Pleased with our care? Do tell us and share your experience with others in the comments section at www.nhs.uk You can also give feedback on your care in our Outpatient Departments using a link to our patient experience survey on our website: www.bhrhospitals.nhs.uk Think we could do better? Please tell us so we can take immediate steps to put things right, and improve care for other people in the future. You can ask to speak to the nurse in charge or your doctor, or get in touch with our PALS team: Available at both Queen’s and King George Hospitals 8.30am5.30pm Email: PALS@bhrhospitals.nhs.uk Queen’s: 01708 435454 King George Hospital: 0208 970 8234 24 hour answer phone 0800 389 8324 Haematology/Oncology Outpatient Guide. Queen’s Hospital Romford sub-title Did you know if you have been diagnosed with cancer you are entitled to free prescriptions? Ask for a medical exemption certificate and get GP or hospital doctor to sign it- certificate is valid for 5 years. Date:June 2014 Review date: June 2016 This information is available in alternative formats. For more information, please ask a member of staff or ask to speak to the PALS office. Introduction Welcome to the Haematology/Oncology outpatients department. This leaflet has been designed to help you understand the department and what you can expect of us as a team. Hospital transport is available for those who need it. Your GP will be able to arrange transport for your first appointment if you are unable to come via public transport and have no one to bring you. We will be able to arrange further transport if you fulfil the correct medical criteria. How to get to the hospital. What to bring with you Buses 365,128,175,193 and 496 ,498,499,898 all call into the hospital grounds. The hospital is about a 15 minute walk or 5 minute bus ride from Romford mainline railway station. If coming via public transport please be aware that the department is at the far end of the hospital and it is a quite a distance to walk. Please ask at the information desk in the main atrium if you require a porter to assist you in a wheelchair. It may be useful for you to bring a family member or friend with you, but no more than 2 will be able to come into the room with you due to the size of the rooms. Before you leave home please check you have the following: If coming via taxi, please ask to be dropped off at the Oncology department entrance. Car Park We have our own car parking facilities located at the rear of the hospital (next to A&E). The car park is only operational MondayFriday and is locked during weekends and bank holidays. Please follow signs for the Haematology/Oncology car park from the front of the hospital. On entering you will be asked by security which department you are attending- the barrier will then be lifted and you can park your car. Once you have finished your visit to the hospital, you need to return to the car park machine (outside the reception) press the third button, pay £2.00 and be issued with an exit ticket. We do not keep any change for the ticket machine. Blue badge holders are not exempt from car park charges. Your appointment letter and any information that we have sent you. All of the medicines that you are currently taking or using including both prescription and over the counter medicines. Information about any change in your personal details including address or GP A list of questions you would like to ask during your appointment. Any samples requested by the hospital or had any blood tests requested prior to appointment. Money to pay for using the car park. Where is the Haematology/Oncology outpatient department? The outpatient department is found within the Haematology/Oncology department. This is in the orange zone, ground floor of Queen’s Hospital. It is comprised of: Main reception Outpatients’ clinics - this is the area where the clinics are held. It is open Monday - Friday 9.00am 5.00pm Radiotherapy department - this is the department which delivers radiotherapy. It is open Monday Friday 8.45am - 5.00pm Sunflower Suite(Chemotherapy day unit) - this is the department where patients receive chemotherapy, blood transfusions and other supportive care. It is open Monday- Friday 9.00am 7.00pm. Georgia Cordery Therapy room - This is the complementary therapy room. It is open Monday to Friday. Phlebotomy (blood tests) Blood tests are available Monday- Friday 9.00am-12.30 pm. It is closed on the last Wednesday of every month. Macmillan Cancer Information Centre - This is where you can access information, leaflets and booklets about your illness. It is open 9.00 am 5.00pm Monday - Friday. The Haematology/Oncology inpatient ward is Mandarin B ward. This is located on the third floor via the orange lifts. There are hot/cold drinks and snack machines located in the main reception of the department. All waiting rooms have drinking water fountains. There are toilets and baby changing facilities situated in all areas. The restaurant and coffee shop can be found in the main atrium of the hospital. Who will you meet? The Haematology and Oncology teams are multi-disciplinary teams who work together to provide your care. The following descriptions will explain briefly what each part of the team does and how we work together. Oncology Consultants: these are Consultants who specialise in the care of patients with cancer. They prescribe chemotherapy, radiotherapy, other drug related treatments and will monitor your illness and progress. Haematology Consultants: these are Consultants who specialise in the care of patients who have an illness/disorder of the blood and bone marrow. They also prescribe chemotherapy, other drug related treatments and will monitor your illness and progress. They each have a team of registrars and senior house officers working with them. Your consultant has overall responsibility for your care; however you will not always be seen by them but by any of the doctors in the consultant’s team. The registrars regularly move around the department and to other hospitals within London and Essex to ensure they receive a broad training. You may therefore see several different registrars during your visits to the department. Outpatient nurses: these are nurses who are based in the outpatient clinics with knowledge of your illness and the treatment which is offered within this department. They are available to support and care for you and your carers. They can be contacted on 01708 503191 Monday - Friday 8.30am 5.00pm. Chemotherapy nurses: these are nurses who are specially trained to deliver chemotherapy and are based within the Sunflower suite. They have specialised knowledge about chemotherapy and its side effects and will be able to support you and your carers. They can be contacted on 01708 435285. Health care support workers (HCA): these are a group of staff who work in the outpatient clinics and day unit alongside the nurses who are able to help and support you. Therapeutic Radiographers: these are staff who are specially trained to deliver radiotherapy. They have specialised knowledge about radiotherapy and its effect. Clinical Nurse Specialist (CNS): we have specialist nurses in: Brain and CNS cancers Breast cancer Bowel cancer Upper Gastro-Intestinal cancer Gynaecological cancers Haematology Head and Neck cancers Lung cancer Renal and urology cancers Skin cancer Sickle Cell Disease Unknown Primary You may well have been allocated to a CNS already and will have their contact details. If not please enquire when you come to your first appointment. Students: we may have student doctors, nurses and radiographers in the department. We appreciate your support as we are training them BUT if at any point you do not wish for a student to be present for any reason please do say so. This wish will be respected and it will not affect your treatment. Receptionists: who will book your next outpatient follow up appointment and who you can contact if you need to re-arrange an appointment. They can be contacted on 01708 503173 Monday - Friday 8.30am - 5.00pm. An answer phone is switched on during busy times and is frequently checked. If you leave a message your call will be returned to you the same day unless it is after 5pm.We also have an email address which can be used for changing outpatient appointments: HaemOncOutpatQH@bhrhospitals.nhs.uk Macmillan Cancer Information officer: based in the Macmillan Cancer Information Centre. She and trained volunteers, are able to provide literature on all aspects of living with cancer, the opportunity to discuss treatments, side effects and other cancer related issues, the opportunity to talk to someone confidentially and over the phone information and support for those not able to access the service in person. We also have information about local support groups. A wig ordering service is available via the information officer and we have a supply of headscarves and bandanas for sale. The information officer can be contacted on 01708 435174 For more information about your condition you may wish to look at www.nhs.co.uk/ips this is the Information Prescription Service available on the NHS Choices website. Macmillan Advice Project: aims to help patients their families and carers financially by offering welfare benefits and debt advice. Please phone 0208 514 1359 or ask one of the outpatient nurses or Macmillan Cancer Information Officer. A benefits officer visits the department on Wednesday mornings and Friday afternoons. Counsellors/Psychotherapists: we have a team of highly trained psychologists, psychotherapists and counsellors who are available to help you if you have any emotional issues. Ask your Doctor or one of the nurses if you would like to be referred to them. Please see separate information leaflet available for more information. Complementary therapy: we are able to offer a variety of complementary therapies to patients and their carers. These include; aromatherapy, reflexology, indian head massage, gentle massage for cancer. If wish to book a therapy please see separate information leaflets which are in the department. Clinical trials team: As part of your treatment you may be asked to take part in a clinical trial. Clinical trials are research studies involving patients which compare a different type of medical care with the best treatment or treatments currently available. Clinical trials are carefully designed to minimise the risks and maximise the benefits to all the people who take part regardless of which treatment they get. You may decide you do not want to take part in a clinical trial. This is fine and you will still receive the best treatment for your illness. Before you take part in a trial one of the nurses from the clinical trials team will carefully explain to you about what is involved. You will be given time to think about entering the trial. Once you have agreed to the trial you will be asked sign a consent form. The clinical trials team will be able to answer any questions you may have and will be there to support you through the trial. You can withdraw from the trial at any time and this will not affect your treatment. Macmillan Specialist Palliative Care Team: This team provides an advisory role for patients with advanced and or progressive life limiting illnesses who are experiencing difficulties associated with their illness. You can be referred to this team for: symptom control, emotional support, financial support or assessment for hospice/community support. What to expect on your first visit Please check in at the main reception desk (Reception desk 1). You will be asked to take a seat in the main waiting room and wait until your name is called. When your name is called, you will be met by one of our nurses or HCA’s who will bring you around to the clinic rooms and weigh you. Please let them know if you have any concerns about your visit to the department. You will then be seen by a doctor who will discuss your medical history with you and the reason for your visit to the department. They will discuss your illness and any proposed treatment. They may also examine you. As stated before, this may not be the consultant but may be a registrar. If it is a registrar who has seen you, they will then introduce you to the consultant who is in charge of your care. We will provide written information about any proposed treatment for you to take home. Do please feel free to ask any questions you have or ask for any clarification about anything that is confusing you. It may be helpful to think of questions before your visit and bring them written down with you. Letters Many patients appreciate getting copies of the letters which are sent to the GP about their appointment. It can be hard to remember everything that was said at the time and means you can see what information is being communicated about you and your illness. It is a national recommendation that you are offered copies of your clinic letters for your own records/ information Some people prefer not to receive such letters. If you prefer not to receive the letters, please tell the doctor you are seeing so this can be documented. Some of the things in your letter may be difficult to understand, talk to your clinical nurse specialist, Macmillan Cancer Information Officer, district nurse, GP or hospital doctor as necessary. Haemoglobin (red cells) these are the cells which carry oxygen around the body. Neutrophils (white cells) these are cells which fight infection Platelets- these are the cells which are responsible for clotting of blood Other blood tests can be done to look at different chemicals in your blood and test your kidney and liver functions. Some tumours produce chemicals and a blood test can be done to look at the level of these. This can help the doctor know how well treatment is working or help monitor your illness. Not all tumours produce these chemicals. Waiting times. We try to ensure that you do not have to wait for long periods before being seen by a doctor. However due to unforeseen events delays sometimes occur. We will endeavour to inform you of any delays and an estimated length of time. Priority is given to those who are very sick or travelling via hospital transport. If you are delayed arriving at the hospital please contact us: if you are more than 30 minutes late and have not contacted us you may not be seen. You may be delayed if you have been asked to have a blood test or X-ray before seeing the doctor. Some Common investigations. Sometimes you will be sent for investigations. The list included here describes the most common ones. Please ask if you require more information or if the investigation/test you need is not listed. Blood tests Full blood count - this checks the levels of different cells in the blood X-Ray These are painless tests where x-rays are used to form an image on a screen. CT scan This is a specialised form of x-ray which produces a cross-sectional picture of your body. You may be asked to swallow some liquid or to have an injection prior to this test this allows us to see your internal organs better. MRI Scan This is similar to a CT scan but it measures the energy different cells produce when they rotate. It is painless but very nosiy.the machine is very enclosed so if you suffer from claustrophobia please let us know, so that we can help you. P.E.T scan This is a specialised type of scan .It helps to tell whether tissue is active or inactive and can supplement the information provided by other x-rays or scans. It will be done at another hospital. Bone scan This is done in the Nuclear Medicine department. It involves having an injection of a small amount of radiation which distributes itself around your body over the next three or four hours. A scan is then performed using a gamma camera. You will not feel unwell. Bone Marrow biopsies This is a minor procedure performed by the registrar or clinical nurse specialist in the Sunflower suite. A local anaesthetic is injected into the back of the hip area and a sample of bone marrow is taken. You need to rest for a few minutes, putting pressure on your back Further appointments When you have finished seeing the doctor, he/she will give you a form to return to the reception desk. When you hand this into the reception desk the receptionist will make you your next appointment and you will be given an appointment card. If the receptionist is not available a box will be left on the reception desk- please leave your form in this box and the appointment will be sent to you in the post. We will endeavour to accommodate your request for appointments but this may not always be possible- clinics are booked in time order. If you have any queries concerning an appointment or would like to change an appointment please telephone us on 01708 503173 Monday- Friday 8.30am-5.00pm. Or email us on: HaemOncOutpatQH@bhrhospitals.nhs.uk If you are unable to attend an appointment or are an inpatient, can you please inform us as soon as possible so we are able to offer this appointment to another patient. Main hospital switchboard Reception Appointments Outpatient nurses Radiotherapy reception Chemotherapy day unit Macmillan Information centre Complementary therapies Macmillan advice project Matron Oncology consultants Dr Ball secretary Dr Beaton secretary Dr Bridgewater secretary Dr Gershuny secretary Dr Gibbs secretary Dr Quigley secretary Dr Raouf secretary Dr Shamash secretary Dr Sims secretary Dr Staples secretary Dr Tarver Haematology consultants Dr Brownell secretary Dr Grant secretary Dr Hemmaway secretary Dr Krishnan secretary Dr Mohan Dr Saja secretary Dr Stevens secretary 01708 435000 01708 503173 01708 503173 01708 503191 01708 435474 01708 435285 01708 435174 01708 504208 0208 514 1359 01708 435000 ext 6839 Ext 3438 Ext 2879 Ext 3438 Ext 3438 Ext 3429 Ext 2875 Ext 2879 Ext 3440 Ext 3429 Ext 2875 Ext 3440 Ext 3436 Ext 3437 Ext 3436 Ext 3434 Ext 3434 Ext 3437 Ext 3434