St. Helens and Knowsley Hospitals
NHS Trust
Cancer & Palliative Care
Service Directory
Fourth Edition – April 2007
Produced by Cancer Services Version Four April 2007
NHS
CONTENTS
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
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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 Service 68
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
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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 Corrigan
Lead Nurse/Manager - Cancer Services
0151 430 1055
Anita.Corrigan@sthk.nhs.uk
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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 Thind
Tel: 0151 430 1265
Rani.Thind@sthk.nhs.uk
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 Corrigan
Tel: 0151 430 1055
Anita.Corrigan@sthk.nhs.uk
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 Corrigan
Tel: 0151 430 1055
Anita.Corrigan@sthk.nhs.uk
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2.1
SUSPECTED CANCER REFERRALS
St Helens & Knowsley Hospitals NHS Trust
Urgent Suspicious Cancer Referral Pro-forma
Patient Details
GP Practice Details (stamp)
Surname:
Practice Name:
Address:
First Name:
Age/DOB:
Postcode:
Contact Number:
Evening Telephone:
Postcode:
Telephone:
Fax:
Email:
Referring GP:
Mobile:
New NHS number:
Decision to refer date:
Address:
/
/
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
3Haematology
(x-ray to be done prior to referral)
11Skin
GI 8Breast 9Brain 10Lower GI
5Urology 6Testicular 7Upper
4Head
& Neck
12Sarcoma
State clinical reason for suspicion of cancer - See Referral Guidelines – Include any
investigation results and any other relevant information.
FAX THIS FORM WITHIN 24 HOURS OF YOUR DECISION TO REFER TO:
UROLOGICAL 0151 430 1901
GYNAECOLOGICAL 0151 430 1043
ENDOSCOPY 0151 430 1892
ALL OTHER CANCER REFERRALS 0151 430 1629
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1GYNAECOLOGY-Urgent
5UROLOGICAL
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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/ unresolving 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
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& 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
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- 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
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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
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 interictal 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)
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9LOWER
GI - Signs & Symptoms
of predictive value of bowel
cancer
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•
•
•
•
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•
•
•
7BREAST
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- 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
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•
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 Referral
Melanoma - Pigmented lesion
which have >=1 of the
following features:
 Growing in size
 Changing shape
 Irregular outline
 Change in colour
 Mixed colour
 Itch/ bleeding
 Inflammation
NB 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
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– 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
Committee
Mr G. Cawdell
Lead Clinician – Gynaecology
Miss L. Chagla
Lead Clinician – Breast
Mr R. Green
Lead Clinician – Skin
Dr J. Hendry
Lead Clinician – Lung
Mr I. Khan
Lead Clinician – Upper GI
Mr R. Kiff
Lead Clinician – Colorectal
Dr C. Littlewood
Lead Clinician – Palliative Care
Mr A. Massey
Lead Clinician – Urology
Dr 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.
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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:
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4.5
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.
The MDT should agree cover arrangements for each core member,
agreed by the lead clinician of the MDT
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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:
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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 sitespecific 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 day
This ensures the MDT Co-ordinators have time to find all notes and xray 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.
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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.
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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.
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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 prebook 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.
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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 …………..
MDT Lead Clinician
Clinician
Signed ……...………………….. Date ……………….
Dr Thind, Cancer Services Lead
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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 patients
Key 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 (SSCNS) 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:
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-
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 ……………..……………
MDT Lead Clinician
Date …………..
Signed ……...………………….. Date ……………….
Site Specific – Clinical Nurse Specialist
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Appendix 3 - Clinical Nurse Specialist Protocol
Initial contact with a newly diagnosed cancer patient
Introduction
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), 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 Protocol
To describe the role of the site-specific nurse specialist on Initial contact with a newly
diagnosed cancer patient
Terminology and Definitions
For 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. 09.0017.00, 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.
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2.3
SERIOUS DIAGNOSIS FAX
PRACTICE PROTOCOL
SERIOUS 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).
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NHS
St. Helens and Knowsley Hospitals
NHS Trust
Cancer Diagnosis – 24 hour communication
Speciality
Dear Doctor …………………………………………
RE:
Date ……………………
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
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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.
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Team Members
Role
Barbara Jost
Ruth Jackson
Karen Pocock
Holly Donaghy
Philip Walker
Maureen Scotton
Janet Davies
Deborah Kilshaw
Janice Ashton
Gill Levey
Shirlie Deveney
Dawn Porter
Unit Manager
Chemotherapy Sister
Chemotherapy Nurse
Chemotherapy Nurse
Chemotherapy Nurse
Chemotherapy Nurse
Receptionist
Receptionist
Health Care Assistant
Counselling Manager
Assistant Counselling Manager
Research Practitioner
Jeanette Ribton
Oncology Nurse Specialist
Raphael Kawonga
Haematology Staff Grade
Dr M Abbas
Oncology Staff Grade
Peter Smith
Laura Evans
Oncology/Haematology
Pharmacist
Oncology Dietician
Elaine Smith
Denise Ambage
Lisa Ryan
Sandra Clegg
Haematology Secretary
Haematology Secretary
Haematology Secretary
Oncology Secretary
Contact Details
Monday to Friday
9–5
0151 430 1687
0151 430 1687
0151 430 1687
0151 430 1687
0151 430 1687
0151 430 1687
0151 430 1614
0151 430 1614
0151 430 1687
0151 430 1687
0151 430 1687
0151 430 1147
Bleep 1148
0151 430 2269
Bleep 0014
0151 430 1825
Bleep 1826
0151 430 1995
Bleep 0227
0151 430 1514
Bleep 1514
0151 430 1201
Bleep 0208
0151 430 1825
0151 430 1825
0151 430 1825
0151 430 1910
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Ward G5 – 0151 430 1560
In-patient Advice
Surgical/ Medical On Call Team.
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3.2
CLINICAL TRIALS TEAM
Team Members
Role
Dr E Marshall
Jenny Almond
Dawn Porter
Consultant Oncologist
Merseyside & Cheshire Cancer
Research Network Manager
Research Practitioner
Sarah Simpkin
Clinical Trials Nurse
Michelle Harvey
Jeanette Ribton
Clinical Trials Data Clerk
Oncology Nurse Specialist
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Contact Details
Monday to Friday
9–5
0151 430 1910
0151 482 7804
0151 430 1147
Bleep 1148
0151 430 1147
Bleep 1147
0151 430 1147
0151 430 2269
Bleep 0014
4.
SITE SPECIFIC PATIENT SERVICES
4.1
CANCER SERVICE – Breast
Core Multidisciplinary
Team Members
Role
Miss L. Chagla
Mr R. Audiso
Lead Consultant
Consultant Breast
Surgeon
Consultant Radiologist
Dr S. Desmond
Dr O. Harris
Dr E. Gradwell
Dr S. Kelly
Dr H Innes
Dr R Sripadam
Consultant Radiologist
Consultant Pathologist
Consultant Pathologist
Clinical Oncologist
Sue McNicholas
Breast Care Specialist
Nurse
Breast Care Specialist
Nurse
Breast Care Nurse
MDT Co-ordinator
Chris Bebb
Louisa Mahon
Jill Atherton
Extended
Multidisciplinary
Team Member
Colette Murray
Chris Jonkers
Rob Rosser
Mr K. Graham
Mr R. Alvi
Dr Lynn
Greenhough
(Alder Hey Hospital)
Marie Curie centre
Mr A. Ray
Dr R. Thind
Dr M. Pinto
Dr N. Hasan
Sarah Simpkin
Nina Agnew
Contact Details
Monday to Friday
9-5
0151 430 1607
0151 430 1079
0151 426 1600
Ex2491
0151 430 1185
0151 430 1827
0151 430 1839
Clatterbridge Centre
for Oncology
0151 334 4000
0151 430 1908
0151 430 1908
0151 430 1908
0151 430 1061
Role
Contact Details
Monday to Friday 9-5
Palliative Care Cancer
Nurse Specialist
Breast radiographer
Clinical Psychologist
Consultant Plastic
Surgeon
Consultant Plastic
Surgeon
Clinical genetic/genetics
counsellor
0151 430 1953
Physiotherapist/
Lymphoedema
Associate Specialist
Consultant Radiologist
Consultant Pathologist
Consultant Pathologist
Trials Nurse
Warrington Screening
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0151 430 1185
0151 430 1654
0151 430 1262
0151 430 1401
0151 430 1528
0151 430 1265
0151 430 1731
0151 430 1190
0151 430 1147
01925 230923
OUT OF HOURS CONTACT INFORMATION
Out-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 CLINICS
Consultant
Clinic Type
Day
Site
Miss Chagla
Breast New patients Wednesday AM
Burney Breast
Unit
Miss Chagla
Breast Revisits
Wednesday PM
Burney Breast
Unit
Mr Audisio
Breast New patients Tuesday PM
Burney Breast
Unit
Mr Audisio
Breast Revisits &
Thursday PM
Burney Breast
new non-urgent
Unit
Mr Audisio
Breast Revisits
Friday AM
Stephenson
House
Mr Ray
Breast New patients Monday AM
Burney Breast
Unit
Mr Ray
Breast Revisits
Friday PM
Burney Breast
Unit
Dr Innes
Breast New patients Friday AM
Stephenson
and Revisits.
Wednesday PM
House
Alternate Monday
AM
Dr Innes
Breast New patients Tuesday PM
St Helens
and Revisits.
OUTPATIENT CLINICS
Nurse
Clinic Type
Specialist
Sue McNicholas Breast Prosthetic
Or Chris Bebb
Clinic
BREAST SCREENING/RECALL
Dr R. Thind
Breast Screening
Assessment
Dr O. Harris
Breast Screening
Assessment
Dr S.
Breast Screening
Desmond
Assessment
Day
Site
Tuesday PM
Whiston
Monday AM
Whiston
Monday AM
Whiston
Monday AM
Whiston
Multidisciplinary Team Meeting held, every Friday at 13.00
Venue: Post Graduate Centre
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4.2
CANCER SERVICE – Colorectal
Multidisciplinary Team
Members
Role
Mr R. Kiff
Mr D. Maitra
Lead Clinician
Colorectal Surgeon
Mr M. Scott
Dr J McLindon
Colorectal Surgeon
Physician
Gastroenterologist
Medical Oncologist
Clinical Oncologist
Dr E Marshall
Dr Whitmarsh
Dr A. Evans
Dr. S. Kelly
Helen Carroll
Angela Fitzgerald-Smith
Paul Ratcliffe
Extended
Multidisciplinary Team
Carolyn Swash
Debbie Maddox
Laura Evans
Tony Ellis
Consultant Radiologist
Consultant Pathologist
Colorectal Nurse
Specialist
Colorectal Nurse
Specialist
MDT Co-ordinator
Role
Stoma Nurse Specialist
Specialist Palliative Care
CNS
Dietitian /nutritionist
Clinical geneticist /
genetics counsellor
Social Worker
Contact Details
Monday to Friday
9-5
0151 430 1529
0151 426 1600
Ext. 2339
0151 430 1911
0151 430 1281
0151 430 1910
Clatterbridge Centre
for Oncology
0151 334 4000
0151 430 1265
0151 430 1839
0151 430 1078
0151 430 1685
0151 430 1061
Contact Details
Monday to Friday 9-5
0151 430 1221
0151 430 1274
0151 430 1201
0151 430 1201
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via GP/NHS Direct. If urgent local A&E
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.
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OUTPATIENT CLINICS
Consultant
Clinic Type
Mr Kiff
Colorectal
Cancer/General
Mr Kiff
Colorectal
Cancer/General
Mr Maitra
Colorectal
Cancer/General
Mr Maitra
Colorectal
Cancer/General
Mr Scott
Colorectal
Cancer/General
Mr Scott
Colorectal
Cancer/General
Dr Marshall
Oncology
(Chemotherapy)
Dr Marshall
Oncology
(Chemotherapy)
Dr Whitmarsh Oncology (Radiology)
ENDOSCOPY SESSIONS
Mr Kiff
Wednesday PM
Mr Maitra
Alternate Friday PM
Rapid Access Friday PM
Day
Tuesday AM
Site
Whiston
Friday AM
St Helens
Wednesday AM
Whiston
Thursday AM
St Helens
Thursday AM
Whiston
Friday PM
St Helens
Monday AM
Whiston
Thursday AM
Whiston
Monday AM
Whiston
Multidisciplinary Team Meeting held, every Monday at 13.00
Venue: X-ray Seminar Room
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4.3
CANCER SERVICE – Gynaecology
Multidisciplinary Team
Members
Role
Mr G. Cawdell
Vacant
Lead Clinician
Medical Oncologist
Dr J Zekri
Clinical Oncologist
Dr J. Kirwan
Gynaecology Oncologist
Dr N. Hasan
Dr O. Harris
Consultant
Histopathologist
Consultant Radiologist
Diane Dearden
Clinical Nurse Specialist
Jill Atherton
MDT Co-ordinator
Extended
Multidisciplinary Team
Colette Murray
Role
Sarah Simpkin
Dr M. Abass
Gill Levey
Maria Embleton
Specialist Palliative Care
CNS
Clinical Trials Nurse
Oncology Staff Grade
Psychosocial /
psychosexual counsellor
Staff Nurse
Contact Details
Monday to Friday
9-5
0151 430 1663
Clatterbridge Centre
for Oncology
0151 334 4000
Clatterbridge Centre
for Oncology
0151 334 4000
Women’s Hospital
0151 702 4265
0151 430 1824
0151 426 1600
Ext.2491
0151 426 1600
Ext. 2348
0151 430 1061
Contact details
Monday to Friday 9-5
0151 430 1274
0151 430 1147
0151 430 1910
0151 430 1687
0151 426 1600
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via GP/NHS Direct. If urgent local A&E
Department.
In-patient Advice
H4 or Via Gynaecology On Call Team.
G5 if chemotherapy related.
Non-urgent Advice
Gynaecology Oncology Nurse Answer Phone
Service.
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OUTPATIENT CLINICS
Clinic Type
Gynae-Oncology
Rapid Access Pelvic Mass
Rapid Access Post-Menopausal
Bleeding
Rapid Access Post-Menopausal
Bleeding
Rapid Access Post-Menopausal
Bleeding
Vulvoscopy
Day
Alternate Monday AM
Wednesday AM
Tuesday PM
Wednesday PM
Friday PM
Alternate Wednesday
PM
*Clinics take place in Maternity and Gynaecology Unit
COLPOSCOPY SESSIONS
Colposcopy
Monday am/p.m.
Colposcopy
Tuesday am/p.m.
Colposcopy
Thursday am/p.m.
Colposcopy
Thursday am/p.m.
Colposcopy
Friday am/p.m.
Site
*Whiston
*Whiston
H1,
Whiston
H1,
Whiston
H1,
Whiston
HI,
Whiston
H1, Whiston
H1, Whiston
H1, Whiston
H1, Whiston
H1, Whiston
Multidisciplinary Team Meeting held alternate Mondays at 09.15 prior to
Oncology Clinic
Venue: X-Ray Seminar Room
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4.4
CANCER SERVICE – Haematology
Multidisciplinary Team
Members
Role
Dr G. Satchi
Dr J. Tappin
Dr T. Nicholson
Dr R. Kawonga
Lead Clinician
Consultant Haematologist
Consultant Haematologist
Staff Grade –
Haematology
Jeanette Ribton
Oncology Nurse
Specialist
Haematology/Oncology
Macmillan CancerNurse
Specialist
Ward Manager – G5
Unit Manager – Lilac
Centre
Trials Practitioner
Angela Madigan
Sr. I Kearney
Sr. B. Jost
Dawn Porter
Contact Details
Monday to Friday
9-5
0151 430 1887
0151 430 1292
0151 430 1825
0151 426 1600
Ex 2473
Bleep 1826
0151 430 1687
Bleep 0014
0151 430 4111
Bleep 4111
0151 430 1560
0151 430 1687
0151 430 1147
Bleep 1148
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via Switchboard to Consultant on-call
In-patient Advice
G5 Ward
OUTPATIENT CLINICS
Consultant
Clinic Type
Dr G. Satchi
Anticoagulation
Dr G. Satchi
Anticoagulation
Dr G. Satchi
Haematology
Dr G. Satchi
Haematology
Dr J. Tappin
Haematology
Dr J. Tappin
Haematology
Dr T. Nicholson
Haematology
Dr T. Nicholson
Haematology
Day
Monday AM
Site
St Helens
Tuesday PM
Whiston
Wednesday AM
Thursday AM
Wednesday AM
Friday AM
Wednesday AM
Friday AM
Whiston
St Helens
Whiston
Whiston
Whiston
Whiston
Multidisciplinary Team Meeting held weekly on Wednesday at 14.00
Venue: X-ray Seminar Room.
Joint MDT with North Cheshire Hospitals 1st Wednesday of the month
15.00
Venue: X-ray Seminar Room.
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4.5
CANCER SERVICE – Head & Neck
Multidisciplinary Team
Members
Role
Mr Nandapalan
Consultant
Otolaryngologist
Consultant
Otolaryngologist
Consultant
Otolaryngologist
Medical Oncologist
Mr Daud
Mr Jones
Dr Husband
Dr Hasan
Consultant
Histopathologist
Contact Details
Monday to Friday
9-5
0151 430 1598
0151 430 1573
0151 529 5248
Clatterbridge Centre
for Oncology
0151 334 4000
0151 430 1190
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via GP/NHS Direct. If urgent local A&E
Department.
In-patient Advice
D2 Ward
OUTPATIENT CLINICS
Consultant
Clinic Type
Mr Daud
ENT
Mr Daud
ENT
Mr Nandapalan
ENT
Mr Nandapalan
ENT
Mr Jones
ENT
Dr Husband
Mr Jones
Head & Neck
Day
Monday AM
Friday PM
Tuesday AM
Thursday PM
Tuesday PM
2nd, 4th & 5th
Tuesday PM
1st & 3rd
Site
Whiston Hospital
Whiston Hospital
Whiston Hospital
Whiston Hospital
Whiston Hospital
Whiston Hospital
Multidisciplinary Team Meeting held at University Hospital Aintree
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4.6
CANCER SERVICE – Lung
Multidisciplinary Team
Members
Role
Dr. J. Hendry
Dr. P. Stockton
Respiratory Physician –
Clinical lead for Lung
Cancer
Respiratory Physician
Dr S Twite
Respiratory Consultant
Joanne Brown
Dr. J. Wide
Lung Cancer Clinical
Nurse Specialist
Lung Cancer Clinical
Nurse Specialist
Lung Cancer Clinical
Nurse Specialist
Specialist Palliative Care
CNS
Consultant Radiologist
Dr N. Mohsin
Consultant Radiologist
Dr A. Dar
Dr E. Marshall
Mr. Shackcloth
Dr. Z. Malik
Consultant
Histopathologist
Consultant Oncologist
Thoracic Surgeon
Consultant Oncologist
Lorraine Price
MDT Co-ordinator
Extended
Multidisciplinary Team
Members
Dr Littlewood
Pool member
Rob Rosser
Jane Shepherd
Role
Pauline Murphy
Carol Dawson
Robert Case
Willowbrook Hospice
Palliative Care physician
Social Worker
Clinical Psychologist
Chaplain/ pastoral care
worker
Bereavement care worker
Contact Details
Monday to Friday
9–5
0151 430 1899
0151 426 1600
Ex 2638
0151 426 1600
Ex 2638
0151 430 1367
0151 430 2326
0151 430 2326
0151 430 1274
0151 426 1600
Ex 2485
0151 426 1600
Ex 2485
0151 430 1827
0151 430 1910
0151 228 1616
Clatterbridge Centre
for Oncology
0151 334 4000
0151 430 1061
Contact details
Monday to Friday
9-5
0151 430 1347
0151 430 1634
0151 430 1657
0151 430 8736
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via GP/NHS Direct. If urgent local A&E
Department.
In-patient Advice
Ward F2, G16, C1 or Via Medical On Call Team.
Non-urgent Advice
Lung Cancer Nurse Answer Phone Service.
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OUTPATIENT CLINICS
Consultant
Clinic Type
Dr Hendry
Lung Shadow
Clinic
Dr Stockton
Lung Shadow
Clinic
Dr Marshall
Cancer Clinic
Dr Marshall
Cancer Clinic
Mr Soorae
Thoracic Surgery
Clinic
Dr Z Malik
Oncologist
Radiotherapy
Day
Thursday am
Site
Whiston Hospital
Thursday am
Whiston Hospital
Monday am
Thursday am
1st and 3rd
Tuesday p.m.
Thursday am
Whiston Hospital
Whiston Hospital
Whiston Hospital
Whiston Hospital
BRONCHOSCOPY SESSIONS
Alternate Monday p.m.
Dr Stockton
Tuesday am
Dr Ridyard
Wednesday p.m.
Dr Hendry/Dr Corless
H2, Endoscopy
Unit
H2, Endoscopy
Unit
H2, Endoscopy
Unit
Multidisciplinary Team Meeting held every Thursday morning, at 08.30
Venue: Brandreth Suite
Pre-thoracic Surgery MDT Meeting alternate Tuesdays, at 14.00.
Venue: Hackworh Suite
X Ray MDT Wednesday 12.30 – 14.00
Venue: X-Ray Seminar Room
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4.7
CANCER SERVICE – Skin
Multidisciplinary Team
Members
Mr Green
Mr Hancock
Dr Curley
Dr Herbert
Role
Dr Marshall
Dawn Porter
Consultant Oncologist
Clinical Trials/Research
Practitioner
Dermatology Nurse
Specialist
Dermatology Nurse
Specialist
Consultant Pathologist
Consultant Oncologist
Tom Crowe
Chris Hunt
Dr Gradwell
Dr Husband
Consultant Plastic Surgeon
Consultant Plastic Surgeon
Consultant Dermatologist
Consultant Radiologist
Contact Details
Monday to Friday
0151 430 1664
0151 430 1044
0151 430 1507
0151 426 1600
Ext. 2265
0151 430 1910
0151 430 1147
Bleep 1148
0151 430 1953
0151 430 1482
0151 430 1827
Clatterbridge Centre
for Oncology
0151 334 4000
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via GP/NHS Direct. If urgent local A&E
Department.
In-patient Advice
Holbrook Unit
Non-urgent Advice
Dermatology Nurse Specialist Answer Phone
Service
OUTPATIENT CLINICS
Consultant
Clinic Type
Mr Green
*Skin Cancer
Dr Curley
Skin Cancer
Dr Marshall
Skin Cancer –
Oncology
Day
Tuesday PM
Tuesday PM
Tuesday PM 1st &
3rd
Site
Whiston Hospital
Whiston Hospital
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
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4.8
CANCER SERVICE – Upper Gastrointestinal
Multidisciplinary Team
Members
Mr Khan
Role
Lead Clinician
Contact Details
Monday to Friday 9-5
0151 430 1239
Mr A. Li
UGI Surgeon
0151 430 1528
Ms Chagla
UGI Surgeon
0151 430 1607
Mr Kanwar
Dr Preistley
UGI Surgeon
0151 430 1528
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
0151 430 1599
Laura Evans
Nurse Consultant
Gastroenterology
Oncology Dietician
Kathy McDermott
Chest Physiotherapist
Bleep 1188
Barbara Ashall
Upper GI Nurse Specialist
Peter Smith
MDT Co-ordinator
0151 290 4143
Bleep 2600
0151 430 1061
Dr Littlewood
Consultant in Palliative Care
Medicine
0151 430 1381
0151 430 1347
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice Via GP/NHS Direct. If urgent local A+E Department
Lilac Centre 0151 430 1687
In-patient Advice
Ward D3 0151 430 1440
Ward G5 – if chemotherapy related
Non-urgent
Barbara Ashall CNS Answer Phone service 0151 290 4143
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ENDOSCOPY SESSIONS
Dr Francis
Miss Chagla
Paul Madigan
Mr Khan
Mr Kanwar
Monday am
Alternate Monday p.m.
Tuesday/Thursday p.m.
Alternate Wednesday p.m.
Alternate Monday a.m. and every
Friday a.m
Alternate Wednesday p.m.
Mr Memon
Dr Turner
OUTPATIENT CLINICS
Consultant
Clinic
Day
Site
Whiston
Ms Chagla
UGI/GEN
Mr Li
General
Alternate Monday
am
Monday am
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 08.30
Venue: X-Ray Seminar Room
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St Helens
4.9
CANCER SERVICE – Urology
Multidisciplinary Team
Members
Role
Mr Massey
Mr Gana
Mr Khattak
Dr Marshall
Dr Malik
Lead Consultant Urologist
Consultant Urologist
Consultant Urologist
Medical Oncologist
Clinical Oncologist
Dr Meek
Lead Radiologist
Dr M. Pinto
Sue Charles
Nancy Chisholm
Nerys Williams
Julie Keith
Lead Histopathologist
Nurse Specialist
Nurse Specialist
Nurse Specialist
MDT Co-ordinator
Extended
Multidisciplinary Team
Claire Littlewood
Role
Dennis McComas
Lorna Evans
Mary McBirnie
Consultant in Palliative
Care
Senior Nurse Specialist
Dietitian
Urology Sister
Ann Caton
Urology Sister
Carolyn Swash
Dr Clark
Stoma Nurse
Clinical Oncologist
(testes patients + bladder
patients who required
chemotherapy treatment
only)
Assistant Counselling
Manager
Shirlie Deveney
Contact Details
Monday to Friday
9-5
0151 430 1976
0151 430 1907
0151 430 1907
0151 430 1910
Clatterbridge Centre
for Oncolgy
0151 334 4000
0151 426 1600
Ex 2492
0151 430 1731
0151 430 1076
0151 430 1898
0151 430 1076
0151 430 1061
Contact Details
Monday to Friday 9-5
0151 430 1058
0151 430 1898
0151 430 1201
0151 426 1600
Ex 2528
0151 426 1600
Ex 2528
0151 430 1221
0151 430 1687
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via GP/NHS Direct. If urgent local A&E
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.
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OUTPATIENT CLINICS
Consultant
Clinic Type
Mr Massey
Urology
Mr Massey
Urology
Day
Tuesday pm
Thursday pm
Mr Gana
Urology
Wednesday am
Mr Gana
Mr Gana
Urology
Urology
Mr Khattak
Mr Khattak
Nursing Team
Urology
Urology
Rapid Access
Haematuria Clinic
Nursing Team
Prostate Assessment
Clinics
Mr Gana
Flexible Cystoscopy
Lists
Flexible Cystoscopy
Flexible Cystoscopy
Friday am
1st Wednesday
pm
Monday AM
Thursday PM
Monday am
& Alternate
Thursday pm
Monday pm
Wednesday am
& Alternate
Thursday pm
Thursday am
Mr Massey
Dennis
McComas
Dennis
McComas
Sue Charles
Sue Charles
Sue Charles
Site
Whiston Hospital
St Helens
Hospital
St Helens
Hospital
Whiston Hospital
Newton Hosptial
Whiston Hospital
Whiston Hospital
A1 Ward
A1 Ward
A1 Ward
Friday am
Tuesday am
A1 Ward
A1 Ward
Flexible Cystoscopy
Wednesday pm
A1 Ward
Stable Prostate
Cancer Clinics
Stable Prostate
Cancer Clinics
Chemotherapy
Intravesical
Immunotherapy
Monday pm
Thursday am
St Helens
Hospital
Whiston Hospital
Friday pm
On the district
Multidisciplinary Team Meeting held weekly on a Monday at 11.45 – 12.15
Venue: X-Ray Seminar Room
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5. PALLIATIVE CARE
5.1
PALLIATIVE CARE - Hospital Specialist Palliative Care Team
Team Members
Role
Dr C Littlewood
Consultant in Palliative
Medicine
Consultant in Palliative
Medicine
Dr J Wiseman
S.P.R. (Rotational every
12 months)
Dr Jenny Smith
Mrs Jan Leatherbarrow
Robert Case
Mrs Collette Murray
Ms Debbie Maddox
Miss Claire Johnston
Mr Andrew Dickman
Mrs Jackie Bruce
Mrs Josie Dold
Mrs Denise Delaney
Mrs Simone Taylor
Team Leader, Specialist
Palliative Care CNS
Specialist Palliative Care
CNS
Specialist Palliative Care
CNS
Specialist Palliative Care
CNS
CNS – Heart Failure/
FCP Facilitator
Pharmacist
P.A. to Dr Littlewood
Team Secretary
Team Secretary
Data Entry Clerk/
Admin Assistant
Contact Details
Monday to Friday
9-5
0151 430 1347
0151 430 1347
0151 430 1347
0151 430 1274
0151 430 1953
0151 430 1274
0151 430 1274
Pager: 07654661703
Or 0151 430 1274
0151 430 1058
0151 430 1274
0151 430 1274
0151 430 1274
OUT OF HOURS CONTACT INFORMATION
Out-patient Advice
Via GP or Community Nurse
In-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 14.00
Venue: 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:
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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.
Referrals
Referrals 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.
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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:
Page 1
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.
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Page 2
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
Hospice
Referrer 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
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Reasons for Referral Table
Reason for Referral Role of the Health Care Team
with Advice and Support from
Specialist Palliative Care Team
as needed
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)
Criteria for Direct Patient Contact
by Specialist Palliative Care Team
in conjunction with Ward Team
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.
Uncontrolled/escalating pain
(Adapted from Referral Criteria RLUH Palliative Care Team, March 2002)
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ACCESS TO PALLIATIVE CARE OUT-PATIENT CLINICS
WHEN & WHERE?
MONDAY
Held at:
WILLOWBRO
OK
HOSPICE
(p.m.)
WHISTON
(p.m.)
COPD –
Monthly
(commencing
19.04.04)
Dr C.M.
Littlewood
WEDNESDAY
THURSDAY
FRIDAY
WILLOWBROOK
HOSPICE (p.m.)
Community linked
WHISTON (a.m.)
Stephenson House
Brandreth Suite
Parallel clinic to
Dr. E. Marshall
Oncology/Lung
Cancer
WHISTON (a.m.)
Stephenson House
Brandreth Suite
Parallel clinic to
Dr. A. Flavin
Oncology/Breast
Cancer
Dr. C.M. Littlewood
Dr. C.M. Littlewood
NEWTON
COTTAGE
(alternate
Wednesdays)
Dr. J. Wiseman
HOW TO REFER?
 Referrals for WHISTON clinics - by formal letter to
Dr 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-ordinator
Fax: 0151-493-1006 General Office
NOTE: Patients initially attending Whiston clinics may be linked into
Hospice services, as felt appropriate.
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Referral for Specialist Palliative Care Services
Patient Details
NHS Number:
Hospital ID:
Hospice ID:
Title:
Forename(s):
Gender:
Surname:
Address:
Carer Details
Name of Carer:
Relationship to Patient:
Carer Tel:
Is Patient Living Alone? Y
Involved Professional
Community Contact
PCT:
GP Name:
GP Surgery:
GP Tel:
Postcode:
DN Name:
Tel:
Hospital Contact Details
Age:
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
Current Treatments:
Disease mang’t
N
CURATIVE
NONCURATIVE
Past Treatment:
Is Patient Aware of Referral: Y
Details of Understanding for Patient/Carer
Patients Understanding of Diagnosis:
N
Carers Understanding of Diagnosis:
Current Medication
Previous Medication (State Reaction/Poor
response)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
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Referral for Specialist Palliative Care Services
NHS Number
Hospital ID
2
Hospice ID
Reason(s) for Referral
Please 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
Team
Fax (0151) 430 1925
Community Palliative Care
Team
Fax (0151) 289 8776
Willowbrook Hospice
Fax (0151) 493 1006
Referral to MEDICAL OUTReferral to MEDICAL OUTPATIENT CLINIC FORMAL
PATIENT CLINIC FORMAL
LETTER ONLY TO:
LETTER ONLY TO:
Dr Littlewood
Dr Wiseman
Consultant in Palliative Care
Consultant in Palliative Care
Medicine,
Medicine
Whiston Hospital
Willowbrook Hospice
Prescot L35 5DR
Prescot L34 2QT
Tel: 0151 430 1274
Tel: 0151 430 8736
If you think this Referral requires ‘OUT-OF HOURS’ Service – Please see details below
Referrer Details
Print Name
Date of Referral
Referrer Tel No:
If More Urgent: 9.00 am – 5.00 pm Monday
to Friday
Hospital Palliative Care Team:
Tel: 0151 430 1274
Community Palliative Care Team:
Tel: 0151 431 0156
OUT-OF-HOURS SERVICE
Willowbrook Hospice
Tel: 0151 430 8736
All referral will be reviewed within 24-48
HOURS
Designation:
Signature:
(Signature Confirms Approval of Patient’s
GP or Consultant).
WILLOWBROOK Office Use Only:
DATE REFERRAL Received ……………..
DATE of INTIAL CONTACT
………………..
DATE of INTIAL ASSESSMENT
……………
DATE of ACCEPTANCE
…………………….
TO BE COMPLTED ON ORGINAL FORM
ACCEPTED
REFUSED on OTHER GROUNDS (e.g. too
unwell)
CANCELLED (e.g. died)
Date ………….. Signature …………………..
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5.2
PALLIATIVE CARE - Willowbrook Hospice
Willowbrook Hospice
Portico Lane
Prescot
Merseyside
L34 2QT
Telephone: 0151 430 8736
Fax:
0151 493 1006
Willowbrook 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 Service
Currently 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 nonmalignant 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 care
9 beds for assessments, symptom control, rehabilitation and terminal care.
Outreach Services
Day 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.
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
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 Therapies
Sister
Staff Nurse
Senior Physiotherapist
Therapy Assistant
Chaplaincy 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.
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Education
Education is a major part of our work. Willowbrook Hospice aims to offer coordinated, 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.
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Medical Team
Team Members
Dr Jenny Wiseman
Dr Anthony Thompson
Clinical Team
Mrs Chris Haywood
Mrs Margaret
McConaghy
Lucy Scriven
Role
Consultant in Palliative Medicine
Assistant Medical Director
Head of Clinical Services
Team Leader for In-Patient Services
Team Leader for Outreach Services
Chief Executive
Neil Wright
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5.3
PALLIATIVE CARE - Macmillan Clinical Nurse Specialist Palliative Care Community
Community Clinical Nurse Specialists Palliative Care
Willowbrook Hospice
Portico Lane
Prescot
Merseyside
L34 1QT
Telephone: 0151 431 0156
Fax:
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 Criteria
The 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 form
Telephone, 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.
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Team Members
Dr Jenny Wiseman
Gillian Harthen
Amanda Watson
Helen Mack
Geoff Prince
Julie Parr
Zoe Keating
Maggie Cooke
Role
Consultant in Palliative Medicine
Clinical Nurse Specialist Team Leader
Macmillan CNS
Macmillan CNS
Macmillan CNS
Macmillan CNS
Macmillan CNS
Macmillan CNS
Out of hours service
Willowbrook Hospice Tel 0151 430 0156
MDT Meeting
Clinical Meeting every Monday 9.30 am at Willowbrook Hospice
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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.
Criteria for Accessing the Integrated Palliative Home Care Team
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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.
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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
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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
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6.0
EXTENDED SERVICES
6.1
EXTENDED SERVICES - Hospital Based Pain Team
Medical Team Members
Role
Dr Konstantin Levshankov
Dr Mike Forsyth
Mrs Mary Doolan
Consultant Anaesthetist
Staff Grade Anaesthetist
Theatre/Chronic Pain
Nurse
Theatre/Chronic Pain
Nurse
Secretary
Mrs Eileen O’Neil
Mrs Anne Roberts
Contact Details
Monday to Friday
9-17
0151 430 1455
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
Dr K Levshankov
Multidisciplinary
Spinal Clinic
Dr K Levshankov
Multidisciplinary
Spinal Clinic
Dr K Levshankov
Theatre session
(invasive
procedures/TENS/a
cupuncture)
Dr K Levshankov
Outpatient Pain
Dr M Forsyth
Clinic
Dr K Levshankov
Pain Management
Programme
Day
Monday pm
Site
Whiston
Tuesday pm
St Helens
Thursday am
Whiston
Thursday pm
Whiston
Friday am
Whiston
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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.
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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 pm
On Wednesdays 1.30 – 2 pm Exposition and Quiet Prayer
Every 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.
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Chaplaincy Team
Sister Susan Molloy
Denomination
Roman Catholic
Sister Eileen O’Riordan
(Part-time)
Revd. Jayne Shepherd
Head of Department
Revd. Jamie Hartwell
Roman Catholic
Church of
England
Free Church
Contact details
Whiston Hospital Site
Bleep 0042
St Helens & Peasley Cross
Sites Bleep via switchboard
All sites – Bleep 0041
All sites – Bleep 0041
Contact details for other Faiths & Special Needs
Jehovah’s Witness
Church of Jesus Christ Latter Day Saints (Mormon)
Unitarian
Jewish
Othodox
Reformed
Progressive
Lay Visitor
Islam/Moslim/Muslim
Hindu/Sikh
Ba’hai
Buddist
Seventh Day Adventist
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0151 430 3296
01744 811077
0151 263 4899
0151 722 2079
0151 722 5438
0151 733 5871
0151 722 1810
0151 709 2560
0151 263 7965
0151 733 8614
0151 727 0108
0151 226 4385
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.
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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.
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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 inpatient.
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).
Gallstones
Give “Eating for Health” booklet.
N.B. There is no evidence to suggest a role for low fat diets in the
management of gallstones.
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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.
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Referral to the Dietetic Service – Inpatients
St Helens & Knowsley NHS Hospitals Trust
Department of Nutrition & Dietetics
Request for Dietetic Assessment
Date
Date Received
Ward
Consultant
Please attach patient information label. If none
available, please insert details. (Include NHS
Number)
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
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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
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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 History
Diagnosis & 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)
Biochemistry
Cholesterol ………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:
Print Name:
Address:
Date:
Designation: GP/PN/Other …..............
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
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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 multidisciplinary 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 Service
Henley House
Delph Lane
Whiston
Merseyside
L35 7JE
Telephone Number: - 0151 290 2010
Fax Number:- 0151 290 2017
Please do not hesitate to contact us if you would like more information or would
like to discuss a referral.
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6.5
EXTENDED SERVICES – SUPPORT Smoking Cessation
SUPPORT
FOR THOSE WHO WANT TO QUIT SMOKING
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.
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Referral system for Hospital Patients
Ask the patients
Do you smoke?
Have you ever tried to stop?
Are you interested in stopping smoking?
If no interest is
shown
If interested in stopping smoking
Advise smoker to
stop
ADIVSE
 Give clear, strong, personalised advice
 Tie smoking to immediate health effects
and consequences
 Give relevant information leaflets
Inform of:
 National helpline for further
info on 0800 169 0169
 Self-referral to SUPPORT
on 0800 1952131
Refer to SUPPORT
Fax Referral
Self Referral
Complete patient details on referral
form
By ringing 0800 195 2131 (use for
patients who live outside St Helens
and Knowsley district)
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.
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SUPPORT
ST HELENS & KNOWSLEY
FOR THOSE WHO WANT TO QUIT
SMOKING
merseyside health action zone
a healthy life for merseyside
SECTION ONE – BRIEF INTERVENTION
ASK/ASSESS

SMOKER
ADVICE

ALL SMOKERS TO STOP
ASSIST

FOLLOW UP IF INTERESTED YES NO 
REFER

TO SUPPORT
YES/NO
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
Hospital


HV  DN 
 Cardiac Rehab
Other (Please state) 
Midwife
Hosp Facilitator 
Pharmacy 
FAX TO:
ST HELENS (North & South) 01744 755439
NEWTON/HAYDOCK 01925 271014 KIRKBY 0151 545 0141
KNOWSLEY (Central & South) 0151 292 9355
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EXTENDED SERVICES – ICCP (Integrated Cancer Care Programme)
6.6
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 Coordinator, 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.
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Data Safety
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 Coordinator 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
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7.
SUPPORT GROUPS
7.1
SUPPORT GROUPS - Local Support Groups/Services
Service
Age Concern
Role
Advice and assistance
to elderly people in the
community.
Benefits Agency
Office
Advice and assistance
with benefits.
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 by
St Helens Carers
Centre.
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Contact Details
Age Concern St Helens
Mansion House
Victoria Park
St Helens, WA10 2UE
Tel: 01744 752644
ageconcern@acsthelens.or
g.uk
www.acsthelens.org.uk
Age Concern Knowsley
1 Griffiths Road
Huyton, L36 6NA
Tel: 0151 480 4632
e-mail:
frank.reppion@acknowsley
.org.uk
www.ageconcernknowsley.
org.uk
Benefits Agency Office
Gregson House
2 Central Street
St. Helens, WA10 1UF
Tel: 08456088503
www.dwp.gov.uk
Lilac Centre
Rowan House
Whiston Hospital
Warrington Road
Prescot, L35 5DR
Tel: 0151 430 1687
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 Church
Peel House Lane
Widnes
Widnes & Runcorn
Cancer Support Group
21-23 Alforde Street
Widnes
WA8 7TR
Tel: 0151 423 5730
Citizens Advice
Bureau
Confidential advice
www.citizensadvice.org.uk
and information on a
wide range of subjects. HALEWOOD
15/21 Ravenscourt,
Leathers Lane
Halewood L26 OUP
Tel: 08451221300
KNOWSLEY
10A Church Street
Prescot L34 3LA
Tel: 08451221300
HUYTON
Nutgrove Villa
1 Griffiths Road, Huyton
Merseyside, L36 6NA
Tel:08451221300
www.knowsleycab.org.uk
ST HELENS
Millennium Centre
Corporation Street
St Helens, Merseyside,
WA10 1HJ
Advice line: 08701212027
Appt: 01744 737866
www.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.
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“Lyndale”
40 Huyton Lane
Liverpool
L36 7XG
0151 489 3538
Knowsley Carers
Centre
Patient Partnership
Group
Roy Castle
Samaritans
Offering: - Information,
Support, Respite,
Social Activities, Sign
Posting, Advice,
Carers Groups,
Voucher Scheme,
Emergency Cards,
Benefits Advice,
Newsletter
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.
Support Group for
people/carers with
Lung Cancer
Meets at 2 pm first
Tuesday of each
month.
24 hour telephone
Helpline
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Knowsley –Carers Centre
149 Cherryfield Drive
Kirkby
Knowsley
L32 8SE
Tel: 0151 549 1412
Halewood –Carers Centre
St Mary Day Centre
Hillingten Avenue
Huyton
L26 9TY
Tel: 0151 448 9771
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
200 London Road
Liverpool
Meresyside L3 9TA
Tel: 0800 358 7200
Website:
www.roycastle.org
0151 708 8888
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 Floyd
01744 884097
Widnes & Runcorn
Cancer Support
Group
Offering: - Information,
Support, Social
Activities, Sign
Posting, Advice,
Carers Groups,
Welfare Rights, Legal
Advice and Benefits
Advice.
21 Alforde Street
Widnes
WA8 7TR
Tel: 0151 423 5730
Open 10am-3pm every day
 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.
Website:
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Email:
dee.graal@tiscali.co.uk
www.widnesruncorncsg.org
.uk
7.2
SUPPORT GROUPS - Local Bereavement Support
Service
Role
Age Concern – Knowsley
Free and confidential
bereavement support.
Contact
Details
0151 480 4632
www.ageconcer
nknowsley.org.
uk
Cancer Counselling
Lilac Centre, Whiston Hospital
Free and confidential
bereavement support.
0151 430 1687
Knowsley Counselling Service
Free and confidential
bereavement support.
0151 480 6270
www.knowsleyc
ounsellingagen
cy.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
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7.3
SUPPORT GROUPS - National Support - General
Service
British Association
for Counselling and
psychotherapy
Role
BAC can refer people to a local
counsellor. They have
information sheets on
counselling.
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.
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.
Gives information on cancer
treatments and research trials.
Cancer Counselling
Trust
Cancer Research
UK
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Contact Details
BACP House
15 St John’s
Business Park,
Lutterworth,
Leicestershire
LE17 4HB
Tel: 0870 443 5252
Email:
bacp@bacp.co.uk
Website:
www.bacp.co.uk
www.cancercaresoci
ety.org
1 Noel Road,
London N1 8HQ
Tel: 020 7704 1137
Fax: 020 7704 8620
Email:
support@cctrust.org.
uk
Website:
www.cctrust.org.uk
P.O.Box 123
Lincoln's Inn Fields,
London WC2A 3PX
Support ServicesTel:
020 7121 6699
Switch:02072420200
Email:
cancer.info@cancer.
org.uk
Website:
www.cancerresearch
uk.org
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.
CancerLink
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.
(merged with
Macmillan Cancer
Relief)
Macmillan Cancer
Relief
Provides home care nurses
through the Macmillan Service
and financial grants for people
with cancer and their families.
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.
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Cancerbacup
3 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 MondayFriday,
9am – 8 pm
www.cancerbacup.or
g.uk
e-mail through
website
fax: 02076969002
cancerline@macmill
an.org.uk
www.macmillan.org.
uk
Macmillan Cancer
Relief 89 Albert
Embankment
London SE1 7UQ
Freephone:
0808 8082020
9 am to 10 pm
Monday to Friday
89 Albert
Embankment
London
SE1 7TP
Tel: 02075997777
Email through
website
www.mariecurie.org.
uk
QUIT
Provides telephone support
and information leaflets for
smokers who want to stop.
Can also refer you to local stop
smoking groups.
General – Smoking
Cessation see page
70
Tenovus Cancer
Information Centre
Cancer Buddies
Network
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.
Brings together people form all
walks of life for support and
friendship.
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Quit, Ground Floor,
211 Old Street
London
EC1V 9NR
Helpline:: 0800
002200
Email:
Counselling:
stopsmoking@quit.o
rg.uk
Email:
info@quit.org.uk
Website:
www.quit.org.uk
43 The Parade,
Cardiff, CF24 3AB
Tel:02920482000
www.tenovus.com
www.cancerbuddies
network.org
National Support – Children
Sargent Cancer
Care for Children
The Children’s
Cancer and
Leukaemia Group
(CCLG)
(Former
The UK Children's
Cancer Study
Group)
Winstons wish
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 Sargent
Griffin House
161 Hammersmith
Road, London
W6 8SG
Tel: 020 8752 2800
Child Cancer
Helpline: 0800 197
0068 Mon-Fri
9 am to 5 pm
Email:
helpline@clicsargent
.org.uk
Website:
www.sargent.org
Umbrella organisation of all
UKCCSG
children's cancer centres within University of
the UK. It formulates treatment Leicester, 3rd Floor,
plans, runs clinical trials,
Hearts of Oak
researches and monitors new
House,9 Princess
drugs and produces a booklet, Road, West
available in four different
Leicester, LE1 6 TH
languages, called 'A parent's
Tel:01162494460
Guide to Children's Cancer.'
Fax: 01162549504
Email:
info@cclg.org.uk
Website:
www.ukccsg.org.uk
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.
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Winstons Wish
Clara Burgess
Centre, Bayshill
Road, Cheltenham,
GL50 3AW
Tel:01242515157
Helpline:084520304
05
Email:
info@winstonswish.
org.uk
Website:
www.winstons.org.u
k
National Support – Teenagers
Riprap
General – support
for teenagers
A website developed
especially for teenagers who
have a parent with cancer
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www.riprap.org.uk
Hilde Hjelmeland
Ahmedzai
Rip Rap Project
Manager
University of
Sheffield.
Trent Palliative Care
Centre, Little
Common Lane,
Sheffield, S11 9NE
7.4
SUPPORT GROUP - National Support – Site-Specific
BREAST
Hereditary 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.
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.
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.
BRAIN
British Acoustic
Neuroma
Association
Gives information and support
for people with acoustic
neuroma.
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Information Centre,
St Anne Cottage,
Over Haddon,
Derby, DE45 1JE
Tel: 01629 813000
Email:
canhelp@btopenwor
ld.com
Website:
cancerhelp.org.uk
1D Broadway House
112-134 The
Boarding
Wimbledon, London
SW19 IRL
Tel: 020 8543 5577
Email:
info@ukbcc.org.uk
Website:
www.ukbcc.org.uk
Kiln House, 210 New
King's Road, London
SW6 4NZ
Tel: 0207 384 2984
Tel: 0808 800 6000
Minicom helpline:
080 800 6001
Email:
info@breastcancerc
are.org.uk
Website:
www.breastcancerca
re.org.uk
Oak House, Ransom
Wood Business
Park, Southwell Rd
West, Mansfield,
Notts NG21 0HJ
Tel: 01623 632143
Email:
admin@banauk.com
Website:
www.bana-uk.com
COLORECTAL
Bowel 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
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.
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.
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7 Rickett Street,
London, SW6 1RU
Tel: 020 7381 9711
Helpline:
08708506050
Email:
admin@bowelcance
r.org.uk
Website:
www.bowelcancer.or
g.uk
15 Station Road,
Reading, Berkshire
RG1 1LG
Tel: 0800 328 4257
Tel: 0118 939 1537
Email:
cass@colostomyass
ociation.org.uk
Website:
www.colostomyassoi
caition.org.uk
Peverill House, 1-5
Mill Road Ballyclare,
Co. Antrim BT39
9DR
Tel: 0800 018 4724
Tel: 028 9334 4043
Fax: 028 9332 4606
Email: info@theia.org.uk
Website:
www.ileostomypouc
h.demon.co.uk
GYNAECOLOGY
Gynae C
A support organisation for
women with gynaecological
cancers and their partners,
families and friends. Provides
publications, meetings,
telephone support and
counselling.
1 Bolingbrooke
Road, Swindon,
Wiltshire, SN2 2LB
Tel: 01793 491116
Email:
Gynae_C@yahoo.co
m
Website:
www.communigate.c
o.uk/wilts/gynaec
Ovacome
A national support group for all Elizabeth Garrett
those involved with ovarian
Anderson Hospital,
cancer, including patients,
Huntley Street,
families, friends, carers and
London. WC1E 6DH
health professionals.
Tel: 020 73809589
Email:
ovacome@ovacome
.org.uk
Website:
www.ovacome.org.u
k
The Daisy Network
Offers support, group meetings PO Box 183,
(Premature
and workshops for woman
Rosendale, BB4
menopause support affected by premature
6WZ
group)
menopause. For written
information send a large SAE
Email:
to the above address.
Daisynetwork.org.uk
Website:
www.daisynetwork.o
rg.uk
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HAEMATOLOGY
International
Myeloma
Foundation: UK
Office
Funds research into myeloma
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'.
Myeloma UK,
Lower Ground
Floor,37 York Place,
Edinburgh, Scotland
EH1 3HP
Tel:+44(0)
1315573332
Helpline: 0800 980
3332
Email:
myelomauk@myelo
ma.org.uk
Website:
www.myeloma.org.u
k
Unit 2-3
Heathgate Place
75-87 Agincourt
Road, London
NW3 2NU
Tel: 020 7284 1234
Email:
heathgate@anthony
nolan.org.uk
Website:
www.anthonynolan.o
rg.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.
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 0101
Email:
info@lrf.org.uk
Website:
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 2GA
Freephone: 0808
808 5555
Email:
information@lympho
ma.org.uk
Website:
www.lymphoma.org.
uk
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Leukaemia Care
HEAD & NECK
British Thyroid
Foundation
National
Association of
Laryngectomee
Clubs
Several local groups
throughout Britain. Offers
support and companionship to
patients and their families.
Some financial assistance is
available and a small number
of holiday caravans.
One Birch Court,
Blackpole East,
Worcester WR3 8SG
Tel: 01905 755977
24hour careline:
0800 169 6680
Email:
enquiries@leukaemi
aCARE.org.uk
Website:
www.leukaemiacare.
org.uk
Produces a newsletter and
booklets about the thyroid
gland, thyroid disease and
thyroid cancer. Runs a network
of local support groups.
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 preand post-operative patients.
PO Box 97, Clifford,
Wetherby, West
Yorkshire LS23 6XD
Tel: 01423 709707
www.btf-thyroid.org
Lower Ground floor
152 Buckingham
Place Road, Victoria,
London SW1W 9TR
Tel: 0207 703 8585
www.patient.co.uk
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Information
Website:
www.laryngectomee
s.inuk.com
LUNG
Roy Castle Lung
Cancer Foundation
British Lung
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.
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.
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200 London Road,
Liverpool,
Merseyside L3 9TA
Tel: 0800 358 7200
Website:
www.roycastle.org
73/75 Goswell Road,
London EC1V 7ER
Tel: 020 7688 5555
Fax: 020 7688 5556
Email:
breatheasy@britishl
ungfoundation.com
Website:
www.lunguk.com
SKIN
MARCS 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.
Skin Cancer
Research Fund
Promotes research into all
aspects of skin cancer and
provides support and
information to people with skin
cancer.
Skinship UK
A telephone helpline for
anyone with skin problems
including cancer. Puts patients
in touch with other patients.
Offers one to one counselling.
SKIN/ HEAD & NECK
British Association Members are helped to
of Skin Camouflage disguise skin problems with
camouflage make-up.
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Wessex Cancer
Bellis House
11 Westwood Road
Southhampton
S)17 1DL
Email:
MARCS
line@salisbury.nhs.u
k
Website:
www.wessexcancer.
org
Department of
plastic surgery,
Frenchay Hospital,
Frenchay, Bristol,
BS16 1LE
Tel: 0117 970 1212
Email:
caroline.newton@no
rthbristol.swest.nhs.uk
Plascow Cottage,
Kirkgunzeon,
Dumfries, DG2 8JT
Tel: 01387 760567
P.O.Box 202
Macclesfield,
Cheshire, SK11 6FP
Tel: 01625 871129
Email:
Basc9@hotmail.com
Website: www.skincamouflage.net
Disfigurement
Guidance Centre
Provides advice, support and
practical help to patients and
health professionals.
Let's Face It
Support Network
Provides support, information
and mutual help for people
with facial disfigurement.
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.
UROLOGY
Urostomy
Association
Orchid Cancer
Appeal
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.
Funds research and promotes
awareness into testicular and
prostate cancer.
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Website:
www.dgc.org.uk
72 Victoria Avenus
Westgate on sea
Kent CT8 8BI
Tel: 01843833724
Email:
chrisletsfaceit@aol.c
om
Website:
www.lets-faceit.org.uk
Chairman: David
Kirby
22 Vulcan House
Vulcan Road
Solihull
B91 2JY
Tel: 0121 704 9860
Website:
www.opa.org.uk
Central Office, 18
Foxglove Avenue,
Uttoxeter,Staffs,
ST14 8UN
Tel: 08707707931
Email:
secretary.ua@class
mail.co.uk
Website:
www.uagbi.org
St Bartholomew's
Hospital, London
EC1A 7BE
Tel: 020 7601 7808
Email: info@orchidcancer.org.uk
Website:
www.orchidcancer.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………………………………………………………………………………
…………………………………………………………………………………………..
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