Here are some useful digital resources for children and young people within Newham.
Some of these resources are also applicable to all of NEL.
Borough: Newham
Newham GP – Paeds Referral Pathway
TNW GP DIRECT ACCESS GUIDANCE FOR ULTRASOUND REFERRAL
Newham – Prolonged Jaundice referral pathway and guidance
Newham – Faltering Growth Guideline
Useful notes on signs of faltering growth, which teams to contact and what wards if needed. Red flags highlighted
Newham – Prolonged Jaundice
This is the Newham prolonged jaundice
Tower Hamlets Women’s Health Hub
Single Point of Access for women’s health advice and triage to the right service
Women’s Health Hub clinics led by a multidisciplinary team
Why a Women’s Health Hub?
Tower Hamlets faces significant challenges in managing women’s health:
·increasing demand for care, particularly for chronic problems like menopause, menstrual health, PCOS and other pelvic health
·variable confidence and skill sets in managing women’s health in primary care
·convoluted pathways across community, general and specialist services
·long wait times
·women going to the wrong sub-specialty clinics
·inefficient use of outpatient capacity
Overview of changes to Gynaecology referral pathways
Single Point of Access
From Friday 1st December 2023, all GP requests for advice or referrals for gynaecology services go through a Single Point of Access – except for 2 week waits, women in pregnancy, abortions, emergency gynaecology and <16 year olds.
On ERS, GPs will use, within the Gynaecology specialty:
Advice & Guidance – Tower Hamlets Women’s Health Hub Single Point of Access – Barts Health NHS Trust – R1
Advice and triage provided by a MDT, including:
·Consultant Gynaecologist
·Sexual and Reproductive Health Consultant
·GP with a Special Interest (GPSI) in Women’s Health
·Administrator
on Monday afternoon, Tuesday morning and Thursday morning
We are also working towards providing a hotline for GPs to briefly discuss any queries they may have.
Practised running through Advice & Guidance over last 6 weeks and reduced backlog.
Aim to improve quality of advice and more efficient use of services (including new Women’s Health Hub clinics)
Women’s Health Hub clinics
MDT at Sylvia Pankhurst Centre/Community Women’s Health Services at Mile End Hospital
On Wednesdays and Fridays starting on Wednesday 3rd January 2024.
For common gynaecological needs (not requiring invasive investigation), including:
Menorrhagia, LARC (contraception and menorrhagia), Postnatal care 8 weeks plus, Chronic Pelvic pain, Vaginismus, AUB, Menopause, Urogynaecology, Urinary incontinence, PMS, PCOS, Difficult smears/ difficult threads, Biopsies (vulval).
The clinics are run by:
·GPs with a Special Interest (GPSI) in Women’s Health who are experienced GPs working in Tower Hamlets practices.
·Physiotherapist offering specialist assessment and rehabilitation for pelvic, bladder and bowel pain and dysfunction. They support women for incontinence, chronic pelvic pain, vaginismus, sexual intercourse issues and post-natal care (beyond 6-8 weeks).
·Specialist Nurse e.g. for LARC insertion for menorrhagia and/or contraception, biopsies and difficult coil thread checks.
·Sonographer to ensure that any patients requiring scanning can be identified, scanned and receive other investigations and care within the same visit.
·Sexual and Reproductive Health Consultant and Consultant Gynaecologist for specialist care and to provide necessary training, supervision and support for other members of the team.
·Health Care Assistant
What else?
Joint NEL work / plans:
·North East London Community Gynaecology weekly drop-in
every Wednesday at 1:00-2:00pm on MS Teams to discuss cases, ask questions, or listen and learn. Gynaecologists/SRH Consultants from North East London (Homerton, Barts and BHR) give advice or answer questions on anything related to women’s health e.g. menopause, menstrual health, contraception and vulvovaginal problems. Please email guyslade@nhs.net if you want the meeting invite or more information – or you can join the meeting here
·Development of common pathways
·Shared evaluation of our Women’s Health Hub services
·Exploring potential for shared roles across North East London, e.g. women’s health dietitian
·We are also open to ideas from primary care and others about how we can achieve our aims during the pilot
Work will begin soon on the business case for a service after the pilot ends from September 2024.
Foot Health Service – Newham
Click here to find foot health related information for Newham
Foot Health Service – Newham | East London NHS Foundation Trust (elft.nhs.uk)
ENT Services replacement at Royal London Hospital
ENT Services replacement at Royal London Hospital
(Tower Hamlets, Newham, Waltham Forest & City & Hackney)
Dear Colleagues,
As you are aware Communitas have been providing ENT services across North East London for several years, including Barts Health.
However, there are Adult and Paediatric Emergency Services at Royal London Hospital (RLH) site that are still available on eRS.
These services will be closed on eRS and replaced with email triage service as of the 8st December 2023 for both Adult and Paediatrics as below to align with other Barts Health sites.
Service line closure on eRS for RLH as of 8st December 2023 are:
Emergency ENT RAS (RLH) Barts Health NHS Trust – R1H
Emergency Paediatric ENT RAS (RLH) Barts Health NHS Trust – R1H
Replacement service at RLH for Adult and Paediatrics is:
The new service is an email triage service and the referral will need to be sent to bartshealth.ENTreferralsRLH@nhs.net
This is the referral form to use – which can also be found on resource publisher:
Please follow the instructions within the referral form before emailing a referral, also make sure to use a dedicated practice email address for sending the referrals.
Please note that the current Community ENT services provided by Communitas are running as normal, these are:
TNW ENT Triage Service – Adults (16 years +)
TNW ENT Triage Service – Children aged 5 – 16 years
City and Hackney Communitas ENT Service – Adult
City and Hackney Communitas ENT Service – Children aged 5 – 16 years
If you have any queries, please contact nelondon.tnw.e-rsqueries@nhs.net (TNW only)
Patient Access To Medical Records – Digital First
Patient Access to Medical Record – 1st session
4th of September 2023 – 1PM – 2PM
Patient Access to Medical Record – 2nd session
3rd of October 2023 – 12PM – 1PM
Hospital Only
NEL
| Name | Download link |
|---|---|
| (NEL) Hospital only list | CLICK TO DOWNLOAD |
BHR
| Name | Download link |
|---|---|
| (BHR) Hospital only list | CLICK TO DOWNLOAD |
ELFT – Adult Community Health Services and Mental Health Services
Click here to find out more about Adult Community Health Services and Mental Health Services in each area:
CITY & HACKNEY
ADHD
| Name | Download link |
|---|---|
| ADHD information schools | CLICK TO DOWNLOAD |
| ADHD medication shortage easy-read patient information leaflet V1.0 | CLICK TO DOWNLOAD |
| ADHD medication shortage memo V1.0 | CLICK TO DOWNLOAD |
| ADHD PIL | CLICK TO DOWNLOAD |
Discharge Medicines Service – Community Pharmacy
The NHS Discharge Medicines Service (DMS) is a new nationally commissioned essential service that all community pharmacy contractors have to provide. The aim of the service is to improve the communication of changes to a patient’s medication when they leave hospital, to prevent harm from medicines, reduce readmissions and to improve patients outcomes. Trusts (Acute, Mental Health, Community) will identify appropriate patients and refer them to their usual or preferred community pharmacy on discharge with information about medication changes made in hospital.
Community pharmacist have been commissioned to provide a new NHS Discharge Medicine Service, which is being rolled out locally across Tower Hamlets, Newham and Waltham Forest (TNW). A joint working group has been working on the implementation and the service will be rolled out gradually from all Trusts across North East London (NEL) from July 2021.
| Name | Download Link |
|---|---|
| NEL – Discharge Medicines Service Referral Form | CLICK TO DOWNLOAD |
| NEL Discharge Medicines Service Pathway | CLICK TO DOWNLOAD |
| NEL – Discharge Medicines Service Presentation | CLICK TO DOWNLOAD |
TOWER HAMLETS
| Name | Download link |
|---|---|
| (TH) Local implementation of the NHS Discharge Medicines Service | CLICK TO DOWNLOAD |
Newham End of Life Care – Community Pharmacy
| Name | Download Link |
|---|---|
| Newham – End of Life Community Pharmacy | CLICK TO DOWNLOAD |
| Newham End of Life Care Service Specification | CLICK TO DOWNLOAD |
| Newham End of Life Care Stock List | CLICK TO DOWNLOAD |
Newham Latent TB Service – Community Pharmacy
| Name | Download Link |
|---|---|
| Newham Latent TB Service – Participating Pharmacies | CLICK TO DOWNLOAD |
| Newham Latent TB Service – Treatment Protocol |
Others – Shared Care Guideline
DMC Healthcare
| Name | Download Link |
|---|---|
| SCG_DMC_Efudix | DMC Healthcare |
North Central London
| Name | Download Link |
|---|---|
| Shared Care Guideline Sativex Treatment of Multiple Sclerosis related Spasticity | North Central London |
St Francis Hospice
| Name | Download Link |
|---|---|
| BHR CCGs GPs and St Francis Hospice Shared Care Guidelines | St Francis Hospice |
Waltham Forest / Newham Formulary
North East London (NEL) is in the process of harmonising the existing formularies in-use across NEL onto a single NEL-wide electronic formulary. The new NEL electronic formulary is expected to be launched by the end of 2024.
- At current, users will not be able to access the full version of the Tower Hamlets and Waltham Forest/Newham formularies (BNF FormularyComplete).
- In the interim, please access the simplified version of the formularies below. Note that the links within these pages do not open onto other pages.
- It should be noted that the simplified version is not up-to-date. Please refer to the NEL Formulary and Pathways Group (FPG) decision log for formulary updates made since October 2022.
Useful links
- Quick guide – how to check formulary status of drugs
- NICE electronic BNF
- FPG decision log
- Primary care infection antimicrobial guidance
WF/NH Formulary
Osteoporosis
NEL
| Name | Download link |
|---|---|
| Calcium and vitamin D (colecalciferol) preparations for adults at risk of osteoporosis guidance (NEL) | CLICK TO DOWNLOAD |
BHR
| Name | Download Link |
|---|---|
| (BHR) BHR CCGs and BHRUT transfer of care monitoring and guidance for denosumab in post menopausal women with osteoporosis | CLICK TO DOWNLOAD |
| (BHR) BHR CCGs and BHRUT updated osteoporosis pathway | CLICK TO DOWNLOAD |
City & Hackney
| Name | Download link |
|---|---|
| Bisphosphonate drug holidays guidance C&H | CLICK TO DOWNLOAD |
Vaccines
BHR
| Name | Download Link |
|---|---|
| (BHR) Vaccine fridge temperature out of range guidance | CLICK TO DOWNLOAD |
Barts Health – Rapid access chest pain clinic
Who to refer
Inclusion criteria:
– The patient must be suffering from a new onset of chest pain thought likely to be angina.
– If your patient is male, he must be over 30 years-old
– If your patient is female, she must be over 40 years-old (women over 35 years old will only be considered if there is particular concern and significant cardiac risk factors)
Exclusion criteria:
– We cannot see your patient if they are suffering from suspected unstable angina or a myocardial infarction. Instead, please refer them directly to A&E.
– If your patient has already been treated by cardiology within the last 6 months, please would you refer them back to their original Consultant Cardiologist and not to the Rapid Access Chest Pain Clinic.
– If your patient has palpitations or suspected arrhythmias, please refer them to the Heart Rhythm Clinic.
– If you patient is suffering from suspected Heart Failure, please refer them to the Heart failure team/ Clinic.
– If your patient does not meet the age criteria and you suspect cardiac cause of symptoms please refer to Cardiology Clinic
How to refer
Referral form can be found on Resource Publisher (RP) EMIS under RACP( rapid access chest pain)
All forms must be sent via ERS
Referral contact details:
Telephone: 0203 594 6049
Royal London Hospital – Ambulatory Care
AEC does not replace any of the existing outpatient pathways at Barts Health (2WW, neurology, arrhythmias, rheumatology, respiratory, etc,)
Some of the common conditions we see:
Pulmonary embolism
Transfusions for anaemia,
Headache,
Acute Jaundice,
Uncontrolled Hypertension
Exclusion criteria
Paediatrics (< 16yrs), Surgical/Trauma problems, Infection control issues, Acute confusion/delirium, acute psychiatric illness
Please also ensure:
– Patient is not critically ill
Pulse < 100
BP > 100 Systolic
Sats> 92% or > 88% if COPD
GCS15 ( or 14 if known Dementia)
– The patient is appropriate to be discharged with current package of care.
– Patient/relatives able to arrange their own public/private transport? (or prearranged hospital transport)
– A clinical review would avoid admission
Other considerations
At predictable risk of deterioration based on history and preliminary investigation
Is not ambulant or mobile in a wheelchair and able to transfer with assistance of one
Already under investigation
The problem is of a chronic nature
Who to refer
All referrals to be discussed with the Ambulatory care team
Following which please complete the referral form (already EMIS under Ambulatory Emergency care) and email it to the team
Before referral
please include patients phone number, NHS number, reason for referral, when the patient should be seen, outline investigations required.
An AEC nurse will contact the patient to arrange an appointment, DO NOT tell the patient to arrive in AEC until they have been contacted
Service contact details
Acute Medicine Consultant: 02035945642 or via switch ext 45642
Out of hours – On call Medical SPR: 02035945645 or via switch ext 45645
email: Bhnt.rlh-ambulatory@nhs.net
Additional notes
Diagnosis and treatment of DVT
VTE nurse specialists provide same or next day (except weekends and Bank Holidays) assessment, diagnosis and treatment of suspected Deep Vein Thrombosis (DVT)
09:00 – 15:00 Monday-Friday: Contact the AEC nurse: 02035945700 or via switch ext 45700
Out of hours: Send to the Emergency Department with a referral letter
Location: Accessed via the main entrance of Royal London Hospital, Ground Floor, opposite lift core 8.
Medicines Guidelines – General Guidance
NEWHAM / WALTHAM FOREST
| Name | Download Link |
|---|---|
| 7 day prescribing letter | CLICK TO DOWNLOAD |
| Hospital Only List | CLICK TO DOWNLOAD |
| Safe Fasting during Ramadan | CLICK TO DOWNLOAD |
| School Letter – OTC Medication | CLICK TO DOWNLOAD |
| Patients considering private referrals | CLICK TO DOWNLOAD |
| Patient Letter – retrospective prescriptions | CLICK TO DOWNLOAD |
| Patients travelling abroad | CLICK TO DOWNLOAD |
| Private Prescription Policy | CLICK TO DOWNLOAD |
| Recording Medicines prescribed elsewhere | CLICK TO DOWNLOAD |
| Repeat Prescribing Policy | CLICK TO DOWNLOAD |
| Safety Custody of Medicines in Primary Care | CLICK TO DOWNLOAD |
| Non-Medical Prescribing Policy | CLICK TO DOWNLOAD |
| Working with Industry | CLICK TO DOWNLOAD |
Minor Eye Conditions Service (MECS)
Patients can access a schemes for minor eye conditions that is currently running in City & Hackney, Islington, Newham, Tower Hamlets, and Waltham Forest. Find out more information and dedicated pages on each area from this site:
Barts Health GP Direct Access to CT for Suspected Pancreatic Cancer
GP Direct Access to CT for Suspected Pancreatic Cancer
We are writing to update you on GP access to urgent direct investigations for suspected cancer at Barts Health. As you may know, NICE guidelines (NG12; Suspected cancer: recognition and referral) recommended that GPs consider referring patients directly for urgent (within two weeks) investigations in specific clinical situations. The imaging departments across Barts Health will make this service available from 01 September 2021 providing equitable access to NG12 diagnostics across London.
Radiology Process and Safety Netting
You will be able to request an urgent CT abdomen & pelvis for suspected pancreatic cancer via T-quest. For those practices using C the Signs (in Newham and Waltham Forest) this will be included within the risk assessment and recommendations.
GPs should only request an investigation urgently if the patient meets the NICE criteria. Radiology services are under considerable strain, and a request to undertake a test within two weeks should be clearly justifiable on clinical grounds.
- Consider an urgent direct access CT scan (to be performed within 2 weeks) to assess for pancreatic cancer in people aged 60 and over with weight loss and any of the following:
- diarrhoea
- back pain
- abdominal pain
- nausea
- vomiting
- constipation
- new‑onset diabetes. [2015]
- The order is built into T-quest with a description of ” CT Pancreas NICE NG12″ and will only be visible for patients 60 and over.
- Patients must have a recent serum creatinine within the last 3 months, please include the result and date of the test in the clinical details box.
- If you have any queries about requesting this diagnostic test, please email the Radiology team for further information and advice.
Tower Hamlets: bartshealth.imagingadviceandsupportrlh@nhs.net
Newham: Radiology.gpsupport@nhs.net
Waltham Forest: Bartshealth.imaging-appointments@nhs.net
- Practices should ensure they have safety netting systems to follow up patients referred in this way to check that the test has been undertaken within two weeks, and the report received.
Onward Referral
Where the result indicates a suspicious lesion, GPs should refer to the relevant 2WW pathway.
The CT report will signpost the referrer to the most appropriate next step where for example a benign lesion is identified on the scan.
Education & Resources
There is an online learning resources available on Gateway C and the Healthy London Partnership supporting early diagnosis of Pancreatic Cancer, these can be accessed via the web links below.
Course: Pancreatic Cancer – Early Diagnosis
East London Eating Disorder Service (Adults)
Community-based service providing support to adults in Newham, Tower Hamlets, and City & Hackney.
Specialist evidence-based treatment to individuals struggling with eating disorders and disordered eating symptoms
NEL Prescribing and Medicines Newsletter
Please share these newsletters / bulletins with colleagues within your practice:
This page will hold the last 6 newsletters / bulletins. If you require any older documents, please email nelondonicb.medicinesoptimisationenquiries@nhs.net
NEL Medicines & prescribing newsletter
Barts Health Renal consultant hotline
For URGENT CLINICAL KIDNEY QUESTIONS REQUIRING CLINICIAN TO CLINICIAN DISCUSSION- significant rise in creatinine, hyperkalaemia, and nephrotic syndrome
– GPs can call the Barts Health renal consultant hot phone 02035945751 Mon – Fri 8.30 to 5pm