Haematology
For curriculum content http://www.jrcptb.org.uk/specialties/haematology
The haematology team at ESH is an expanding team running a busy level 2B service. This means that we look after pretty much all types of inpatient chemotherapy, with the exception of bone marrow transplants and Acute lymphoblastic leukaemia.
The team comprises of four consultants and an associate specialist, with aspirations to have an SpR in the team within the next few years.
- Dr Pawel Kaczmarek, Dr Gleb Ivanov, Dr Barry Jackson, Dr Emma O’Donovan, Dr Mike Gwynne
We have two specialist nurses, and hope to recruit a third specialist nurse soon. We also have a specialist nurse in transfusion, and are currently recruiting anticoagulant nurses.
- Alison Costain, Ian Corro, Simon Goodwin
Inpatients
We have five dedicated side rooms on Godstone Ward, and average 8-15 in patients. We have a dedicated SHO on the ward, and the feedback is that, although a busy job, it is a fantastic learning experience.
Inpatient work is mainly high dose chemotherapy regimens – ESHAP, AML induction, IDA-RAM, High dose Methotrexate, to name but a few. We also see neutropenic sepsis, other complications of chemotherapy and acute presentations of malignancy. The SHO also sees patients on the Chemotherapy Day Unit, and is encouraged to come to clinic on a weekly basis. There are two consultant-led ward rounds per week, and the consultants appreciate that this is a highly specialist group of diagnoses and are happy to come to the ward at any point outside of official ward round slots.
Outpatients
We have clinics on two sites, East Surrey Hospital (three clinics with seven consultant slots) and Comet Ward in Crawley Hospital (four clinics with eight consultant/associate specialist slots). We aspire to have CNS led clinics. Outpatient work is 75% haemato-oncology and 25% non-malignant.
We see a wide range of malignancies, ranging from Chronic lymphocytic leukaemia, B and T cell Non Hodgkins lymphomas, Hodgkin disease, Myeloma, Hairy cell leukaemia, Chronic Myeloid leukaemia, Chronic Myelomonocytic leukaemia, Myeloproliferative disorders, Aplastic anaemia and paroxysmal nocturnal haematuria, Myelodysplastic syndrome and acute myeloid leukaemia. These are mainly managed with out-patient chemotherapy which is administered at Godstone chemotherapy day unit, Comet day unit at Crawley Hospital, and, rarely at home.
Non malignant work includes a large anticoagulant service with 1500 patients on warfarin, and a high throughput of complex thrombotic issues that we see in clinic. We also see conditions including neutropenia, Monoclonal gammopathy of uncertain significance, Immune Thrombocytopenic Purpura, Thrombotic Thrombocytopenic Purpura, Haemolytic Uraemic Syndrome, Hereditary red cell disorders, and a vast range of Bleeding disorders.
We also run a one stop shop for IV iron in iron deficiency at Comet Ward in Crawley.
Laboratory
As haematologists we also have responsibility for the haematology and transfusion laboratories. We report blood films and bone marrows and oversee the more complex test ordering. We authorise blood product release and work hand in hand with the laboratory staff to provide an interface between lab and clinicians.
Liaison Haematology
We run a 24-7 consultant led service on call. We are happy to answer telephone queries, and review patients on the ward or in clinic and review their blood results and blood films as clinically appropriate.