Colorectal services

GPs should complete the Pan-London Urgent Suspected Cancer form in full, using the current version found here: NHS England - London » Urgent Cancer Referrals.

Please upload the referral via eRS.nhs.uk/.

The colorectal team deliver a Referral Assessment Service. This means that we will triage referrals and book the appointment directly with the patient. Their first appointment is usually by phone.

Please ensure that your patient has completed a blood test within 6 months and that the results are available in time for their first appointment.

Please also see the Homerton Cancer Referral Toolkit. This is for clinicians working in the NHS. It can be accessed by people with an NHS.net email address. This gives more detailed information for referrers to support your conversations with patients about what to expect at their appointments.

For most patients referred to our colorectal service, we phone them first to ask a few questions. This may be with a doctor or a nurse. This will help us plan any tests you may need before your appointment with the consultant at the hospital.

This phone call may happen very soon after your GP refers you to the service. We usually send a text message before with the date and time of the phone call. We will try our best to call you on time. It will be from a private or withheld number. Please allow one hour for this call and try to stay in a quiet place.

You may need some tests before meeting with the consultant. If so, someone will be in touch about this. Please ensure you attend these tests before your appointment.

We may ask you to come to hospital for one or more test, such as:

• MRI  (Magnetic resonance imaging) - a scan that produces images of the body, using a large magnet and radio waves. This gives detailed images of almost every internal structure in the human body, including the organs, bones, muscles and blood vessels
• Colonoscopy - uses a thin, flexible telescope to check the large intestine
• Endoscopy - a long, flexible tube with a light attached to it looks inside the body
• CT scan - uses x-rays to takes images at different angles. This is more detailed than a normal x-ray
• Sigmoidoscopy (rigid or flexible) - uses a small tube with a light at the end to check the rectum and sigmoid colon (lower part of the large bowel). Air is introduced into the intestine through the sigmoidoscope to inflate it for better viewing. If necessary, the doctor will take a biopsy (small tissue sample). This will be looked at under a microscope by a specialist to see if it contains any cancer cells. 

  We aim to carry out all tests and give you the results within 28-days. These types of appointments are part of the NHS Urgent Suspected Cancer Pathway. We are monitored by the Department of Health on this. You can read more about this here: Urgent Suspected Cancer Pathway | Homerton Healthcare NHS Foundation Trust

Remember - most patients referred this way do NOT have cancer. But it is important that we check you quickly so you can get the best care, if needed. Please try and attend all your appointments. If you can’t attend, let us know as soon as possible on 020 8510 5099.  

If you are diagnosed with cancer, your clinician will discuss the best options for you. Together, we will agree a treatment plan. We must arrange for your first treatment within 62 days from the day your GP referred you.

Patients who require surgery for colorectal cancer will be operated on at Homerton. Chemotherapy and radiotherapy treatment will take place at St Bartholomew’s Hospital.

After surgery, we will arrange for a follow-up appointment in the outpatients’ department with a surgeon or the Nurse Consultant. They will inform you of your pathology/histology results. This is taken from a sample of cells after your surgery. The pathology/histology results show if the area is completely clear of cancer or if you need more treatment. If you do need more treatment, we will refer you to an oncologist to discuss your options.

Clinical Nurse Specialist (‘key worker’)
We have a Colorectal Clinical Nurse Specialist who sees all patients diagnosed with colorectal cancer. If you do not need further treatment after your surgery, your Colorectal Clinical Nurse Specialist will give you follow-up support, either in a face-to-face clinic or over the telephone. 

Colorectal, stoma and palliative care clinical nurse specialist teams provide ongoing practical and emotional support and can refer to other health care professionals, if appropriate. We provide a telephone support service as well as a colorectal stoma support group, helping patients cope with their physical and emotional issues.

The Colorectal Clinical Nurse Specialist runs different clinics throughout the week. They act as your key worker. This means they are your point of contact and support while you are under the care of the team.

The Colorectal Clinical Nurse Specialist Team can offer:

• advice, information and support to patients diagnosed with colorectal cancer
• advice on treatment options
• information on any investigations
• referral to another team member
• information on local support groups information on relevant websites and charities

Telephone: 020 8510 7599/ 07785 577 558
Available: Mondays - Fridays, 9am-5pm

If you unable to contact the Clinical Nurse Specialist, you can also contact the Macmillan Cancer Pathway Navigator. The Navigator supports the nurses in their day-to-day activities. As they are not medically qualified, they are unable to give medical advice.
Telephone: 020 8510 8969

Macmillan Centre
Our Macmillan Cancer Information and Support centre is open between 8am to 4pm, Monday, Tuesday, Thursday and Friday. You will find it by the main entrance of the hospital by our Patient Advisory and Liaison Service (PALS).

We are also at the end of the phone for cancer patients, their relatives and carers to answer questions or to direct your call to the appropriate person. 

For more details and contact information, please visit our webpage - Homerton Macmillan Cancer Information and Support Service

Psychological support
Cancer affects the whole person, not just the body. If you or your family would like to talk about the emotional side effects of cancer, we have Cancer Psychologists available. You will need to be referred by a doctor or a nurse involved in your care, or your GP. Sometimes we have a waiting list, but we will let you know if this is the case.

You can read more about this service here: Psychological support for cancer | Homerton Healthcare NHS Foundation Trust

Prehabilitation and Rehabilitation
Prehabilitation is an element of rehabilitation where your journey to recovery starts before your surgery or treatment has even begun. It helps you prepare for your upcoming treatment and improve your health and fitness. You can read more about our prehabilitation service here: Homerton Cancer Prehabilitation

Rehabilitation is similar but occurs after the surgery or treatment. Our prehab/rehab team consists of a physiotherapist, dietician and a Prehabilitation Technician.

Financial Support at Homerton
Financial advice is available from Macmillan Toynbee Hall Welfare Rights Service. For telephone advice or to book a face-to-face appointment please call the helpline on 020 7392 2958 or email macmillan.advice@toynbeehall.org.uk
Find further information here: Macmillan Welfare Rights Service - Toynbee Hall | Macmillan Cancer Support

Your care will be provided by a group of experts called a multidisciplinary team (MDT). This is a team of doctors, nurses and other health professionals specialising in treating your type of cancer. You can discuss your care with them and ask them any questions you have about your treatment. Our team includes:

Consultants

• Mr. Adnan Alam, MS FRCS
  Consultant Colorectal (General Surgeon), Lead Clinician for the Colorectal Cancer MDT
• Mr Amir Ghanbari, FRCS
  Consultant Colorectal & General Surgeon, Clinical Lead in Inflammatory Bowel Disease & Lead for General Surgery
• Filipe Carvalho
  Nurse Consultant in Colorectal Disease
• Dr Laura Marelli
  Consultant Gastroenterologist, Clinical Lead for Endoscopy, Director for the NEL BCS Centre
• Dr Nora Thoua
  Consultant Gastroenterologist
• Dr Kowa Jie-Ying
  Consultant Radiologist
• Dr Peter Boavida
  Consultant Radiologist
  
• Dr Sarah Slater
  Consultant Medical Oncologist
• Pablo Nenclares
  Consultant Clinical Oncologist
• Jessica Hopewell/Sadiah Aziz
  Colorectal Clinical Nurse Specialist / Keyworker
  Phone: 020 8510 7599
  Mobile: 07785 577 558
• Irene Fernandes
  Stoma Care Clinical Nurse Specialist
  Phone: 020 8510 5318
  Mobile: 07785 971 120

Extended Colorectal team members 

• Muhammad Numan
  MDT coordinator
  The MDT Coordinator is responsible for tracking the patient along their care pathway with the team and identifying potential breaches of cancer waiting times and targets. Their role ensures that all relevant patients are discussed at MDT meetings with supporting clinical information.

In 2024 we surveyed patients about their experience with the Colorectal Cancer Nursing Team led by Vicenta Lazarescu, Colorectal CNS.

We wanted to identify areas for local improvement and to inform the work of the Colorectal Nursing team.

Our confidential paper survey asked patients to answer 10 questions following their appointment in the Nurse-Led Cancer Surveillance Clinic. Once completed, patients popped their survey in a box located in the outpatients’ area.

44 surveys were returned and were included in the overall data. Of those patients who responded, 66% were aged 61 years or more, 25% were aged 46-60 years, and 9% of patients were aged 31 to 45 years.

No patient identifiable data was collected.

You can see the summary of results below.

• 93% of patients had a specialist nurse present when they were told about their diagnosis, 5% could not remember, and 2% responded that no CNS was present at the time of their diagnosis.
• 100% of patients were assigned a Key Worker/Specialist Nurse as their main point of contact.
• 100% of patients responded that it was easy for them to get in contact with their Key Worker/Specialist Nurse.
• 100% of patients responded that they were supported by the colorectal nursing team throughout their treatment.
• 100% of patients feel satisfied with their surveillance follow-up (options were satisfied or not satisfied).
• 100% of patients feel they were given adequate information regarding their surveillance follow-up and what it involves.
• 100% of patients feel confident in discussing their concerns with their Key Worker/Specialist Nurse.
• 100% of patients are satisfied with the colorectal nursing service (options were satisfied or not satisfied).