HCH SERVICES – ADULTS
SPEECH AND LANGUAGE THERAPY
Service Description
The Adult Speech and Language Therapy Service is provided to patients aged 16 years and over who
present with a complex range of communication and/or swallowing problems. The caseload includes stroke
patients, those with progressive neurological disease, and long-term conditions, patients with head and
neck cancer and patients with pathological and functional voice disorders.
Service Model
All staff have postgraduate training in assessment and management of dysphagia. Patients presenting with
swallowing problems will undergo a clinical evaluation and may have objective assessment with a video
fluoroscopy swallow examination carried out by a multidisciplinary team. This team consists of a consultant
radiologist, radiographer and speech and language therapist. It is a moving dynamic X-ray which confirms
risk of aspiration and if the patient is safe for oral feeding. It enables us to trial consistencies and
compensatory techniques and can be pivotal in a patient‟s future management. The recording of this
procedure is usually played back to the patient and carer and a full report is completed and sent to the
referring agent by the speech and language therapist following consultation with the radiologist.
Patients presenting with a neurological problem, either post an acute episode, e.g. stroke or as the result of
a progressive neurological disease (long term conditions), will be assessed and an appropriate course of
treatment offered with defined goals and outcomes. A regular therapy group is run monthly with a
community neuro-physio for Parkinsons patients and their carers.
At Mount Vernon Hospital input is also given to inpatients on Edmunds Ward – a care of the elderly rehab
ward and to patients on Daniels Ward - Continuing Care Unit, and to Northwood & Pinner Community Unit.
There is attendance at weekly Consultants‟ Ward Round meetings and close liaison with Nursing and AHP
staff.
There is also speech and language therapy input to cancer patients on Wards 10, 11 and Marie Curie
Wards – at Mount Vernon Hospital and close liaison with medical staff, clinical nurse specialists and
dieticians.
The Domiciliary/Community Service aims to:

Provide input to patients with poor mobility who cannot access outpatient services.

Prevent acute hospital admissions/readmissions by identifying the risk of aspiration and setting up a
management plan for that patient. This will involve good clear communication with GPs, District
Nurses, carers and staff in Nursing Homes as well as training sessions for those involved in the care
of the patient at home. There will be close liaison with the Community Dietician and subsequent
ongoing reviews will be required.

Maintain and promote independence in the Community

Minimise and prevent further deterioration/loss of function.

Assess patients‟ needs for communication aids (for which there is no budget).
page 1

Provide vital training in dysphagia management to staff in nursing and residential homes.
Location(s) of Service Delivery
(a) Mount Vernon Hospital – North of Borough
The service operates from 9 a.m. to 5 p.m. Monday to Friday and is available for inpatients and
outpatients. Not including Bank holidays.
(b )The Warren Health Centre – South of Borough
The service operates from 8.30 to 4.30 Monday to Thursday and is available for outpatients presenting
with swallowing and/or communication problems.
(c) Hillingdon Hospital
9 a.m. to 5 p.m. Outpatient service for patients referred by ENT Consultants’ Clinic with pathological
and functional voice problems. All patients referred initially by their GP are also referred for specialist
ENT examination prior to therapy (according to Royal College of Speech and Language Therapists
Guidelines).
(d) Community Domiciliary Service
This provides a service to a variety of neurological, long-term conditions and palliative patients who
are physically unable to access an outpatient service. This operates as part of the Community Rehab
team based at Eastcote Health Centre
Days/Hours of operation
The service operates Monday to Friday from 9am to 5pm, excluding bank holidays.
Tel: 01895 488200
page 2
HCH SERVICES – ADULTS
COMMUNITY MATRONS
Service Description
Community Matrons is a specialist and innovative service which is delivered by Advanced Assessment
Nurses. Each Community Matron will have a caseload of up to fifty patients. This is pro-rated for part time
and newly appointed Community Matrons.
There are five primary functions of the Community Matron:
1. Clinical - Provides advanced skill and knowledge in managing long-term conditions which includes
a level 3 medicine review
2. Care coordination - Helps to manage care across providers, supports timely and organised
hospital discharge. Proactively addresses future care needs
3. Communication - Provides timely and ongoing GP, patient and family communications
4. Coach - Empowers the patient to self-care, assists with providing greater understanding to patients
about their conditions
5. Care champion - Helps patient plan and achieve care preferences and goals
All patients must consent to being placed on the programme and are included whether they reside in their
own homes or are in a care home.
The Commissioner expects that during periods of explained or unplanned leave the service will give priority
cover to patients on existing case loads and ensure that Matrons provide cross cover according to patient
needs.
Core Links are:

Heart Failure Nurses

General Practice

Diabetic Team

Rapid Response

District Nurses

Hospital Consultants

Social Services

COPD out reach Team

Community mental health
Location(s) of Service Delivery
The Community Matron hub is currently based at Ickenham Clinic, Community Close, Long Lane, Ickenham
UB10 8RE. Direct Line: 01895 488820. However, individual Community Matrons are aligned with the
relevant district nursing teams; enabling more integrated working.
Days/Hours of operation
page 3
Operating hours are 9-5 Monday to Friday excluding Bank Holidays.
During out of hours, the patient can access medical services through the following routes:
 Contact their GP Practice for advice and be informed of how to access Out Of Hours medical
services.
 If the patient is known to District Nursing service they would contact the District Nursing message
service.
 If the patient‟s condition is liable to deteriorate out of hours, the patient will be advised to contact
Rapid Response.
 In an emergency the patient will be advised to phone for an ambulance.
The service is usually delivered in the patients own home though the Community matron will see patients in
the GP surgery if appropriate and follow patients in to hospital if they have been admitted.
page 4
HCH SERVICES – ADULTS
COMMUNITY DENTAL SERVICE (CDS)
Service Description
The service provided consists of specialist dentists, trained dental nurses and administration staff as
follows:
 Ickenham -4.78wte
 Uxbridge – 5.51wte
 admin/management – 3.4wte
Specialist Services
The CDS is responsible for determining the treatment needs of the patient based on the information
contained in the referral document this includes



Provision of advice to the referring clinician in the form of a suggested treatment plan
Accepted for treatment
People with a learning disability who meet the service criteria
The CDS offers the following specialist dental services to patients
Endodontics
 Complex or sclerosed root canal anatomy in anterior teeth only
 Management of open apices, resorption and trauma
 Endodontic surgery in the presence of adequate conventional obturation
 Retreatment‟s in strategic and restorable teeth
 Removal of posts/separated instruments
 Trauma
 Complicated endodontics in the permanent dentition
Prosthodontics
 Treatment planning or supervisory tutorials
 Cases complicated by congenital abnormalities of dental tissue
 Assess, advise and treat complex cases beyond the scope of the GDP
Periodontics
 Aggressive forms of periodontitis in juveniles
 Generalised aggressive periodontitis in adults
 Specific crown lengthening and root resection at the specialist‟s discretion.

Initial therapy (as below) must have been completed prior to referral:
 Patient motivation
 Demonstration of plaque control techniques
 Smoking cessation advice and enrolment in smoking cessation programme if required
 Removal of any plaque retentive factors
 Subgingival scaling with root surface debridement
 Monitoring
Referrals for treatment are accepted if after initial therapy there is still active periodontal disease: bleeding
on probing, suppuration, static or increasing pocket depth > 7mm in the presence of:
page 5


A plaque score below 10%
Progress made towards smoking cessation (if applicable).
Referrals shall also be accepted for diagnosis and treatment planning for the following:
 patients with pockets >5.5 mm who have failed to respond to treatment
 patients with pockets >3.5 mm who are aged less than 19 years old
 patients with medical problems affecting the periodontium (i.e. diabetes)
 patients with furcation involvement, with active disease
 pre-restorative surgery
Specialist Paediatric Dental Care
The CDS shall accept referrals for the following treatments and conditions;



Complex medical needs
Gross caries
Behavioural problems
Public Health Functions
The oral health promotion role remains within the CDS. Initiatives to promote oral health improvement and
the prevention of disease will include supporting Health Fairs, Sure Start / Children‟s Centres, Brushing
for Life, smoking cessation, oral cancer awareness and the prevention of oral disease.
The oral health promotion service shall also provide advice and information to schools on request.
School Screening
The CDS will continue to provide school screening functions linked to local activity.
The service will complete FP17s for each completed course of treatment and submit to the Dental
Practice Board.
Services not for admission to the service
The CDS shall not provide care to patients on referral that is wholly available as part of the regulatory
framework for mandatory dental care, as defined in Part 5 of the NHS (General Dental Services Contract)
Regulations 2005.
Patients requiring GA will be referred to secondary NHS Trusts in line with guidance under Payment By
Result.
Urgent Care and Out of Hours Services
The CDS is not responsible for providing out of hours services. However it will have details of how
patients can contact the Out of Hours Triage Service on its telephone answering machine outside normal
surgery hours.
The CDS will provide a “help line” telephone number to local GDPs. This number will be used by GDPs
needing to access advice or make an urgent referral into the service. Urgent slots will be made available
wherever possible.
Location(s) of Service Delivery
The CDS service operates from two sites as follows:
Ickenham Clinic
Community Close
Long Lane
Ickenham
UB10 8RE
Uxbridge Health Centre
Chippendale Waye
page 6
Uxbridge
UB8 1QJ
Contact Tel: Tel: 01895 488620
Days/Hours of operation
Services operate from Monday to Friday from 8.30-12.30 and 1.30-5.00 (excluding bank holidays).
Emergency appointments are available for clients who are undergoing treatment.
Services are provided at the following clinics.
 Ickenham Clinic
 Uxbridge Health Centre
page 7
HCH SERVICES – ADULTS
COMMUNITY REHABILITATION
Service Description
The service consists of Chartered Physiotherapists, Technicians, Assistants, Speech & Language
Therapists, and a Community Dietician who are registered with appropriate bodies as relevant.
All referrals undergo an initial assessment and are triaged for prioritisation. Any referrals which do not meet
the criteria detailed above are returned to the initial referrer or redirected onto more appropriate services.
Patients meeting the criteria will receive an initial assessment whereby problems are identified,
individualised care plans are developed and interventions or treatments are provided as appropriate. The
models of care vary but the essential and common components are:
 Clinical assessment to ascertain the patient‟s suitability for rehabilitation and supporting equipment
 Selection of appropriate treatment modalities.
 Advice and on-going management programmes to facilitate self-management.
Treatment modalities include:
 Joint mobilisation and manipulation
 Therapeutic exercise and functional rehabilitation
 Electrotherapy
 Acupuncture
 Self-management advice
 Specific pain management advice
 Connective tissue and massage techniques including deep transverse frictions and soft tissue release;
 Assessment and management of dysphagia, communication problems and other Speech & Language
conditions
 Home enteral feeding in patient‟s home environment including nursing and residential homes.
All patients are continuously reassessed and discharged as appropriate with the patients GP receiving a full
discharge summary
The service has access to the Community Equipment Loan & Wheelchair Service, a small amount of
patient specific equipment (including TENS machines with disposable electrodes for patient short term loan)
and acupuncture needles.
Location(s) of Service Delivery
This service is delivered within the patients‟ home/residential setting. HCH Staff are based at the clinics
listed below. Referral number for the team: 01895 486127
Eastcote Health Centre
Abbotsbury Gardens
Eastcote
HA5 1TG
Telephone 01895 488694
Fax 01895 625268
Franklin House
The Green
Rickards Close
West Drayton
UB7 7 PW
page 8
Tel: 01895 452 480
Laurel Lodge Clinic
Harlington Road
Hillingdon
UB8 3HB
Telephone 01895 484870
Fax 01895 625268
Days/Hours of operation
Operational times are 8am to 5pm, Monday to Friday excluding Bank Holidays.
page 9
HCH SERVICES – ADULTS
CONTINENCE
Service Description
There are three aspects of the service:
 Assessment, advice, monitoring and prescription of appropriate incontinence products by Health
Visitors, District Nurses, School Nurses, and Paediatric Nurses who have additional training. The
Continence Advisor oversees this.
 Provision and delivery of prescribed incontinence products to patients homes/residential homes
 Referral of complex cases, education and training of staff & other professionals, carers, and users to the
Specialist Continence Adviser
Following a full assessment of a patient the appropriate continence product is prescribed. Each patient
receives a leaflet on the continence delivery service including how to contact them to notify them of any
changes required or to discuss any problems with deliveries.
Patients are informed of their first delivery date and subsequent deliveries are generated by the patient.
Emergencies are covered by in house stock at Laurel Lodge or buffer stock at specific clinics. The service
aims to reassess patients on an annual basis.
Key interventions & therapies undertaken by the Specialist Continence Advisor are:
 Assessments of complex cases and follow up intervention is dependent on need
 Advise & information to patients, carers and professionals
 Health promotion sessions & campaigns
 Education & training to carers and professionals
 Diagnosis, treatment and management of complex bladder & bowel problems
 Bladder scans, trial without catheter, intermittent self catheterisation.
 Oversees the home delivery service
Location(s) of Service Delivery
The Warren
Uxbridge Road
Hayes
UB4 0SF
Phone: 01895 484840 (messages can left on the answer machine)
Fax: 01895 484841
Days/Hours of operation
The team operate 8am to 4pm Monday to Friday, excluding bank holidays.
page 10
HCH SERVICES – ADULT SERVICES
DIABETES
Service Description
The service provides care and support for adult patients who have complex or difficult to manage cases of
Diabetes in the community. The service provides clinic appointments and home support visits. More
complex cases are seen by in clinic by the services Diabetic GPwSI‟s.
The service provides a named Diabetes Specialist Nurse (DSN) for each GP Practice in Hillingdon.
Education and training in the management of Diabetes is provided for patients, carers, statutory and
voluntary organisations. Newly diagnosed diabetic patients are encouraged to attend DESMOND training
sessions run by the service.
Location(s) of Service Delivery
HESA Primary Care Centre
52 Station Road, Hayes, UB3 4DD
- Tel 01895 485001
Or in Patients Homes
Days/Hours of operation
The team‟s working hours are from 9am to 5pm Monday to Friday excluding bank holidays.
page 11
HCH SERVICES – ADULT SERVICES
DISTRICT NURSING
Service Description
The District Nursing Service supports housebound patients by providing skilled nursing care in their own
homes and/or other community settings, prevents hospital admission as appropriate, and aids in the safe
early discharge of patients from hospital into the community, wherever possible.
The District Nursing Services provides specialist assessments and development of individualised packages
of care to enable patients to have treatment in the most appropriate environment.
Clinics will be run for ambulatory wound care patients in three locations across the borough. The service is
provided for patients whose wounds take longer than fifteen minutes to dress. Patients with complex
wounds should be referred to the Tissue Viability service.
Location(s) of Service Delivery
District Nursing teams are currently based at 9 sites across the borough as listed below. They are aligned
to GP practices with a named District Nurse attached who will have regular interaction with practice staff,
apart from the Twilight DN service which is centrally based at Ickenham Clinic and provides care across the
whole of the borough out of hours. The District Nursing Service Lead can be contacted at:
Laurel Lodge on Tel: 01895 484870









Cedar Brook Surgery
Uxbridge health Centre
Eastcote Health Centre
Elers Road Clinic
Ickenham Clinic
Minet Clinic
Northwood Health Centre
Oak Farm Clinic
Belmont Medical Centre
Ambulatory Wound Care is provided from
 Northwood Health Centre
 Cedar Brook Clinic
 Oak Farm Clinic
Days/Hours of operation
The service is run between 8am and 12.30am (Twilight service commencing at 4.30pm), 365 days a year.
page 12
HCH SERVICES – ADULT SERVICES
DISTRICT WHEELCHAIR SERVICE
Service Description
This service provides a wheelchair assessment of appropriate equipment for clients with reduced or no
mobility. The service ensures accessibility in the home environment and equipment issued is suitable
wherever possible.
The service reviews people with long term disabilities and replaces equipment due to change in clinical
need or where equipment becomes obsolete or beyond economic repair.
The service is run with a patient centred approach with patient choice and education emphasised through
 Voucher Scheme where patients are able to purchase a wheelchair of their choice using a voucher
allocated by the service
 Hillingdon Wheelchair Users Group which meets monthly
Location(s) of Service Delivery
Hillingdon Independent Living Centre,
Wood End Centre,
Judge Heath Lane,
Hayes,
Middlesex
UB3 2PB
01894 484880
The centre is a purpose built building and includes excellent wheelchair access with parking for disabled
people within close proximity to the entrance. A variety of facilities including disabled toilets and a minicom
with appropriate loop system for people with hearing impairment are also available within the centre.
The service sees patients in a variety of settings including patient‟s homes, schools, day centres, nursing
homes and hospitals.
Days/Hours of operation
The service operates Monday to Friday, from 8.15am to 4.15pm excluding bank holidays.
page 13
HCH SERVICES – ADULT SERVICES
EPIOC (ELECTRICALLY POWERED INDOOR AND OUTDOOR WHEELCHAIRS)
Service Description
Following the initial „paper‟ assessment and prioritisation, the clinical and lifestyle needs of the service user
will be fully assessed. The full assessment must provide compatibility with other transport modes of the
service user, for example their private car or wheelchair accessible vehicle.
The service user and, where appropriate, his or her carers or enablers, will be fully consulted and
meaningfully involved throughout the assessment process. Assessors must arrive at optimum
recommended solutions to needs. Nothing shall compromise or diminish the optimum assessment of what
the clinical and lifestyle needs of the applicant require.
In general it is recommended that the least expensive solution should be prescribed provided that will meet
the service user‟s assessed clinical and lifestyle needs.
Priority will be given in the following order:
1. URGENT – Children and adults at risk:
 Who are in danger of developing or who have pressure sores related to their seated posture.
 With progressive neurological conditions affecting the ability to sit in a normal chair.
 Who have had a recent significant change in their condition due to disease process, or surgery.
2. PRIORITY – Children who are changing due to growth.
3. ROUTINE - Adults with a stable condition.
Emergency requests where there is mechanical failure which cannot be rectified under the maintenance
agreement will be given high priority.
Assessment should be carried out in the most appropriate environment, in order to best assess the clients
needs. This should include the full range of community settings in addition to the wheelchair clinic.
The wheelchair clinic should:
 Comply with the mandatory requirements of the Disability Discrimination Act and Part M of the
Building Regulations.
 Have convenient, designated Disabled Parking close to the clinic, with help and a method of
accessing help, when assistance is required.
 Have sign posting suitable for people with physical and sensory disabilities. A reception/waiting
area clearly identified.
 Access to local transportation systems.
 Have wheelchair accessible W.C. including changing facilities.
 Have access to beverages, a telephone and food for diabetic clients.
 Clearly display information on the service, available to take away in appropriate formats.
 The clinic space should be separate from the waiting area and have:
- a plinth, a hoist and appropriate weighing facilities.
- space to accommodate 6 or 7 people and assessment equipment
- full range of current assessment equipment
- privacy and dedication of space for the duration of the clinic
- access to a range of ground surfaces, ramps, kerbs, floorings.
page 14
Location(s) of Service Delivery
Hillingdon Independent Living Centre,
Wood End Centre,
Judge Heath Lane,
Hayes,
Middlesex
UB3 2PB
01895 484880
The centre is a purpose built building and includes excellent wheelchair access with parking for disabled
people within close proximity to the entrance. A variety of facilities including disabled toilets and a minicom
with appropriate loop system for people with hearing impairment are also available within the centre.
The service sees patients in a variety of settings including patient‟s homes, schools, day centres, nursing
homes and hospitals.
Days/Hours of operation
The service operates Monday to Friday, from 8.15am to 4.15pm excluding bank holidays.
page 15
HCH SERVICES – ADULT SERVICES
HILLINGDON CENTRE FOR INDEPENDENT LIVING CENTRE (HCIL)
Service Description
HILC is run by trained assessors, trusted assessors and volunteers who provide professional advice as
necessary.
The service can offer:






Equipment information and advice
Equipment trial at the centre – information and advice printouts and manufacturers literature given.
Equipment demonstration with therapist and or company representative providing a quotation
Assistance is given with report written and applications for charity funding
Sign posting and referral onto appropriate services i.e. physiotherapy, continence service, social
services, Banstead Mobility, British Gas home assessment service
DASH who provide trusted assessors, volunteers, information on benefits, independent living schemes,
accessible venues, advocacy, disability rights and support services.
Referral onto the following services:








Provider Services staff
Hillingdon Hospital and Mount Vernon
Social Services, Occupational Therapy staff, Case managers, home-care service, Nursing home and
Residential home
Day Centre and housing departments
Hillingdon Wheelchair Service
Falls groups
Expert patient training
Local user groups
Location(s) of Service Delivery
Hillingdon Independent Living Centre
Wood End Centre
Judge Heath Lane
Hayes
Middlesex
UB3 2PB
01895 484880
Days/Hours of operation
The service operates from Monday to Friday, 8.30- 4.15pm excluding bank holidays
page 16
HCH SERVICES – ADULT SERVICES
HEART FAILURE
Service Description
The core services provided by the team include: Initial assessment and medication review;
 Symptom assessment;
 Education of disease, symptoms and treatments;
 Promotion of self management, awareness of returning symptoms;
 Optimisation of research based medicines, including necessary blood tests;
 Palliative care assessment and input;
 Regular review;
 Health promotion, e.g. smoking cessation;
 Ensuring appropriate interventions/treatments offered are appropriate;
 A patient helpline i.e. – patients given Heart Failure nurses mobile number for queries & reporting
returning symptoms;
 Referral to other appropriate services, e.g. physiotherapy, Rapid response, diabetes team, district
nursing;
 Access to equipment via HILC
The service works closely with GPwSI‟s, Primary health care staff (District Nurses & GP), Hillingdon
Hospital Heart Failure Team and cardiology teams.
Location(s) of Service Delivery
Oak Farm Clinic
Long Lane
Hillingdon
UB10 9PB
01895 484810
However patients are seen at HESA Primary Care Centre, Mountwood Surgery, Hillingdon Hospital and in
their own homes.
Days/Hours of operation
The service operates from 9am to 5pm Monday to Friday excluding bank holidays.
page 17
HCH SERVICES – ADULT SERVICES
INFECTION PREVENTION & CONTROL
Service Description
The Service will comprise of an Infection Prevention & Control Team (DIPC, Band 8a and Band7) providing
infection prevention and control support to Hillingdon Community Health and Primary Care services at
Hillingdon PCT. The Team will provide training, development, support, reporting, audit, policy development,
surveillance, evidence collection, inspection, out break advice, liaison with interdependent agencies and
representation for the PCT at local and regional forums.
Location(s) of Service Delivery
The Service is based at Hillingdon Community Health, Kirk House 97 High St, Yiewsley, West Drayton UB7
7HJ. The team will travel across the borough during the course of their work. Contact Tel: 01895 488217
Days/Hours of operation
The Service will operate on a Monday to Friday 9 to 5 basis but will liaise with the Clinical on call and
Director on call to brief and offer advice on infection control, in particular, out breaks as necessary.
page 18
HCH SERVICES – ADULT SERVICES
MSK (MUSCLO-SKELETAL) PHYSIOTHERAPY
Service Description
The service is delivered by qualified physiotherapists who have post graduate experience in
musculoskeletal assessment and management. All physiotherapists practice autonomously, complying with
clinical guidelines and efficacy of practice and professional codes of conduct.
The service includes:
 Clinical assessment based on the principles of musculoskeletal physiotherapy to ascertain the patient‟s
suitability for physiotherapy.
 Selection of appropriate physiotherapy treatment modalities.
 Advice and on-going management programmes to facilitate self-management.
 Recommendations for further management are sent to the referrer on completion of an episode of care
Location(s) of Service Delivery
The Community Musculoskeletal (M/S) Physiotherapy service is located across the Borough at the following
centres:







Eastcote Health Centre, Abbotsbury Gardens, Eastcote, HA5 1TG
West Mead Clinic, Westmead South Ruislip, HA4 0TN
Harefield health Centre, Rickmansworth Road, Harefield, UB9 6JY
Uxbridge Health Centre, George Street, Uxbridge, UB8 1UB
The Warren Health Centre, The Warren, Hayes, UB4 0SF
West Drayton Physio Centre, 145 Station Road, West Drayton, UB7 7ND
Laural Lodge Clinic, Harlington Road, Hillingdon, UB8 3HB
The service lead can contacted at
Laurel Lodge
Harlington Road
Hillingdon
UB8 3HB
01895 484870 or 01895 485015
Days/Hours of operation
The service will operate Monday to Friday, 8:00am to 6.00pm which includes two evening sessions, and
also Saturday (excluding Bank Holidays)
page 19
HCH SERVICES – ADULT SERVICES
NORTHWOOD & PINNER COMMUNITY UNIT
Service Description
The service aims to offer a multidisciplinary approach including a dedicated Ward Pharmacist,
Physiotherapy, Occupational Therapy, Nursing, Activities Coordinator, Tissue viability Link Nurse, regular
support from Specialist Nursing Services including Palliative Care, Tissue Viability, Continence advice,
Social Worker and volunteers.
The Unit usually comprises of the following beds. However it has been agreed with Hillingdon PCT that the
beds can be managed flexibility
 Intermediate Care
 Respite Care
 Step up beds
Intermediate Care patients receive
 Full multidisciplinary rehabilitation programme
 Medical cover is provided by a local GP
Respite Patients receive
 Six weeks flexible respite care is provided per year in agreement with relatives, carers and the unit
 Medical cover is provided by patient‟s own GP
Step-up beds
 Available for patients assessed in the community
 Short term inpatient care
 Prevents hospital admissions
 Medical cover is provided by a local GP
Key Links
In order to provide a seamless service for patients the following key links are maintained.











Acute Trusts
Community Matrons
Rapid Response
District Nursing
Palliative Care Team
Specialist Nursing Teams
Michael Sobell House
Harlington Hospice
Voluntary Services
Social Services
General Practice
Location(s) of Service Delivery
The Unit is housed on the Mount Vernon hospital site within the medical block alongside two inpatient
wards run by Hillingdon Hospital
Northwood and Pinner Community Unit
Medical Block, Mount Vernon Hospital
Rickmansworth Road, Northwood
HA6 2RN - Tel: 01923 844 226
page 20
Days/Hours of operation
The service runs twenty-four hours a day, seven days a week throughout the year.
page 21
HCH SERVICES – ADULT SERVICES
PALLIATIVE CARE
Service Description
Initial assessment is undertaken by a member of the Specialist Palliative Care Team (SPCT) and levels of
intervention are determined according to need:
Level 1 - Advice and information for health professionals from specialist palliative care team (no
direct patient contact)
Level 2 - Single consultation /one off visit
Level 3 - Intervention requiring review on regular basis
Level 4 - Complex palliative care requiring intensive/regular review.
Core services offered are
Direct Clinical Support which includes
 Providing expert nursing advice in managing and care planning for complex symptom control issues
with patients in need of specialist palliative care at all stages of their illness
 Regular review and anticipatory planning with patients, carers and health professionals
 Home support visits
 Community based clinics (Consultant and nurse led)
 Expert symptom control advice to Rapid Response team and Community Matrons
 Telephone advice to both patients and professionals
Indirect Clinical Support. Specialist Advice/Case Review which includes
 Regular case review with P.H.C.T. (Under the guideline of Gold Standard Framework)
 Case analysis with individual teams or practices
 Developing patient pathway guidelines
 Telephone advice – generic
 Liaison/ collaborative work
 Out of hours service for palliative care patients
Indirect clinical support is also offered to
 Primary health care staff (DN & GP), multi-professional health care team
 Other Palliative care centres i.e. Michael Sobell House
 Social services
 Continuing Care Palliative Nursing beds units (Hayes Cottage Nursing Home, Northwood and
Pinner unit)
 Michael Sobell House outreach team
 Voluntary agencies i.e. Harlington Hospice, Marie Curie
Key areas for intervention including
 Advice and support with management of pain and symptom control
 Support for emotional, psychological or spiritual distress related to disease for patients and /or
carers
 Support/ advice for Health Professionals managing complex cases
 Complex care planning around the end of life
 Ethical dilemmas related to palliative care.
 Assistance with care planning, especially in relation to discharging dying patients or those with
complex needs.
 Help managing the interface between acute and palliative care
page 22



Identification of training needs and the delivery of appropriate training packages
throughout Hillingdon form a key function of the team.
Developing local guidelines and policies regarding palliative care issues
Implementing national guidelines (End of Life initiatives: Gold Standard Framework, Liverpool Care
Pathway, Preferred place of care/ Death)
Due to the nature of the patients that the service see, the Palliative Care team ensures they have close
links with a wide variety of other teams, which include the following:




Rapid Response/Twilight Team and Michael Sobell House with whom the Palliative Care team
inform them about and supply management plans for patients who are deemed to be „At Risk‟ on a
weekly basis
The Hillingdon Hospital - Clinical Nurse Specialists and several Consultants providing specialist
medical support, one of whom focuses entirely on the community.
Social Services, voluntary organizations, MacMillan, cancer network, GPs, nursing homes and other
Provider Services teams.
HARMONI GP deputising service ensuring correct out of hours care planning which is key to
maintaining patients care at home by improving the communication handover form. Within this all
patients at level 3 and Level 4 (see levels of intervention) have anticipatory medications in the house
in the event of a rapid deterioration in condition that may result in the patient being unable to tolerate
oral medications. Patients with a Palliative Care HARMONI form can use a bypass number to
access medical advice quickly. The team has designed an information sheet for patients and
carers in order to reduce anxiety around out of hour‟s service provision. Experience has shown that
in times of crisis families tend to call 999. This sheet is to aid communication and ensure the fast
access to informed support.
Location(s) of Service Delivery
The Furze
Hillingdon Hospital
Pield Heath Road
Uxbridge
UB8 3NN
01895 279412
The team provides care in both patients‟ own homes and nursing homes within the Borough of Hillingdon
Days/Hours of operation
The service operates Monday to Friday, 8.30am to 4.30pm excluding bank holidays.
page 23
HCH SERVICES – ADULT SERVICES
PODIATRY
Service Description
The service is offered to anyone who is registered with a Hillingdon GP and eligibility is prioritised to those
with a known Medical and or Podiatric Risk factor, using a Triage model of care (refer to appendix).
The service includes Podiatrists and Podiatry Assistants with expertise in a wide area of podiatric practice,
including for example Nail Surgery, Diabetes, Biomechanics, Vascular Assessment and Wound Care.
Those patients meeting the criteria are seen in a modern treatment room with a powered patient chair and
minor surgery equipment.
The service provides the following core functions to patients:
 Nail surgery
 Diabetes screening
 Foot care assessment
 Patient Education
 Gait analysis for both paediatrics and adults
 Assessments and prescriptions for Orthotics
The Podiatry department can also offer de-bridement of foot ulcers
Location(s) of Service Delivery
Podiatry services are provided at the following centres to ensure accessibility to elderly and disabled
people:










Eastcote Health Centre,
Harefield Health Centre,
Hesa Primary Care Centre,
Ickenham Clinic,
Laurel Lodge Clinic,
Minet Clinic,
Uxbridge Health Centre,
Yiewsley Health Centre,
Westmead Clinic,
Grassy Meadows Day Centre.
Domiciliary visits are provided for patients who are housebound, a limited transport service is provided
for disabled patients unable to travel without assistance to the clinic locations.
There is also a service at, Hillingdon, and Mount Vernon Hospitals for inpatients and consultant
referrals with particular emphasis on diabetes and ulcer management. Additionally, at Hillingdon
Hospital a service is provided for Care of the Elderly and the Elderly Mentally ill units.
Additionally Podiatric Surgery is provided to residents of Hillingdon via an SLA with West Middlesex
page 24
University Hospitals.
Patient Phone Line:
Fax number:
01895 485005 (available 09:30-12:30 & 13:30-15:30)
01895 625268
Days/Hours of operation
The service operates from 8.30am to 5.pm, Monday to Friday, excluding bank holidays
page 25
HCH SERVICES – ADULT SERVICES
RAPID RESPONSE
Service Description
The service is intended to be short term (maximum of ten days) with efforts on the stabilisation and initiation
of appropriate treatments and services to maintain and stabilise the patient before transition to other core
services. It is not an emergency response service; patients experiencing life-threatening symptoms should
still dial 999.
Location(s) of Service Delivery
The service base is Ickenham Clinic, patients are assessed in their own home/residential setting. However
the service does also see patients in A&E, the Observation Ward and within Nursing Homes.
Ickenham Clinic
Community Close
Ickenham
UB10 8RE
Telephone: 01895 488820
Days/Hours of operation
Rapid Response Service operates 09.00 to 00.30, 365 days a year for assessment, 08.00 to 21.00 for
provision of care (assistance with activities of daily living).
The Community Phlebotomy Service will run from Monday to Friday, 9am to 5pm excluding Bank Holidays.
page 26
HCH SERVICES – ADULT SERVICES
SAFEGUARDING ADULTS
Service Description
The following services are provided either individually by the Safeguarding Adults Team:
 All Training for clinical and non clinical staff delivered in line with Hillingdon Multi-agency Safeguarding
Adults policies and procedures. To also offer training to GP‟s, Dentists and Optomotrists, as well as any
other contracted workers for NHS Hillingdon.
 To provide expertise in the field of safeguarding Adults
 Audits (of standards) are conducted to maintain a high quality service
 Attendance at Strategy Meetings and Case Conferences – we attend/enable attendance/contribution of
all relevant health professionals (who know the adults) at all case conferences relating to Hillingdon‟s
Vulnerable Adults.
 To represent NHS Hillingdon at the Local Safeguarding Adults Board and their subsequent sub groups
to contribute to inter agency working.
 Links and advice to Hospital Trusts and independent contractors and other agencies e.g. Social
Services, Education, Police and Voluntary Services
 Joint investigation of cases with Social services team; focusing on health aspects
 Visit GP practices and various HCH services to raise the profile
 To ensure staff are supported where necessary when managing a safeguarding Adults case.
 To ensure that NHS Hillingdon has awareness of national and local guidelines and utilises documents in
development of strategies
 To work closely with all key agencies involved in Safeguarding Adults.
 To raise awareness through outreach, visiting groups, societies and other organisations
 To work as first point of contact for staff with queries regarding Safeguarding Adults issues.
 To be easily contactable and accessible for staff, partners, clients, families and carers.
 To develop and write policies and contribute in the re-writing of London Borough of Hillingdon‟s multi
Agency Policy.
 To identify access to all nursing homes in the borough with Hillingdon‟s Social Care Inspection Team
and advise on health issues including documentation and any other issues that are identified.
 To review any relevant incident reports and investigate, building a picture of recurring problem areas
Safeguarding vulnerable adults, older people and their carers from all forms of abuse and neglect is a
priority in Hillingdon for all partners across the Local Strategic Partnership.
Location(s) of Service Delivery
Kirk House
97-109 High Street
Yiewsley
West Drayton
Middlesex UB7 7HJ -
Tel No: 01895 488241
Out of hours there is a senior manager on call 07958 331 078 and a Director on call 07960 827 840.
Days/Hours of operation
The service operates Monday to Friday between 8am and 4pm (excluding weekends and Bank Holidays)
page 27
HCH SERVICES – ADULT SERVICES
SPECIAL SEATING
Service Description
A range of specialist seating for postural and functional purpose will be provided from the service. The
service will not be providing short-term loans - this will either be covered under other PCT contracts or not
at all.
Patients of all ages requiring this service have severe physical disabilities that prevent them from being
adequately seated in a standard issue wheelchair.
The seating needs of these patients fall into two groups:
1. Accommodative seating - designed to support the patient with fixed postural deformities in order to
provide comfort and maintain existing function.
2. Adaptive seating - facilitates active change in the patients posture to enable the patient to achieve a
more functional position for various activities.
Location(s) of Service Delivery
Hillingdon Independent Living Centre,
Wood End Centre,
Judge Heath Lane,
Hayes,
Middlesex
UB3 2PB - 01895 484880
The centre is a purpose built building and includes excellent wheelchair access with parking for disabled
people within close proximity to the entrance. A variety of facilities including disabled toilets and a minicom
with appropriate loop system for people with hearing impairment are also available within the centre.
The service sees patients in a variety of settings including patient‟s homes, schools, day centres, nursing
homes and hospitals.
Days/Hours of operation
The service operates Monday to Friday, from 8.15am to 4.15pm excluding bank holidays.
page 28
HCH SERVICES – ADULT SERVICES
TISSUE VIABILITY
Service Description
The Tissue Viability (TV) Service provides a specialist complex wound service for patients registered with a
Hillingdon GP who have a complex tissue viability problem or a non healing deteriorating wound. The
service is provided in a clinic setting for patients that are able to attend or in a domiciliary setting for
housebound patients. The TV service aim is to prevent inappropriate admissions to hospital by facilitating
and providing specialist wound management within the Community and if appropriate to facilitate discharge
from hospital. An attending Vacular Consultant attends the Complex Wound Clinics
In 2006 the team received a national award for “Innovations in Primary Care for the model of the complex
wound clinic (Wounds UK 2006 Awards 2006 2 (3) 85-8, Primary Matters, September 2006).
Clinical Care

The tissue viability nursing service provides specialist input, undertaking full assessment of patients
and then outlining a programme of care and treatment pathway together with the patient, Health
Care Professional (HCP) and General Practitioner (GP). The patient will be given a follow-up
visit/appointment to assess progress if clinically necessary. Total management of the patients care
is not provided. (See management pathway).
Training, Guideline/Policy Development and Audit
 Providing education, facilitation and support to HCP‟s, implementing national and local guidelines,
policy development and audit of practice. The service organizes several annual training events and
also provides rolling training programmes for Leg Ulcer Management, Prevention and Management
of Pressure Ulcers and Wound Assessment and Management for all levels of clinical staff. The
Complex Wound Clinics allows HCP‟s to attend for hands on clinical practice experience in Leg
Ulcer and Wound Management which has been shown to be one of the most effective learning
methods.
Location(s) of Service Delivery


Community including patients‟ homes, and Northwood & Pinner Community Unit.
Complex Wound Clinic (CWC) Hesa Primary Care Centre, 52, Station Road Hayes Middlesex. The
clinic has the use of four clinical rooms on the ground floor which has disabled access.
 Nursing Homes
Tel contact No: 01895 485002 (Mobile: 07903740290)
Days/Hours of operation
Monday - Friday 8.30am -5pm excluding bank holidays.
page 29
page 30