Adult Services

Community Care

Adult patients who live in the London borough of Brent and Harrow and those who attend Central Middlesex or Northwick Park Hospital are provided with on going life-long specialist community care by the specialist team who are based at Brent Sickle Cell & Thalassaemia Centre.

The Centre is a walk-in centre and patients are seen for genetic and health counselling, information and advise on health and social issues. Where necessary the patient will be visited at their home in order to conduct an environmental home assessment and give guidance on care and prevention of illness. In an attempt to provide comprehensive care there is liaison with other members of the community care team such as the GP, hospital care providers, community nurse, practice nurse, social worker, pharmacist, voluntary sector support workers and other agencies.

The aim is to support and enable the individual to live resourcefully within the community, develop self-management skills, manage their illness effectively, prevent ill health and as much as possible avoid hospitalisation.

Specialist Sickle Cell & Thalassaemia Adult Clinic

A specialist sickle cell and thalassaemia clinic is provided in the Haematology Outpatient Centre, based on the 2nd floor of Central Middlesex Hospital:

Clinic Days Clinic Time
Tuesday 9am – 1pm

To book or cancel a clinic appointment contact, the clinic clerk based in the Haematology Department, Tel: 020 8453 2292

Patients with sickle cell disease, thalassaemia and related conditions are registered with the adult clinic from the age of sixteen years approximately. Those who are already known to the service through the children’s clinic are supported in making the transition from children to adult services. Others are new referrals from their GP or another hospital. The clinic is run by a multidisciplinary team of specialists which include a hospital based specialist nurse, specialist blood doctor (haematologist), community specialist nurses, a clinical psychologist, social worker, healthcare assistant, clinic clerks, and the person taking blood (phlebotomist). All these work together to provide an effective individually tailored care for patients and their families.

On average adult patients attend clinic twice a year provided they are well and there is no specific reason for them to attend more frequently. On one of these routine visits they will have an ‘annual overall’ check up during, which they will have their blood pressure, temperature, oxygen carrying capacity and weight checked. A sample of urine will be tested to check that their kidney is working properly and any deviation from the normal identified and where necessary action taken to correct any problems. The patient will have bloods taken to check for level of anaemia and how well all body systems, like the kidney, heart and the liver are working.

During this annual check up clinic visit the patient will be seen by all members of the specialist team for an assessment and they are given the opportunity to discuss any issues which may be of concern to them. The specialist nurse will use this time to check the patients understanding of their condition, talk to them about how to look after themselves and avoid illness, check that they are taking their medications and their immunisations are up to date, discuss any health and social issues that may be aggravating their illness, for example, unemployment, problems at work, housing, financial difficulties and personal relationships.

During the same clinic as part of regular routine investigations and to identify early signs of problems the patient may also be seen by other specialists such as the heart specialist, the lung specialist and the eye specialist. If problems are identified the patient will be treated or referred for further tests or care.

Any problems identified during these sessions may require that the patient be referred to another more appropriate doctor, for example, a doctor who specialises in dealing with liver problems; they may also be referred to other agencies such as social services and a voluntary organisation support officer.

During the clinic session patients often meet other patients, forge friendships and are able to offer support to each other.

The frequency of hospital clinic appointments will depend on how the illness is affecting the individual.

Emergency Services

The majority of patients manage their illness very well at home. If their condition does not appear to be responding well to the remedies they have taken and their condition is not critical they are advised to visit their GP at the surgery if they are able to do so or call their GP for a home visit if necessary.

There are situations where it is necessary to call for urgent medical attention, for example, if the painful sickle cell crisis is moderate to severe and the individual is not able to travel by car and or if their condition is critical such as if the individual is not responding to stimulation, in this instance an ambulance must be called immediately by dialling 999 and asking for an ‘ambulance’.

In-Patient Hospital Management

Because of the high risk of getting infection patients with sickle cell and thalassaemia try to manage their illness at home as much as possible and only come into hospital when they are very ill or they can no longer manage at home, for example, if they need stronger pain medications or investigation of the cause of their acute illness.

All adult patients with sickle cell disease, Thalassaemia or related conditions who are registered with the NW London Hospitals NHS Trust attend Central Middlesex Hospital, few attend Northwick Park Hospital.

During an acute illness the majority of patients are admitted to Central Middlesex hospital via either Accident & Emergency department or with prior agreement some patients with uncomplicated sickle cell disease can self refer to the sickle cell day care unit during the day.

Day Care Unit 020 8453 2562 9am - 4pm

On the day care unit the patient will be assessed and where appropriate given nursing and medical care. If their condition improves and they become well enough by 4pm they are discharged home if not they are admitted to the main hospital ward as an in-patient where they will continue to receive on-going nursing and medical care.

In-patients are managed on a dedicated medical ward, Roundwood 1, or on one of the other medical wards as follows:

Name of Ward Telephone No. Visiting Times
Roundwood 2 020 8453 2002 2pm - 4pm and 6pm - 8pm
Roundwood 3 020 8453 2505 2pm - 4pm and 6.30pm - 8pm
Roundwood 4 020 8453 2034 2pm – 4pm and 6.30pm – 8pm
Roundwood 1 020 8453 2044/2023 2pm - 4pm and 6pm - 8pm

Sickle Cell and Thalassaemia Specialist Team:

In-patients are managed on a dedicated medical ward and continue to be cared for by the specialist Sickle Cell & Thalassaemia team, see the Specialist Team.

If health advice is required out of office hours patients should contact NHS Direct on Tel: 0845 4647 or visit their website www.nhsdirect.nhs.uk