specialists (CNS) within Knowsley PCT and St Helens PCT operate an open referral system. Anyone may refer themselves, or someone else for assessment.Any patient with a malignant disease or life-limiting condition will be accepted to the service.Referrals will be with the full knowledge of the doctor and the nurse-in-charge of the team undertaking the patient’s care and management.The Macmillan CNS will assist the District Nurse Team Leader in assessing the needs of patients and relatives. The Macmillan CNS will not take over care but act as a specialist resource. Patients requiring nursing care should be referred directly to the District Nurse.Not all patients with malignant disease or life-limiting conditions will require intervention from a Macmillan CNS. Referrals should be made with the patient’s agreement and for:Patients who have problematic pain or other symptoms.Patients or their relatives requiring informed support at time of diagnosis/recurrence.Relatives or carers requiring support over and above what Primary Carers provide, and where there are complex needs.Staff requiring support in order to continue caring effectively for the above patient group.Bereavement problems in families known to the Macmillan Service.Referrals can be made by:Completing a referral formTelephone, if urgent, followed by a completed referral form.Contact from the Macmillan CNS, and frequency of visits, will be determined by the Macmillan CNS on an individual basis.


- 50 -

Team Members RoleDr Jenny Wiseman Consultant in Palliative MedicineGillian Harthen Clinical Nurse Specialist Team LeaderAmanda Watson Macmillan CNSHelen Mack Macmillan CNSGeoff Prince Macmillan CNSJulie Parr Macmillan CNSZoe Keating Macmillan CNSMaggie Cooke Macmillan CNS

Out of hours service

Willowbrook Hospice Tel 0151 430 0156

MDT Meeting

Clinical Meeting every Monday 9.30 am at Willowbrook Hospice


- 51 -

5.4 PALLIATIVE CARE – St Helens Integrated Palliative Home Based Project

Integrated Palliative Home Care Team

The St Helens PCT and Integrated Palliative Home-Based Project aims to enhance it’s home-based services to those with life threatening conditions.

The project will compliment existing health and social care input to enable patients, carers and families to continue with their everyday lives during this time.

Referral to this service can be made by any Health Care Profession, patient/carer as long as the patient has been assessed by a District Nurse or Senior Hospital Staff.

As care and support is provided according to the needs of the patient and carer, referrals should whenever possible be pre planned so that the service can respond quickly to an urgent situation.

Aims of the service.

To enable terminally ill patients to be cared for and die at home, where that is their identified wish.

To provide nursing care which is supplementary to the existing District Nursing Service.

To offer a combination of psychological and practical support to the patient and family.

To support the patients with palliative needs from hospital or hospice.

To provide support during times of crisis for patient or carer and to prevent unnecessary admission to hospital or hospice.

To increase the overall provision of home based Palliative Care.

To increase the availability of care for longer periods of the day.

To extend community palliative care services to people with cancer and other life threatening conditions.


- 52 -

Criteria for Accessing the Integrated Palliative Home Care Team

The patient must be listed on the Palliative Care Register or have a life expectancy of six months or less [DS1500].

This service is available to any patient who is in the terminal stage of their illness [registered with a St Helens GP], and aims to increase the availability of care for longer periods of the day and night.

To access 24 hour round the clock care patients need to be commenced on an Integrated Care Pathway.

All patients who are referred and are living at home must have been assessed by the District Nursing Service.

All patients must be aged eighteen and over.

All patients in hospital who are referred must have been assessed by the ward manager or DN Liaison. The DN Service must be made aware of any referrals of patients being discharged with any of the services.

All patients referred to the service must be referred with the full knowledge of the GP

These services are here to enhance the District Nursing Services and not to replace them. They will give families added support and security in difficult times.

It is very important that families are aware that these services are available to allow patients to choose where they wish to spend their final days.Please try to plan ahead and refer to the service as soon as you have identified the need.


- 53 -

5.5 PALLIATIVE CARE - Integrated Palliative Home Care Team – Henrietta Project

Any Health Care Professional Patient/Carer can make referral to this service as long as a District Nurse or Senior Hospital Staff has assessed the patient

As care and support is provided accordingly to the needs of the patient and carer, referrals should whenever possible be pre planned so that the service can respond quickly to an urgent situation

Aims of the service

To enable terminally ill patients to be cared for or die at home, where that is their identified wish

To provide nursing care which is supplementary to the existing District Nursing Service

To offer a combination of psychological and practical support to the patient and family

To support the patients with palliative needs from hospital or hospice

To provide support during times of crisis for patient and carer and to prevent unnecessary admission to hospital or hospice

To increase the overall provision of home based Palliative Care

To increase availability of care for longer periods of the day

To extend community palliative services to people with cancer or other life threatening conditions


- 54 -

Criteria for Assessing the Integrated Home Care Team

The patient must be listed on the Palliative Care Register or have a life expectancy of six months or less (DS 1500)

This service is available to any patient who is in the terminal stage of their illness (Registered with a Knowsley GP) and aims to increase availability of care for longer periods of the day

The District Nursing Service must have assessed all patients who are referred and are living at home

The patients must be aged eighteen and over

The Ward Manager or DN Liaison must have assessed all patients in hospital who are referred. The DN Service must be made aware of any referrals of patients being discharged with any of the services

All patients referred to the service must be referred with the full knowledge of the GP

These services are here to enhance the District Nursing Service and not to replace them. They will give families added support and security in difficult times

It is very important that families are aware that these services are available to allow patients to choose where they wish to spend their final days

Please try to plan ahead and refer to the service as soon as you have identified the need


- 55 -

6.0 EXTENDED SERVICES

6.1 EXTENDED SERVICES - Hospital Based Pain Team

Medical Team Members Role Contact Details Monday to Friday9-17

Dr Konstantin Levshankov Consultant Anaesthetist 0151 430 1455Dr Mike Forsyth Staff Grade AnaesthetistMrs Mary Doolan Theatre/Chronic Pain

NurseMrs Eileen O’Neil Theatre/Chronic Pain

NurseMrs Anne Roberts Secretary 0151 430 1455

OUT OF HOURS-CONTACT INFORMATION

Outpatient advice 0151 430 1455 (answer machine)Inpatient advice 0151 430 1455 (answer machine)

Anaesthetist on call via switchboard for urgent advice

OUTPATIENT CLINICS

Consultant Clinic Type Day SiteDr K Levshankov Multidisciplinary

Spinal ClinicMonday pm Whiston

Dr K Levshankov MultidisciplinarySpinal Clinic

Tuesday pm St Helens

Dr K Levshankov Theatre session (invasive procedures/TENS/acupuncture)

Thursday am Whiston

Dr K LevshankovDr M Forsyth

Outpatient Pain Clinic

Thursday pm Whiston

Dr K Levshankov Pain Management Programme

Friday am Whiston


- 56 -

Description of the service:

Chronic Pain Clinic works in collaboration with Hospital Palliative Care team to provide a range of services aimed at alleviating pain, enhancing the quality of life and functioning of the patients with chronic pain.

We aim at improving pain control and addressing pain-modifying issues in the multidisciplinary context.

We offer:

Initial assessment of pain and pain related issues in the context of its multifactorial and multidimensional nature.

Assessment and modification of the treatment regime according to individual needs.

Formulation of the pain management approach based on specific needs of the patient in collaboration with Hospital Palliative Care team.

Non pharmacological interventions – transcutaneous electrical nerve stimulation, acupuncture.

Interventional therapies – neuromodulation, specific neuroablative procedures, systemic and regional drug infusions, somatic and autonomic blocks.

Reassessment of the patient’s progress at appropriate and regular intervals and modification of the treatment regime according to individual response.

Education of the patient and those involved in the care of the patient.


- 57 -

6.2 EXTENDED SERVICES - Chaplain/Pastoral Care

Spiritual Care Services

The Spiritual Care Team is made up of whole time and part time chaplains representing the different Christian denominations; we also have a Secretary and a large group of carefully selected and trained volunteers. We are here to make provision for the spiritual and religious needs of patients, relatives, and staff of all faiths and none. We are available at all times of the day and night, either through the department (0151 430 1657) or, in emergency and out of hours, by calling the switchboard and asking for the on call chaplain. If you need to contact a religious leader of a non-Christian faith for yourself or a patient in your care we can give details of names and telephone numbers. We can also liase with local churches.

Services are held at St Helens and in the Chapel at Whiston at Christmas and Easter and to mark particular events.

Our regular services at Whiston Chapel are as follows:Every Sunday there is a Mass at 11 am and Holy Communion at 2 pmOn Wednesdays 1.30 – 2 pm Exposition and Quiet PrayerEvery Friday staff of the Islamic faith, meet in the Chapel at lunchtime to pray.

The Chapel at Whiston is open at all times for prayer or reflection.The Prayer Room at St Helens can also be made available by request.

NB For more information please refer to our Patient Information Leaflet and our Staff Support leaflet. We also have a Spiritual Care page on the Intranet.

How to Contact the Chaplains: -

The Spiritual Care Department at Whiston is our main base and Ann Wright, Spiritual Care Secretary, works in the Office on weekday mornings. Our Direct Line is (0151) 430 1657, this can be used for all routine calls. Alternatively please use the bleeps or long range pagers via switchboard.


- 58 -

Chaplaincy Team Denomination Contact detailsSister Susan Molloy Roman Catholic Whiston Hospital Site

Bleep 0042Sister Eileen O’Riordan(Part-time)

Roman Catholic St Helens & Peasley Cross Sites Bleep via switchboard

Revd. Jayne ShepherdHead of Department

Church of England

All sites – Bleep 0041

Revd. Jamie Hartwell Free Church All sites – Bleep 0041

Contact details for other Faiths & Special NeedsJehovah’s Witness 0151 430 3296Church of Jesus Christ Latter Day Saints (Mormon) 01744 811077Unitarian 0151 263 4899JewishOthodoxReformedProgressiveLay Visitor

0151 722 20790151 722 54380151 733 58710151 722 1810

Islam/Moslim/Muslim 0151 709 2560Hindu/Sikh 0151 263 7965Ba’hai 0151 733 8614Buddist 0151 727 0108Seventh Day Adventist 0151 226 4385


- 59 -

6.3 EXTENDED SERVICES - Department Of Nutrition and Dietetics

REFERRAL PROCEDURE

If a patient meets the following criteria, please complete a Dietetic referral request form in full.

REFERRALS:

A doctor or registered nurse (D grade or above) must sign all referrals.

PATIENTS WILL NOT BE SEEN IF A REFERRAL REQUEST FORM IS NOT COMPLETED & SIGNED. NUTRITION RISK SCORE MUST BE CALCULATED AND DOCUMENTED ON THE REFERRAL REQUEST FORM.

Phone the Dietetic Department on Ext 1201 or 1474 to inform your ward Dietitian that you have a referral. Indicate reason for referral. A referral request form must still be completed, which will be collected when the Dietitian attends the ward. Alternatively the form can be faxed to the Dietetic Department on 1461.

The Dietitian aims to see referrals for Enteral and Parenteral Nutrition within one working day (applicable Whiston only).

The Dietitian aims to see all other referrals within 2 working days of receiving the referral (applicable Whiston only).

Refer as early as possible. Patients referred on day of discharge will NOT be seen as an inpatient.

Referrals received after 12.00 noon on Fridays may not be seen until the following Monday.


- 60 -

DEPARTMENT OF NUTRITION AND DIETETICS

REFERRAL CRITERIA

PATIENTS WHO WILL BE SEEN AS AN IN-PATIENT:

Nutritional risk score High (> 10).

Nutritional risk score Moderate (5-9) after review.

Patients requiring Parenteral Nutrition (PN).

Patients requiring Enteral Nutrition i.e. nasogastric (NG), nasojejunal (NJ), Percutaneous Endoscopic Gastrostomy (PEG), jejunostomy (JEJ) feeding. N.B. Starter feeding regimen available on all wards.

Diabetes if:

Newly diagnosed New to insulin therapy Poor appetite, weight loss or REGULAR hypos.

If patients do not fit one of the categories stated above, give the diet sheet ‘Food and Diabetes’. All newly diagnosed individuals should also be given this booklet to give them basic information until they see the Dietitian.

Ulcerative Colitis All newly diagnosed. Patients with previously diagnosed Ulcerative Colitis experiencing weight loss and diarrhoea.

Crohn’s Disease All newly diagnosed. Patients with previously diagnosed Crohn’s disease experiencing weight loss and diarrhoea.

Coeliac Disease All newly diagnosed. N.B. Gluten free diet available from Catering. Gluten free bread and biscuits available from Pharmacy.

Dysphagic patients with a poor oral intake.

Patients presenting with cancer cachexia.

Oesophagogastrectomy / oesophageal stent.

Colostomy / Ileostomy Refer if indicated by nutritional risk score.


- 61 -

Pressure sores Refer if indicated by nutritional risk score.

Liver disease Refer if indicated by nutritional risk score. N.B. Nursing staff to provide patient with “No Added Salt” diet sheet.

Renal failure Refer if indicated by nutritional risk score or dietary restrictions are required.

Note

Low albumin is NOT an appropriate reason for referral as it is a poor marker of nutritional status. Albumin is a good indicator of the severity of illness when used in conjunction with the acute phase proteins, such as C-reactive protein (CRP). Assuming normal hepatic function,

When CRP is increased and albumin is low = illness.When CRP is normal and albumin is low = protein depletion.

PATIENTS SEEN AS OUT-PATIENTS if complete written referral received.

Obese Patients with a BMI > 35 and no other pre-existing medical condition. Those with BMI > 30 with Ischaemic Heart Disease (IHD), Diabetes, COPD or 2 or more risk factors for cardiovascular disease. Nursing staff to provide “Eating for Health” booklet whilst patient is an in-patient.

Lipid lowering Patients with a cholesterol > 6mmol/l. Provide non-MI patients with a ‘Healthy Eating for Healthy Heart’ leaflet. MI patients will receive this in their pack from the Cardiac Nurse.

PATIENTS NOT SEEN

Diverticular Disease Give “High Fibre” diet sheet and Diverticular Disease leaflet produced by the Digestive Disorders Foundation (if purchased by Ward Manager).

GallstonesGive “Eating for Health” booklet. N.B. There is no evidence to suggest a role for low fat diets in the management of gallstones.


- 62 -

Constipation Give “High Fibre” diet sheet and ensure adequate fluid intake. Check medication.

Gastric Ulcers Give the leaflet “Practical Advice for Gastric Discomfort” along with “Eating for Health” booklet.

Hiatus Hernia, Indigestion, or Heartburn Give the leaflet “Practical Advice for Gastric Discomfort” along with “Eating for Health” booklet.


- 63 -

Referral to the Dietetic Service – Inpatients

St Helens & Knowsley NHS Hospitals TrustDepartment of Nutrition & Dietetics Request for Dietetic AssessmentDate Date Received Please attach patient information label. If none

available, please insert details. (Include NHS Number)

Ward Consultant

Diet Suggested

Clinical Details

Weight Nutrition Risk Score

Signature of Medical Officer

Please call the Dept of Nutrition & Dietetics with the above details on Ex 1201. Alternatively fax to 1461


- 64 -

Referral to the Dietetic Service –

Referral to the Community Dietetic Service For Patients Requiring a Domiciliary Visit

Referrals will be triaged. Please use BLOCK CAPITALS and complete in full. Incomplete referrals will be returned

Name: ………………………………………………………………………………..…..

Address: ………………………………………………………………………..……....

Postcode: …………………………………………………………………………….…

Tel No.: ……………………………………………………………………………..……

DOB: ……………………………………………………………………………….…….

GP name: ……………………………………………………………………….………

GP address: ……………………………………………………………………….……-----------------------------------------------------------------------------------------------------------------1) Appetite reduced from normal quantities for >2 weeks? : Yes □ No □

2) Is visual weight loss apparent? : Yes □ No □

3) Recent 3 month weight history: ……………………………………… Current BMI :…………...

4) Is the patient palliative? : Yes □ No □-----------------------------------------------------------------------------------------------------------------

Diagnosis & Clinical Details: ……….……………………………………………..…

………………………………………………………………………………………………

………………………………………………………………………………………………

Diet Suggested ………………………………………………………………………………

…………………………………………………………………………………………………..

Relevant Medication: ……………………………………………………………..… ………………………………………………………………………………………………..

___________________________________________________________________GP Signature: Date:

Print name: Designation & Base:

Please send to Dietetics, Birch House, Whiston Hospital or fax to 0151 430 1461


- 65 -

Referral to the Dietetic Service –Referral to ‘CHANGES’ the Adult

Weight Management Service(Inclusion criteria – BMI ≥ 35kg/m2)

Please use BLOCK CAPITALS and complete in full (any incomplete or inappropriate referrals will be returned)

Name: ………………………………………….. Title: ………. D.O.B: ………………………

Address: ………………………………………………………………………………………

Postcode: …………………………………….. Tel No: …………………………………..

GP name: …………………………………………………………………………………….

GP address: ………………………………………………………………………………….___________________________________________________________________________________Medical HistoryDiagnosis & Clinical Details ………………………………………………………………..…………………………………………………………………………………………………Diabetes□ Stroke □ Osteoporosis □ Sleep Apnoea □ MI □ Cancer □ Chronic Joint Pain □ Epilepsy □Angina □ Renal □ Thyroid Dysfunction □ Psychiatric Illness □PCOS □ COPD □ Anxiety/Depression □ Post Surgery □Weight related infertility □ History of eating Disorder □Others ………………………………………………………………………………………... __________________________________________________________________________________

Height ………….cm Weight ……………..kg BMI ………………..kg/m2 (Inclusion criteria – BMI ≥

35kg/m2) BiochemistryCholesterol ………mmol/L TG ………mmol/L HDL ……… mmol/L LDL ……… mmol/L FBS………..mmol/L HbA1c …………….% (diabetes only) Blood Pressure …………..mm/Hg Others ……………………..

Relevant medication List of current medications attached □Not currently on any medication □____________________________________________________________________________________Any special requirements e.g. wheelchair access, hearing impairment, literacy difficulties, learning difficulties, translator needed, registered blind please specify ………………………………………………………………………………………………………. ……………………………………………………………………………………………………….If a domiciliary visit is required is there any information which needs to be known?Please state: …………………………………………………………………………………………………………………………………………………………………………………………………____________________________________________________________________________________

Signature of referrer: Date:Print Name: Designation: GP/PN/Other …..............Address:

Please send to the Weight Management Service, Department of Nutrition and Dietetics, Old Tower Hill Health Centre, Moorfield, Kirkby, Merseyside, L33 1XD

In collaboration with St Helens PCT and St Helens Council


- 66 -

6.4 EXTENDED SERVICES - The Speech & Language Therapy Service

The Speech and Language Therapy Service is provided by Knowsley Primary Care Trust. All Speech and Language Therapists are licensed and registered by the Royal College of Speech and Language Therapists and are members of the Health Professions Council.

The role of the Speech and Language Therapist is to provide assessment, treatment and advice to people and/or their relatives who have difficulties with communication and/or swallowing.

There is an open referral policy, which allows anyone to make a referral to the service, however swallowing referrals must be signed by a doctor. Referrals from professionals must be in writing.

Speech and Language Therapist generally work as a member of a multi-disciplinary team which may consist of Doctors, Nurses, Physiotherapists, Occupational Therapists, and Dietitians according to need.

Referrals should be sent to:-

The Speech and Language Therapy ServiceHenley HouseDelph LaneWhiston MerseysideL35 7JE

Telephone Number: - 0151 290 2010Fax Number:- 0151 290 2017

Please do not hesitate to contact us if you would like more information or would like to discuss a referral.


- 67 -

6.5 EXTENDED SERVICES – SUPPORT Smoking Cessation

SUPPORT Smoking Cessation Service

Do you support patients who are smokers ?

St Helens & Knowsley SUPPORT aims to offer friendly advice and support to smokers who want to stop smoking.Since its launch in November 1999, we have received over 6000 referrals and helped nearly 4000 people to set a quit date. Over 50% of those setting quit dates with SUPPORT, stayed quit for at least 4 weeks.A smoker using SUPPORT is 6 times more likely to stay quit than someone using willpower alone.

How can I find out more information, or be referred to SUPPORT ?

Hospital patients can be referred to the community based SUPPORT service. Once they are discharged from hospital, they can receive weekly support from one of our smoking cessation specialists. Referral form can be completed and faxed to the most appropriate number on the referral form.

Staff can also be supported in their quit attempt by attending regular counselling sessions, usually run in the hospital. Nicotine Replacement Therapy products or Zyban will be available on prescription, provided you are suited to their use. Intensive help and advice is also available.

Leaflets and posters are available to any member of staff wishing to promote the stop smoking message.

For further help/information, contact Emma Sloan on ext 1431 (Monday &Tuesday only) or Andrea Goodman 01744 811735 on any other day.


- 68 -

S U P P O R TFOR THOSE WHO WANT TO QUIT SMOKING

Referral system for Hospital Patients


- 69 -

Ask the patients

Do you smoke?Have you ever tried to stop?Are you interested in stopping smoking?

If interested in stopping smoking

ADIVSE Give clear, strong, personalised advice Tie smoking to immediate health effects

and consequences Give relevant information leaflets

If no interest is shown

Advise smoker to stop

Inform of: National helpline for further

info on 0800 169 0169 Self-referral to SUPPORT

on 0800 1952131

Refer to SUPPORT

Self Referral

By ringing 0800 195 2131 (use for patients who live outside St Helens and Knowsley district)

Fax Referral

Complete patient details on referral form

Fax form to one of the 4 numbers the bottom of the form depending on where the patient lives

For further help/information, contact Emma Sloan on ext 1431 (Monday & Tuesday only) or Andrea Goodman 01744 811735 on any other day.

ST HELENS & KNOWSLEY S U P P O R T FOR THOSE WHO WANT TO QUIT

SMOKING

merseyside health action zone a healthy life for merseyside

SECTION ONE – BRIEF INTERVENTION

ASK/ASSESS SMOKER YES/NO

ADVICE ALL SMOKERS TO STOP

ASSIST FOLLOW UP IF INTERESTED YES NO

REFER TO SUPPORT

THIS PATIENT HAS EXPRESSED A GENUINE DESIRE TO STOP SMOKING

PATIENTS NAME NHS No ADDRESS TELEPHONE No POSTCODE NAME OF PATIENTS GP PATIENTS SIGNATURE OF CONSENT DOES THE PATIENT HAVE ANY HEALTH CONDITIONS THAT YOU FEEL SUPPORT SHOULD BE MADE AWARE OF REFERRERS NAME REFERRERS TEL No/ADDRESS (if you require feedback of patients progress)

REFERRER IS GP PN HV DN Midwife Cardiac Rehab Pharmacy Hospital Hosp Facilitator Other (Please state)


- 70 -

FAX TO:ST HELENS (North & South) 01744 755439

NEWTON/HAYDOCK 01925 271014 KIRKBY 0151 545 0141KNOWSLEY (Central & South) 0151 292 9355

6.6 EXTENDED SERVICES – ICCP (Integrated Cancer Care Programme)

Aims

1. To improve the overall quality of Cancer care by increasing co-ordination between care. Providers, thus strengthening communication links with patients and their carers.

2. To reduce duplication of effort and prolonged or unnecessary hospital admissions.

3. To improve the satisfaction of both patients carers and staff with the care delivered to people with cancer.

Benefits for you... The right care at the right time in the right place. A single point of contact through a Care Co-ordinator for community

services. Reduced anxiety and timely support for you, your family, carers and

friends. Improved access to information at each stage of the care pathway. Improved quality of care by closely following your journey, ensuring

compliance with care procedures. Eliminating gaps and avoiding duplication of services. Responding to your preferences for treatment and care. Use existing resources more efficiently and effectively, adjusting to local

needs and priorities. More knowledgeable district nurses who will acquire additional training

and skill in patient assessment, communication and management of changes in condition

The Local Plan Patient’s will be contacted by ICCP Care Co-ordinator.

The Care Co-ordinator will need 15 minutes to ask you about your health, living and support arrangements and any specific concerns you have.

Throughout your care the Care Co-ordinator will co-ordinate information on your appointments, treatments, referrals, medication, periods of stay in different care settings and transfer between them.

You will be offered support to increase awareness of your condition and enable you to identify and react appropriately to changes. The Care Co-ordinator, and a senior staff nurse, will be able to offer direct healthcare advice and, through links to specialists in Cancer care, will answer any concerns that arise.

Data Safety


- 71 -

To ensure the most appropriate care is offered, confidential records of your health and personal details will be held and maintained by the ICCP Care Co-ordinator in a secure, password protected electronic database, which is registered under the Data Protection Act 1998.

All staff involved in this programme receive training and updates in data security and the Caldicott Guidelines, (Strict guidelines for releasing patient information therefore ensuring patient confidentiality).

Specialist Support

If you require this leaflet in another language, large print or another format, please contact the ICCP Care Co-ordinator.

Your Views

Your comments on the quality of our services are always welcome. The Care Co-ordinator will be happy to answer concerns and pass on feedback regarding this programme.

For further information on the Integrated Cancer Care Programme, contact the ICCP Care Co-ordinator Jackie Ward Tel: 0800 121 8396


- 72 -

7. SUPPORT GROUPS 7.1 SUPPORT GROUPS - Local Support Groups/Services

Service Role Contact Details Age Concern Advice and assistance

to elderly people in the community.

Age Concern St HelensMansion HouseVictoria ParkSt Helens, WA10 2UETel: 01744 [email protected] www.acsthelens.org.uk

Age Concern Knowsley1 Griffiths RoadHuyton, L36 6NATel: 0151 480 4632e-mail: [email protected]

Benefits Agency Office

Advice and assistance with benefits.

Benefits Agency OfficeGregson House2 Central StreetSt. Helens, WA10 1UFTel: 08456088503www.dwp.gov.uk

Benefits Advice Free confidential advice the first Thursday of the month between 3 pm – 5 pm in the General Office Day Room outside the Lilac Centre, Rowan House. No appointment is required. This is supported bySt Helens Carers Centre.

Lilac CentreRowan HouseWhiston HospitalWarrington RoadPrescot, L35 5DR

Tel: 0151 430 1687


- 73 -

http://www.dwp.gov.uk/

http://www.ageconcernknowsley.org.uk/




http://www.acsthelens.org.uk/

Bosom Buddies Breast Cancer Support Group. The aim of the group is to help and support. Meetings the first Wednesday of every month at 7.00 p.m. Trinity ChurchPeel House LaneWidnes

Widnes & RuncornCancer Support Group21-23 Alforde StreetWidnesWA8 7TRTel: 0151 423 5730

Citizens Advice Bureau

Confidential advice and information on a wide range of subjects.

www.citizensadvice.org.uk

HALEWOOD15/21 Ravenscourt, Leathers LaneHalewood L26 OUPTel: 08451221300KNOWSLEY 10A Church StreetPrescot L34 3LATel: 08451221300

HUYTONNutgrove Villa1 Griffiths Road, HuytonMerseyside, L36 6NATel:08451221300www.knowsleycab.org.uk

ST HELENSMillennium Centre Corporation StreetSt Helens, Merseyside,WA10 1HJAdvice line: 08701212027Appt: 01744 737866www.adviceguide.org.uk

Knowsley Cancer Support

Group for people with any kind of cancer. Offers support and information, social activities, library, telephone support, and home and hospital visits.Open Monday to Friday,10am–3:30 p.m.

“Lyndale”40 Huyton LaneLiverpoolL36 7XG0151 489 3538


- 74 -

http://www.adviceguide.org.uk/

http://www.knowsleycab.org.uk/

http://www.citizensadvice.org.uk/

Knowsley Carers Centre

Offering: - Information, Support, Respite, Social Activities, Sign Posting, Advice, Carers Groups, Voucher Scheme, Emergency Cards, Benefits Advice, Newsletter

Knowsley –Carers Centre149 Cherryfield DriveKirkbyKnowsleyL32 8SETel: 0151 549 1412

Halewood –Carers CentreSt Mary Day CentreHillingten AvenueHuytonL26 9TYTel: 0151 448 9771

Patient Partnership Group

The group was established in June ’06 and represent the voice of cancer service users to the Trust, covering all tumour types, social classes and ethnic minorities.

The group provide a forum for patients and carers to influence the development of cancer services within the locality and are actively involved with Trust business and participate in service improvement initiatives.

Meeting take place every 6 weeks on a Tuesday evening at 1730 to 1930 in the Post Graduate Centre, Whiston Hospital.

For further information contact Mrs Jacquie Kelly, Service Improvement Facilitator, Cancer Services, Whiston Hospital, Tel: 0151 430 1055

Roy Castle Support Group for people/carers with Lung CancerMeets at 2 pm first Tuesday of each month.

200 London RoadLiverpoolMeresyside L3 9TATel: 0800 358 7200Website:www.roycastle.org

Samaritans 24 hour telephone Helpline

0151 708 8888


- 75 -

http://www.roycastle.org/

St Helens Cancer Support Group

Travel the journey together. Informal atmosphere. Chance to meet people who have just had cancer. Share experiences or just sit and listen. Carers and family members welcome. Monthly meeting last Monday of each month at The Millennium Centre, St Helens, at 7pm,Weekly drop-in meeting every Friday Millennium Centre between 1 pm – 4 pm.

Mr Denys Floyd01744 884097

Widnes & Runcorn Cancer Support Group

Offering: - Information, Support, Social Activities, Sign Posting, Advice, Carers Groups, Welfare Rights, Legal Advice and Benefits Advice.

Cancer Self Help Group meets every Thursday afternoon 1.30 pm – 3.00 p.m.

Hand-in-Hand group 2nd Wednesday of every month 7.30 pm at Old Police Station, Mersey Road, Runcorn.

21 Alforde StreetWidnesWA8 7TRTel: 0151 423 5730Open 10am-3pm every day

Email: [email protected]

Website:

www.widnesruncorncsg.org.uk


- 76 -

http://www.widnesruncorncsg.org.uk/

http://www.widnesruncorncsg.org.uk/


7.2 SUPPORT GROUPS - Local Bereavement Support

Service Role Contact Details

Age Concern – Knowsley Free and confidential bereavement support.

0151 480 4632

www.ageconcernknowsley.org.uk

Cancer CounsellingLilac Centre, Whiston Hospital

Free and confidential bereavement support.

0151 430 1687

Knowsley Counselling Service Free and confidential bereavement support.

0151 480 6270

www.knowsleycounsellingagency.com

Liverpool Bereavement Service Free and confidential bereavement support.

0151 708 6706

Samaritans – Liverpool Free and confidential bereavement support.

0151 708 8888

St Helens Bereavement Service Free and confidential bereavement support.

01744 451793


- 77 -

http://www.knowsleycounsellingagency.com/






7.3 SUPPORT GROUPS - National Support - General

Service Role Contact Details British Association for Counselling and psychotherapy

BAC can refer people to a local counsellor. They have information sheets on counselling.

BACP House15 St John’s Business Park,Lutterworth,LeicestershireLE17 4HBTel: 0870 443 5252Email:[email protected]: www.bacp.co.uk

Wessex Cancer Trust

Offers emotional support and practical help where possible, through support groups around the country. Telephone and one-to-one counselling, telephone link service, holiday accommodation and information on other charities and cancer-related organisations.

www.cancercaresociety.org

Cancer Counselling Trust

Offers confidential counselling to individuals, couples or families affected by cancer. Counselling is given by registered counsellors and psychotherapist. Face to face counselling is offered at the London office; for people unable to get to the London office telephone counselling is available.

1 Noel Road, London N1 8HQTel: 020 7704 1137Fax: 020 7704 8620Email: [email protected]: www.cctrust.org.uk

Cancer Research UK

Gives information on cancer treatments and research trials.

P.O.Box 123 Lincoln's Inn Fields, London WC2A 3PXSupport ServicesTel: 020 7121 6699Switch:02072420200Email: [email protected]: www.cancerresearchuk.org


- 78 -

http://www.cancerresearchuk.org/

http://www.cancerresearchuk.org/



http://www.cctrust.org.uk/



http://www.cancercaresociety.org/

http://www.cancercaresociety.org/

http://www.bacp.co.uk/


Cancer BACUP Offers support and information on all aspects of cancer. Telephone advice provided by Specialist nurses. Cancer BACUP's cancer counselling service offers counselling at its London and Glasgow based offices The counselling service can provide information about counselling and what services are available in local areas.

Cancerbacup3 Bath Place, Rivington Street, London, EC2A 3JR Support Service on 020 7696 9003 or Freephone 0808 800 1234 to speak to a cancer specialist nurse. Lines are open Monday-Friday,9am – 8 pm www.cancerbacup.org.uke-mail through websitefax: 02076969002

CancerLink

(merged with Macmillan Cancer Relief)

Offers support and information on all aspects of cancer in response to telephone and letter enquiries. Acts as a resource to over 370 cancer support and self help groups throughout the UK and publishes a range of publications on issues about cancer.

[email protected]

www.macmillan.org.uk

Macmillan Cancer Relief

Provides home care nurses through the Macmillan Service and financial grants for people with cancer and their families.

Macmillan Cancer Relief 89 Albert Embankment London SE1 7UQFreephone:0808 80820209 am to 10 pm Monday to Friday

Marie Curie Cancer Care

Runs ten centres (hospices) throughout the UK and a community nursing service, which works with the district nursing service and supports cancer patients and their carers in their homes.

89 Albert EmbankmentLondonSE1 7TPTel: 02075997777Email through websitewww.mariecurie.org.uk


- 79 -

http://www.mariecurie.org.uk/

http://www.mariecurie.org.uk/

http://www.macmillan.org.uk/

http://www.macmillan.org.uk/



http://www.cancerbacup.org.uk/

http://www.cancerbacup.org.uk/

QUIT

General – Smoking Cessation see page 70

Provides telephone support and information leaflets for smokers who want to stop. Can also refer you to local stop smoking groups.

Quit, Ground Floor, 211 Old Street LondonEC1V 9NRHelpline:: 0800 002200Email:Counselling: [email protected]:[email protected]: www.quit.org.uk

Tenovus Cancer Information Centre

Provides an information service on all aspects of cancer and practical and emotional support for cancer patients and their families. Freephone cancer helpline staffed by nurses, social worker and counsellor. Drop-in centre and support group.

43 The Parade,Cardiff, CF24 3ABTel:02920482000

www.tenovus.com

Cancer Buddies Network

Brings together people form all walks of life for support and friendship.

www.cancerbuddiesnetwork.org


- 80 -

http://www.cancerbuddiesnetwork.org/

http://www.cancerbuddiesnetwork.org/

http://www.tenovus.com/

http://www.quit.org.uk/



National Support – Children

Sargent Cancer Care for Children

Offers emotional and financial support to young people under the age of 21 who have been diagnosed with cancer. Sargent Care Professionals are based at major centers throughout the UK and support each child and family from the date of diagnosis onwards.

CLIC SargentGriffin House161 Hammersmith Road, LondonW6 8SGTel: 020 8752 2800Child Cancer Helpline: 0800 197 0068 Mon-Fri 9 am to 5 pmEmail: [email protected] Website: www.sargent.org

The Children’s Cancer and Leukaemia Group (CCLG)

(FormerThe UK Children's Cancer Study Group)

Umbrella organisation of all children's cancer centres within the UK. It formulates treatment plans, runs clinical trials, researches and monitors new drugs and produces a booklet, available in four different languages, called 'A parent's Guide to Children's Cancer.'

UKCCSGUniversity of Leicester, 3rd Floor, Hearts of Oak House,9 Princess Road, West Leicester, LE1 6 THTel:01162494460Fax: 01162549504Email:[email protected]: www.ukccsg.org.uk

Winstons wish Winston’s Wish is a charity which supports bereaved children and young people. They also offer guidance and information to families and to anyone concerned about a child after bereavement.

Winstons WishClara Burgess Centre, Bayshill Road, Cheltenham, GL50 3AWTel:01242515157Helpline:08452030405Email:[email protected] Website:www.winstons.org.uk


- 81 -



http://www.ukccsg.org.uk/


http://www.sargent.org/



National Support – Teenagers

Riprap

General – support for teenagers

A website developed especially for teenagers who have a parent with cancer

www.riprap.org.ukHilde Hjelmeland AhmedzaiRip Rap Project ManagerUniversity of Sheffield.Trent Palliative Care Centre, Little Common Lane, Sheffield, S11 9NE


- 82 -

http://www.riprag.org.uk/

7.4 SUPPORT GROUP - National Support – Site-Specific

BREASTHereditary breast cancer helpline

A national helpline giving information and help to women concerned about a family history of breast cancer. Has an information pack on genetic testing for breast cancer.

Information Centre, St Anne Cottage, Over Haddon, Derby, DE45 1JETel: 01629 813000Email:[email protected]:cancerhelp.org.uk

UK Breast Cancer Coalition

Organisation which campaigns to improve the welfare and health interests of all women in this country with, or threatened by breast cancer.

1D Broadway House 112-134 The BoardingWimbledon, LondonSW19 IRLTel: 020 8543 5577Email:[email protected]: www.ukbcc.org.uk

Breast Cancer Care

A national organisation giving emotional support and practical advice to women who have, or fear they may have, breast cancer. Has a national volunteer support service.

Kiln House, 210 New King's Road, London SW6 4NZ Tel: 0207 384 2984Tel: 0808 800 6000 Minicom helpline: 080 800 6001Email: [email protected] Website: www.breastcancercare.org.uk

BRAINBritish Acoustic Neuroma Association

Gives information and support for people with acoustic neuroma.

Oak House, Ransom Wood Business Park, Southwell Rd West, Mansfield, Notts NG21 0HJTel: 01623 632143 Email:[email protected]:www.bana-uk.com


- 83 -

http://www.bana-uk.com/



http://www.breastcancercare.org.uk/

http://www.breastcancercare.org.uk/

http://www.ukbcc.org.uk/




COLORECTALBowel Cancer

(former:Colon Cancer Concern & Beating Bowel Cancer)

Provides an information service; funds research into new treatments for bowel cancer; and campaigns for better treatments and screening programmes

7 Rickett Street, London, SW6 1RU Tel: 020 7381 9711 Helpline: 08708506050Email: [email protected]: www.bowelcancer.org.uk

British Colostomy Association

Offers support, reassurance and information to anyone who has had a colostomy or is facing one. Offers home and hospital visits by experienced colostomates, and telephone advice and support. Twenty area organisers throughout Great Britain.

15 Station Road, Reading, Berkshire RG1 1LG Tel: 0800 328 4257 Tel: 0118 939 1537 Email: [email protected] Website: www.colostomyassoicaition.org.uk

The Ileostomy and Internal Pouch Support Group

Aims to help anyone who has had, or is about to have their colon removed and has an ileostomy or internal pouch. A network of over 60 branches throughout the UK provide advice, information leaflets and home/hospital visiting. Has membership fees.

Peverill House, 1-5 Mill Road Ballyclare, Co. Antrim BT39 9DR Tel: 0800 018 4724 Tel: 028 9334 4043 Fax: 028 9332 4606 Email: [email protected]: www.ileostomypouch.demon.co.uk

GYNAECOLOGYGynae C A support organisation for 1 Bolingbrooke


- 84 -

http://www.ileostomypouch.demon.co.uk/

http://www.ileostomypouch.demon.co.uk/

http://www.colostomyassoicaition.org.uk/

http://www.colostomyassoicaition.org.uk/

mailto:[email protected]%20


http://www.bowelcancer.org.uk/

http://www.bowelcancer.org.uk/



women with gynaecological cancers and their partners, families and friends. Provides publications, meetings, telephone support and counselling.

Road, Swindon, Wiltshire, SN2 2LB Tel: 01793 491116Email: [email protected] Website: www.communigate.co.uk/wilts/gynaec

Ovacome

A national support group for all those involved with ovarian cancer, including patients, families, friends, carers and health professionals.

Elizabeth Garrett Anderson Hospital, Huntley Street, London. WC1E 6DHTel: 020 73809589Email: [email protected]: www.ovacome.org.uk

The Daisy Network (Premature menopause support group)

Offers support, group meetings and workshops for woman affected by premature menopause. For written information send a large SAE to the above address.

PO Box 183, Rosendale, BB4 6WZ

Email:Daisynetwork.org.ukWebsite:www.daisynetwork.org.uk

HAEMATOLOGYInternational Funds research into myeloma Myeloma UK,Produced by Cancer Services - Version Four (April 2007)

- 85 -

http://www.daisynetwork.org.uk/

http://www.daisynetwork.org.uk/

http://www.ovacome.org.uk/

http://www.ovacome.org.uk/



http://www.communigate.co.uk/wilts/gynaec

http://www.communigate.co.uk/wilts/gynaec

Myeloma Foundation: UK Office

and also provides information to patients on any aspect of myeloma and its treatment. Produces a helpful booklet 'A concise review of the disease and treatment options'.

Lower Ground Floor,37 York Place, Edinburgh, ScotlandEH1 3HPTel:+44(0) 1315573332Helpline: 0800 980 3332Email: [email protected]: www.myeloma.org.uk

Anthony Nolan Bone Marrow Trust

Runs Europe's largest register of fully tissue-typed volunteer donors. Anyone wishing to be a bone marrow donor should contact the Donor department.

Unit 2-3Heathgate Place75-87 Agincourt Road, LondonNW3 2NUTel: 020 7284 1234 Email:[email protected]:www.anthonynolan.org.uk.

Leukaemia Research Fund

Devotes all its resources to research into the causes, treatment and cure of leukaemia, the lymphomas and melanoma. Provides a patient information service and booklets on the diseases and their treatment.

43 Great Ormond Street London WC1N 3JJ Tel: 020 7405 0101Email:[email protected]:www.lrf.org.uk

Lymphoma Association

The Lymphoma Association provides information and emotional support to anyone whose life has been affected by lymphoma (lymphatic cancer) . The helpline is staffed by people who have had training in understanding lymphomas, their treatments and related issues.

P O Box 386, Aylesbury, Buckinghamshire HP20 2GAFreephone: 0808 808 5555Email: [email protected] Website: www.lymphoma.org.uk

Leukaemia Care Several local groups throughout Britain. Offers

One Birch Court, Blackpole East,


- 86 -

http://www.lymphoma.org.uk/

http://www.lymphoma.org.uk/



http://www.lrf.org.uk/


http://www.anthonynolan.org.uk/

http://www.anthonynolan.org.uk/



http://www.myeloma.org.uk/

http://www.myeloma.org.uk/



support and companionship to patients and their families. Some financial assistance is available and a small number of holiday caravans.

Worcester WR3 8SGTel: 01905 75597724hour careline:0800 169 6680Email:[email protected]:www.leukaemiacare.org.uk

HEAD & NECKBritish Thyroid Foundation

Produces a newsletter and booklets about the thyroid gland, thyroid disease and thyroid cancer. Runs a network of local support groups.

PO Box 97, Clifford, Wetherby, West Yorkshire LS23 6XDTel: 01423 709707www.btf-thyroid.org

National Association of Laryngectomee Clubs

Aims to promote the welfare of laryngectomy patients and their families. Produces a range of booklets, including a handbook for patients. Supports 80 local laryngectomy clubs. Visits pre- and post-operative patients.

Lower Ground floor152 Buckingham Place Road, Victoria, London SW1W 9TRTel: 0207 703 8585www.patient.co.uk

Information Website:www.laryngectomees.inuk.com


- 87 -

http://www.laryngectomees.inuk.com/

http://www.laryngectomees.inuk.com/

http://www.patient.co.uk/

http://www.leukaemiacare.org.uk/

http://www.leukaemiacare.org.uk/



LUNGRoy Castle Lung Cancer Foundation

Funds medical research, patient care, and advocacy. Has a lung cancer patient network which provides support groups, information booklets on lung cancer and treatments, and a video on dealing with breathlessness. Support group meets the first Tuesday of every month.

200 London Road, Liverpool, Merseyside L3 9TATel: 0800 358 7200Website: www.roycastle.org

British Lung Foundation

Raises funds for research into lung diseases and provides information. Runs Breathe Easy: a free club for people who have breathlessness. Has a support network and a newsletter which offers a "keep in touch" service.

73/75 Goswell Road, London EC1V 7ERTel: 020 7688 5555Fax: 020 7688 5556Email: [email protected]: www.lunguk.com


- 88 -

http://www.lunguk.com/



http://www.roycastle.org/

SKINMARCS Line

(Melanoma and Related Cancer of the Skin)

Wessex Cancer Trust is the home of the MARC’s helpline and advice centre

MARCS Line is a telephone information service for people with skin cancer, their families and friends. Provides information, literature and advice about skin cancers and their prevention.

Wessex CancerBellis House11 Westwood RoadSouthhamptonS)17 1DLEmail:MARCS [email protected] Website: www.wessexcancer.org

Skin Cancer Research Fund

Promotes research into all aspects of skin cancer and provides support and information to people with skin cancer.

Department of plastic surgery, Frenchay Hospital, Frenchay, Bristol, BS16 1LETel: 0117 970 1212Email: [email protected]

Skinship UK A telephone helpline for anyone with skin problems including cancer. Puts patients in touch with other patients. Offers one to one counselling.

Plascow Cottage, Kirkgunzeon, Dumfries, DG2 8JTTel: 01387 760567

SKIN/ HEAD & NECKBritish Association of Skin Camouflage

Members are helped to disguise skin problems with camouflage make-up.

P.O.Box 202 Macclesfield, Cheshire, SK11 6FPTel: 01625 871129Email: [email protected]

Website: www.skin-camouflage.net


- 89 -

http://www.skin-camouflage.net/

http://www.skin-camouflage.net/





http://www.wessexcancer.org/

http://www.wessexcancer.org/



Disfigurement Guidance Centre

Provides advice, support and practical help to patients and health professionals.

Website: www.dgc.org.uk

Let's Face It Support Network

Provides support, information and mutual help for people with facial disfigurement.

72 Victoria AvenusWestgate on seaKent CT8 8BITel: 01843833724Email:[email protected]:www.lets-face-it.org.uk

Oesophageal Patients Association

The Association’s objectives are to help new patients and their families to cope with any difficulties arising as a result of treatment.

Chairman: David Kirby22 Vulcan HouseVulcan RoadSolihullB91 2JYTel: 0121 704 9860Website: www.opa.org.uk

UROLOGYUrostomy Association

Helps people who are about to have, or have had, surgery resulting in the diversion or removal of the bladder. Gives information, help and advice on appliances, work situations, and marital problems.

Central Office, 18 Foxglove Avenue, Uttoxeter,Staffs, ST14 8UNTel: 08707707931Email: [email protected]: www.uagbi.org

Orchid Cancer Appeal

Funds research and promotes awareness into testicular and prostate cancer.

St Bartholomew's Hospital, London EC1A 7BETel: 020 7601 7808Email: [email protected]: www.orchid-cancer.org.uk


- 90 -

http://www.orchid-cancer.org.uk/

http://www.orchid-cancer.org.uk/



http://www.uagbi.org/



http://www.lets-face-it.org.uk/

http://www.lets-face-it.org.uk/

http://www.dgc.org.uk/

St Helens & Knowsley Hospitals

Cancer & Palliative Care Service Directory

8. Amendment Form

If you have any changes, please fill in the form below and return to:Anita Corrigan, Lead Nurse/Manager – Cancer Services, Whiston Hospital.Tel: 0151 430 1055 Fax: 0151 430 1074

Date………………………………………………Page………………………………

Name…………………………………………………………………………………..

Title……………………………………………………………………………………..

Address………………………………………………………………………………..

…………………………………………………………………………………………..

Telephone……………………………………….

E-mail………………………………...

Website………………………………………………………………………………

Any other changes………………………………………………………………………………

…………………………………………………………………………………………..


- 91 -

Health & Medicine

cancer and palliative care directory