hillingdon locum information pack - glendale medical...
TRANSCRIPT
Glendale Medical Centre www.glendalemedicalcentre.org.uk
PRACTICE INFORMATION PACK Revised April 2016
This pack is designed to provide a wealth of essential information to help familiarization with policies and procedures within the practice, including assistance with induction of new staff and Locums. Not all the information will be relevant to all staff.
Every attempt has been made to keep this information pack as up to date as possible, however procedures do change and should you come across information that may be out-dated or incorrect when using this pack please email [email protected]. Your feedback is also welcome.
This is a live document and will periodically be updated to reflect changes. Further information can also be accessed by clicking on the highlighted hyperlinks- only via PC msword/adobe- please let Dr Nanavati know if you cannot download any documents.
Locum/salaried staff Induction drill
At your first visit you will be shown around the practice to familiarize yourself with the essentials including location of emergency drugs, resuscitation box, defibrillator, panic button, fire exits, toilets, location of consulting rooms and nurses room.Use of telephone- how to call receptionists, nurse, other Drs, how to get outside line.Computer-how to log into computer system (windows and clinical system)As well as ICE and Ereferrals
Practice website (which gives comprehensive information about the practice) www.glendalemedicalcentre.org.uk
practice address- 155 High Street Harlington UB3 5DA tel 02088978288
map and directions
Partners Dr Mayur Nanavati Dr Anu Amanan
Salaried GPs Dr Rubinder Matharoo Dr Amanjot Kaur
Practice nurse Mrs Sue Bardell
Practice manager Mrs Jenny Cook
Receptionists—Anette Mckeon, Helene Brennan, Kulwant Seehra, Sasha Wakefield, Allison Wood.
Conditions of employment with Glendale Medical Centre are set out in the contract of employment and Job description and also include the following-
All new staff will require to be CRB checked ( or have evidence of a CRB check been carried out within the last year)
In addition locums/clinical /staff need to be on a CCG performers list, have evidence of level 3 child protection training and adult BLS within last 2 years. Evidence of current GMC registration (and be on the GP register) and evidence of membership of the MDU/ MPS Locums and GPs (Partners and salaried GPs) need to be annually appraised as part of their revalidation and must ensure they are regularly involved in CPD and the appraisal process as administered by NHS North West London- please ensure you are signed up to clarity toolkit.
Also Practice nurses are required to have annual appraisals and be familiar with the new re-validation requirements for Nurses.
Appraisal Team Contact Details
Helen Nicholson, Appraisal Coordinator [email protected]: 0113 807 0706
Siobhan Singlehurst, Appraisal and Revalidation Manager
[email protected]: 07900 713 054
Dr Anouska Hari, Appraisal and Revalidation Lead.Hillingdon, Kensington + Chelsea and Hammersmith + Fulham.
Dr Gouri Dhillon, Appraisal and Revalidation Lead.Ealing and Hounslow [email protected]
Dr. Eva Larsson, Appraisal and Revalidation Lead.Brent [email protected]
Dr. Deen Mirza, Appraisal and Revalidation Lead.Westminster [email protected]
Dr. John Sanfey, Appraisal and Revalidation Lead.Harrow [email protected]
Edward Ward, Head of Performance and Revalidation [email protected]
Dr David Finch, NW London Area Medical Director and Responsible Officer [email protected]
Appraisal and Revalidation Team NHS England - North West London Team4th FloorSouthside105 Victoria StreetLondonSW1E 6QT
The practice uses EMIS WEB for staff unfamiliar with Emis Web a comprehensive training programme may be arranged but initially you can familiarize yourself with the basics of EMIS web by following the web links below and the summary document on getting around EMIS WEB
EMIS WEB TUTORIAL
NAVIGATING AROUND EMISWEB
How can I alert someone if a patient collapses whilst I am consulting? Press the Red button at the top right hand corner of your EMIS Web pag
Glendale Medical Centre is located in the borough of Hillingdon in Harlington which is just North of Heathrow Airport. We are an urban practice with mainly social class 3 4 and 5 patients. Many of our patients are employed at the Airport and by surrounding supporting industries (eg hotels). We have a high proportion of patients from ethnic minorities and whose first language is not English. Because of the airport- employment levels are high.The practice serves a relatively younger population compared to the north of the borough with a larger population of families with young children. Because of this there is a greater demand for same day appointments with acute presentations and the need to assess and treat children same day.In general we are usually able to offer appointments the same day to patients that want one. And
we reserve and open up appointments the same day. We try to offer advance appointments but if a suitable advance appointment is not available then the patient is asked to ring back in the morning to be fitted in that day.
There are 2 main hospitals in the borough under designation Hillingdon Hospitals NHS trustClick on the hospitals for more information
THE HILLINGDON HOSPITAL, UXBRIDGETel: 01895 238 232
MOUNT VERNON HOSPITAL, NORTHWOODTel: 01923 826 111
Both are part of the same trust but as our practice is in the extreme south of the borough, most of our patients are usually referred to or attend the Hillingdon Hospital site
Other nearby hospitals are:
3. Northwick Park Hospital, Harrow Tel: 0208 864 32320208 864 6080 (GP admissions)
www.nwlh.nhs.uk/
4. Ealing Hospital, EalingTel: 0208 967 5000
www.ealinghospital.org.uk
5. Watford General Hospital, Watford Tel: 01923 244 366
www.westhertshospitals.nhs.uk
ordering tests
RADIOLOGY X-rays
These are performed at Hillingdon (THH) or Mount Vernon (MVH) Hospitals. you should order x-rays/scans via Anglia ICE accessed by tests menu in the consultation
mode (please ask practice manager or one of the main Drs here if unclear how to use). You should sign and date the printed request and for scans the practice will need to phone the department for an appointment
There is direct access for routine x-ray with no need for an appointment. Details as are below: Hillingdon Hospital
01895279392 Mon – Fri: 8:00am – 4:45pm Mount Vernon Hospital 01923844320 Mon – Fri: 9:00am – 7:15pm
Results are usually sent to the practice down the LINKS system or via fax/post as a hard copy report. Any outstanding reports can be obtained from the X-ray secretaries on 01895 279 864.
Ultrasound These are performed at both hospitals and are usually by appointment only. Again
complete the Anglia ICE computer form and give to the patient to arrange own appointment as per
instructions on the form
Try to ensure accurate patient contact details to facilitate appointments etc.
Urgent ultrasound requests can be discussed with the radiologist /sonographer Results are usually sent to the practice down the LINKS system or via fax/post as a hard
copy report. Any outstanding reports can also be obtained from the X-ray secretaries on 01895 279 864
CT/MRI At present GPs do not have access to these tests and they are only available on specialist
request. You should refer to the appropriate specialty if this is a necessary part of the management.Nb there are specific pathways locally for MSK issues (ie upper limb, lower limb and spinal)Patients should have followed the pathway eg physio prior to referral to CATS triage via C&B.
DEXA scans
Full axial DEXA scanning is available in the Medical Physics Department at Northwick Park Hospital. Referral for this is by completing the relevant form and sending it to the Department. This should also be available at the surgery. (See Appendix A)
Northwick Park Medical Physics Department Tel: 0208 869 2330, Fax: 0208 869 2710
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CARDIO-PHYSIOLOGY ECG The practice at present doesn’t have in-house ECG serviceReferral can be made to the hospital using the relevant hospital form , complete with
practice and patient details. The patient will normally need to book an appointment for a routine ECG at the hospital. The report of the ECG is usually sent to the practice. If there are acute changes normally they refer to A&E, otherwise the report is sent within 10 days to practice.
Hillingdon Hospital: Tel: 01895 279 248 Mount Vernon Hospital Tel: 01923 844 468
24 Hour ECG /BP Monitoring Refer via the Department of Cardiology at Hillingdon Hospital.
Use the direct access form available on the documents via emis web-please complete all patient parameters
Echocardiogram
Referral is via the Department of Cardiology at Hilingdon Hospital. Use the direct access form available on the documents via emis web-please complete all patient parameters
Molly Teoh is the Senior Cardiac Nurse and can be contacted on 01895 238 282 Bleep 5551
Lisa Casey is a Heart failure Nurse and can be contacted on 01895 238 282 Bleep 5867
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PATHOLOGY The Pathology laboratories are based at Hillingdon Hospital and Mount Vernon Hospital.
This includes Haematology, Biochemistry, Microbiology, Serology and Histopathology. Practice computer systems is linked with the laboratories and we have daily transport of samples to the laboratory via courier. (not Thursdays)
Times of collection may vary so it is best to check with the practice for specifics. Usually collection is after midday Monday – Friday not thursday. Certain samples (e.g. semen) will need to be delivered directly to the hospital laboratory at Hillingdon Hospital.
Pathology requesting The Anglia ICE software is used in practices and in the borough hospitals to request
pathology tests and view the results. This is the preferred method of requesting pathology tests but to access ICE one needs to have special access (i.e. unique login) on the computer system at the individual practice. If one does not have ICE
access or if the system is down then pre-printed handwritten forms may be used. The pre-printed
handwritten forms are in triplicate and it is important to ensure that the patient and practice details appear on all 3 pages.
Pathology results
Results of tests requested by clinicians in the practice and by clinicians at most NWL hospitals will be available on EMIS investigations menu after download
Results of tests requested by Hospital based practitioners can be viewed via the Anglia ICE system (this is only available if one has ICE access). These results can be downloaded into the patient’s GP record on EMIS. Please avoid duplication where appropriate by checking on Anglia ICE whether tests have already been done .The Pathology Lab at Hillingdon Hospital can also be contacted to get outstanding results on 01895 275 285
Please familiarize yourself with our pathology test protocol to minimize risk of adverse events
Phlebotomy
Specify on the form if the test is routine/ urgent and inform the patient if they need to fast.
Below is some information on the various phlebotomy sites and their timings:
Walk-In service – no appointment necessary: Hillingdon Hospital:
Mon – Fri: 8:00am – 4:30pm Mount Vernon Hospital: Mon – Fri: 8:00am – 4:30pm
Pre-booked Appointments: Hesa Centre (Hayes Town) Tel: 01895 486 001
Children’s Blood test appointments can be made at Wendy ward, Hillingdon Hospital on 01895 279530
8 Oral Glucose Tolerance Tests (OGTT) are by appointment only and patients need to be
provided with the request form to take to their appointment:– Hillingdon Hospital: Tel: 01895 279 147Mount Vernon Hospital Tel: 01923 844 732
appointments can take up to 6 weeks or more OGTTs are used less often with hba1c now being used more often-
Please follow
WHO GUIDELINES FOR DIAGNOSING DIABETES
Samples
For all samples sent from the surgery please ensure that the relevant patient details are on the specimen.
For urine bottles - ensure that the lids are properly replaced so the sample is not leaking. Stool samples should be delivered directly by the patient to the laboratory. There are specific instructions for semen samples. In addition to the pathology request form there is a secondary form which needs to be completed in order for the laboratory to process the sample. Copies of this can be printed off when ordering via Anglia ICE
Specimen bottles for 24 hour urine collections can be collected from the laboratory by the patient.
Cervical smear samples are processed at Northwick Park Hospital – See section on Cervical Smears for specifics
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COMMUNITY SERVICES PhysiotherapyCommunity and Hospital Referrals for physiotherapy need to be done via ereferrals
Domiciliary physiotherapy is also available for housebound patients and this should be specified on the form.
Occupational therapist Hospital based Occupational therapy is for inpatients only and deals with discharge
planning etc. Hillingdon Hospital: Tel: 01895 279 366Community Occupational Therapy is referred to via letter to Social Services at the Civic
Centre in Uxbridge.
Speech therapist For adult referral -refer directly via letter to the Department of Speech and Language
Therapy at Hillingdon Hospital. For children -can refer to paediatric speech therapy - based at Hillingdon hospital or the
community clinic based at Eastcote Health Centre / Minet Clinic - There are referral proformas for the different age groups (See Appendix B)
To refer - Complete a “Foot Health Assessment form” or send a referral letter to the Podiatry contact centre.
Tel: 01895 823 956• Hesa Primary Care Centre (Hayes)
Tel: 0208 845 5888 • NHS podiatric surgery is available at West Middlesex Hospital (refer via Choose &
Book for this) Podiatry services available on the NHS are limited. Referrals are triaged at the contact centre. If in doubt the appropriateness of the referral should be discussed.
If <70yrs and not diabetic – no chiropody services available on NHS – to see privately If >70yrs and not diabetic – can be referred to Chiropody for certain problems Diabetic patients can be referred for Chiropody
A list of local chiropodists is available in yellow pages .yell.com
Orthotics Patients can be referred directly to this service which is based at Hillingdon Hospital, via referral letter to the department.
Social Services The Social Services department is based at Civic Centre, Uxbridge. More information can
be accessed from the Hillingdon council website on www.hillingdon.gov.uk Elderly Social Services: Tel 01895 445 544Mental Health approved Social worker: Tel: 01895250111Children’s Social Worker: See Appendix C
Child Protection Hillingdon has its own Safe-guarding Children Team. The team consists of various health
care professionals. See appendix BAll child protection concerns should also be discussed same day with the duty Dr. at the surgery
Jenny Reid is the Lead Nurse. Tel: 01895 452 119, 07956 224 288 Regular training courses for health care professionals in Safe-guarding Children are
locally available. Appendix B has further contact details in specific areas of Safe-guarding Children.
Health Visitors Health Visitors are allocated to patients based on the street address of the patient. They
are based at the various local clinics – referral is via CNWL direct booking centre (d/w receptionists)
Dietician
referral can be made via letter to the Dietetics and Nutrition department at Hillingdon Hospital
Elderly Day Hospital This is a useful service for certain patients who are elderly with complex problems, who
need to be seen by the Care of the Elderly team. Appropriateness of referral can always be discussed with the team at the contact numbers below.
Referral is by phone / letter / fax to the relevant hospital Hillingdon Hospital: Tel: 01895 279 297Fax: 01895 279 454Mount Vernon Hospital Tel: 01923 844 856 Fax: 01923844 467
Palliative care Palliative care is based at Mount Vernon Hospital. The Macmillan Nurses are also based at Hillingdon Hospital Tel: 01895 279 457/6 Syringe driver prescription forms should be available at the individual practices. Care UK currently covers out of ours care for Hillingdon patients. Care UK Palliative
care handover forms should be completed for all palliative care patients so that they have access to quick care out-of-hours.
Forms are available at reception or. Complete the form and fax to care UK @ fax: 01895 279 452. A note should be made in
the patient’s records that this has been done.
Palliative care symptom control guidelines are available to assist you (Appendix D)
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District Nurses
District Nurses are based at various health centres in the borough and are able to provide various
services to housebound patients such as bloods tests, dressings, etc. It is best to ask at the surgery what method is used to contact/refer to the district nurses.
District nurses can be accessed by referral to cnwl at Laurel Lodge The messaging service for the District Nurses is based at Laurel Lodge, which can be used to leave a message for the District Nurses about particular patients under their care
Laurel Lodge Tel: 01895234001Referrals are usually faxed ask the receptionist to fax your referral on headed paperRapid response This is a team of healthcare professionals who are very helpful in situations where
hospital admission may be prevented and to facilitate hospital discharge. It is a multidisciplinary
team comprised of nurses (including community matrons), occupational therapists,
physiotherapists, social workers etc. They are able to assess patients at home and follow up for a maximum of 10 days. They
endeavour to contact the patient within 2 hours of referral and do have specific referral criteria. They liaise closely with the Elderly Day Hospital in Hillingdon Hospital and are based at Ickenham Clinic. Referral to them is as follows:
• Telephone patient details to contact centre (09:00am – 00:30am) – 01895 633 546• Fax patient summary +/- referral letter to 01895 674 606• Can speak to member of team on 01895 628 816 or 01895 637 286 to discuss details / appropriateness of the referral.
Community Matron These nurses are based at Ickenham Clinic (Tel: 01895 637 286) and manage complex
patients with the following: • >65yrs old • >2 admissions via A+E in the past year • 2 or more Chronic Diseases • on 8 drugs or more Each Community Matron has an allocated area and your practice should be able to inform
you of how to refer to their relevant matron.
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Ambulance Tel: 0207 827 4555 (by pass no for emergencies - blue light) Tel: 0207 827 4525 (routine call 3-4hrs) This is to be used for immediate and routine ambulance services. Blue light ambulance
can be accessed via 999It is important to make a note of the reference number given by operator in case of any
delay.
Acute and Out of Hours Services There is an 24 hour Accident & Emergency Department at Hillingdon Hospital. ://www.thh.nhs.uk/Departments/ae.htm Emergency referral to on-call specialities is discussed below in the Referrals section.
Mount Vernon Hospital has no A&E Department but does have a Minor Injuries Unit (09:00 – 20:00 daily)
://www.thh.nhs.uk/Departments/minorinjuries.htm
The surgery sub contracts its Out of hours care which is provided by Care UK and this is accessed via 0845 850 1568.
NHS Direct: 0845 46 47
Domiciliary visits for eye screening Some local opticians offer domiciliary visits for eye checkups. They may help with
fundoscopy and diabetic screening. The CCG run retinopathy screening service also does domiciliary visits.
Long term oxygen therapy
HOOF forms are on Emis Web. Complete and fax to company providing home oxygen (patient needs to have been seen by specialist and evaluated in order to
receive oxygen therapy, except palliative care )
14 REFERRALS General Referrals
Before considering a referral you may wish to get a 2nd opinion by asking patient to see own/another GP within practice. Otherwise referrals to 2ndry care should be made via Ereferrals Ideally this should be done during the consultation as its convenient for the patient – otherwise if you leave a message for the practice manager to organize this with your referral letter, this will be organized.
Referrals are now done via the Ereferral process. If you do not have a smartcard and are not on the Ereferral please discuss with Jenny (PM) how we can do your referrals
Some urgent referrals can be made via letter which is faxed to the specialty office at the hospital depending on clinical necessity. 2ww proformas should be completed and faxed to the hospital- the receptionists will obtain confirmation of receipt by the hospital by confirmation return fax.
Emergency Referrals
See attached poster for organizing an ambulance including phone numbers and minimum information required (updated April 2016)
Contact the relevant specialty at the desired hospital and discuss the referral. It is important to check when referring where to send the patient (eg to the Acute Medical assessment unit / to A&E etc). The referral letter can be given to patient to present when they reach hospital or faxed to the relevant number where the receiving team can get it. If it is a handwritten letter then make sure there is a copy taken to be scanned into the patient’s records.
You should also do a summary printout for the patient to take to the hospital.
Procedure for suspected DVT Refer same day to medical team on call at THH for Doppler assessment and
anticoagulation if indicated Procedure for suspected PE Refer same day to on call medical team at THH for assessment and anticoagulation if
indicated. Familiarize yourself with the protocol for calling ambulance from Surgery (also see
above section on ambulance)
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2 week rule referrals The relevant proformas can be complted via the documents menu on EMIS consultation
mode..Complete the proforma, ensure correct patient contact details and hospital choice are
indicated and sign the form. The form is then faxed to the relevant hospital - fax numbers are available on the last
page of each referral form. The completed form should be faxed within 24 hours of the decision to refer the patient.
Rapid Access Chest pain Clinic (RACPC) This Clinic is based at Hillingdon Hospital Complete proforma and fax to the number on the form ensuring correct patient contact
details (See Appendix F). If the patient is already under the cardiologist’s care they should be
referred urgently back to the consultant’s clinic and not to the RACPC. If the patient is having chest pain which needs immediate attention (i.e. indicating they
maybe having an MI or ACS) then they need to go to hospital via Ambulance (999) as there are specific protocols in place which may indicate that patient needs to be redirected to Harefield Hospital for angioplasty. Familiarise yourself with the practice procedures regarding this as well as the location in the practice of Aspirin and other emergency medication.
TIA / Stroke Clinic The TIA clinic is run at Hillingdon by Dr Andrea Parry. There is a new electronic referral
form which should be available on the computer system at the practice, which also helps to decide the speed with which to refer the patient and relevant contact numbers. It is important to complete the form on the computer and fill in all the relevant fields. The Stoke Specialist nurse can be contacted on Tel: 01895 238 282 Bleep For suspected stroke – refer the patient directly to on call medical team at Hillingdon Hospital – ideally patients should have investigations within 24 hrs. Procedures for managing acute stroke are changing and there are provisions now for patients within 4-5 hours of onset of symptoms to be taken via 999 ambulance to a Hyperacute Stroke Unit (HASU) for thrombolysis. Once stabilised then the patient will be transferred to the local rehabilitation unit.
Ophthalmology For queries you can contact on call ophthalmology @ Hillingdon Eye Clinic (only in-
hours) on Tel: 01895 279223/07825420785 Emergencies -> Western Eye Hospital, Marylebone Road, London NW1 5QH, Tel: 020 3312 6666
Moorfields City Hospital, 162 City Road, London EC1V 2PD, Tel: 020 7253 3411There is an urgent eye clinic @ Watford General Hospital, Tel: 01923 436 083. These
clinics are run daily. To refer to this service the patient will need a referral letter and it is prudent to call the clinic to verify that they are running an urgent clinic on the day in question.
Routine ophthalmological referral is as per the normal practice process.
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ENT Emergency referrals – can try Ear Clinic @ Hillingdon Hospital if in-hours, Tel: 01895
279 22324 hour on call service based at Northwick Park – refer here if likely to need admission
or if out of hours (Northwick Park GP emergency admissions - Tel: 0208 864 6080 – better to
use this number as it takes a very long time to get through via the switchboard!)Routine referral is as per the normal practice process.
Tudor Centre (Sexual Health Clinic) This is the Genito-urinary medicine department based at Hillingdon Hospital. There is a Walk-in service hence no appointments are needed. Patients can also be referred directly to the specialty via referral letter. Times: Mon: 8:30 – 11:00; 15:00 – 17:30
Tue: 8:30 – 11:00; 13:45 – 16:00
Wed: 8:30 – 10:30; 13:45 – 16:00
Thurs: 13:45 – 18:00
Fri: 8:30 – 10:30 Tel: 01895 279 537
Infectious Diseases There is an Infectious Diseases Department at Northwick Park Hospital who can be
contacted to discuss cases / referred to via letter / Choose and Book process. They are able to advise and see patients urgently as needed.
The team can be contacted via the NPH GP admissions line on Tel: 0208 864 6080
Pain Management
There is now a community pain service CATS which accepts all referrals via ereferrals
Thyroid Lump Clinic
This special clinic runs on a Monday. It is specifically for patients who have a normal Thyroid function but have a lump in the thyroid region. Referral is via letter which can be posted / faxed to the MrBabu’s (Consultant Surgeon) secretary on 01895 279 714. Should the patient have an abnormal TFT then referral to the Endocrinologist is recommended
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Breathlessness clinic This is a multidisciplinary team of Clinical psychologists, Respiratory nurses,
physiotherapists and Occupational therapists. They will see moderate – severe COPD patients
cope with breathlessness. It is a 5 week group clinic involving non-pharmacological techniques aimed at helping these
patients cope and improving their quality of life. Patients need to be able to speak English and referral is
via letter to the Clinical Health Psychology Department. Tel: 01895 279 374
Fax: 01895 279 046
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Psychiatry Referrals Outpatient Adult Mental Health is provided by the Community Mental Health Teams
(CMHT). There are 3 main teams in the borough and patients are referred based on the address of
their There is now a single point of access referral form as of November 2015 which is accessible via EMIS
Elderly Psychiatry is based at the Woodlands centre and referral is via letter direct to them.
Inpatient services are based at HILLINGDON Hospital at the Riverside centre for adult psychiatry and the Woodlands Centre for elderly psychiatry (>65yrs).
Emergency referrals. There is an A+E psychiatric liaison service at HILLINGDON Hospital and referral is done by contacting the on call psychiatry team or the A+E liaison team via the hospital switchboard (Tel:
01895238282) The CRISIS team also has input for acute psychiatric problems and also follow up
patients recently discharged from inpatient services.
However using the single point of access form can also be used for patients requiring urgent assessment within 24 hours
Child and Adolescent Psychiatry is provided by CFACS (Child, family and adolescent services). They deal with children up to the age of 16/18yrs. They are based in Uxbridge. Referral is by completing their specific proforma and faxing it to their department. The proforma should be available at the surgery. (See Appendix G)
Private Psychiatric referrals can be done – the main private hospitals nearby are: Cygnet hospital in Ealing( ://www.cygnethealth.co.uk/psychiatric/hospitals/ealing/) Cygnet Hospital in Harrow (formerly known as Bowden House Clinic) ( ://www.cygnethealth.co.uk/psychiatric/hospitals/harrow/) .
Counselling is provided by the PCT and is based at Mount Vernon Hospital – Counsellors do come to various practices within the borough so it is useful to check if this is the case at your surgery. Referral to the service is via referral letter directly to the Primary Care Counselling Service (PCCS) at Mount Vernon Hospital. The waiting times are normally high.
There is a good community counselling service run by a charity in Uxbridge. There is normally a fee but this is means tested. The patients are seen and assessed quickly. ://www.communicarecounsellingservice.co.uk/
HILLINGDON DRUG AND ALCOHOL SERVICE
This service is based in Uxbridge and deals with patients with substance abuse issues. Referral to HDAS for detox programmes and assessment for addiction treatment is via referral letter direct to the service.
Hillingdon Action Group for addiction management is a part of the HDAS services and can be accessed by self-referral
For other psychiatric information HILLINGDON MIND produced a publication entitled “Mental Health”. This useful resource has contact numbers for various support groups and organizations that can help people with mental health problems and may be found within the surgery – MIND have stopped producing this but one may be able to obtain a copy by contacting them directly.
Useful contacts: LINK (young person’s counselling 14-25yrs) 01895 238 884 HDAS (drug and alcohol)
01895 207 777CRUSE (Bereavement counselling)
01895 811 330RELATE (Relationship counselling)
020 8427 8694MIND (general mental health issues)
01895 271 559Mead House:
Referrals for mental health conditions to 2ry care by letter
020 8561 6676Mil House:
01895 206 800Pembroke Centre:
01895 622 424Crisis Team:
01895 619 840Psych Liaison Team:
01895 238 282Emergency Social Worker
01895 250 111Riverside Centre:
01895 279 602 Woodlands Centre:
01895 279 970
Further useful information on the mental health services in the borough especially regarding more
Specialized departments such as Eating Disorders etc. can be found on CNWL mental health services
Paediatric Referrals For emergency referrals contact the on-call Paediatric team and send the patient with a
letter. (Children under the age of 1yrs presenting direct to A+E are seen by the Paediatric on-
call team anyways, but it is always good practice to discuss referral with the team before sending the patient).
Routine referrals to paediatric outpatients are done via the normal referral process.
Child Development Centre (CDC) (CWANS – Children with additional needs) The Child Development Centre is based at Hillingdon Hospital. There are specific criteria for referral to this service and these can be found with their
referral form. On the referral form there is a consent page which parents/guardians will need to
complete before you can send the referral form to the CDC. Once completed the form should be posted to the CDC (address is on the referral form) Most surgeries should have a copy of the referral form. Additional copies can always be
requested from the CDC. (See Appendix H)
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Private Referrals
There are several private hospitals in the area. Referrals are normally done by a private referral letter which is then given to the patient to take to their appointment. Please find below a list of the nearest services.
Hillingdon consulting rooms The Consulting rooms are based at Hillingdon Hospital. Most of the Hillingdon
consultants are able to see patients privately in the consulting rooms. Tel: – 01895 279 713Individual consultant contact details are available in Appendix J ://www.thh.nhs.uk/Patients/Private/private.htm
BMI Healthcare
This provider has 2 hospitals in the vicinity
Clementine Churchill Hospital 020 8872 3872
This is located in Harrow and more details can be accessed at ://www.bmihealthcare.co.uk/cch
Bishopswood Hospital
01923 835 814
This is located in Northwood at the back of Mount Vernon Hospital
More details can be accessed at ://www.bmihealthcare.co.uk/bishopswood
Spire Healthcare This provider has 2 hospitals in the vicinity
Spire Bushey Hospital – 020 8950 9090
This is located in Bushey, Watford, north of the borough.
More details can be accessed at ://www.spirehealthcare.com/bushey/
Spire Thames Valley Hospital - 01753 662 241
This is located is Wexham, Buckinghamshire, West of borough
More details can be accessed at ://www.spirehealthcare.com/ThamesValley/
Bowden House (Psychiatric) – Harrow – 0208 9667000
21 WOMENS HEALTH Early Pregnancy Assessment Unit (EPAU) The EPAU will scan pregnant women up to 14 weeks gestation who fit their clinical
criteria (generally PV bleeding with abdominal discomfort) The EPAU accepts referrals via phone / fax. Tel: 01895 279 440Fax referral letter detailing LMP, EDD, clinical details, patient contact details to 01895
279 189
Give patient a completed and signed Ultrasound request form which they should take to the appointment.
The EPAU will contact the patient directly so it is important to leave the correct telephone contact details for the patient.
The EPAU is located on First floor, Maternity Building, Hillingdon Hospital @ entrance to Marina ward
If you are suspecting an ectopic pregnancy contact the On-call Gynaecology team at THH first via
switchboard on 01895 238 282
Antenatal Booking procedure
If patient presents to surgery please complete the electronic maternity booking form and send by fax- alternatively Patients can self-refer
Complete the “booking referral form” for North West London which should be available on the computer.
Ensure it is filled out correctly with contact details and hospital choice. State any medical needs / concerns on booking forms so these can be addressed early.The Booking form should be faxed to relevant number. (In case of Hillingdon hospital
Fax: 01895 279 613) Fill in the antenatal template on EMIS system – as appropriate for the individual practice.
Complete a FW8 form for prescription exemption – this is then sent by post and the patient will receive their prescription exemption card in due course.
Give patient Blue folder (if available), Emma’s diary, information on smoking cessation and antenatal screening as appropriate for the patient.
Addition antenatal information: Once referred to the hospital, patients will have their dating scan between 11-14weeks,
booking appointment with the hospital antenatal clinic about 16weeks and their anomaly scan
between 19-21 weeks.
Many surgeries will have the community midwife holding sessions in the practice to see the antenatal patients from 24 weeks onwards – you should check with the practice to see what their procedure is for this.
MAT B1 forms can be issued from 21 weeks onwards (previously was from 26 weeks)
Healthy Start and Sure Start forms can be obtained from the midwife or patients can order them via the relevant websites:
www.healthystart.nhs.uk/index.html
www.direct.gov.uk/en/MoneyTaxAndBenefits/BenefitsTaxCreditsAndOtherSupport/Expectingorbringingupchildren/
22
In emergencies: Patients <18weeks gestation will be seen in THH A+E Patients >18weeks gestation will be seen in the maternity unit – there is antenatal triage
(in-hours) which can be contacted to refer the patient for same day assessment if needed. Tel: 01895 279 054, if out of hours best to contact the antenatal ward or the on call Obstetric Registrar.
Termination of Pregnancy procedure The Hillingdon CCG has an arrangement with Marie Stopes for TOP procedures.
In general referral is usually by completing a Marie Stopes referral form (attaching HSA1 is not necessary, you can just cross it and Marie Stopes will take care of it). The patient then contacts the Marie Stopes booking centre to arrange an appointment.
Family planning LARCs including implants and IUCDs are not being offered at this practice –patients should be asked to make an appointment with a local family planning clinic. They can also do emergency IUCDs for post coital contraception.
Family planning clinics also operate in the borough and these can be found at
www.hillingdoncommunityhealth.org.uk/contraception-sexual-health
For Female sterilisation– counsel and refer to Gynaecology if patient is insistent For Male sterilisation – counsel and refer via Marie Stopes by letter or completing the
vasectomy proforma (ask at the practice if the latter is available)
Cervical Smears Always confirm the procedure in the practice with the practice nurse .As a general guide: Take smear and complete template on EMIS
Complete the cytology request form (preferably on computer or by hand) Place smear and form in specimen bag and give to reception to send to Northwick Park
Hospital Advise patient that they should receive a letter @ home regarding the result. If they do
not receive this within 2-3 weeks, they should contact the surgery to chase the result.
Vaginal Ring Pessary Clinic This service is provided at Uxbridge Health Centre in a weekly clinic where ring
pessaries can be fitted by GP referral and also where Mirena IUS are fitted where clinically indicated.
OTHER SERVICES
Complex Wound Treatment Centre This team is based at the HESA clinic in Hayes. They have strict referral criteria and
more information on this can be obtained by contacting them at the HESA Clinic on Tel: 01895 486 011
Diabetic Specialist Nurses This team of nurses is based at the HESA clinic in Hayes. They have strict referral
criteria and more information on this is available in Appendix L. They also run the DESMOND course which is a structured education programme for newly diagnosed patients with Type 2 Diabetes.
Childhood Immunisation schedule (updated Aug 2015)
OTHER INFORMATION
At both Hospitals other specialized clinics exist. As mentioned previously if you feel you need to refer a patient and are not sure how to proceed it is best to liaise with colleagues in the surgery to find out how and where to refer.
We have also included copies of the following documents: 1. Hillingdon PCT Antibiotic Prescribing guidelines which were issued in Jan 2008 as a
helpful guide when prescribing (see Appendix K )2. Chronic Pain Management Algorithm (see Appendix P) 3. Hillingdon Lipid Guidelines (see Appendix Q) 4. Red list Drugs (see Appendix R) – These are medications not prescribed in primary
care
Statement of fitness to work: As of 6th April 2010 The DWP has given new guidance on medical sick notes. The forms
have replaced the Med3 and Med5 forms. Guidance on completing these can be obtained via the DWP website on:
www.dwp.gov.uk/healthcare-professional/news/statement-of-fitness-for-work.shtml
You can create and print out a med3 form using the emed3 reed code during a consultationThis is the correct method as the certificate and its contents are recorded during the consultation
USEFUL CONTACT INFORMATION Telephone Numbers Hillingdon Hospital Switchboard
01895 238 282 Northwick Park Switchboard
0208 864 3232 Northwick Park GP admissions line
0208 864 6080 Ealing Hospital Switchboard
0208 967 5000 Mount Vernon Hospital Switchboard
01923 826 111 Watford General Hospital Switchboard 01923 244 366
Civic Centre, Uxbridge
01895 250 111
25 Addresses for Local Health Clinics Further information at
www.hillingdoncommunityhealth.org.uk/clinics-a-health-centres
Hesa Primary Care Centre, 52 Station Road, Hayes, UB3 4DS Tel: 01895 486 001 Fax: 01895 486 034
Ickenham Clinic, Community Close, Long Lane, Ickenham, UB10 8RE Tel: 01895 637 286 Fax: 01895 677 594
Laurel Lodge Clinic, Harlington Road, Hillingdon, UB8 3HD Tel: 01895 231 221 Fax: 01895 236 018
Minet Clinic, Avondale Drive, Hayes, UB3 3NR Tel: 020 8573 2634 Fax: 020 8813 6972
Northwood & Pinner Community Unit, Medical Block, Mount Vernon Hospital, Rickmansworth Rd,
Northwood Tel: 01923 844 226 Fax: 01923 844 553
Northwood Health Centre, Neal Close, Acre Way, Northwood HA6 1TH Tel: 01923 827 744 Fax: 01923 820 834
Oak Farm Clinic, Long Lane, Hillingdon, UB10 9PB Tel: 01895 232 743 Fax: 01895 239 199
Uxbridge Health Centre, Chippendale Waye, Uxbridge, UB8 1QJ Tel: 01895 252 461 Fax: 01895 814 170
The Warren Health Centre, Uxbridge Road, Hayes, UB4 0SF Tel: 020 8756 0644 Fax: 020 8756 0528
Westmead Clinic, Westmead, South Ruislip, HA4 0NT Tel: 020 8845 5888 Fax: 020 8842 0590
Wood End Park Clinic, Judge Heath Lane, Hayes, UB3 2PB Tel: 020 8848 8258 Fax: 020 8848 8622
Yiewsley Health Centre, 20 High Street, Yiewsley, West Drayton, Middlesex, UB7 7DP Tel: 01895 443 686 Fax: 01895 430 399
26 Document Outline
BOROUGH INFORMATION RADIOLOGY /X-rays /Ultrasound CT/MRI DEXA scans CARDIO-PHYSIOLOGY /ECG 24 Hour ECG Monitoring 24 Hour Blood Pressure Monitoring Echocardiogram PATHOLOGY Pathology requesting Pathology results /Phlebotomy Samples COMMUNITY SERVICES /Physiotherapy Occupational therapist Speech therapist Podiatry/ Chiropody referrals /Orthotics Social Services Child Protection Health Visitors Dietician Elderly Day Hospital Palliative care /District Nurses /Rapid response Community Matron School nurses /Ambulance Acute and Out of Hours Services Domiciliary visits for eye screening /Long term oxygen therapy REFERRALS General Referrals Emergency Referrals Procedure for suspected DVT Procedure for suspected PE 2 week rule referrals /Rapid Access Chest pain Clinic (RACPC) TIA / Stroke Clinic /Ophthalmology /ENT /Tudor Centre (Sexual Health Clinic) Infectious Diseases Pain Management Thyroid Lump Clinic Breathlessness clinic /Psychiatry Referrals Paediatric Referrals Private Referrals WOMENS HEALTH Early Pregnancy Assessment Unit (EPAU) Antenatal Booking procedure Termination of Pregnancy procedure Family planning Cervical Smears Vaginal Ring Pessary Clinic OTHER SERVICES Complex Wound Treatment Centre Diabetic Specialist Nurses OTHER INFORMATION USEFUL CONTACT INFORMATION Telephone Numbers Addresses for Local Health Clinics
You are advised to use a chaperone during consultations involving intimate examinations/when the patient requests one /when you feel that there might be a risk posed by not having an independent observer etc.Our nurse and receptionists are trained and can be invited in to act as chaperones
APPENDIX B
Please make yourself familiar with our child safeguarding policy and you should take immediate and appropriate action as per policy if you become aware of a child safeguarding concern.Your overall duty is to the health and safety of the child and that there is no immediate or ongoing risk of any harm.
The practice manager/clinician should be made aware of any new concern at the end of your session.
Please make your -self familiar with our adult safeguarding procedures –please refer to the Hillingdon safeguarding adult policy below -
Adult safeguarding concerns can also be reported to Hillingdon social services link below
http://www.hillingdon.gov.uk/article/13733/Contact-details-for-Safeguarding-adults-services
You should familiarize yourself with the mental capacity act
You should adhere to the practices confidentiality policy
All staff should report significant events and analysis of these is an essential part of managing and minimizing risks- please see the attached document on SEA (courtesy CQC)
Persons responsible for issuing repeat prescriptions should familiarize themselves with the practice’s prescribing policies including repeat prescribing protocol below- Locums should NOT add new items to the repeat prescribing menu but leave them as acute. For acute items only minimal quantities eg analgesics should be prescribed for anticipated duration of symptoms.We have seen adverse events when for example large quantities of naproxen have been prescribedYou must also keep the repeat prescribing systems clean and up to date by taking off items no longer required and also try and keep all items synchronized – this reduces workload and also minimizes risks of adverse events. Please also encourage eprescribing to patients as again it reduces risks.
See our policy on what drugs to carry in the Doctors bag for home visiting
You should adhere to our health and safety policy
HANDING Patients to OOH Care etc.
How do I make GPOOHs, 111, 999, THH, Community services aware of a patient who has palliative care needs on a 24/7 basis? Create, complete and ensure review of the CMC record, an integrated health care record. https://protocolrm.syhapp.thirdparty.n hs.uk .Other policies and procedures listed below (These are the policies most relevant to new staff but is not and exhaustive list)
Maintaining records and summarizing guidelines (code for notes summary on computer is 9344)
Computer records need to be well maintained and clinicians should ensure that they accurately record all consultations, patient encounters, medication changes etc. Notes should be summarized in accordance with attached guidelines.
Please only code issues as problems if you feel that they need to be on the problems register (active past etc.) and also give them a duration eg hypothyroidism (indefinite), Chest infection (say 2 weeks). Some read codes have been inappropriately entered as problems/inappropriate durations- eg “had a chat to patient”, “ child 6 week check (done in 2005 remaining as active problem).Please also enter free text as appropriate to elaborate on problem.
Staff are encouraged to alert a senior member of staff if there are any concerns raised about the behavior of another member of staff, concerns about a doctor or nurse which may include behavior with staff or patients during consultations, complaints by patients etc. we operate an open and honest culture where staff should not feel that they cannot report anything that worries them without fear of retribution.