INDUCTION DOCUMENT FOR RESPIRATORY MEDICINE AT NGH
Contents
1.
2.
3.
4.
5.
6.
Work practice within the Department
Respiratory medicine staff
Respiratory wards and bed allocation
Timetables for ward rounds, clinics and departmental meetings
Useful contacts in associated departments
Appendix A – HOOF forms and O2 ordering
1. WORK PRACTICE WITHIN THE DEPARTMENT
Welcome to Respiratory medicine. We hope that you will work hard, learn and enjoy this attachment. Please speak to your supervising
consultant or Jennifer Hill, Clinical Director if you have personal or clinical concerns.
Junior Staffing at NGH
We have moved to a ward based system with juniors on each ward working together to cover the ward and any outliers belonging to the
consultants on the base ward. You will be allocated a consultant for clinical/educational supervision and will work for their team most of the
time, but will be expected to work with and for the other team on the base ward. To ensure safe inpatient care during times of annual /study
leave, on call and sickness, the Junior Drs Coordinator may need to move you between wards and teams. Where possible such moves will be
restricted to SHO grade juniors, but all grades of staff may be required to cross cover other teams. It is essential that all juniors advise Nicola
Burden, the Junior Drs co-ordinator, of any planned or unplanned absence.
The rota has been designed to ensure that there are at least 2 juniors on each ward every day with at least one being more senior than an FY1.
Holidays are allocated centrally with each junior Dr given 9 days of leave. Swops may be accommodated but may be denied if there is
insufficient cover across the respiratory unit. If you are on leave or working on a bank holiday you will be entitled to an extra day of leave and
this can be taken whenever you wish, as long as your ward teams are covered and it is agreed in advance. To allow advanced planning each
team should sit down at the start of the attachment to arrange study leave and request any swops.
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A template will be produced weekly to show who is on the wards and who is expected to cross cover other teams. Please check your e mails
regularly for these timetable adjustments and let Nicola know of any problems with what is suggested. On occasions junior Drs will be expected
to cover colleagues on M2, the pulmonary hypertension ward, at RHH.
Board rounds
We operate a policy of multidisciplinary board rounds between nursing staff, therapists and Drs at 9am every weekday. These board rounds are
expected to be quick and concise – diagnosis, medically fit, social issues. The morning’s work should be prioritised using the information from
these meetings - see sick patients requiring urgent review first, followed by those who can go home, and then the rest of the patients. TTOs
should be done immediately for patients going home that day.
4 Step Board Round Structure
Diagnosis
Medically fit?
Y/N
Sick needing immediate
review?
Y/N
Social issues?
Y/N
NB. Please prioritise sick patients and those who are
medically fit with no social issues for review first on WR
- and do TTOs immediately
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Ward rounds
Please ensure that all patients under your care are seen every day of the working week. If a patient is on the ward but has not yet been seen
on the post-take ward round their notes should still be reviewed and summarised, and any investigations chased /ordered in advance of the
post take round.
Please document in the notes as per the ‘SOAP’ guidance (see below).
Subjectively eg, chest pain persists
Objectively – eg, SpO2 98% on air, BP 97/45
Assessment – eg. Pneumonia resolving
Plan – eg. Repeat CXR, check CRP
Acute Respiratory admissions
There has been a Speciality Respiratory take at NGH since December 2010.
There is a Respiratory consultant of the week from 10am to 7pm Monday-Friday. One of the other Respiratory consultants will do an early post
take ward round daily between 8 and 10am seeing 6-8 patients who are next to be seen on the electronic post take list (likely those admitted
after 6pm on the preceding evening). Please ensure that the initials of the consultant who sees these patients is put on to the electronic take
sheet after the ward round.
An acute medicine F1 is allocated to the 8-10am respiratory post take ward round and works from 8.15am-4.15pm. If the acute F1 is absent
you may be expected to attend the Respiratory post take ward round and will be warned of this beforehand.
The Respiratory SHO/F1 who is allocated to ‘cover MAU’ on the rota will work with the Respiratory consultant of the week and acute registrar to
look after patients on MAU 1-3 and patients admitted on the take. They will work from 10-6pm meeting the team at 10am in the Doctors room
on MAU 1 each day.
Juniors on base wards are not expected to see patients under their consultant who remain on MAU 1-3 as they are the responsibility of the
acute Respiratory team.
Time
(weekdays)
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8-10
10 -16
16-18
18-19
19 -overnight
Consultant
on-call by
phone
Rota via
switchboard
Early PTWR
Respiratory
Consultant
Acute Med
FY1
(8.15am4.15pm)
Respiratory
Consultant of
the week
Acute Resp
SpR
Respiratory
SHO/FY1
Early PTWR
8.15am - Early
PTWR
Respiratory Consultant of the week
Joins MAU ward round until
4.15pm
MAU & PTWR ward round and reviewing new
admissions
MAU ward round 10-18pm
Respiratory referrals
MAU ward round 10-18pm
Criteria for triage to respiratory medicine are  Asthma/COPD
 Suspected PE
 CF
 Suspected TB
 Interstitial lung disease
 Bronchiectasis
 Pneumonia
 Unusual respiratory infection
 Suspected lung cancer
 Pneumothorax
 Pleural effusion
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Rota via
switchboard


Haemoptysis
Respiratory failure
Triage decisions are made by A and E staff initially but can be reviewed by medical SHOs or registrars with the help of the on call Respiratory
consultant and patients can be moved between speciality take lists where appropriate. Please note that heart failure patients should be
admitted under Diabetes and Endocrinology. Care of the Elderly may be more appropriate for elderly patients with advanced frailty or dementia
presenting with aspiration pneumonia – please discuss with the Respiratory consultant if unsure.
Admissions to RSU
The RSU is a 4-bedded unit delivering NIV to COPD patients with acidotic type 2 respiratory failure. During office hours admission is through Dr
Hughes or his registrar. Out of hours admission must be agreed by the Respiratory on call consultant (available through switchboard).
Emergency admissions to the CF Ward
The CF ward is covered by Drs Edenborough and Wildman who provide continuous on-call cover.
CF patients will only be admitted via the CF team, usually via the CF out patient clinic. Any CF patient presenting out of hours will be notified
to the CF consultant and admitted via the MAUs in the usual way pending review.
Respiratory Referrals
The Acute Respiratory Registrar is available via a dedicated LRP (via switchboard) to see Respiratory referrals and can discuss these patients
with the acute respiratory physician of the day as necessary. There is a secondary rota for the other Respiratory registrars to cover the MAUs
and see referrals when the the acute SpR is on annual leave /study leave /in clinic.
The acute / referrals registrar is also expected to act as pleural / thoracoscopy liaison. The BTS guidelines are clear on the management on the
place of thoracoscopy in the patient with an undiagnosed exudative effusion. Once exudate is confirmed and empyema outruled with a
diagnostic US guided aspirate, and a CT scan performed, please discuss thoracoscopy with LL, JH1 or SR1 and list the patient for the Tuesday
pm thoracoscopy list via the MDT co-ordinators on 66318. The thoracoscopy patient information leaflet and protocol are available via the MDT
co-ordinator. These patients need to have the procedure explained, have the relevant investigations (including G and S), premedication and
consent, which is the responsibility of the acute Respiratory registrar. All patients are transferred to Brearley 2 after the procedure for after-care
and for a 2 night stay.
Bed allocation beyond the base wards (see accompanying table)
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There are no internal outliers within the medical wards ie. if a diabetes patient is inadvertently admitted to Brearley 2 the patient will
automatically be taken over by SKS/ JH1 unless the admitting team specifically requests to keep that patient under their care.
The following wards are ‘keep your own’ areas after admission under a Respiratory consultant –
ITU / HDU
Chesterman 2
Huntsman 2-7
SAC
TAU
During busy periods (outliers > 50 for 3 consecutive days) an escalation policy may come into effect to cohort outliers to be looked after
according to geographical areas. In this situation we would take all medical outliers in Chesterman wards Chesterman 1 – OMP / SB4
Chesterman 3 – MW2 or FE1/ JH1
Chesterman 4 – RJH / SKS
Length of stay (LoS)
LOS can be improved considerably by good discharge planning. Estimated date of discharge (EDD) should be recorded at admission (box on
PTWR proforma) and be used on ward boards and in the notes. Data from other hospitals demonstrates that this reduces LoS. Planned
discharge dates should mean that TTO’s are done in advance allowing patients to be discharged earlier in the day, via the discharge lounge if
possible.
Late completion of TTO’s is an unacceptable but common cause of delayed discharge. The 9am board rounds are aiming to identify unwell
patients or those for discharge that day who should be seen FIRST on the ward round. TTOs should be completed immediately for patients
who are medically fit with no social issues to allow immediate transfer to the discharge lounge.
Coding
Accurate and complete coding is essential if the Trust is to be fully reimbursed for the work that it does. The diagnoses in e-discharge
summaries must include
 A Primary Diagnosis
 All Secondary Diagnoses - active problems that contributed to the length of stay.
 “?” or “possible” diagnoses are not acceptable and these terms should not be used. “Probable” diagnoses are acceptable
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 All procedures (including catheterisation)
A coding guide and Coding sheets are included (see appendix).
Patient Results
At the end of each day please view and file all the results on ICE for your consultant’s patients – please do not file abnormal results that you do
not understand unless you have discussed them with a senior colleague.
Discharge Summaries
Dictated discharge summaries have been replaced by the ICE based e-Discharge template which will amalgamate the previous flimsy TTO and
the dictated and typed discharge summary. Please start these on patients as soon as they reach the base wards and include as much of the
vital details which impact on coding (see below) as possible. A copy is given to the patients on discharge so please ensure that DNAR
decisions and serious diagnoses have been discussed with the patient.
At discharge
Please review the patient notes and read through your e-discharge summary to ensure it tells GP the salient points about the patient’s
admission. Would you understand what has happened to the patient this admission from the TTO?
Review all results on ICE for this patient episode and ensure they have been acted on and are filed. Do not file abnormal results that you do
not understand and have not discussed with a senior Dr.
Check whether the patient needs a repeat CXR in recovery (consolidation on CXR usually requires repeat at 6-8 weeks by GP)
Comment on the TTO if bloods have been abnormal and advise the GP if/when repeat blood test are required (this should be a rare occurrence
and should be agreed with a registrar or consultant).
If a patient requires a repeat CT eg to follow up a lung nodule please request the CT stating on the request the month in which the repeat scan
is required.
Compare the discharge medication list to the list from admission – comment on any changes to medication in the appropriate box and ensure
no medication has been missed off inadvertently.
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Ensure that all home oxygen is documented (including short burst, ambulatory and LTOT)– particularly when it has been newly started. Please
ensure that the e-discharge is copied to the oxygen nurses for them to follow the patient up.
Confirm whether the patient requires hospital clinic follow and state -the consultant who will see the patient and their clinic code if known eg OMP TB clinic
-the time interval eg 3 months
-list any pulmonary function tests required at clinic as these are pre-booked for the patient eg “with Spiro, TLCO”
-any other details eg “CXR on arrival”
Please note that Early Supported Discharge Scheme for COPD should be recorded in the community follow-up section.
Oxygen prescription
The National Patient safety agency and BTS require that Oxygen is regarded as a drug and prescribed as such. This should now be done on
the STH prescription chart and must be filled for ALL patients receiving oxygen. Write up the initial flow rate and device and a target saturation
(88-92% for patients in/prone to type 2 respiratory failure and 94-98% for rest even if they have a diagnosis of COPD).
HOOF (home oxygen order form)
These must be filled in accurately and promptly to prevent discharge being delayed (see later filled example). Do NOT fill as an emergency
order unless your consultant explicitly requests this and countersigns the form (this is extremely expensive). Please send copies of e-Discharge
letters of all patients newly commenced on home oxygen to the oxygen nurses who will follow the patients up in their clinic. Any patients now
sent home on LTOT who have one or more storeys to their property will need to have an additional comment from the prescriber (in box 11 of
HOOF A) along the lines of: ‘will require oxygen upstairs and down’. The engineer will then either offer piping-in or install two concentrators.
Thromboprophylaxis
A thromboprophylaxis risk assessment must be completed within 24 hours of admission for all patients and dalteparin prescribed as
appropriate. There is a significant financial penalty for failing to adhere to this. There is a pre-printed dalteparin prescription on the drug chart to
act as reminder. The risk assessment forms have now been incorporated into the admissions clerking proforma. Please check that these are
filled in and ensure that elective and direct to base ward emergency admissions have risk assessments done.
Dementia
The dementia screening tool should all be filled for all patients within 72 hours of admission and is in the clerking proforma.
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Outpatient outcome forms
These will be on the front of patients notes in the clinic and should be competed for all patients, to include follow up plans, current status of
investigations and treatment and any tests performed in clinic.
From April 2014 we will monitored by the CCG against a target of all clinic letters leaving the trust within 48 hours and containing the following
information - diagnosis
- reason for follow up
- changes to medication
- GP actions required
The secretaries will be asked to type letters with this information in a template but I would just ask you to ensure that you dictate letters within
the clinic session and do not delay with the intention of getting back to them later in the week.
Clinical supervision and educational opportunities
Foundation Drs have an educational and clinical supervisor for each attachment. CMT Drs have an educational supervisor for the whole year
within STH (the first consultant with whom they work) and a clinical supervisor who is the consultant they are working with in each attachment.
Please arrange an early, mid and end attachment meeting with your supervising consultant. You will be expected to have drafted a personal
development plan and to sign off on this and your learning agreement at the first meeting. Please try to request work based assessments at
regular intervals during your attachment rather than leaving these to the end of the post when time may be short.
You can request remote access to the library facilities to allow you to perform literature searches or personal study away from the work place.
The British Thoracic Society has an excellent (and free) website with a number of useful guidelines available for reference.
Study leave will be granted as much as possible but must be requested in writing (or e mail) at least 4 weeks ahead of time. Please inform
Nicola Burden of any planned leave. Registrars should have received a list from the Deanery of important and funded study leave courses and
conferences and should contact Lynne Laver at RHH to access funds.
Attendance at conferences will be first allocated to those who are presenting their own work, and then by rotation according to previous
conference attendance. Please discuss study leave early during the attachment with your consultant.
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In the past trainees, having secured themselves a place on deanery courses, have failed subsequently to attend or provide timely advice to
organisers such that the place can be released to other trainees. This is considered highly unprofessional and in breach of standards laid down
by GMC in terms of professionalism and good medical practice. Please endeavour to attend (or cancel) booked study courses.
SHO Education Days
There are 3 days per 4 month block allocated when you may undertake educational activities as you are not included in the ward numbers.
The activities you choose to undertake should be decided in conjunction with your educational supervisor and depend on your training needs.
It is expected you will use this time to meet the requirement for you to attend clinics.
A timetable for clinics and procedural sessions available for you to attend can be found below. Please email the consultant in advance when
you wish to attend their clinic to ensure that you can be accommodated on the day in question. This is a good opportunity to obtain MiniCEX or
CBD.
For those who have been on TAKE the day before an education day please try to clerk respiratory admissions and attend the early PTWR at
8am on your education day to present your patients on the PTWR. This is a good opportunity to get feedback from your take days and obtain
an ACAT.
Pulmonary Function Testing occurs 5 days a week and you should discuss with Cheryl Roberts if there are specific more complicated tests
such as CPET or Mannitol challenge that you wish to see.
You do not have to spend the whole session in one activity. For example you could present on the post take ward round, watch a
bronchoscopy, and watch a pulmonary function test in the same morning. However you should arrange to attend sufficient clinics to meet your
training requirements during these days.
If you are not otherwise engaged on an educational day (eg the clinic finishes early) then you should return to work on your base
ward.
Sick leave
If you are unwell and cannot attend work you are obliged to contact medical personnel and Nicola Burden, on ext 66318. Nicola can liaise with
Joanne Nettleton if you will be missing an on call shift. After returning to work you must contact Nicola Burden and arrange a back to work
interview with Dr Jennifer Hill, Clinical Director of Respiratory Medicine.
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Acute Medicine – Clinical Coding
Key Co-morbidities to Document in Case Notes/e-Discharge
CO-MORBIDITY
Any kind of cancer – identify location
Any kind of infection – identify location
Respiratory Failure (acute or chronic)
Bronchiectasis
Cachexia
Heart Failure – (CCF, LV dysfunction, diastolic, Cor pul)
Diabetes – (IDDM or NIDDM)
Ulcer of Lower Limb
Faecal Incontinence
Gastritis
Arthritis (OA, RA)
Depressive Episode
Senility (cognitive decline) or Dementia (formal Dx)
Difficulty in Walking (uses walking aid)
Dependence on a Wheelchair
Problem lists
Record a problem list where possible in the notes
 Primary diagnosis
 Current co- morbidities on treatment
 Active problems influencing care
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Primary diagnosis - a working diagnosis is acceptable;
?PE ?LRTI ?CVA with queries is not.
Multiple problems can be recorded e.g. Pneumonia, NSTEMI, hyperkalemia but be specific – record acute coronary syndrome not cardiac
/chest pain
Current comorbidities on treatment – see above
Are listed on the laminated sheets found on all respiratory wards as an aide memoire
Record Obesity (BMI>25), include Smoker – advised to stop
Active problems influencing care – these are the ‘softer’, more socially aware issues, found at the end of the laminated sheet.
Examples include Depression +/- anxiety (on treatment or active), poor mobility (uses a stick or walking aid), poor vision (registered blind or
poor vision contributed to their admission)
Record all procedures done – include CT scan, pleural procedures, CT Biopsy
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2. Respiratory medicine staff
Consultants (NGH)
Dr C Barber (CB2)
Dr S Bianchi (SB4)
Dr F P Edenborough (FE1)
Prof D Fishwick (DF1)
Dr J M Hill (JH1)
Dr R J Hughes (RJH)
Dr J Hurdman (JAH)
Dr Rod Lawson (RAL)
Dr L Lewis (LL)
Dr O M Pirzada (OMP)
Dr S Saha (SKS)
Dr M J Wildman (MW2)
Consultants
Dr S Bianchi
Dr F P Edenborough
Dr J M Hill
Dr J Hurdman
Dr R J Hughes
Dr R A Lawson
Dr L Lewis
Dr O M Pirzada
Dr S Saha
Dr M Wildman
Consultants (RHH)*
Dr R Condliffe (RAC)
Dr C Elliott (CAE)
Dr D Kiely (DGK)
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Specialist interests
Occupational Lung Disease, lung cancer
Interstitial Lung Disease, sleep
Cystic Fibrosis
Occupational Lung Disease
Lung Cancer
Sleep, non-invasive ventilation
COPD, pulmonary hypertension
COPD (community based)
Pleural disease
TB, bronchiectasis
Lung Cancer, asthma
Cystic Fibrosis
Ext.
52086
66270
14680
Sec
11740
14770
66432
Bleep/Mobile
Mobile/LRP
2190/Mobile
LRP/Mobile
66313
15537
14646
14278
2373/LRP
Mobile
14681
14678
15212
14278/14646 LRP/Mobile
14661
2323/LRP
15283
2303/Mobile
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Prof S Renshaw (SR2)
Prof I Sabroe (IS1)
Pleural disease / ILD
Asthma, Pulmonary Hypertension
*see RHH induction document for junior Drs rotating to RHH
Clinical Director
Dr Jennifer Hill
Service Manager
Chris Hayden
Assistant service managers
Claire Walker
Michael Fordyce
Matrons
Ruth Marrison
Jane Sendel
Lung Cancer MDT Coordinators
Julie Key (Lung Pathway Co-ordinator)
Nicola Burden (MDT co-ordinator/ Junior Medical Staff Co-ordinator)
Sara Shaw (Clerical Officer)
)
)66318
)
Chief of Pulmonary Physiology
Cheryl Roberts
Consultants and Secretaries Offices
All consultants and secretaries are in the Brearley outpatients (below Brearley wards)
Chest Clinic
Outpatient Reception
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Ext.
66494
Fax.
15745
Pulmonary Function Unit
14768/14784
66389
Specialist Nurses
Asthma specialist nurse, Clare Daniel
COPD/Oxygen specialist nurses
Lung Cancer specialist nurses, Anne Clegg/ Sarah Field / Helena Stanley
Cystic fibrosis specialist nurses
Respiratory nurse specialist, Dawn Weston
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66308
66388 Bleep 2526
66956/bleep 2937
66281 fax 66280
69758
3. Respiratory Wards and bed allocation
Brearley 1 (28) –14 JAH
14 FE1/MW2
Brearley 2 (28) –14 JH1
14 SKS
Brearley 3 (28) –14 SB4
14 OMP
Brearley 4 (24) – 10 RJH*
14 LL
CF Ward (12) – CF and elective respiratory patients
NGH Junior Staffing
Team
MW2/FE1*
JAH
SKS
JH1
OMP
SB4
RJH
LL
Acute
Br 1 – 14 beds
Br 1 – 14 beds
Br 2 – 14 beds
Br 2 – 14 beds
Br 3 – 14 beds
Br 3 – 14 beds
Br 4 – 10 beds
Br 4 – 14 beds
MAU1-3
CF*
14 BEDS
Reg
1 per ward
1 per ward
1 per ward
1 per ward
1
1
SHO
1
1
1
1
1
1
2
1
To be
rostered on
fortnightly
basis
1
*MW2 and FE1 rotate 2 monthly between CF and general respiratory medicine
Designated wards
 TB
 Lung cancer
 COPD/NIV and acute PE
 Cystic Fibrosis
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Br 3 (RH1/RH2 for –ve pressure rooms)
Br 2 (CF ward for elective admissions)
Br 4
CF ward
F1
1
2
1
1
1
1
1
1
1


Sleep
asthma
Ward telephone Nos
Br 1
Br 2
Ward 15089 14326
Clerk
Fax
15090 66812
Drs
69155
Office
Ward
69309
Nos
Br 3, 4 (CF ward for elective sleep studies)
Br 1
Br 3
Br 4
CFW
MAU1 MAU2 MAU3 RH1
RH2
Ch 1
15096 15092 66580 14140 69435 15874 15084 66961
Ch 3
Ch 4
69077 69077
15097 14333 52137 69190 52148 15289
69916
66129 66129
15093
A
52145 15873 15085 69353 14518 14335 69853
15960
61363 52137 B
52146 15872
14320 14419 14337
14096
C
52147 15871
66120
14097
D
15113
E
66094
HB
66361
4. Timetables for ward rounds, clinics and departmental meetings
Weekly ward rounds
SB4
Monday 9am & Thursday 9am Brearley 3
FE1
Monday 9am & Thursday 2 pm Brearley 1
JH1
Monday 9am & Thursday 9am Brearley 2
RJH
Monday am & Thursday am Brearley 4
OMP
Monday pm & Thursday am Brearley 3
SKS
Monday 9am Brearley1/2, Thursday 9am Brearley 1/2,
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66912
66966
MW2
CF Team
Monday 9am & Thursday 2 pm Brearley 1
Monday 9.00am (full), Wednesday 11.00 (part), Thursday 2.00 (part) (on CF Ward)
Consultants will visit the ward most days to discuss sick or new patients and do a ‘board round’.
Outpatient clinics (SpR’s are expected to attend those marked*)
SB
Monday (Gen) pm*, Wednesday (sleep) pm*, Friday (ILD) am*
FE1
Tuesday pm* (alt. weeks)
CB2
Tues pm lung cancer (JH1 Reg attends every week)
JH1
Monday pm general Respiratory alternate weeks* Tuesday pm lung cancer (alternate weeks), Wednesday am lung cancer
(SKS Reg alternates weekly between SKS and JH1 list);
RJH
Tuesday am (Gen)*, Friday am (Sleep)*,
RAL
Wednesday pm and Thursday am (COPD)
OMP
Monday (TB) pm*, Tuesday pm (alt. weeks), Thursday (TB) pm*
SKS
Tuesday* pm lung cancer alternate weeks and Wednesday am* (reg alternates weekly between SKS and JH1 list)
Thursday pm*
MW
Tuesday pm* (alt. weeks)
CF Team
Monday AM (CF SpR)*, Wednesday PM# (CF Outpatient Unit)
Clinics
Attachment name
Asthma/COPD
JAH/FE/MW2
Wards
Brearley 1
FE/MWRM tues pm
SB4SLP wed am
Lung cancer
Bronchiectasis/TB
NIV/pleural
SKS/JH1
OMP/SB4
RJH/LL
Brearley 2
Brearley 3
Brearley 4
JH1/SKSLC weds AM
OMPRM mon pm
LL-LC tues PM
SKSRM thurs pm
MKWILD Fri am
RJHSLP Fri AM
PPH
CF
CF Mon AM
CF Weds PM
PPH
CF
acute (cross city)
Specialist/referrals
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OMPRM
JH1RM m
weeks)
RJHRMSB4RM
EDUCATIONAL
OPPORTUNITIES
FOR ACUTE AND SPECIALIST POSTS
Monday
AM
OLD
NGH
PE clinic
Difficult asthma
Rheum/Resp
Bronchiectasis
RHH
NGH
RHH
NGH
Thursday
OLD
NGH
Difficult a
Comm C
EBUS
Friday
ILD
EBUS
NGH
NGH
Comm D
Tuesday
PM
Comm C
Thoraco
Wednesday
Clinic letters
Letters have to leave the trust within 48 hours of the clinic, so please ensure that you dictate them at the end of each clinic session.
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We are mandated by the CCG to include the following information in all clinic correspondence (and will be financially penalised for not doing
so).
 diagnosis
 reason for follow up eg. to monitor ILD
 GP action
 Change of medication
Bronchoscopy lists*
Tuesday 9.00am
bronchoscopy list – SB/ MW/FE1
Thursday 1.30pm
bronchoscopy / EBUS list – RJH/ JH1
Friday 9.00am
bronchoscopy / EBUS list – OMP / SKS
*book procedure with lung cancer MDT co-ordinator on 66318
Nicola Burden will ensure that bronchoscopy lists are allocated to registrars on the rota to ensure that educational opportunities are not lost.
Registrars must be supervised at all times when performing bronchoscopy unless they have completed CCT when they can bronchoscope
independently. After discussion between consultant and registrar, SpRs within 6 months of CCT may bronchoscope independently if the
consultant supervising that list is available in the hospital and can attend within 5 mins.
Thoracoscopy list
Tuesday 2.00pm
thoracoscopy list – JH1/SR /LL
*book procedure with lung cancer MDT co-ordinator on 66318
Departmental educational and other meetings
 departmental educational meeting - Monday 1.00 – 2.00 pm (lunch usually provided), Change Room between Brearley 3 and 4.
Timetable will be circulated by SKS
 Lung cancer MDT meeting - Tuesday 8.15 -10.30am - Lecture Theatre, Vickers Corridor
 Clinical Radiological Conference - Tuesday 1-2 pm – Seminar Room, X-ray Department
 Service improvement CHANGE meeting – Wed 2-3pm – CHANGE room between Brearley 3 and 4
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


F1 Teaching - Thursday lunchtime 12.30 – 2.00 pm – (lunch provided), Medical Education Centre
Occupational respiratory radiology meeting – Thursday 1-2pm - Seminar room-x-ray department
ILD radiology meeting – Friday 8.15-9am – Seminar room-x-ray department
Chest drain teaching
There is an official trust chest drain teaching course for SpRs which should be completed (with sign off) before drains should be inserted within
the trust – please contact Dr Steve Renshaw to enrol.
See STH chest drain policy on Intranet.
5. USEFUL CONTACTS IN ASSOCIATED DEPARTMENTS
Thoracic Surgeons
Mr J G Edwards
69279 Bleep 826/ Mobile
Mr J Rao
15390 Mobile
Ms L Socci
Oncologists
Clinical
Dr Trish Fisher
Medical
Prof Penella Woll
Dr Sarah Danson
Thoracic Radiologists
Dr Sue Matthews
66344
Dr Matthew Bull
14822
Dr Catherine Hill
14271
Dr Aki Kamil
Pathologists
Dr Kim Suvarna
Dr Yota Kitsanta
Dr Jonathan Bury
265334016
14862
14850
65248
65060/ 65206
65704
Contacts for :
PACS registration/induction (including SMART cards)
Computer login access / passwords / digital dictation
265334016
66347
69040
Appendix A
Home Oxygen Order Form (HOOF)
– correctly filled in
Part A (Before Oxygen Assessment – Non-Specialist or Temporary Order)
All fields marked with a ‘*’ are mandatory and the HOOF will be rejected if not completed
1. Patient Details
1.1 NHS
Number*
1.2 Title
1.3 Surname*
1.4 First
name*
1.5 DoB*
1.6 Gender
1111111111
Mr
1.10 Mobile no.
Mouse
2. Carer Details (if applicable)
67 Disney Way
Sheffield
Michael
2.1 Name
01/05/1951
X

Male
Female
2.2 Tel no.
1.8 Postcode* S5 7AU
2.3 Mobile no.
3. Clinical Details
4. Patient’s Registered GP Information
3.1 Clinical
Code(s)
3.2 Patient on
NIV/CPAP
3.3 Paediatric
Order
4.1 Main Practice name:*
01

Yes

Yes
 No
 No
5. Assessment Service (Hospital or Clinical Service)
5.1 Hospital or Clinic Name: Northern General Hospital
5.2 Address Herries Road
Sheffield
De Ath Surgery
4.2 Practice address: Sick Road , Sheffield
4.3 Postcode* S66 6MB
265334016
1.9 Tel no. 0114 2225522
1.7 Permanent address*
4.4 Telephone no. 08445 111111
6. Ward Details (if applicable)
6.1 Name: Ward 1
6.2 Tel no.: 0114 2222222
6.3 Discharge date: 22 / 01 / 2013
5.3 Postcode:S5 7AU
5.4 Tel no:
8. Equipment*
7. Order*
9. Consumables*
For more than 2 hours/day it is advisable to select a static concentrator
(select one for each equipment type)
Litres /
Min
Hours /
Day
Type
Quantit
Nasal Canulae
y
2
15
8.1 Static Concentrator
1
Back up static cylinder(s) will be supplied as appropriate
Mask % and
Type
yes
8.2 Static Cylinder(s)
A single cylinder will last for approximately 8hrs at 4l/min
10. Delivery Details*
10.1 Standard (3 Business Days)

10.2 Next (Calendar) Day
11. Additional Patient Information
If patient has ambulatory oxygen already please put following
statement
Please leave ambulatory oxygen in situ
X
10.3 Urgent (4 Hours)

12. Clinical Contact (if applicable)
12.1 Name: Dr Consultant
12.2 Tel no.
12.3 Mobile no.
13. Declaration*
I declare that the information given on this form for NHS treatment is correct and complete. I understand that
if I knowingly provide false information, I may be liable to prosecution or civil proceedings. I confirm that I am
the registered healthcare professional responsible for the information provided. I also confirm that the patient
has read and signed the Home Oxygen Consent Form.
Aide Memoire to completing HOOF
1. All sections marked with * are mandatory
2. A static concentrator is sufficient for delivering LTOT. Static cylinders weigh 18kg when full and are not
ambulatory.
3. Next day delivery should be appropriate for hospital discharges. Engineer will need to have access to
property.
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4. Emergency (4hr) installation requires Consultant signature and is rarely necessary. Discuss with O2
nurses.
5. If patients already have ambulatory O2 please state ‘leave ambulatory supply in situ’ in box 11.
6. If patients already have some form of O2 at home they will need to have a HOOF form B filled in by the O2
nurses (which cannot be done by junior Drs) – please contact the O2 nurses
7. New ambulatory O2 cannot be ordered on Part A HOOF. This is done via the oxygen assessment service
post discharge.
8. Ensure a contact number is provided in case of query. If the patient lives alone this will need to be a family
member who can access their property to allow O2 delivery
9. Fax copy to O2 service (14511)
Any queries – contact O2 nurses
265334016