Haematology Cancer services

Please make your referral using the Pan-London Urgent Suspected Cancer form in full, using the current version. Current versions are found here: NHS England — London » Urgent Cancer Referrals.  
GPs should upload the referral via eRS.nhs.uk.

Please ensure the referral includes full blood count test, including: blood film, urea & electrolytes (U+E), lactate dehydrogenase (LDH), liver function test (LFT), serum calcium, immunoglobulins, serum protein electrophoresis, if appropriate, and serum free light chains. 

If there is a lump of concern, it would be helpful to book an ultrasound test before the first appointment, but this should not delay the appointment, and we do not require results before you make the referral. 
Please book an appointment with your patient before they leave your surgery. 

The Homerton Cancer Referral Toolkit 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. 

We will send a text message inviting you to come to clinic. This can happen quite soon after your GP refers you to us. Please try to be available.  
Please arrive 15 mins before your appointment time, as you may need to have some tests before seeing the consultant. If we sent you an appointment letter, please bring this, and any medication you are taking.  
We try hard to minimise delays in clinic, but you should allow up to 2 hours for your appointment. If your GP has asked for you to have some blood tests, please make sure these are done before your appointment.

In the clinic, we will carry out some tests. You may have one or more of the following tests:

• blood tests
• bone marrow biopsy - we take a small sample of bone marrow using a thin needle. We then send this to the lab for a specialist to look at. It may feel a little uncomfortable but is quite quick. You should feel fine after 
  lymph node biopsy - this is when we take a sample from a lymph node - this is a small oval shaped organ that is part of the lymphatic system. It is important for taking away harmful stuff from the body. It also produces white blood cells
• radiology scans, such as:
  • ultrasound - uses sound waves to build up a picture of inside the body. We often use this to check neck lumps.
  • X-ray - helps us take pictures of the inside of the body
  • CT scan - uses x-rays to take images at different angles inside the body. This is more detailed than a normal x-ray
  • MRI (Magnetic resonance imaging) - a scan that uses 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.  

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

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, we will arrange for you to be treated at one of our partner hospitals. This is normally St Bartholemew’s Hospital in the City of London, or the Royal London Hospital in Whitechapel. 

Common types of treatment for blood cancers include:

• Chemotherapy - strong chemicals a used to kill the cancer cells. This is given either by an injection or is taken orally (through the mouth), as a tablet, capsule or liquid
• Radiation therapy (also known as radiotherapy) - rays (such as x-rays) are used to kill the cancer cells or shrink tumours
• Immunotherapy - this is often used for leukaemia. It uses the body’s immune system to attack the cancer cells
• Targeted therapy - tries not to damage healthy cells while treating cancer cells
• Stem cell transplant (also known as bone marrow transplant) - replaces unhealthy cells with healthy cells.

Which treatment you can have will depend on the type of blood cancer, your age and overall health.  
A clinician from one of our partner hospitals will discuss the best options for you. Together you will agree a treatment plan. We must arrange for your first treatment within 62 days from the day your GP referred you. 

Clinical Nurse Specialist (‘key worker’) 
The Haematology Service is run by an Advanced Nurse Practitioner and supported by a Macmillan Cancer Pathway Navigator. They are your main point of contact and support while you are under the care of the Haematology team, at Homerton. If you are referred to a different hospital for your care, a Clinical Nurse Specialist at that hospital will continue to care for you.
 
Clinical Nurse Specialists/ Advanced Nurse Practitioners run different clinics throughout the week. They offer:

• advice, information and support to patients diagnosed with blood 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 .

The Haematology Advanced Nurse Practitioner is Katherine Beverley 
Telephone: 0208 510 7309 
E-mail: Katherine.beverley@nhs.net/ or huh-tr.haematologyadmin@nhs.net 
Mondays - Fridays, 9am-5pm 
If you unable to contact the Advanced Nurse Practitioner, 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  

Our Macmillan Cancer Information and Support service is available between 8am to 4pm, Monday, Tuesday, Thursday and Friday. You will find our Information and Support Manager by the main entrance of the hospital, next to our Patient Advisory and Liaison Service (PALS).
 
Patients, their relatives and carers can also call us on 020 8510 5191. We can answer questions or direct your call to the right person.  
For more details and contact information, please visit the Macmillan Cancer Information and Support Service webpage

Cancer affects the whole person, not just the body. We have Cancer Psychologists available to talk to patients and family members about the emotional effects of cancer. 
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: Cancer Psychology service [pdf]