Haematology

Introduction

The Guy’s and St Thomas’ NHS Foundation Trust Haematology Visiting Professional Programme (VPP) will provide international visiting professionals the opportunity to experience our highly acclaimed haematology department first hand. The programme offers a unique chance to be fully integrated within a haematology service which is at the forefront of clinical activity, training and research. 

The programmes are designed by our clinical leads to provide unique development experiences which enable visiting professionals to enhance their clinical expertise to transfer back to their work place. Participants will have exclusive access to observe and work alongside our haematology faculty and the opportunity to gain insight into our Trust and the role haematology consultants play within the NHS.

Programme aims

The programme is aimed at those who wish to extend their clinical expertise in haematology within Guy’s and St Thomas’ NHS Foundation Trust.

The aims of the programme include:

• Direct experience and exposure to clinics and ward rounds
• Participation in multidisciplinary team meetings
• Access to departmental seminar programmes and trust wide programmes
• The opportunity to develop peer networks and working relationsships facilitated by mentorship throughout the programme
• The opportunity to complete a specialty project and potentially a publication

Individual weekly timetables will be created depending on each visiting professional’s requirements.

A Certificate of Attendance will be awarded to visitors upon the end of their programme.

Format

The haematology programme is delivered within the hospital work place and it includes exposure to clinics, inpatient ward rounds, multidisciplinary team meetings, and access to the departmental educational programme depending on the length of programme. 

Visiting professionals will be aligned with supervisors from within the clinical teams who will facilitate agreed learning and development needs. 

We will also provide visitors with access to the Trust’s visiting professional mentorship and support.

Who can apply

This programme is intended for non-UK healthcare professionals specialising in haematology including specialist registrars, consultants, psychologists and nurses. 

Visitors have the choice of applying for a practical attachment or observership programme. Those wishing to apply for a practical attachment must have GMC registration. You can apply for GMC registration directly through the main GMC website, alternatively The Royal College of Physicians run a medical training initiative, which facilitates GMC registration and provides sponsorship for a Tier 5 visa. You can find out more about their Medical Training Initiative by visiting their website.

Programme duration

We are able to offer visiting professional programmes for periods of 3 to 12 months. The programme’s duration can be tailored to the specific learning requirements of those visiting the Trust.

Haematology service

The Haematology service encompasses the treatment of both malignant and non-malignant haematological diseases with expertise in:

• General and Immuno-haematology
• Haemoglobinopathies
• Haemostasis and Haemophilia
• Health psychology
• Leukaemia and myelodysplastic syndrome
• Lymphoma
• Myeloma
• Myeloproliferative neoplasms
• Obstetric haematology
• Paediatric Haemophilia and Haematology
• Sickle cell disease and red cell disorders
• Teenage and young adult (TYA)
• Thrombosis
• Transfusion medicine and patient blood management

A full range of inpatient, day-case and outpatient services is provided and has a purpose built day unit and outpatient facility which opened in 2010. The team comprises of 24 members of A&C staff, 17 Consultant Haematologists, 12 registrars and a large number of nursing staff.

General and Immuno-haematology

The general haematology service at GSTT covers experience in a large Trust environment where we provide a large outpatient service for the community and Trust offering reviews of patients with anaemias and cytopaenias. We have a large ITP service and enrol patients in the UK ITP registry. Our Haemachromatosis service is comprehensive with initial patient assessment, diagnostics; long-term nurse led venesection clinics for management and established links with hepatology colleagues. We have the largest and most effective multidisciplinary iron deficiency and rapid access anaemia service which complements our goals for patient blood management and supports patients in pre-surgical assessments. In addition we carry out consultative haematology reviews for the Trust inpatients as required in all disciplines – surgery, medicine, oncology, gynaecology, obstetrics to name a few. We have regular attendance in clinics by undergraduate, post graduate, elective and international doctors. Opportunities are offered to carry out audits, Quality Improvement Projects and case presentations/publications.

Haemostasis and Haemophilia

The Centre for Haemostasis and Thrombosis is an accredited clinical and laboratory service managing people with bleeding and clotting disorders. The service manages a registry of 1200 patients with confirmed bleeding disorders. The children’s services at Guy’s and St Thomas Foundation Trust is based in Evelina Children’s Hospital, London.

The Centre is fully accredited with Haemophilia Comprehensive Care Centre certification through regional and national audit by the UKHCDO (United Kingdom Haemophilia Centre Doctor’s Organisation). Clinical Pathology Accreditation (CPA) UK Ltd since 1994 in molecular genetics, haematology and specific biochemical and immunological analysis. In addition to specialist laboratory services for thrombotic and haemostatic blood tests, we provide a full genetic diagnosis and information service, including prenatal diagnosis.

As a comprehensive centre the services we offer are: Investigation of acquired and inherited bleeding disorders; family and genetic studies; genetic counselling; paediatric clinics; orthopaedic clinics and specialist consultations for complex, general and orthopaedic surgical procedures; combined haemophilia/HIV/hepatology clinics; peri-operative advice and management; women’s bleeding clinics in collaboration with the gynaecology service; physiotherapy and psychology services.

Health psychology

Our health psychology service specialises in supporting patients and their families and/or carers cope with the short and long term impact of having a haematological disorder, including inherited conditions such as sickle cell disease and haemophilia. We offer:

• psychological interventions such as cognitive behavioural therapy
• support group sessions for patients/their families and/or carers
• staff support
• neuropsychological assessment
• contribute to team meetings, seminars, teaching and training
• attend ward rounds and clinics

We are based in Guy’s Hospital Clinical Haematology and aim to be an integral part of the medical/nursing teams in order to contribute towards the holistic care of our patients. We chair the British Psychological Society Special Interest Group for Psychologists in Haemoglobinopathies and are involved in research. We contribute to postgraduate psychology teaching programmes and offer placements for undergraduate and postgraduate psychology students/trainees.

Leukaemia and myelodysplastic syndrome

The leukaema and myelodysplasia service offers state of the art inpatient, ambulatory and outpatient care for patients with acute leukaemias (ALL and AML), myelodysplastic syndrome (MDS) and related myeloid disorders. We work closely with King’s College Hospital for patient requiring allogeneic stem cell transplantation.

We have significant expertise in molecular diagnostics and immunophenotyping for acute leukaemias and serve as the national reference laboratory for molecular residual disease (MRD) monitoring in AML. We participate in several national phase II and III trials including AML19 and UKALL14.

Lymphoma

The lymphoma service at the Trust is the largest receiver of new referrals across south and west London. The large renal, HIV and ENT services are reflected in the number of PTLD, HIV related and Head and Neck lymphoma presentations and the unit manages a significant number of patients with ATLL. The Trust also provides a cutaneous lymphoma service through the St John’s Institute of Dermatology. Consequently, we can offer a broad lymphoma experience as well as more focused attention on specific areas of interest. A range of clinical trials include ongoing phase 1, 2 and 3 studies. The service is intimately supported by our excellent CNS, dietetic, clinical psychology, TYA and extended AHP teams as well as Guy’s Cancer Centre and strong diagnostics including the haemato-oncology pathology service, with FISH and molecular testing applied to solid specimens while flow cytometry complements EBUS specimens, and our internationally leading PET centre. We work closely with partner organisations across London including for those patients proceeding to haematopoetic stem cell transplantation. We have ongoing local, national and international research collaborations and are active in NCRN lymphoma groups. For individuals within this programme we would strongly support a project leading to (inter-)national presentation with a view to submission for publication. The service also provides state-of-the-art radiotherapy for lymphoma as part of combined modality treatment.

Myeloma

We have a large and well-established myeloma service. The team has vast experience in dealing with all types of myeloma and we offer all treatment types, including newer treatments such as novel agents and vertebroplasty/kyphoplasty. We also provide the serum free light chain assay, which allows more accurate monitoring of myeloma.

We have an active clinical research programme in myeloma and many ongoing trials.

Myeloproliferative neoplasms

The myeloid service at GSTT is diverse and covers the spectrum of myeloid conditions as well as a broad ranged clinical service we also offer state of the art diagnostics and international excellence in several areas including national leukaemia diagnostics and minimal residual disease monitoring. For myeloproliferative neoplasms we offer a range of clinical trials from phase I to IV, and a large internationally renowned practice. We are part of the systemic mastocytosis network and recognised as a centre of excellence in that field. At our sister institution patients undergo stem cell transplantation and this institution also house national services for paroxysmal nocturnal haemoglobinuria and aplastic anaemia. We often host visiting clinicians and are able to offer a broad range of experience options including a project for presentation at national/international meetings. We offer twice yearly preceptorships in the myeloproliferative neoplasms.

Obstetric haematology

The obstetric haematology service at GSTT is recognised internationally with renowned expertise in the management of anaemia, immune thrombocytopenia, thrombosis, thrombophillia, myeloproliferative disease and sickle cell disease in pregnancy. The service is for patients who are either pregnant or planning to get pregnant. The learning opportunities include gaining an understanding of how to develop an obstetric haematology service, management of high risk pregnancies and rare diseases in pregnancy, attending local, regional and national meetings and a project in obstetric haematology with a view to present at a national or international meeting and be supported to produce a publication.

Paediatric Haemophilia and Haematology

The paediatric haematology service of GSTT is based at Evelina London Children’s Hospital and manages children with bleeding and thrombotic disorders, general haematological problems and haemoglobinopathies. The haemophilia centre provides comprehensive care for children with inherited bleeding disorders including inhibitor management and surgery. The service is comprised of a multidisciplinary team of specialist nurses, physiotherapist and psychologist. The haemoglobinopathy service manages children with sickle cell disease, thalassaemia and other haemoglobin disorders. The centre provides a range of specialist services including transcranial Doppler scanning and an active stroke prevention blood transfusion programme. We support our very busy paediatric and neonatal intensive care units and general paediatric wards with consultative reviews. Bone marrow biopsies in children are performed as indicated with paediatric blood film and bone marrow morphology assessment. Being co-located with the corresponding adult services, there is a seamless transition service. We are also actively involved in research in haemophilia, thrombosis, sickle cell disease and ITP. The service therefore provides in depth experience in non-malignant paediatric haematology for visiting professionals with scope for a research project if interested.

Sickle cell disease and red cell disorders

Inherited red cell disorders include sickle cell disease, alpha and beta thalassaemia and other forms of anaemia (e.g. G6PD deficiency, Diamond Blackfan anaemia).

We have close links with community services and have specialist diagnostic laboratory services for red cell disorders. Our patients are offered the opportunity to participate in international trials and local research projects.

Our haematology day unit offers a red cell apheresis service for patients with long-term chronic complications of sickle cell disease.

Teenage and young adult (TYA)

Being diagnosed with cancer/brain tumour when someone is in their late teens or early to mid-20s is always difficult. The TYA service exists to help make things easier, both for patients and their family.

There are many forms of cancer that develop in people aged 16-24. These include leukaemia and lymphomas; testicular and ‘germ cell’ tumours; melanoma; brain tumours, and other cancers that usually affect older adults, such as bowel, thyroid, ovarian or breast cancers.

Patients will have already had their diagnosis made by their oncologist or haematologist, and it is their expert team who will treat the patient’s particular cancer. The role of the Young Adult Cancer Service is to provide the extra support patient’s might need to help them cope with the diagnosis and the way it might impact on their plans for education, work, and possibly their relationships with family, friends and partners.

Thrombosis

The Thrombosis service has a registry with over 1300 patients with complex thrombotic disease. The team run the acute VTE service within the Trust, prevention of VTE within the Trust, a cancer and VTE service, a tertiary thrombotic thrombocytopenia service and all the anticoagulation services including DOAC (Direct Oral Anticoagulant) clinics. The team work closely in providing joined up services for post thrombotic syndrome with Vascular & Intervention Radiology and with the obstetric service to cover high risk women with thrombotic issues.

The Department offers a wide range of services to patients with difficult thrombotic problems from all over England.

Interests are in thrombosis, thrombophilia, obstetric haematology and acquired bleeding disorders. The team are actively involved in several multinational studies and translational research.

Transfusion medicine and patient blood management

The transfusion service at GSTT is one of the UK’s largest, most challenging transfusion services split across sites including adult and paediatric hospitals, benchmarked excellent in national audit, external quality assessment, MHRA inspection and peer review. We have strong links with the national blood transfusion service and are leading the way with patient blood management strategies to ensure the appropriate use of blood components. We provide an education programme for undergraduates and post graduates and actively participate in transfusion trials and audit. The potential learning experience includes participation in national comparative audit, implementation of patient blood management strategies, attending local, regional and national transfusion meetings and a project in transfusion.

Fees

A course fee per week will be applied; this fee excludes accommodation and travelling expenses. To find out the fee amount please email [email protected].

Please note

Clinicians are able to offer bursaries or discounted placements on an individual basis. This is at the discretion of the Directorates of GSTT and does not affect the terms and conditions of the Visiting Professional Programme agreements.