Our clinical notices for GPs and health partners

This page will have information and updates for our GPs and health partners. 

North Mid update for GPs - November 2021

At a recent Clinical Interface meeting our Primary Care colleagues said that it would be helpful to understand our current waiting times for diagnostic tests. Please see below information about this.

Diagnostic waiting times

Diagnostic

Waiting time

Opening times

Routine MRI

2 to 3 weeks

8am – 7.30pm

Routine CT

2 to 3 weeks

8am – 4.30pm

X-ray

Walk in service

9am – 4.30pm

GP non-obstetric ultrasounds

4-5 weeks

9am – 5pm

Please see out new radiographic request form.

Change to ECG bookings

Due to ongoing Covid-19 infection control restrictions we are still unable to provide a walk in ECG service. To book an appointment please send a referral form to northmid.cardiologyinvestigations@nhs.net. Patients will be booked in by the Cardiology admin team and sent a letter with their appointment date and time. No walk-ins will be accepted due to IPC protocols and safety measures deployed during and post covid.

We will continue to review capacity and safety measures currently in place and increase it accordingly.   Any further changes will be communicated to the GPs accordingly.

If you need to speak to the service regarding an ECG please use the following contact number - 020 8887 3612

Contact details for children’s blood testing service

Our paediatric day assessment unit is receiving numerous calls from parents or carers with children over two years old to arrange blood tests.

Blood tests for children between two and 16 take place in our children’s outpatient department and parents need to book appointment online via our website. This page also contains the correct contact details for our children’s outpatient department if parents have any issues with booking a blood test online.

Find out about blood tests at North Mid | North Middlesex University Hospital

 

 

Advice from the Joint Committee on Vaccination and Immunisation (JCVI) - October 2021

We are writing to let you know that, as per the latest advice from the Joint Committee on Vaccination and Immunisation (JCVI), certain categories of patients who are at risk of immunosuppression are eligible for the extra dose (third dose) of Covid-19 vaccine.

These include patients who are currently on active chemotherapy and/or immunotherapy for cancer and those who had this treatment in the last 6 months. This is being advised as a precautionary measure to increase the immunity level and provide a better vaccine response, based on studies and experience with other vaccines. It is part of the primary course of vaccination and is separate to a booster vaccination, which they will likely become eligible for later, pending further advice.

We have been contacting patients in clinics advising them of their eligibility for the third dose and have asked them to contact their respective GPs regarding this.  We would be extremely grateful if you could kindly support this by providing vaccine appointments for the third dose. The optimal timing of the third dose vaccine is generally just prior to the next cycle of chemotherapy and this information can be provided by the patients. The third dose must be at least 8 weeks after their second dose of Covid-19 vaccine.  The recommendation is to avoid vaccination on the day of the chemotherapy.

Any queries with regards to the vaccine should refer to the ‘Green book’ as with all other vaccination queries. Please also find attached recommendation from UK chemotherapy board for reference.

 

Yours faithfully,

Dr Venkatesh Gajapathy

Clinical Director

Oncology and Palliative Care

North Middlesex University Hospital Trust

Change to ECG bookings - October 2021

Due to ongoing Covid-19 infection control restrictions we are still unable to provide a walk in ECG service. To book an appointment please send a referral form to northmid.cardiologyinvestigations@nhs.net.

Download the form: GP ECG request form.docx [docx] 156KB

Patients will be booked in by the Cardiology admin team and sent a letter with their appointment date and time. No walk-ins will be accepted due to IPC protocols and safety measures deployed during and post covid.

We will continue to review capacity and safety measures currently in place and increase it accordingly.   Any further changes will be communicated to the GPs accordingly.

If you need to speak to the service regarding an ECG please use the following contact number - 020 8887 3612.

North Mid update for GPs – July 2021

Covid-19 updates and service recovery

There has been a national focus on recovering elective activity in 2021/22. We are on track to meet these requirements and have had a continued focus on clinical review and prioritisation of patients who have waited longer on the elective pathways. We are working hard to reduce the number of patients waiting over 52 weeks but recognise that some patients may be anxious or their condition may have changed.
 
If you are concerned that a patient has experienced delays to a follow up appointment and require urgent review, please contact the relevant service the patient is being seen under. 
 
Contact details for our services can be found on our website.

Urgent and emergency care

We have been seeing a substantial increase in attendances at the emergency department (ED) for Type 3 (minors) attendances over the past few weeks, and June 2021 has been the busiest month we have ever had at our ED. There has been a particular rise in the number of children and patients attending who do not require admission. On top of this, 111 activity is also very high.

In order to cope with this exceptional demand particularly during the evenings, we have been booking additional medical and nursing staff particularly for our urgent care centre (UCC).
 
Ways in which you can help: 

  • If any local GP would like to work shifts here please contact Salmaan Khan, our GP lead, on salmaankhan@nhs.net.
  • Maximising referrals to the medicine or care of the elderly hot phones to help bypass the emergency department:
    • Acute medicine hot phone number: 07436 036 515
    • Care of the elderly frailty hot phone number: 07890 039 025
  • Supporting us with work on high intensity users and development of Coordinate My Care (CMC) plans. We will be approaching practices where individuals are registered over the next couple of months to work with you on how we better support these people.

Any support to encourage patients to access care in primary or community care settings would really help us to provide good care for those patients who need urgent and emergency care.

Canterbury ward opening

A 22 bedded unit opened on Canterbury Ward at Chase Farm Hospital on Thursday 20 May as a facility for North Middlesex Hospital to step down medically optimised patients to support patient flow on the acute site.
 
Medically optimised patients that are experiencing discharge delays will be transferred from North Middlesex Hospital to Canterbury ward. This unit will provide a calmer, more suitable environment, with nursing, AHP and GP care provided until they are ready to be moved to their ongoing discharge destination. 
 
North Middlesex Hospital GPs will be providing cover on the unit and may be in contact with patients’ GPs to support their discharge and ongoing provision of care at home or in the community.
 
The GP can contact the ward manager or the matron on the unit on the number below:
 
Ward contact number: 0207 794 0500 Ext. 30103 - 30104
Mobile: 07890 039 026

Book ECGs for patients through ERS

The ECG service is now only available via pre-booking through eRS. No walk-in will be accepted due to infection control protocols and safety measures deployed during and post covid.

If there are no appointments available please add the patient to the Appointment Slot Issues (ASI) list. The service will ensure that the ASI list is monitored regularly and book patients as soon as possible.

We will continue to review capacity and safety measures currently in place and increase it accordingly.  Any further changes will be communicated to the GPs accordingly.

Please note, currently there is no telephone service to book patients, thus patients should not contact the service directly about the ECG appointment. 

If you need to speak to the service regarding an ECG please use the following contact number - 020 8887 2664.

Updates for GPs - June 2021

Covid-19 updates and service recovery

The National Operating Plan published last month states that Trusts must achieve 70% of 2019/20 elective activity, increasing to 85% by July. The Trust is on track to meet these requirements. In May the Trust reached 113% activity for inpatients, 84% for day cases and 92% for outpatients.

North Central London has received additional funding to accelerate recovery and this is being used at North Mid to support extra operating lists and through increased weekend and evening working.

To ensure patients whose elective procedures have been delayed do not come to harm, there has been continued focus on clinical review and prioritisation of long waiters on the elective pathways. We are working hard to reduce the number of patients waiting over 52 weeks. As at 13 May 2021 the number of patients waiting 52+ weeks from referral to first definitive treatment is 88; a reduction compared to April, during which 149 patients were waiting 52+ weeks.

Cancer recovery

Once a patient has been diagnosed, the Trust has continued to provide the same number of treatments as pre pandemic, with surgery happening at independent sector sites.

Radiotherapy has continued to operate throughout the pandemic in line with the new infection control guidelines and have extended the working day to ensure that patients can be treated in a timely manner.   

Chemotherapy during the first wave was delivered in two mobile chemotherapy units and continued to deliver treatments throughout this period. 

Following an extensive refurbishment of the original Chemotherapy Day Unit treatment has returned to the main hospital.  The 31-day decision to treat to treatment standard has consistently been in the 90% and in December 96.55% of patients were treated within 31 days.

Urgent and emergency care

We have been seeing a substantial increase in attendances at the Emergency Department (ED) for Type 3 (minors) attendances over the past few weeks. Any support to encourage patients to access care in primary or community care settings would really help us to provide good care for those patients who need urgent and emergency care.

Canterbury ward opening

A 22 bedded unit opened on Canterbury Ward at Chase Farm Hospital on Thursday 20 May as a facility for North Middlesex Hospital to step down medically optimised patients to support patient flow on the acute site.

Medically optimised patients that are experiencing discharge delays will be transferred from North Middlesex Hospital to Canterbury ward. This unit will provide a calmer, more suitable environment, with nursing, AHP and GP care provided until they are ready to be moved to their ongoing discharge destination. 

North Middlesex Hospital GPs will be providing cover on the unit and may be in contact with patients’ GPs to support their discharge and ongoing provision of care at home or in the community.

The GP can contact the ward manager or the matron on the unit on the number below:

Ward contact number: 0207 794 0500 Ext. 30103 - 30104

Mobile: 07890 039 026

Update to care of the elderly hotphone number

The hotphone provides a service for GPs and other providers calling about patients over 65 with geriatric medicine needs regarding care, advice and treatment plans.

The hotphone can also be used to refer to our Hot Clinics – Care of the Elderly hot clinics provide rapid access from GP referrals to a comprehensive geriatric assessment (CGA), MDT, and diagnostics for patients with frailty, with a focus on admission avoidance.

The Care of the Elderly hot-phone, held by a Consultant Geriatrician 9am-5pm Monday to Friday, and 8am - 4pm weekends and Bank Holidays.

The new care of the Elderly hotphone number is as follows:

Previous number: 07436 561 077

New number: 07890 039 025

Vaccine hub in Northumberland Park

North Mid has brought Covid-19 vaccinations closer to the people of Tottenham this week thanks to the opening of a pop-up vaccination clinic at the Eric Allin Community Centre in Northumberland Park. 

Working in partnership with Haringey Council, the clinic has been open to people over 40 years old wanting to have their first Covid-19 vaccination. There is no need for an appointment; people will be able to walk-in.

The vaccination clinic, run by our community services team at North Mid, is open for Haringey residents who have been unable to book an appointment or are not able to attend appointments during normal working hours. Opening days and hours are available on the Haringey Council website.

The North Mid in the Community team also run a mass vaccination centre at the Dugdale Centre in Enfield Town.

Same Day Emergency Care (SDEC) unit

The new Same Day Emergency Care (SDEC) Unit opened its doors to patients in April 2021 as part of our Hot Floor reconfiguration estates programme. The newly refurbished area, previously known as Ambulatory Emergency Care (AEC) has increased capacity with seven recliner chairs, four consultation rooms and patient waiting space. It provides consultant-led same day medical input for acute patients that can be rapidly assessed, diagnosed and treated in a day case setting.

Patient treatment pathways for SDEC include deep vein thrombosis (DVT), pyelonephritis, lower limb cellulitis, pulmonary embolus (PE), community acquired pneumonia (CAP), atrial fibrillation (AF), acute kidney injury (AKI), headache and hransfusion.

The SDEC vision is to provide outstanding same day care to our patients by:

  • Rapidly diagnosing and treating patients who would otherwise beadmitted to hospital
  • Enabling direct access via GP referral to reduce attendances to A&E
  • Enabling early discharge with rapid follow-up that cannot bemanaged by GP
  • Streamlining patient care with agreed pathways

For SDEC referrals or for acute medical advice, please ring the Acute Medicine hot phone: 07436 036 515

Faster access to patient records thanks to Health Information Exchange (HIE) 

We are delighted to announce that North Mid data is now available in the Health Information Exchange (HIE).

You will be able to view certain information in real time for patients being treated in north central London referred to North Mid, including:

  1. Appointments (future)
  2. Encounters (past visits)
  3. Lab Results (including blood sciences, microbiology, virology and histopathology)
  4. Radiology Reports

Data available on HIE is in line with your local information governance policies. 

If you have any concerns regarding technical issues with the data display, please contact your internal IT department in the first instance or the NCL support desk via email at nclccg.digitalhelpdesk@nhs.net for second line support.

This is the first phase of data sharing with North Mid and we will be working with them to include additional data sets in the future, such as clinical correspondence, vital signs and visit diagnoses.

Phlebotomy (blood tests) 

The on-site North Mid Blood Test Clinic no longer offers GP blood test appointments. GP referrals will only be accepted at our community phlebotomy sites.
 
We currently have next day appointments available at our community based sites, Laurels and Evergreen for all Enfield and Haringey patients. Location and opening times for our community hubs are as follows: 

  • Evergreen Surgery, 1 Smythe Close, Edmonton N9 0TW,
    Monday to Saturday,
    8am to 5pm
     
  • The Laurels Healthy Living Centre 256 St Ann’s Rd, Tottenham, London, N15 5AZ,
    Monday to Saturday,
    8am to 5pm
     
  • Forest Primary Care Centre, 308A Hertford Road, Edmonton, London, N9 7HD
    Monday to Friday
    8am-12pm
     
  • Grovelands Medical Centre, 1 Grovelands Rd, London N13 4RJ
    Monday to Wednesday
    10am to 2pm

All GP blood tests are bookable online by going to https://www.northmid.nhs.uk/blood-tests. Patients can select the location, date and time at their own convenience. All patients must have a booked appointment. There is no walk in service.
 
Please do not advise your patients to come to North Mid as they will be asked to attend a clinic in the community.
 
To book an appointment for blood tests, please go to https://www.northmid.nhs.uk/blood-tests  or call us on 0208 887 3663 / 3664.
 
GPs are able to send the patient request forms to a generic North Middlesex email for printing only: northmid.bloodtestrequestforms@nhs.net

Updates for GPs - May 2021

New North Mid chief executive named as Dr Nnenna Osuji

Dr Nnenna Osuji has been successfully appointed to the role of Chief Executive at North Middlesex University Hospital NHS Trust. She is anticipated to take up her new role in summer 2021.

Dr Osuji will join us from her current role as Deputy Chief Executive and Medical Director at Croydon Health Services NHS Trust in south London. An experienced haematologist, she will continue as a clinician when she takes up her new role.

Dr Andy Heeps will continue as interim Chief Executive until Dr Osuji begins her role at North Mid. 

Covid-19 updates and service recovery

The NHS’s National Operating Plan, released last month, states that Trusts must achieve 70% of 2019/20 planned surgery activity, increasing to 85% by July. The Trust is on track to meet these requirements.

Our outpatient appointments are already at approximately 95% of 2019/20 levels and around 30% of outpatient appointments are being delivered virtually.

We have been seeing a substantial increase in attendances at the A&E Department over the past few weeks. We want to encourage people to seek help from healthcare services when they need it and not delay due to concerns of Covid-19. However, we would urge that people who do not need A&E use alternatives for example NHS 111, walk-in centres or their local pharmacy.

Covid-19 vaccinations and testing

Our mass vaccination centre run by our community services team in Enfield Town continues to be a success. To date we have vaccinated nearly 17,000 people with the first dose of the Oxford-AstraZeneca vaccine.

Phlebotomy (blood tests) 

The on-site North Mid Blood Test Clinic no longer offers GP blood test appointments. GP referrals will only be accepted at our community phlebotomy sites.
 
We currently have next day appointments available at our community based sites, Laurels and Evergreen for all Enfield and Haringey patients. Location and opening times for our community hubs are as follows: 

  • Evergreen Surgery, 1 Smythe Close, Edmonton N9 0TW,
    Monday to Saturday,
    8am to 5pm
     
  • The Laurels Healthy Living Centre 256 St Ann’s Rd, Tottenham, London, N15 5AZ,
    Monday to Saturday,
    8am to 5pm
     
  • Forest Primary Care Centre, 308A Hertford Road, Edmonton, London, N9 7HD
    Monday to Friday
    8am-12pm
     
  • Grovelands Medical Centre, 1 Grovelands Rd, London N13 4RJ
    Monday to Wednesday
    10am to 2pm

All GP blood tests are bookable online by going to https://www.northmid.nhs.uk/blood-tests. Patients can select the location, date and time at their own convenience. All patients must have a booked appointment. There is no walk in service.
 
Please do not advise your patients to come to North Mid as they will be asked to attend a clinic in the community.
 
To book an appointment for blood tests, please go to https://www.northmid.nhs.uk/blood-tests or call us on 0208 887 3663 / 3664.
 
GPs are able to send the patient request forms to a generic North Middlesex email for printing only: northmid.bloodtestrequestforms@nhs.net

Prostate cancer pathway update 

We have undertaking mapping of the pathway and patient shadowing and interviews and as a result have implemented some changes. This includes changes which have significantly shortened the length of time on the diagnostic pathway and a new patient information leaflet.
 
We would really appreciate your support with these pathway changes and would ask you to consider the following when referring a patient to us on the two week wait pathway for suspected prostate cancer.
 
Referrals:

  • Provide comprehensive past medical history and clinical details in referrals
  • Avoid multiple referrals for the same patient
  • Ensure that patients are available to attend appointments for the next 2 months after referral

Undertake:

  • A recent PSA level ( 2 PSA levels if possible).
  • An MSU. Please do not do a PSA if the patient has a UTI
  • An eGFR

Patient experience:

  • Inform patients why they are being referred. We find they are often not aware of why they have been referred so are worried and anxious
  • Alert us if patients require assistance with translators if English is not first language
  • Provide an up to date contact details (especially a phone/mobile number)

Updates for GPs - April 2021

Dr Andy Heeps becomes interim Chief Executive

From Thursday 1 April 2021, Dr Andy Heeps took over as interim Chief Executive at North Mid following Maria Kane’s recent departure to North Bristol NHS Trust. He is a consultant obstetrician and has been chief operating officer at North Mid since 2018, and more recently, deputy chief executive.

Covid-19 updates

At the NHS England public board meeting earlier this week NHS Chief Executive Sir Simon Stevens announced that the national incident level for the NHS Covid-19 response will now be reduced from level 4 to level 3, effective immediately.

While we will continue to maintain a national incident infrastructure, this will shift the management of the incident from nationally co-ordinated to a regional level. This mirrors how we operated during the summer of 2020 and reflects the reduced number of Covid-19 patients in our inpatient wards and intensive care.
 
What this means for our services
The decline in Covid-19 hospitalisations means that we have been able to restart some elective surgery and we are currently reviewing all services so that we can plan to increase the number of these operations happening over the coming weeks.
 
Outpatient attendances have increased in March 2021 to pre-Covid-19 levels. In March 2021 approximately 10% of outpatient appointments were delivered via telephone or virtually.
 
Attendances at North Mid's Emergency Department (ED) have increased in March 2021 to pre-Covid-19 levels with an average of 530 ED attendances per day.
 
GP referrals are beginning to increase to pre-Covid-19 levels but are currently around 6% lower than March 2020.

Covid-19 vaccinations and testing
Our mass vaccination centre run by our community services team in Enfield Town continues to be a success. To date we have vaccinated nearly over 13,000 people with the first dose of the Oxford-AstraZeneca vaccine.

Phlebotomy (blood tests) 

The on-site North Mid Blood Test Clinic no longer offers GP blood test appointments. GP referrals will only be accepted at our community phlebotomy sites.
 
We currently have next day appointments available at our community based sites, Laurels and Evergreen for all Enfield and Haringey patients. Location and opening times for our community hubs are as follows:

  • Evergreen Surgery, 1 Smythe Close, Edmonton N9 0TW,
    Monday to Saturday,
    8am to 5pm
     
  • The Laurels Healthy Living Centre 256 St Ann’s Rd Tottenham London N15 5AZ,
    Monday to Saturday,
    8am to 5pm

All GP blood tests are bookable online by going to https://www.northmid.nhs.uk/blood-tests. Patients can select the location, date and time at their own convenience. All patients must have a booked appointment. There is no walk in service.
 
Please do not advise your patients to come to North Mid as they will be asked to attend a clinic in the community.
 
To book an appointment for blood tests, please go to https://www.northmid.nhs.uk/blood-tests
 
GPs are able to send the patient request forms to a generic North Middlesex email for printing only: northmid.bloodtestrequestforms@nhs.net

Rapid Diagnostic Centre (RDC) reminder  

North Mid launched the Rapid Diagnostic Centre (RDC) on  18 January. The RDC is a diagnostic pathway for patients with non-specific symptoms that could indicate cancer. This patient cohort doesn’t necessarily fit the criteria for a referral onto a site specific 2ww pathway.

All enquiries should be made to Northmid.rdc@nhs.net

Find out more information on the North Central London CCGs website.

Updates for GPs - March 2021

Covid-19 updates

  • Over the last month we have seen a rapid decrease in the numbers of patients with Covid-19 in our medical wards and a more gradual decline in ITU.
  • Our ‘Captain Sir Tom Moore’s Centenary Ward’ opened last week and will be located next to the hospital’s Pymmes building and will be used to for our surgical elective pathway. 

Covid-19 vaccinations and testing

Our mass vaccination centre run by our community services team in Enfield Town continues to be a success. To date we have vaccinated nearly 3,000 people with the first dose of the Oxford-AstraZeneca vaccine.

Phlebotomy (blood tests)

The on-site North Mid Blood Test Clinic no longer offers GP blood test appointments. GP referrals will only be accepted at our community phlebotomy sites.

We currently have next day appointments available at our community based sites, Laurels and Evergreen for all Enfield and Haringey patients. Location and opening times for our community hubs are as follows:

  • Evergreen Surgery, 1 Smythe Close, Edmonton N9 0TW,
    Monday to Saturday,
    8am to 5pm
  • The Laurels Healthy Living Centre 256 St Ann’s Rd Tottenham London N15 5AZ,
    Monday to Saturday,
    8am to 5pm

All GP blood tests are bookable online by going to https://www.northmid.nhs.uk/blood-tests. Patients can select the location, date and time at their own convenience. All patients must have a booked appointment. There is no walk in service.

Please do not advise your patients to come to North Mid as they will be asked to attend a clinic in the community.

To book an appointment for blood tests, please go to https://www.northmid.nhs.uk/blood-tests

GPs are able to send the patient request forms to a generic North Middlesex email for printing only: northmid.bloodtestrequestforms@nhs.net

Updates for GPs - February 2021

Covid-19 updates

There was a rapid increase in Covid-19+ patients in our acute and ITU beds last month.

We have seen the numbers of patients decreasing in our medical wards but the pressure on ITU remains. We have been able to close escalation areas such as Endoscopy Suite and Theatre Recovery. 

Following the decision to stop all non-emergency activity on a temporary basis, we have started our elective activity recovery planning that will take us out of the second wave and allow us to gradually increase our elective activity safely.

Vaccinations and testing

We have opened a mass vaccination centre at the Dugdale Centre in Enfield Town that will help us vaccinate hundreds of people a day. This will be open for priority groups set by the Joint Committee on Vaccination and Immunisation, including people over 70 years of age, frontline healthcare staff and clinically extremely vulnerable people.

As the national vaccination programme evolves and expands, so will the Dugdale Centre, offering vaccinations to residents in the local community in Enfield and Haringey according to Government prioritisation.

Rapid Diagnostic Centre (RDC) launched

North Mid launched the Rapid Diagnostic Centre (RDC) on the 18th January. The RDC is a diagnostic pathway for patients with non-specific symptoms that could indicate cancer. This patient cohort doesn’t necessarily fit the criteria for a referral onto a site specific 2ww pathway.

This service will offer a more holistic diagnostic experience to patients with non-specific symptoms and will provide a one-stop service where possible. Other benefits to patients include:

  • Enhanced consultant-led triage process to enhance speed and efficiency of pathway
  • To provide the patient with a clear diagnosis or onward management plan in addition to tests that exclude/identify cancer
  • To provide enhanced support to patients from clinicians, CNS and navigators

The RDC diagnostic pathway offers the following key benefits to GPs:

  • Enables effective communication between primary and secondary care
  • RDC referral avoids the need for GPs to do multiple cancer referrals when cancer of unknown origin is suspected

How to refer to the RDC

In order to make a referral:

  1. An RDC referral form must be completed via EMIS

Local EMIS global document library systems in the 2WW Pan London Referral Forms folder > Rapid Diagnostic Centre (RDC) for Non-Specific Symptoms Suspected Cancer Referral Form

  1. Order ‘filter function’ test

When referring to an RDC, GPs should request a prescribed set of investigations (Filter Function tests) e.g. blood tests. Please include as many of the ‘Filter Function’ results as possible when making the referral.  Given the constraints created by Covid it may not be possible to arrange all investigations, and RDCs will be flexible until the situation changes.

A ‘Filter Function’ bundle will be made available soon on tQuest.  

For any pending test results that you have organised at the time of this referral please provide information including type of investigation requested and the Trust performing the tests.

  1. Select specific RDC clinics within e-RS
  2. Submit RDC referral form over e-RS

All enquiries should be made to Northmid.rdc@nhs.net

Website with more information: https://gps.northcentrallondonccg.nhs.uk/service/rapid-diagnostic-centres

As part of this service change the Upper GI 2 Week Wait pathway will become a triage service and appointments will no longer be able to be booked directly. The triage process enables the Trust to determine the most appropriate pathway for the patient - this could be a test or endoscopy before an outpatient appointment.  After a referral has been received it will be vetted by a consultant and the patient will either be booked an appointment or have diagnostic tests organised.

Phlebotomy (blood tests)

The on-site North Mid Blood Test Clinic no longer offers GP blood test appointments. GP referrals will only be accepted at our community phlebotomy sites.

We currently have next day appointments available at our community based sites, Laurels and Evergreen for all Enfield and Haringey patients. Location and opening times for our community hubs are as follows:

  • Evergreen Surgery, 1 Smythe Close, Edmonton N9 0TW,
    Monday to Saturday,
    8am to 5pm
     
  • The Laurels Healthy Living Centre 256 St Ann’s Rd Tottenham London N15 5AZ,
    Monday to Saturday,
    8am to 5pm

All GP blood tests are bookable online by going to https://www.northmid.nhs.uk/blood-tests. Patients can select the location, date and time at their own convenience. All patients must have a booked appointment. There is no walk in service.

Please do not advise your patients to come to North Mid as they will be asked to attend a clinic in the community.

To book an appointment for blood tests, please go to https://www.northmid.nhs.uk/blood-tests

GPs are able to send the patient request forms to a generic North Middlesex email for printing only: northmid.bloodtestrequestforms@nhs.net

Inpatient paediatric care returns to North Mid

Last month, we informed you that we temporarily moved our paediatric inpatient services to Great Ormond Street Hospital, as part of our system-wide response to the Covid-19 pandemic. We have now moved these back to North Mid, and we continue to run paediatric emergency services at the hospital.

Post Covid-19 Assessment Service

A Post Covid-19 Assessment Service is being offered to support respiratory complications from Covid-19. This was established in order to follow up inpatients but is now open to GP referrals. The result of a referral may be advice back to the GP, direct access to a diagnostic test or a telephone or face to face appointment.

For queries about this service please contact northmid.postcovid@nhs.net & 0208 887 3511/0208 887 2780.

Rapid Diagnostic Centre (RDC) launched

North Mid launched the Rapid Diagnostic Centre (RDC) on the 18th January. The RDC is a diagnostic pathway for patients with non-specific symptoms that could indicate cancer. This patient cohort doesn’t necessarily fit the criteria for a referral onto a site specific 2ww pathway.

This service will offer a more holistic diagnostic experience to patients with non-specific symptoms and will provide a one-stop service where possible. Other benefits to patients include:

  • Enhanced consultant-led triage process to enhance speed and efficiency of pathway
  • To provide the patient with a clear diagnosis or onward management plan in addition to tests that exclude/identify cancer
  • To provide enhanced support to patients from clinicians, CNS and navigators

The RDC diagnostic pathway offers the following key benefits to GPs:

  • Enables effective communication between primary and secondary care
  • RDC referral avoids the need for GPs to do multiple cancer referrals when cancer of unknown origin is suspected

How to refer to the RDC

In order to make a referral:

  1. An RDC referral form must be completed via EMIS

Local EMIS global document library systems in the 2WW Pan London Referral Forms folder > Rapid Diagnostic Centre (RDC) for Non-Specific Symptoms Suspected Cancer Referral Form

  1. Order ‘filter function’ test

When referring to an RDC, GPs should request a prescribed set of investigations (Filter Function tests) e.g. blood tests. Please include as many of the ‘Filter Function’ results as possible when making the referral.  Given the constraints created by Covid it may not be possible to arrange all investigations, and RDCs will be flexible until the situation changes.

A ‘Filter Function’ bundle will be made available soon on tQuest.  

For any pending test results that you have organised at the time of this referral please provide information including type of investigation requested and the Trust performing the tests.

  1. Select specific RDC clinics within e-RS
  2. Submit RDC referral form over e-RS

All enquiries should be made to Northmid.rdc@nhs.net

Website with more information: https://gps.northcentrallondonccg.nhs.uk/service/rapid-diagnostic-centres

As part of this service change the Upper GI 2 Week Wait pathway will become a triage service and appointments will no longer be able to be booked directly. The triage process enables the Trust to determine the most appropriate pathway for the patient - this could be a test or endoscopy before an outpatient appointment.  After a referral has been received it will be vetted by a consultant and the patient will either be booked an appointment or have diagnostic tests organised.

North Mid update for GPs – Jan 2021

Covid-19 update

There has been a rapid increase in Covid-19 positive patients in our acute and ITU beds and we are now treating patients across the hospital including in escalation areas such as our Endoscopy Suite and Theatre Recovery.
 
The Covid-19 pressure has been increased by the rapid growth of the new variant as well as a continuation or normal winter pressure numbers in our A&E department.
 
We have taken the very difficult decision to stop all non-emergency activity on a temporary basis. This will allow us to continue to safely look after patients, who need urgent, emergency and covid-19 care. We are reviewing this each week.
 
We continue to work with system partners to create additional stepdown capacity and decompress ITU on a daily basis.  
 
Vaccinations and testing

We have started to administer the Covid-19 vaccine to our staff, care home staff and to system partners including Barnet, Enfield and Haringey NHS Trust and local social services. So far, we have delivered 2800 vaccinations.
 
We are currently testing 45% of patient facing staff with PCR testing. Alongside this, we have rolled out Lateral Flow Testing to 2339 of our staff.

Phlebotomy (blood tests) 

From 4 January 2021, The on-site North Middlesex Blood Test Clinic will no longer offer GP blood test appointments. GP referrals will only be accepted at our community phlebotomy sites.
 
We currently have next day appointments available at our community based sites, Laurels and Evergreen for all Enfield and Haringey patients. Location and opening times for our community hubs are as follows:
 
Evergreen Surgery 

1 Smythe Close, Edmonton N9 0TW,
Monday to Saturday,
8am to 5pm
 
The Laurels Healthy Living Centre

256 St Ann’s Rd Tottenham London N15 5AZ,
Monday to Saturday,
8am to 5pm
 
All GP blood tests are bookable online by going to https://www.northmid.nhs.uk/blood-tests.

Patients can select the location, date and time at their own convenience. All patients must have a booked appointment. There is no walk in service.
 
Please do not advise your patients to come to North Middlesex as they will be turned away.
 
To book an appointment for blood tests, please go to https://www.northmid.nhs.uk/blood-tests
 
GPs are able to send the patient request forms to a generic North Middlesex email for printing only: northmid.bloodtestrequestforms@nhs.net

Radiology update

We have postponed all Routine MRI, CT and Ultrasound appointments. We have closed MRI, CT and Ultrasound to GP Direct Access with the exception of cancer pathways.

Please see the below summary of services available:
 

Radiology update

Patients aged over 18:

Imaging Modality

Clinical requirement

North Mid

Ultrasound

Urgent - Cancer suspected (Abdominal)

Yes

Urgent - Cancer suspected (Gynae)

Yes

Urgent - non cancer

Yes

Routine - All

No

MRI

Urgent - Cancer suspected

Yes

Urgent - non cancer

No

Routine

No

X-Ray

Urgent - Cancer suspected

Yes

Urgent - non cancer

Yes

Routine

No

CT

Urgent - Cancer suspected

Yes

Urgent - non cancer

No

Routine

No

Dexa

Urgent - Cancer suspected

No

Urgent - non cancer

No

Routine

No

Women’s health update 

We have cancelled all routine gynaecology clinics except Fertility clinics (2 per month as per The Human Fertilisation & Embryology Authority guidance). Routine hysteroscopy clinics are cancelled.

We are doing urgent gynae clinics and target clinics/hysteroscopies.

Paediatrics update

Inpatient and emergency paediatric care: As part of our system-wide response to the Covid-19 pandemic, we have temporarily moved our paediatric inpatient services to Great Ormond Street Hospital. We do, however, continue to run paediatric emergency services at the hospital in a transformed Children’s A&E department.

Paediatric blood tests: Please note that any paediatric patients who require a blood test need a patient request form to present to the phlebotomist in order for the patient to be bleed. Unfortunately, we are unable to bleed any paediatric patient without a patient request form.

Post Covid-19 Assessment Service  

A Post Covid-19 Assessment Service is being offered to support respiratory complications from Covid-19. This was established in order to follow up inpatients but is now open to GP referrals. The result of a referral may be advice back to the GP, direct access to a diagnostic test or a telephone or face to face appointment.

For queries about this service please contact northmid.postcovid@nhs.net or 0208 887 3511 / 0208 887 2780.

Changes to GP blood test appointments

From Monday 4 January 2021, there will be a change to the way that GP blood test appointments are offered.

The on-site North Middlesex Blood Test Clinic will no longer offer GP blood test appointments. GP referrals will only be accepted at our community phlebotomy sites.

We currently have next day appointments available at our community based sites, Laurels and Evergreen for all Enfield and Haringey patients.

Locations and opening times for our community hubs are as follows:

Evergreen Surgery, 1 Smythe Close, Edmonton N9 0TW, 

Monday to Saturday, 8am to 5pm

The Laurels Healthy Living Centre, 256 St Ann’s Rd Tottenham London N15 5AZ,

Monday to Saturday, 8am to 5pm

All GP blood tests can be booked online northmid.nhs.uk/blood-tests

Patients can select the location, date and time at their own convenience. All patients must have a booked appointment. There is no walk in service.

Please do not advise patients to show up at North Middlesex as they will be turned away.

To book an appointment for blood tests, please go to northmid.nhs.uk/blood-tests

GPs are able to send patient request forms to a generic North Middlesex email for printing only: northmid.bloodtestrequestforms@nhs.net

Changes to repeat prescriptions for haemoglobin disorders

From Tuesday 1 December 2020, the clinical haematology service is changing the way prescriptions are given to patients. 

Historically, patients with haemoglobin disorders (Sickle Cell Disorder, Thalassaemia) received the majority of their repeat prescribed outpatient medication from the Trust via TTA.

We are informing GPs about the most up-to-date medication list and are asking surgeries formally to take over repeat prescribing. This includes the patients’ opiates but excludes specialist drugs like hydroxycarbamide and iron chelation. The Trust will no longer provide routine repeat prescriptions, helping to avoid the possibility of double presciptions, gives you better oversight of you patients' prescriptions and means that patients can pick up medication from their local pharmacy.  

When the patient’s GP informs the service in writing that they are unable or unwilling to provide a particular prescription, the haemoglobinopathy service will continue to do so. Please forward any non-urgent queries via email to northmid.haem@nhs.net. Please also write or email if you cannot provide the patient with a prescription or if you would like us to forward relevant blood results for safe prescribing.

Urgent questions can be directed to the on-call haematologist via the North Middlesex Switchboard.

North Mid Covid-19 recovery update for GPs - November 2020

To manage any future surges in demand, we have a detailed Covid Response Plan in place which we have tested via a table top exercise. This was produced in partnership with the individual services that will be involved in the response and we have a team in place to lead the response.

We currently have two wards dedicated to treating patients with Covid-19 and we are working on creating additional capacity which will be able to support acutely unwell patients with Covid-19 as well as ITU patients.

We are continuing with our elective programme and do not currently intend to scale this back unless Covid-19 activity increases or national guidance changes.
 
We are working in partnership with the independent sector for some elective surgery, and there are plans in place with partners for mutual aid should we need to seek support for ITU capacity.

Phlebotomy

There are two community based phlebotomy hubs in operation.

A seven station 8am – 8pm Phlebotomy service at Evergreen Surgery, 1 Smythe Close, Edmonton N9 0TW. Eight phlebotomy stations at The Laurels Healthy Living Centre 256 St Ann’s Rd Tottenham London N15 5AZ.

Both hubs are open to Enfield and Haringey patients.

Appointments are all bookable by Swiftqueue only and there is no walk in service available at either hub.

GPs will now be able to send Patient Requests Forms to a generic North Middlesex email: northmid.bloodtestrequestforms@nhs.net

The telephone number for the service is: 07483 903 704

Please do not hesitate to contact the service if required as we are committed to working together to ensure that we address the current waiting list challenges.

ECGs

From Wednesday 8 October 2020 GPs were able to book ECGs for patients through e-RS using clinic code AHPOE.

Due to infection prevention and control constraints we are not able to offer a walk-in service at present, and current capacity is for 20 pre-booked slots per day compared to 30 slots a day pre-covid.

The location will be the anticoagulation building which has the advantage of a separate entrance from the main site.

Referral Assessment Service for general gastroenterology referrals

From Monday 12 October 2020 all referrals for general gastro will receive a consultant triage and where appropriate and where sufficient information has been given in a referral, patients will be referred straight to a diagnostic test.

Patients and GPs will receive a letter detailing the intended management plan and requested diagnostic. This should reduce the likelihood of previous experiences, of being held on a waiting list for a consultation before any diagnostic tests are carried out.

GPs should advise patients that referral to North Mid gastroenterology department may not result in an outpatient consultation and that a hospital specialist will respond once they have received a referral, to determine if a patient needs an outpatient consultation by telephone or face to face or whether a diagnostic test appointment needs to be made.

GPs should continue to refer via ERS. 

For all enquiries please email northmid.gastroenterology@nhs.net or call 020 8887 4559.

Changes to children’s A&E

We’re pleased to announce that we opened our new children’s A&E last month following a £1.2million investment.

The investment means that we now have a new dedicated space for children who need mental health support, a doubling in capacity of resuscitation care and a new breastfeeding room. It will also mean we can significantly improve patient experience through the new Changing Places toilet facilities, for children who not able to use the toilet independently, a new relatives room for those waiting while their loved one receives treatment and a separate entrance to the department.

North Mid pilot for 111 First supports London-wide roll out

Following a successful pilot at North Mid, there has now been a London-wide roll out of ‘111 First’, which sees Londoners asked to ring 111 before going to an A&E department.

The scheme aims to help direct patients to the most appropriate urgent or emergency service for their needs, and reduce the need to spend unnecessary time in A&E waiting rooms. If A&E is the right place for their care, NHS 111 can book them a time slot to attend, and North Mid has two slots for these ‘heralded patients’ every hour between 8am – 8pm. 

Clinical strategy launch

A number of our local GPs contributed to our new Clinical Strategy which can be found on our dedicated page.

In this document we outline our plans against five clinical chapters:

  • Cancer services
  • Children and Young People
  • Maternity services
  • Planned care
  • Urgent and Emergency Care

We look forward to working with you to implement these plans over the coming years.

Green light for reshaping elective orthopaedics in north central London

The NHS in north central London will create two new centres for planned orthopaedic surgery.
 
Two partnerships for orthopaedic surgery have been formed by local NHS Trusts: UCLH and Whittington Health will work together to provide inpatient and day surgery across the partnership. North Middlesex University Hospital will work with the Royal Free London, with inpatient surgery at Chase Farm and day surgery at both sites. Outpatient appointments and joint school will also happen across these hospitals.
 
This means that from January, you will need to have conversations with your patients about which partnership they will want to be treated at.
 
For more information about this, please visit the North Central London Partners website.

 

Booking ECGs for patients through e-RS - 8 October 2020 update

From Wednesday 8 October 2020 GPs were able to book ECGs for patients through e-RS using clinic code AHPOE.

Due to infection prevention and control constraints we are not able to offer a walk-in service at present, and current capacity is for 20 pre-booked slots per day compared to 30 slots a day pre-covid.

The location will be the anticoagulation building which has the advantage of a separate entrance from the main site.

New e-RS DOS for general gastro referrals (RAS) - 12 October 2020 update

From Monday 12 October 2020 all referrals for general gastro will receive a consultant triage and where appropriate and where sufficient information has been given in a referral, patients will be referred straight to a diagnostic test.

Patients and GPs will receive a letter detailing the intended management plan and requested diagnostic. This should reduce the likelihood of previous experiences, of being held on a waiting list for a consultation before any diagnostic tests are carried out. 

GPs should advise patients that referral to North Mid Gastroenterology Department may not result in an outpatient consultation and that a hospital specialist will respond once they have received a referral, to determine if a patient needs an outpatient consultation by telephone or face to face or whether a diagnostic test appointment needs to be made.

GPs should continue to refer via ERS.  

For all enquiries please email northmid.gastroenterology@nhs.net or call 020 8887 4559.

Referring patients

A RAS is a triage service set up to deal with complicated clinical pathways.  It enables North Mid to determine the most appropriate pathway for the patient, this could be a test or endoscopy before an outpatient appointment (straight to test).

All referral must be made by GPs only as there is no self referral option for patients.  Referrals will be assessed online by one of our consultants and they will decide whether to see a patient face to face, by video or telephone or to refer the patient for diagnostics.  

Sometimes the triage service may reject a referral, give advice or request further information, so practices will need to monitor the appropriate worklist screen (Referrer Action Required) on e-RS for rejections.

Once a consultant has triaged the referral, the patient and GP will receive an outcome letter from North Mid, on a patient's next step for treatment.

The triage time via RAS will be within 14 days of receiving a referall and the outcome of triage will be communicated to the patient and GP.

Refer to RAS using e-RS

Refer to e-SR

This referral is simple to complete but you must make sure the referral letter and all important information which will be used for the triage has been attached. 

Onward referrals will be made by the service and the patient will be informed.

Practices will need to monitor the worklist for any rejections/requests for further information which might need action. It will no longer be possible to directly book a patient at North Mid for Gastroenterology after the RAS is switched on.

Key messages for patients

Patients may expect to be booked in for an appointment by their GP, but the RAS means this is no longer the case.  Please ensure patients understand that their referral will be reviewed by a specialist so they receive the right care. GPs can request that a specialist will review a patient's case, one of North Mid's specialists will then review it and decide whether there is something more that a practice could do or whether our specialists will see a patient in hospital. 

 

 

North Mid Covid-19 recovery update for GPs - September 2020

Elective (planned) surgery

North Mid has now restarted some of the urgent elective (planned) care that had been paused over the past few months. This has including putting in place robust infection prevention and control measures to ensure that we can deliver care as safely as possible.

Patients have previously been required to isolate for 14 days prior to admission which has made it difficult for some patients to have their surgery. NICE guidance has now been issued and subsequently the process has changed.

Prior to admission patients having elective (planned) surgery are now required to be swabbed for Covid-19 72 hours prior to admission and then isolate along with members of their household for 72 hours.

On the day of admission:

  • All patients must avoid public transport when travelling to and from the hospital, and the Trust can provide patient transport if required
  • The patient will be assessed for any Covid-19 symptoms
  • Elective patients cannot be accompanied into hospital by a friend or relative, unless they are their essential carer or in exceptional circumstances which are pre-agreed in advance
  • A drop off and collection process will be in place for all patients

North Mid plans to restart routine elective care on a service by service basis where it is safe and in the best interests of patients to do so. This is being assessed through a ‘Review and Restart’ process for each service, where plans are discussed at a review meeting chaired by the Chief Operating Officer.

Emergency eye care changes

Access to the Eye Emergency service at North Middlesex will be altered from Tuesday 15 September 2020.

Patients will be advised to “talk before walk” when planning to attend the Emergency Service.

For routine eye complaints please refer via electronic referral system (eRS).

For urgent/acute eye conditions, including:

  • Loss of vision, less than 24-48 hours duration
  • Pain in eye, less than 24-48 hours duration
  • Eye injury/ trauma
  • Chemical injury to eye,
  • Foreign body in eye
  • Floaters getting worse

Please refer with a letter to North Mid Eye Emergency or phone the number:

  • 020 8887 3417
  • 020 8887 2274

For semi urgent symptoms please refer patients to Minor Eye Community Service (MECS) (Optometrists) providers commissioned by the CCG. An updated list of these Community providers is available at the following link: https://primaryeyecare.co.uk

The change is being introduced in line with NCL CCG guidance post Covid-19 to ensure that only patients who need urgent and acute care attend the Emergency Service.

Outpatients

Outpatient appointments continue to be delivered virtually where possible. In the coming weeks we will be increasing the number of outpatients’ appointments but will continue to only bring patients into the hospital for face to face appointments where absolutely necessary.

Once the patient has arrived at the hospital and on entry their temperature will checked, they will be provided with a face mask, directed to hand sanitising facilities and then directed to the Outpatients Reception desk; we will have called or texted the patient beforehand to confirm the appointment and we will use this touch point to convey special instructions for shielded patients.

Shielded patients will be seen on the first slots of the session under enhanced arrangements. This will be monitored and managed by the Outpatients Sister.

Phlebotomy (blood tests)

Community phlebotomy services were initially paused but we have restarted community-based services on the 11th May, with Forest Road Primary Care Centre for Enfield.

On 17th August, North Mid opened a 7 station 8am – 8pm Phlebotomy service at Evergreen Surgery, Edmonton.

We are working to further increase our capacity over the coming 3 months.

Imaging

Clinically urgent imaging and all cancer imaging has been available throughout the pandemic, and the team are now working to address waiting list backlogs for routine work. We are back to normal waiting times for children’s ultrasound scans, CT scans and MRI scans.
We still have a number of patients refusing their scans but are arranging a call back with a clinician with these patients to discuss risk factors and provide reassurance about attending.

Cancer pathways

We are pleased to have continued to support cancer patients through Covid-19, and have maintained outpatients, chemotherapy and radiotherapy activity on site.

We are able to scan patients out of hours or at the start of the day if they are vulnerable, which will reduce their risk. We are encouraging patients not to turn up early to appointments and have socially distanced waiting areas.

Women’s Health Services

Women’s outpatients’ services relocated to the Tottenham Hotspurs stadium in early April, helping to alleviate anxiety for women who were worried about coming to the hospital, during pregnancy. These services moved back to the North Mid site at the on the 1st August.

Key messages for patients

We would encourage all patients to seek help from healthcare services when they need it and not delay due to concerns of Covid-19. However, we would urge that people who do not need A&E use alternatives for example NHS 111, Walk in Centres or contact their GP. For those attending the Hospital we would ask that patients are not accompanied, unless by their essential carer or in exceptional circumstances in order to help with social distancing.

Changes to children’s A&E

We have one of the busiest children’s A&E departments in the country and we have known for some time that it is currently too small to provide the outstanding care that we strive for on a daily basis. We have been told this by our local families, our partners and our staff.

We are therefore investing over £1.2million to redevelop the department so that we can double capacity. During the pandemic, our children’s A&E moved to a different area in our outpatients department. The move has been so successful that we've decided to use it as our permanent location.

The investment will mean the hospital can better meet the needs of local people by paving the way for a new dedicated space for children who need mental health support, a doubling in capacity of resuscitation care and a new breastfeeding room. It will also mean we can significantly improve patient experience through the new Changing Places toilet facilities, for children who not able to use the toilet independently, a new relatives room for those waiting while their loved one receives treatment and a separate entrance to the department.

Redevelopment work started in the middle of July and will be completed in September.

Car Parking

Following on from patient engagement and feedback, we have plans in place to move to a ‘pay on exit’ system to make it easier for those using our car parks, and to ensure they only pay for the time they use. We are working to have this change implemented by the Autumn and will ensure that this is effectively communicated.

 

North Mid Covid-19 recovery update for GPs - July 2020

Elective surgery

North Mid has now restarted some of the urgent elective care that had been paused over the past few months. This has involved a great deal of work, including putting in place infection prevention and control (IPC) measures to ensure that we can deliver care as safely as possible.
Initially this is for the most urgent patients based on clinical need in line with North Central London guidance which has been developed for each elective specialty and will continue to be reviewed in within their respective forums.

It will take some time for elective surgery services to get back to where they were before the pandemic, partly due to reduced efficiency due to the additional infection control requirements, but we are also finding that some patients have a lack of confidence in coming to the hospital for surgery. We are doing everything we can to meet our patients’ needs for fair and equal access to services.

Some of the key IPC measures in place for patients having elective surgery are:

Prior to admission:

  •  We are carrying out patient pre-operative assessments virtually where possible.
  •  Patients must isolate for 14 days prior to admission along with members of their household and have remained asymptomatic
  •  For cardiac and interventional procedures the pathway is 7 days isolation
  •  Patients must be swabbed for COVID-19 on day 14, then 72hrs prior to and on admission day. The patient swabbing service is available 7 days a week for timed appointments only
  •  Transport will be available for drive through swabbing if patients do not own a car

On the day of admission

  •  All patients must avoid public transport when travelling to and from the hospital. Patient transport will be available
  •  On the day of admission the patient must be assessed for any COVID symptoms
  •  Elective patients cannot be accompanied into hospital by a friend or relative, unless they are their essential carer or in some exceptional circumstances
  •  A drop off and collection process is in place for patients

Outpatients

Outpatient appointments have continued during the pandemic but have been delivered virtually where possible. In the coming weeks we will increase outpatients’ activity but will continue to bring patients into the hospital for face to face appointments only where necessary. Patients who are shielding will be seen, with appropriate infection prevention and control measures in place.

For outpatient appointments, ambulatory or diagnostic procedures on the day before the appointment staff will check if the patient is shielding and/or vulnerable and give the patient a timed appointment slot to attend their procedure which will minimise the number of patients waiting in communal/waiting areas.

Phlebotomy

In order to cope with the increased demand from COVID-19 inpatient activity in a safe and resilient manner, as well as maintain the social distancing principles that were introduced, we suspended our Community phlebotomy services in Enfield and Haringey on the 18th of March. The Trust, in conjunction with our NCL partners, commenced restarting community-based services on the 11th May. The Enfield site is based in Forest Road P.C.C. and The Laurels Healthy Living Centre is the location for Haringey. Our capacity is not yet back where it was pre-COVID, but is in line with partner providers activity levels. We are in regular discussion with NCL partners and commissioners and this activity will increase over the next 3 months and as new phlebotomy sites come on line. As part of our plans to increase activity, we plan to open a temporary high activity hub to help address the backlog in demand by the end of July.

Blood requests will continue be restricted to those deemed clinically urgent or essential by the requesting practitioner. As we move to new ways of working post COVID peak, the criteria will be reviewed. Attendance to the blood test centre will be by appointment only; any patient who tries to attend any of the sites without an appointment will be refused entry and turned away. Appointments can be booked by ringing the call centre on 0208 8873663 or via SwiftQ web-based booking once available.

Work is ongoing at an NCL level to improve the booking process, however as an interim measure while this is resolved we would ask the requesting practitioner to send the TQuest request to the patient to bring to the hospital. In the event that the patient is unable to print the request, we will print it at the hospital. Please note that we no longer require the requesting practitioner to mark the request as urgent on the understanding that only urgent requests will be made at this point.

Imaging

Clinically urgent imaging and any cancer/2WW imaging has been consistently available however all routine imagine work is currently on hold. Plans are in progress in order to commence routine imaging over the coming weeks.

Some of our routine work will be sent off site to The Imaging Centre at The Hive in Edgware.

We have a high number of patients refusing their scans and we would ask you to encourage patients that you refer to attend their appointments.

There is some re-validation occurring regarding requests for scans that may no longer be required and MSK ultrasound will be returned to the GP surgeries in line with sector wide agreements.

Cancer pathways

We are pleased to have maintained our cancer performance targets through this challenging period and have maintained 2WW, chemotherapy and radiotherapy activity on site, although with reduced capacity.

Paediatrics

During the COVID-19 outbreak, there was a temporary consolidation of paediatric inpatient services to GOSH. The paediatric emergency department remained open, although activity was lower than normal. Paediatric inpatient beds have been reopened at North Middlesex University Hospital from 8 June onwards.

Women’s Health Services

Our women’s outpatients services relocated to the Tottenham Hotspurs stadium in early April, which helped to alleviate the anxiety for women who were worried about coming to the hospital, particularly during pregnancy. We plan to bring these services back to the North Mid site in our separate maternity building in the coming months.

Key messages for patients

Visitors are not permitted to accompany the patient, unless they are their essential carer or in some exceptional circumstances.
North Mid is following national and pan-London guidance in order to keep our patients safe and reduce the risk of transmission within healthcare environments. We would encourage patients to seek help from healthcare services when they need it, and not delay due to concerns regarding COVID-19.