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Directory of Cancer Services Sunderland CONTENTS INTRODUCTION ............................................................................................. 4 LEAD CONTACTS SUNDERLAND CANCER UNIT ....................................... 5 LEAD CONTACTS PRIMARY CARE .............................................................. 6 BREAST CANCER SERVICES ....................................................................... 7 BREAST CORE MULTIDISCIPLINARY TEAM............................................... 8 BREAST CANCER SPECIALIST NURSES .................................................... 9 COLORECTAL CANCER SERVICES ........................................................... 11 COLORECTAL CORE MULTIDISCIPLINARY TEAM .................................. 12 COLORECTAL SPECIALIST NURSES ........................................................ 13 GYNAECOLOGY CANCER SERVICES ....................................................... 14 GYNAECOLOGY CORE MULTIDISCIPLINARY TEAM ............................... 16 HAEMATOLOGY CANCER SERVICES ....................................................... 17 HAEMATOLOGY CORE MULTIDISCIPLINARY TEAM ............................... 18 HEAD & NECK CANCER SERVICES ........................................................... 19 HEAD & NECK CORE MULTIDISCIPLINARY TEAM .................................. 20 HEAD & NECK CANCER SPECIALIST NURSES ........................................ 21 LUNG CANCER SERVICES ......................................................................... 22 LUNG CORE MULTIDISCIPLINARY TEAM ................................................. 23 LUNG CANCER SPECIALIST NURSES ...................................................... 24 NEUROLOGY CANCER SERVICES ............................................................ 25 NEUROLOGY MULTIDISCIPLINARY TEAM................................................ 26 ONCOLOGY SERVICES ............................................................................... 27 OPHTHALMOLOGY ...................................................................................... 29 ORTHOPAEDIC CANCER SERVICES ......................................................... 31 ORTHOPAEDIC CLINICAL TEAM ................................................................ 32 PAEDIATRIC CANCER SERVICES.............................................................. 33 PAEDIATRIC COMMUNITY NURSING SERVICES ..................................... 34 SKIN CANCER SERVICES ........................................................................... 35 SKIN CANCER CORE MULTIDISCIPLINARY TEAM .................................. 36 THYROID CANCER SERVICES ................................................................... 37 THYROID CORE MULTIDISCIPLINARY TEAM ........................................... 38 UPPER GI CANCER SERVICES .................................................................. 39 UPPER GI CORE MULTIDISCIPLINARY TEAM .......................................... 40 UPPER GI SPECIALIST NURSE .................................................................. 40 UPPER GI SPECIALIST NURSE .................................................................. 40 UROLOGY CANCER SERVICES ................................................................. 42 UROLOGY CORE MULTIDISCIPLINARY TEAM ......................................... 43 UROLOGY SPECIALIST NURSE ................................................................. 45 SPECIALIST PALLIATIVE CARE SERVICES .............................................. 46 SPC MULTIDISCIPLINARY TEAM ............................................................... 47 SPECIALIST PALLIATIVE CARE NURSING SERVICES ............................ 48 OVERNIGHT PALLIATIVE CARE DISTRICT NURSING SERVICE ............. 49 OUTPATIENT CLINIC (PALLIATIVE CARE) ................................................ 50 ST BENEDICTS HOSPICE DOMICILIARY VISITS....................................... 50 ST BENEDICTS HOSPICE – 24 HOUR Advice line .................................... 51 SPECIALIST SOCIAL CARE TEAM – PALLIATIVE CARE ......................... 52 PALLIATIVE CARE EDUCATION ................................................................. 53 Directory of Cancer Services - Reviewed & Updated November 2010 Page 2 of 71 CHAPLAINCY SERVICES ............................................................................ 54 CLINICAL PHARMACY ................................................................................ 55 DISTRICT NURSING ..................................................................................... 56 LYMPHOEDEMA SERVICE .......................................................................... 59 NUTRITION & DIETETIC SERVICES ........................................................... 60 OCCUPATIONAL THERAPY ........................................................................ 61 PHYSIOTHERAPY ........................................................................................ 62 SPEECH AND LANGUAGE THERAPY ........................................................ 63 OFFERING OPTIONS PATIENT AND CARER SUPPORT NETWORK ....... 64 NETWORK / SUPPORT GROUP CONTACT/TEL .................................... 65 NETWORK MEMBER DETAILS CONTACT/TEL ..................................... 66 LOCAL AND NATIONAL SUPPORT SERVICES ......................................... 67 COMPLEMENTARY SERVICES ................................................................... 70 COMPLEMENTARY SERVICES ................................................................... 70 AMENDMENTS/UPDATES ........................................................................... 71 Directory of Cancer Services - Reviewed & Updated November 2010 Page 3 of 71 INTRODUCTION The Cancer Services Directory has been produced to build on existing communication links between primary and secondary care. The Directory contains vital information about the multi-disciplinary teams responsible for cancer care at the Sunderland Cancer Unit. A particular emphasis is given to the Specialist Nurse who is recognised as an important communication link between the patient, the PCT and the Cancer Unit. Hopefully the Directory will help primary care direct patients onto a care pathway that ensures that patients are seen by the most appropriate team in the most appropriate place and in the timeliest fashion. Improvements in patient flow between primary and secondary care should lead to better patient satisfaction. There is already in existence, guidance on the appropriateness of referral and how that referral might be made most efficiently by a faxed pro-forma. This directory is more about making sure that colleagues are aware of the multi-disciplinary approach to patient care. Inevitably teams change and Directory details become dated and inaccurate but to maintain what we believe is a crucial dialogue between all health professionals the directory will be subject to annual amendment to maintain its accuracy. Many thanks for the time and effort that everyone has put in to producing this important Directory. Mr. C. Hartley Lead Clinician for Cancer Services Directory of Cancer Services - Reviewed & Updated November 2010 Page 4 of 71 LEAD CONTACTS SUNDERLAND CANCER UNIT There is a lead team within Sunderland Cancer unit comprising of a lead clinician, manager and a nurse who work in close collaboration to deliver on the strategic and operational agenda for Cancer Services at a local level. Lead Clinician The lead clinician is responsible for the clinical organisation, development and delivery of cancer care across the cancer unit. The lead clinician is a representative voice for medical colleagues relating to all aspects of cancer service provision; therefore communication is a fundamental part of this role. Contact Details: Mr Chris Hartley Tel: 0191 565 6256 Ext: 47206 Lead Manager The lead manager works closely with individual cancer teams and respective business managers to develop multidisciplinary team organisation and services to meet national cancer standards and the targets set out in the National Cancer Plan. The lead manager acts as the Trust‟s modernisation lead for cancer and takes a lead in the business planning process for cancer services. Contact Details: Denise Inskip Ext: 41960 Tel: 0191 569 9660 Lead Nurse The lead nurse is responsible for providing leadership and direction for all nurses involved in cancer care to develop cancer nursing practice in line with local, regional and national priorities. The aim is to facilitate and enable a comprehensive and integrated approach to cancer service delivery and improve the patient‟s experience across the cancer journey. Contact Details: Mel Robertson Tel: 0191 565 6256 Ext: 47444 Directory of Cancer Services - Reviewed & Updated November 2010 Page 5 of 71 Macmillan Cancer Information & Support Manager The lead information and support manager is responsible for providing anyone affected by cancer with information and support at any stage of diagnosis or during and after treatment. The service complements the medical information and services received from health professionals and works with partners across public, private and voluntary organisations to establish a robust support mechanism for all those affected by cancer including patients, families' friends and carers Contact Details: Deborah Spraggon Tel: 0191 5410122 Ext: 40122 LEAD CONTACTS PRIMARY CARE Sunderland Teaching Primary Care Trust has a lead clinician for cancer, allowing them dedicated/protected time to contribute to the development of cancer networks and to raise standards within primary care and influence development and improved communication across secondary and tertiary care. There is also a Cancer Strategic Lead in post to assist in planning and delivering cancer services across South of Tyne and Wear (SoTW). Within SoTW there is a Cross Locality Planning Group for Cancer, where Sunderland has representation from both primary and secondary care. Contact person: Sheila Cooper Strategic Lead (Cancer) Sunderland Teaching Primary Care Trust Tel: 0191 5297224 CONTACT PERSON (S): Dr. H. Choi Cancer Lead Clinician Southwick Health Centre Tel: 08444773689 Fax: 08444773690 Directory of Cancer Services - Reviewed & Updated November 2010 Page 6 of 71 BREAST CANCER SERVICES The breast cancer service provides a specialist breast clinic three times a week on a Monday, Wednesday and Friday. This provides a fast track service for patients with suspected breast cancer allowing the service to achieve the two week cancer waiting time targets. The multidisciplinary team (MDT) meet on a Wednesday (diagnostic and therapeutic) and Friday (diagnostic only) to discuss the results; this enables a multidisciplinary approach to planning the care and treatment of women with breast cancer in a timely manner ensuring that all governments‟ targets are achieved. Due to expansion of the service we are now able to offer a wider variety of operative procedures including sentinel lymph node biopsy, oncoplastic surgery as it pertains to the breast. We offer immediate or delayed breast reconstruction for cancer patients, various benign and cosmetic procedures including male and female breast reduction surgery, augmentation for micromastia and treatment of assymetry. Clinic Times Monday Tuesday Wednesday AM Mr Surtees N/P Mr Iwuchukwu N/P PM Mr Iwuchukwu Review Mr Iwuchukwu Review Thursday Friday Mr Iwuchukwu Male Clinic N/P CONTACT PERSON (S): Mr Obi Iwuchukwu – Lead Clinician Oncoplastic Breast Surgeon Secretary Ms Lynsey Shepherd Tel: 0191 565 6256 Mr Peter Surtees Ext 42630 Ext 42630 Breast /General Surgeon Secretary Mrs Carol Close Tel: 0191 5656256 Directory of Cancer Services - Reviewed & Updated November 2010 Ext 42013 Page 7 of 71 BREAST CORE MULTIDISCIPLINARY TEAM Title Name Ext Lead Clinician Mr Obiukwu Iwuchukwu 42013 Consultant Breast Surgeon Mr Peter Surtees 42013 Staff Grade Mr K Sensarma 42630 Oncologist Dr Wright 49646 Radiologist Dr J Connor 49188 Dr. G. Bunea 42929 Radiographer Maria Maddison 41317 Pathologist Dr M Jain Macmillan Nurse Specialists Michelle Derbyshire 47351 Caroline Misell 47351 Lynn Dunn 47597 Oncoplastic Breast Surgeon MDT Coordinator Directory of Cancer Services - Reviewed & Updated November 2010 41371 Page 8 of 71 BREAST CANCER SPECIALIST NURSES The role of the Macmillan Breast Care Nurse is to offer information, advice, and psychosocial care to patients newly diagnosed with breast cancer. We offer this support throughout the cancer journey, acting as the Key Worker liaising with and referring to the multidisciplinary team as appropriate. A breast prosthesis fitting service is offered in a timely and sensitive manner, ensuring confidentiality and privacy to discuss such issues as body image, sexuality and breast reconstruction. The breast care nurses have been appropriately trained to carry out a nurse led follow up clinic for those patients that meet criteria. The clinic runs along side the consultants clinic in order to provide support and guidance if and when needed. To meet the demands of the cancer reform strategy patient workshops have been adopted to carry out education and self management programmes to aid and support patients understanding of survivorship, breast reconstruction and adjuvant therapies. Research and audit heavily influence the role and the service provided by the breast care nurses in order to constantly improve the nursing service. We provide advice to patients and staff regarding wound care and carry out seroma drainage post-operatively when necessary. The breast care nurses ensure they keep up to date with all aspects of breast cancer and its treatments. We act as an educational resource to staff, teaching formally and informally. Close working relationships have been developed between primary and secondary care to try to facilitate a smooth transition for the patient. Directory of Cancer Services - Reviewed & Updated November 2010 Page 9 of 71 CONTACT PERSON (S): Michelle Derbyshire/Caroline Misell Tel: 0191 565 6256 ext. 47351 Bleep 57592 / 52223 Monday – Friday 08:30-16:30 Directory of Cancer Services - Reviewed & Updated November 2010 Page 10 of 71 COLORECTAL CANCER SERVICES The colorectal service provides specialist clinic facilitating a fast-track approach for patients with a suspected cancer. Depending upon the information contained within the referral letter patients may have some investigations carried out prior to their first appointment with the Consultant e.g. endoscopy. The multidisciplinary team meet every fortnight where each patient‟s case is reviewed and discussed, this facilitates a joint and multidisciplinary approach to planning care and treatment for patients including any support mechanisms that may be required throughout their journey and experience. Clinic Times AM Monday Tuesday Wednesday Thursday Friday Mr.Holtham New clinic (WGC) Mr O‟Dair Review clinic Mr.Farook New patient clinic Mr Corson Follow-up clinic Mr Corson New patient clinic (WGC) Mr Farook Follow-up clinic PM CONTACT PERSON (S): Mr.Holtham review clinic Mr O‟Dair New clinic Mr J. Corson – Lead Clinician Consultant Colorectal Surgeon Secretary – Linda Gregory Ext: 41974 Directory of Cancer Services - Reviewed & Updated November 2010 Page 11 of 71 COLORECTAL CORE MULTIDISCIPLINARY TEAM Title Name Ext Lead Clinician/ Surgeon Mr J Corson 41974 52051 (Bleep) Surgeon Mr G Farook 42177 52597 (Bleep) Surgeon Mr G O‟Dair 42162 57055 (Bleep) Surgeon Mr S Holtham 42177 57059 (Bleep) Gastroenterologist Dr H Mitchison 42779 57002 (Bleep) Dr D Nylander 41461 52062 (Bleep) Dr J Painter 41444 Dr J Crosbie 41444/52493 Dr S Cowlam 42918/52061 Oncologist Dr. I. Pedley Dr K Wright Dr A Azzabi 47424 Radiologist Dr. R. Marsh 41308 Pathologist Dr. S. Tijani 41376 Specialist Nurses Marilyn Boyd Susan Rodda Rosemary Jobling 47221/52137 57517 52597 Oncology Nurse Consultant Melanie Robertson 52593 Chemotherapy Nurse/ Department Manager Sister Jill Bell 47251 MDT Co-ordinator Lynn Dunn 47442 Directory of Cancer Services - Reviewed & Updated November 2010 Page 12 of 71 COLORECTAL SPECIALIST NURSES We aim to provide physical, psychological and spiritual support for men and women who have bowel disease. We work within a specialist colorectal team. Using research-based practice and listening to patients we try to improve and move the service forward. Our role is:To work closely with the Colo-rectal Team in the provision of care to patients with colo-rectal disease including: Colo-rectal Cancer Crohn‟s Disease Ulcerative Disease Constipation and Faecal Incontinence To provide advice, information and support to patients and their families from diagnosis to review. To act as key worker and provide continuity for patients, their families and carers throughout their treatment journey. To offer counselling/advice/teaching and support to any patients undergoing stoma formation, which includes community visits following discharge home. Ensure time, confidentiality and privacy to discuss issues such as body image and sexuality. To co-ordinate the input of other health care professionals. To provide or direct information, education, advice and support for patients, families and staff. We are available to see patients and carers in the outpatient department, on the wards and in the patients home, if required. Our hours of working are 8.30am-4.30pm, Monday to Friday. CONTACT PERSON (S): Marilyn Boyd/Susan Rodda/Rosemary Jobling Tel: 0191 565 6256 Ext: 47221 Bleep: 52137/57517/52597 Directory of Cancer Services - Reviewed & Updated November 2010 Page 13 of 71 GYNAECOLOGY CANCER SERVICES Sunderland currently provides Gynaecology clinics for patients with a suspected ovarian, cervical, endometrial or vulval cancers. There is a dedicated Fast Track PMB/Pelvic mass clinic held on a Tuesday afternoon. Mr MacNab the Gynaecology Oncology Unit Lead Clinician leads this clinic. Diagnostic procedures are carried out in Sunderland on both an in-patient and outpatient basis. Surgery for low-grade endometrial and cervical cancers is undertaken at SRH according to Northern Gynaecology Oncology Centre and Cancer Network agreed guidelines. All other suspected or confirmed cases of Gynaecological cancers are referred to the Queen Elizabeth Hospital in Gateshead (NGOC). Karen Philipson as Specialist Nurse provides support to patients and their families/carers as key worker. Close working relationships with the team at Queen Elizabeth Hospital Gateshead (Gynaecology Oncology Cancer Centre) are an essential part of the service in order to provide a high standard of care to these women especially as they receive treatments on different hospital sites. Clinic Times Monday Tuesday Wednesday Thursday Friday AM PM Mr MacNab Fast track PMB/Pelvic mass clinic. Oncology reviews Ovarian Cancer Screening Directory of Cancer Services - Reviewed & Updated November 2010 Mr MacNab Gynaecology out-patient clinic with some new and review Oncology patients. Page 14 of 71 CONTACT PERSON (S): Mr G. MacNab – Unit Lead Clinician Karen Philipson – Gynaecology Oncology Specialist Nurse Ext 42313 Diane Turnbull – Mr MacNab‟s Secretary Ext 49775 Michelle Kelly – Mr MacNab‟s Support Secretary Ext 49783 Marlene Owen 47442 Directory of Cancer Services - Reviewed & Updated November 2010 - MDT Co-ordinator Ext Page 15 of 71 GYNAECOLOGY CORE MULTIDISCIPLINARY TEAM Title Name Ext Unit Lead Clinician/ Gynaecologist Mr G MacNab 49775 Consultant Histopathologist Dr H Cochrane 41375 Pathology Secretary Maxine Dorward Christine Buckle 41375 Gynaecology Oncology Specialist Nurse Karen Philipson 42313 Nurse Colposcopist Susan Crossman 42633 Mr MacNabs Secretary Diane Turnbull 49775 Biomedical Scientist Janet Rodgers 42818 Cytology Failsafe Co-ordinator Beverley Taylor 41370 MDT Coordinator Marlene Owen 47442 Extended Team Membership Medical Oncologist Secretary (QEH) Gynaecology Oncology Secretaries (QEH) Dr A Hughes Lynn Ashman 0191- 4452124 Christine Hall Elaine Denham 0191- 4452872 Clinical Oncologist Secretary (NCCC) Dr W Taylor 0191- 2138473 Consultant Radiologist Secretary Dr J Connor Patricia Davis Ext Directory of Cancer Services - Reviewed & Updated November 2010 49188 Page 16 of 71 HAEMATOLOGY CANCER SERVICES Clinical Haematology aims to provide a comprehensive high quality service. This involves undertaking the clinical investigations of patients with suspected primary haematological disorders and the provision of treatment and continuing care of patients when such diagnosis are established. Inpatient services are provided within E55 which is a 16-bedded unit, which specialises in caring for adults with haematological malignant and non-malignant disease. Care provision ranges from diagnostic bone marrow biopsy, central line insertion, supportive therapies, simple to intensive chemotherapy regimes, the management of neutropenic sepsis and autologous bone marrow transplantation. Clinical Haematology also provides an outpatient service which is geographically adjacent to the inpatient area and the Chemotherapy and Haematology Day Unit. Clinic Times AM Monday Dr Galloway Dr Marshall (New and review patients) Tuesday Dr Lyons (Review patients) Wednesday Dr Hervey (Review patients) Thursday Dr Upadhye (Review patients) Friday CONTACT PERSON (S): Dr V Hervey - Lead Clinician Tel: 0191 565 6256 bleep 51312 Sister Marie Stubbs Direct Line: 0191 569 9755 Or Tel: 0191 565 6256 ext. 41755/49755 Directory of Cancer Services - Reviewed & Updated November 2010 Page 17 of 71 HAEMATOLOGY CORE MULTIDISCIPLINARY TEAM Title Name Ext Lead Clinician / Leukaemia & Myeloma Lead Dr S Marshall 47582 51315 (Bleep) Lead Clinician / Lymphoma Lead Dr V Hervey 47252 51312 (Bleep) Clinicians Dr M Galloway 47252 52276 (Bleep) Dr Y Upadhye 47582 51306 (Bleep) Dr S Lyons 47248 52487(Bleep) Dr A Nicolle 47248 Consultant 7 (to be appointed Mar10) 47248 51307 (Bleep) Ward Manager Sister Marie Stubbs Direct Line 5699755 Or SRH ext. 41755/49755 Radiologist Dr. C. Nyhsen/ Dr C White 49087 Pathologist Dr. H Cochrane (SRH) Dr G Menon (NGH) 41375 Chemotherapy Nurse/ Day Unit Manager Sister Jill Bell 47251 Clinical Nurse Specialists Faye Armstrong/ Anita Carr 47443 Bleep 59841 Bleep 59843 Haematology Research Nurse Paula Newton/ Alvin Bencito Bleep 52118 Bleep 52110 MDT Co-ordinator Vivienne Hullock 42046 Bleep 59853 Directory of Cancer Services - Reviewed & Updated November 2010 Page 18 of 71 HEAD & NECK CANCER SERVICES The Head & Neck multidisciplinary cancer clinic provides a forum to plan individualised programmes of care for newly diagnosed patients. It enables effective co-ordination of relevant services specific to the needs of the patient and considers any ongoing problems experienced by existing patients either during or after treatment. The team offers advice and support to the patient and family/carers throughout their cancer journey. Clinic Times ALL FRIDAY CLINICS - 08.30-12.00 Mr Burns Mr Martin Mr Hartley Miss Helen Cocks CONTACT PERSON (S): Mr. A Burns – Lead Clinician Consultant in Oral & Maxillo Facial Surgery Secretary Lisa Heaton Tel: 0191 565 6256 ext. 49133 For ENT: Mr. C Hartley Directory of Cancer Services - Reviewed & Updated November 2010 ext. 47262 Page 19 of 71 HEAD & NECK CORE MULTIDISCIPLINARY TEAM Title Name Ext Lead Clinician Oral & Maxillofacial Surgeon Mr R Banks 49949 Oral & Maxillofacial Surgeon Mr I Martin 49132 Oral and Maxillofacial Surgeon Mr A Burns 49133 Lead Clinician ENT Surgeon Mr C Hartley 47262 51196 (Bleep) ENT Surgeon Miss H Cocks 47432/52509 Oncologist (NCCT) Dr Sanjoy Chatterjee 49646 Consultant Radiologist Dr U Schierle 42932 Pathologist Dr Debra Milne 41376 Specialist Nurse Rachael Bannister-Young 41916 Dawn Ivison 59855 (Bleep) Speech and Language Therapist Ann Hurren/Lynn Bolden (Voice Restoration) 49169/49009 51583 (Bleep) Macmillan Speech and Language Therapist Jo Patterson/ Diane Goff (Swallowing Therapist) 47082 52226 (Bleep) Senior Specialist Dietitian Scott Covington 41219 51603 (Bleep) Gastrosotomy Paula Tetlow 41230 52514 (Bleep) Dental Hygienist Gillian Watson 42678 52525 (Bleep) MDT Co-ordinator Sarah Aldridge 47441 Directory of Cancer Services - Reviewed & Updated November 2010 Page 20 of 71 HEAD & NECK CANCER SPECIALIST NURSES The role of the Clinical Nurse Specialist Nurse (C.N.S) is to Act as Key Worker for patients newly diagnosed with head and neck cancer providing, advice, information and support to patients their families and carers throughout their cancer journey. Advice is provided regarding treatment options, such as surgery, radiotherapy and chemotherapy, also addressing pain, symptom control, and psychological/emotional aspects specific to this client group. The C.N.S will endeavour to ensure that continuity of care is paramount throughout the patient‟s cancer journey, Working with appropriate members of the MDT. Education, support and raising awareness of head and neck cancer is required, aimed at health professionals and members of the public . The C.N.S will therefore provide advice and information, relating to tall aspects of head and neck cancer, both in the primary and secondary care settings. Patients diagnosed with head and neck cancer will be reviewed at the weekly Head & Neck Oncology Clinic, or can be referred to the C.N.S by the patient‟s consultant. CONTACT PERSON (S): Rachael Bannister-Young Dawn Ivison Direct Line: 0191 569 9677 Bleep 59855 Directory of Cancer Services - Reviewed & Updated November 2010 Page 21 of 71 LUNG CANCER SERVICES The lung cancer service aims to provide a fast track approach to the consultation, investigation and diagnosis of patients with suspected lung cancer. Subsequent treatment, support and care is planned and provided in consultation with the multi-disciplinary team. Clinic Times Monday AM Dr Meachrey Tuesday Wednesday Thursday Friday Dr Taylor Dr Meachrey Dr Clague Dr Taylor / Dr Clague alternating PM Dr Sridharan CONTACT PERSON (S): Dr Sridharan RGH Dr Sridharan Dr Clague Dr Taylor Nurse led preassessment clinic Dr. H. Clague – Lead Clinician Secretary Susan Mann ext. 47339 Directory of Cancer Services - Reviewed & Updated November 2010 Page 22 of 71 LUNG CORE MULTIDISCIPLINARY TEAM Title Name Ext/Bleep Lead Clinician Dr. I. Taylor 47348 Consultant Physicians Dr. H. Clague Dr. G. Meachery Dr. K. Sridharan 47339 55008 (Bleep) 47558 42007 Cardiothoracic Surgeon Mr S. Stamenkovich 0191 2231450 Clinical Oncologist Dr. R McMenemin 0191 2563569 Medical Oncologist Dr. A Hughes 0191 2563558 Pathologist Dr. S Tijani 41374 Consultant Radiologist Dr. C White Dr. S England 42932 Lung Cancer Specialist Nurse Sue Pollock 47521 52510 (Bleep) Lung Cancer Specialist Nurse Joanne Anderson 47521 52237 (Bleep) Lung Cancer Support Nurse (Chemotherapy) Angela Nicholson 47251 52069 (Bleep) Chemotherapy Nurse/ Department Manager Vacant position 47251 Ward Manager E54 Brendan Cassidy (acting role) 5699754 Direct Line MDT Co-ordinator John Paul Stores 47442 Directory of Cancer Services - Reviewed & Updated November 2010 Page 23 of 71 LUNG CANCER SPECIALIST NURSES The role of the Macmillan Lung Cancer Nurse Specialist is to act as the Key worker in the diagnosis of patients with a Lung Cancer. This involves offering advice, support and information, to the patients and their carer, from initial diagnosis through their cancer journey and into the palliative stage of their disease. This will be achieved by co-ordinating the care of the patient by liaising with the designated consultant and other members of the multidisciplinary team involved in their care around the hospital setting. The Specialist Nurse is available in all breaking bad news clinics and review Consultant clinics to offer support to the patient and their carer. If the patient is admitted into the acute setting the nurse will be available for advise and support and also as a resource for junior medical staff. The Lung Cancer Nurse Specialists holds weekly nurse led clinic for review patients. The LCNS will act as a facilitator and advisor for health care professionals and other agencies and acts as a resource by providing education for all Healthcare Professionals reflecting current clinical developments. Promote communication across the primary and secondary interface and to work in close collaboration with health care professionals across health, social care and education to provide a high quality service to patients and carers. CONTACT PERSON (S): Sue Pollock Tel: 0191 565 6256 Ext: 47521 Bleep 52510 Joanne Anderson Ext: 47521 Bleep 52237 Directory of Cancer Services - Reviewed & Updated November 2010 Page 24 of 71 NEUROLOGY CANCER SERVICES The neurology service provides a fast track approach for patients with a suspected brain tumour. Patients may be referred by the GP with neurological symptoms requiring further investigation and would therefore be seen within the two-week wait. However, many patients with brain tumours present via other routes including Accident and Emergency. Neurosurgery is carried out at Newcastle General Hospital. Patients are either referred back to Sunderland if they require rehabilitation or if they develop epilepsy, for example, otherwise they are usually followed up by the team in Newcastle. If a patient develops epilepsy as a result of the brain tumour then the Epilepsy Specialist Nurse will offer support and advice in collaboration with the multidisciplinary team. Clinic Times AM PM Monday Dr Nath Tuesday SRH Dr Cleland (2,3 & 4) Dr Seidi (2,3,4) MWM (3&4) SRH Dr Nath SRH Dr Cleland Dr Jones MWM Dr Seidi Dr Seidi (1) Wednesday Dr Seidi Thursday Friday Dr Nath (3,5) MWM SRH Dr Cleland Dr Jones Dr Seidi (1,3) Dr Nath MWM STDH Dr Cleland (2) Dr Jones (4) WHC (Figures in brackets denote respective week clinic held each month) CONTACT PERSON (S): Dr P Cleland (Lead in Epilepsy) Secretary Mrs Helen Elsbury 0191 2336161 ext. 42778 Directory of Cancer Services - Reviewed & Updated November 2010 Page 25 of 71 NEUROLOGY MULTIDISCIPLINARY TEAM Sunderland – Consultant Neurologists Dr P Cleland (Lead in Epilepsy) Secretary - S Straughan ext. 42615 Dr O Seidi (Lead in Multiple Schelrosis) Secretary - S Straughan ext. 42778 Dr U Nath (Lead in Parkinson‟s Disease) Page via switch Secretary - H Wood ext. 42452 Dr R Jones Secretary - E Stout ext. 42388 Newcastle – Neurosurgeons Professor Mendelow Mr P Crawford Mr A Jenkins Mr N Todd Mr C Gerber Secretaries – via NGH switch Board Tel: 0191 2336161 Others Dr Roberts: Consultant Oncologist Dr Mallick: Consultant Oncologist Newcastle/Sunderland Royal Hospital Mrs L Park: Neuro Oncology Specialist Nurse Newcastle General Hospital Tel: 0191 273 8811 Bleep 1607 Mr Mark Dowell Epilepsy Specialist Nurse Tel: 0191 565 6256 ext. 47166 Bleep 51667 Directory of Cancer Services - Reviewed & Updated November 2010 Page 26 of 71 ONCOLOGY SERVICES The Oncology service at City Hospital Sunderland (CHS) consists of a number of clinics for new and review patients referred for non-surgical cancer treatments, and attendance of Oncologists at Multi-disciplinary team meetings. A number of Oncologists visit Sunderland on a sessional basis from the Northern Cancer Centre for Treatment (NCCT) at Newcastle to offer a range of treatments across tumour types including Urology, Colorectal, Breast, Lung, Upper GI, and Gynaecological cancers. Clinics are held in the Chester wing out-patient department, a qualified nurse who is part of the Chemotherapy and Haematology Day Unit team supports these clinics. CHS has a nurse Consultant in Oncology to offer a constant presence in Oncology at the Sunderland Royal Hospital site that provides access to Oncology advice and support when patients are admitted with complications to their cancer treatments. Chemotherapy treatments are offered to patients in three settings depending upon treatment regimens; within the hospital Chemotherapy and Haematology Day Unit based on E floor at Sunderland Royal Hospital, at Washington Outreach Chemotherapy Unit at Washington Primary care centre, or within the patients own home. CONTACT PERSON (S): Dr Ian Pedley Specific interest: Sunderland Secretary: Newcastle Secretary: Consultant Clinical Oncology Colorectal and Urology Cancers Tel: 0191 565 6256 ext: 49865 Michelle Gardiner Tel: 0191 219 4204 Dr Katherine Wright Specific interest: Sunderland Secretary: Newcastle Secretary: Consultant Clinical Oncologist Colorectal and Breast Tel: 0191 565 6256 ext: 49865 Andrea Conlin (Colorectal only) Tel: 0101 256 3567 Dr Sanjoy Chatterjee Specific interest: Sunderland Secretary: Newcastle Secretary: Consultant Clinical Oncologist Head & Neck and Breast Tel: 0191 565 6256 ext: 49646 Tel: 0191 2563571 Directory of Cancer Services - Reviewed & Updated November 2010 Page 27 of 71 Dr Andy Hughes Specific interest: Newcastle Secretary: Consultant Medical Oncologist Lung and Gynaecology Cancers Christine Roseby Tel: 0191 256 3558 Dr Ashraf Azzabi Specific interest: Newcastle Secretary: Associate Specialist Medical Oncology Colorectal and Urology Cancers Gail Ord Tel: 0191 256 3132 Tel: 0191 565 6256 ext: 49865 Sunderland Secretary: Melanie Robertson Specific interest: Contact details: Jill Bell Nurse Consultant Oncology / Lead Cancer Nurse Colorectal and Breast Tel: 0191 5656256 Ext 47444 or Bleep 52593 Chemotherapy and Haematology Day Unit Sister / Department Manager Tel 0191 5656256 Ext 47251 / 49822 Directory of Cancer Services - Reviewed & Updated November 2010 Page 28 of 71 OPHTHALMOLOGY The ophthalmic oncology clinic provides a patient focussed service to people with Eye Cancers. It allows the patient to meet the ophthalmic team and enables their Plan of Care to be individualised to meet personal needs. The Team provides support, advice and friendship to the patient, their family and carers throughout their cancer journey. Clinic Times Monday AM Mr Boyce 9-1pm LID Tumours (SEI) PM Mr Wood 1-5pm Tuesday CONTACT PERSON (S): Wednesday Thursday Mr Osborne 9-1pm LID Tumours (UHND) Friday Miss Chapman 9-1pm Mr C M Wood – Lead Clinician Secretary Mrs Kay Dale Tel: 0191 5699067 Fax: 0191 5699275 Directory of Cancer Services - Reviewed & Updated November 2010 Page 29 of 71 OPHTHALMOLOGY CLINICAL TEAMS Title Name Telephone/Ext Consultant Secretary Mr C M Wood Mrs Kay Dale 0191 5699067 49067 Consultant Secretary Mr R Boyce Mrs Anita Huggins 0191 5410037 46231 Consultant Secretary Miss F M Chapman Elizabeth Clark 01915699065 49965 Consultant Secretary Mr S Osborne Anne Marie Campbell 01915699068 49968 Specialist Dr. (Ultrasound) Dr R I Owen 0191 5699067 Nurses: 0191 5699082 Sister Pauline Taylor Staff Nurse Carol Weatherstone 0191 5699950 46249/46298 Directory of Cancer Services - Reviewed & Updated November 2010 Page 30 of 71 ORTHOPAEDIC CANCER SERVICES Patients who present to their GP with a suspected sarcoma or bone cancer should be referred urgently either by fax or telephone call. The referral will be passed to the surgeon on call who will usually see the patient within 24/48 hours. At the consultation, appointments are obtained for all investigations. Where possible, patients will be diagnosed in Sunderland, with more complex cases being transferred to the Freeman Hospital, Newcastle. Orthopaedic chemotherapy is delivered in Newcastle. CONTACT PERSON (S): On Call Bleep: 51241 Fax: 0191 565 3973 Sister Sheila Robson Sunderland Royal Hospital Tel: 0191 565 6256 Ext: 42076 Directory of Cancer Services - Reviewed & Updated November 2010 Page 31 of 71 ORTHOPAEDIC CLINICAL TEAM Consultant Secretary Ext Mr P Bansal Jan Laverick 41467 Mr A Cross Elizabeth Stoker 42465 Mr G DeKiewiet Gail Wheatley 42461 Mr P Dixon Jennifer Dignen 41277 Mr P J Gill Helen Elsbury 42674 Mr Greene Kathleen Bowmaker 42462 Mr L Irwin Carol White 42972 Mr A Nanu Leanne Hindmarch 42460 Mr S O‟Brien Gemma Hackett 41227 Mr G S Roysam Mary Youll 41254 Mr A Stirrat Donna Thomas 42477 Mr I Talkhani Nicola Lawson 41468 Ms L Tourret Helen Rendall 41227 Fax Line Directory of Cancer Services - Reviewed & Updated November 2010 5653973 Page 32 of 71 PAEDIATRIC CANCER SERVICES Children who present to the GP with a suspected cancer/ leukaemia should be referred urgently by fax (0191 5699219) and telephone call to any of the Consultant Paediatricians who will arrange to see the child as soon as is mutually agreed as being necessary. There is a Consultant of the Week system so there is always someone with whom to discuss a child or young adult. Please verify the child‟s carers telephone contact details as being correct and up to date. If the child is found to have or is suspected of having a cancer and requires further investigation or treatment, then the child will be transferred to the RVI in Newcastle. The child‟s care is then taken over and co-ordinated by the multidisciplinary team at the RVI. CONTACT PERSON (S): Dr G R Lawson - Clinical Director and Lead Clinician, Secretary Jill Corner ext. 42488 Dr P Kumar Secretary Sandra Fryatt ext. 42487 Dr A F Mellon Secretary Caroline 42899 Robson ext. Dr N Hopper Secretary Caroline 42899 Robson ext. Dr K Horridge Secretary Irene Greene ext. 42486 Dr C Harvey Secretary Susan White ext. 42485 Dr K Eastham Secretary Catherine Bell ext. 47599 Dr D Bresnan Secretary Catherine Bell ext. 47599 Directory of Cancer Services - Reviewed & Updated November 2010 Page 33 of 71 PAEDIATRIC COMMUNITY NURSING SERVICES If a child with malignancy requires nursing support when they are in their own home then this is planned and co-ordinated by the team in Newcastle. There are several community children‟s nurses in Sunderland who can receive a referral to visit a child. This may involve taking care of any central venous access device, offering and planning practical support, as well as providing additional emotional support to the parents and child. CONTACT PERSON (S): Community Children‟s Nurses Trish Maltby (South PCG) ext. 41236 Christine Hopkinson (North PCG) ext. 41236 Vacancy Directory of Cancer Services - Reviewed & Updated November 2010 Page 34 of 71 SKIN CANCER SERVICES The Dermatology team in Sunderland Royal Hospital provides a service for new and review patients with skin cancer. Patients referred urgently or under „2 week wait‟ rules are seen in protected rapid access slots within regular clinics, and a number of theatre slots are also reserved to ensure prompt treatment when skin cancer is suspected. Dr Lateo and Dr Blasdale have a special interest in Skin Cancer and Cutaneous Surgery, and most procedures are performed as Local Anaesthetic Day Case Surgery within the department. Occasionally cases are referred on to Maxillofacial Surgery, to Plastic Surgery in UHND, or to the Oculoplastic Surgeons as clinically indicated The Local Hospital Skin Cancer MDT (Multidisciplinary team) meets on every other Tuesday, and includes members from the departments of Dermatology, Maxillofacial Surgery, Ophthalmology/ Oculoplastics and Histopathology. This allows good communication between departments and shared care when appropriate. More advanced or complex cases may be referred to the Specialist Skin Cancer MDT at the RVI in Newcastle. The department has close links with the Mohs Micrographic Surgery service in Newcastle, to which patients are referred when considered clinically appropriate. Clinic Times AM PM Monday Tuesday Wednesday Thursday Friday Dr Natarajan Dr Lateo Dr Natarajan (wks 2 + 4) Dr Natarajan Dr Blasdale Dr Niazi Dr Blasdale Dr Lateo Dr Niazi Dr Lateo / Dr Dr Niazi Blasdale Dr Niazi CONTACT PERSON (S) Dr C Blasdale, Consultant Dermatologist Tel: 0191 5656256 Ext: 41559 email:[email protected] Directory of Cancer Services - Reviewed & Updated November 2010 Page 35 of 71 SKIN CANCER CORE MULTIDISCIPLINARY TEAM Team Name Ext Consultant Dermatologist and Lead Clinician Dr C Blasdale 41559 Consultant Dermatologist Dr S Natarajan 47462/59842 Consultant Dermatologist Dr S Lateo 49879 Associate Specialist Derm Dr J Niazi Dr J Chander 47463 Maxillofacial Surgeons Mr J Ryan(Facial Plastics) 49134 Mr A Burns 49133 Mrs K Stone Mr M Dorman Oculoplastic Surgeons Miss F Chapman 49965 Mr R Boyce Oncologist Dr C Kelly 256 3560 Pathologist Dr M Wetherall 41374 Outpatient Sister Denise Burdon 47559 Melanoma Specialist Nurse Ann Irwin 333 2326 (Based at University Hospital of North Durham) Skin cancer specialist nurse Post vacant MDT co-ordinator Post vacant Directory of Cancer Services - Reviewed & Updated November 2010 Page 36 of 71 THYROID CANCER SERVICES The thyroid cancer team in Sunderland Royal Hospital provides a service for new and review patients with thyroid cancer, from diagnosis in clinic to treatment. Patients referred urgently or under „2 week wait‟ rules are seen in protected urgent slots within regular clinics, The local Thyroid Cancer MDT (Multidisciplinary team) meets every other Wednesday, and includes members from the departments of General Surgery, Endocrinology, Radiology, Medical Physics and Histopathology. This allows good communication between departments and shared care when appropriate. Where further treatment options are required, patients are referred to the Oncology Team. Clinic Times Monday Tuesday Wednesday Thursday Friday AM Mr Boobis PM Week 1,3 Mr Leontsinis Week 2 CONTACT PERSON (s): Mr Leontsinis Consultant Surgeon ENT 0191 5656256 ext 47428 Directory of Cancer Services - Reviewed & Updated November 2010 Page 37 of 71 THYROID CORE MULTIDISCIPLINARY TEAM Title Name Telephone/Ext Consultant Surgeon ENT Lead Clinician Mr Leontsinis 0191 5656256 47205 Consultant Surgeon Mr L Boobis 42441 Consultant Endocrinologist Dr Nayar 42017 Consultant Endocrinologist Dr J Chapman 42180 Histopathologist Dr D Milne 41376 Radiologist Dr U Schierle 42932 Head of Medical Physics David Williams 42661 Medical Physicist Andrew Knight 42662 Cancer Nurse Specialist Julie Burton MDT Co-ordinator Sarah Aldridge Directory of Cancer Services - Reviewed & Updated November 2010 0191 2336161 dect 48654 47441 Page 38 of 71 UPPER GI CANCER SERVICES The upper GI service provides a clinic each day to facilitate a fast track approach for patients with suspected oesophageal, gastric, biliary or pancreatic cancers. All newly diagnosed patients will be assessed by the MDT and an appropriate plan of care agreed, enabling a streamlined approach to patient management and family support throughout the patient‟s cancer journey. Patients referred urgently under the two week rules may be seen initially in clinic or endoscopy according to a consultant decision, dependent on the information within the referral letter. All patients should not have taken any PPIs of H2 antagonists for two weeks preceding endoscopy, as per NICE recommendations to reduce the risk of missing gastric cancers at endoscopy. Clinic Times AM Monday Dr Hobday (MWH) Dr Crosbie (MWH) PM Tuesday Dr Painter (SRH) Dr Mitchison Wednesday Dr Nylander Dr Cowlam Dr Crosbie Thursday MDT 8.30 – 9.30 Dr Mitchison (Wash Gal HC) Friday Dr Hobday (SRH) Dr Cowlam Dr Nylander (SRH) Dr painter/Dr Mitchison Endoscopy Times AM PM Monday Dr Painter Tuesday Dr Nylander Dr Morgan Wednesday Dr Hobday Dr Crosbie Thursday Dr Cowlam Fast Track Dr Cowlam Fast Track Dr Hobday Dr Mitchison / Dr Painter (alternating) Fast Track Friday Dr Crosbie Eve ning Fast Track CONTACT PERSON (S): Dr J Painter – Lead Clinician Consultant Gastroenterologist Secretary Gemma Pattison ext. 41444 Fax No. for urgent referrals – 0191 5699216 Directory of Cancer Services - Reviewed & Updated November 2010 Page 39 of 71 UPPER GI CORE MULTIDISCIPLINARY TEAM Title Name Ext Lead Clinician Dr J Painter 41444 Gastroenterologists Dr D Hobday 42918 Dr H Mitchison 42779 Dr D Nylander 41461 Dr J Crosbie 41444/52493 Dr S Cowlam 42918/52061 Oncologist Vacancy Radiologist Dr R Marsh 41308 Pathologist Dr M Theodosoiu 41376 Specialist Nurse Sister Jane Osbourne 47746 Dietician Sarah Whitehead 52202 (Bleep) Jill Savage MDT Co-ordinator John Paul Stores47441 UPPER GI SPECIALIST NURSE The role of the upper Gastrointestinal specialist nurse is to provide an easily accessible point of contact for information, education, advice and support to patients and their families throughout their cancer journey. The aim is to help Directory of Cancer Services - Reviewed & Updated November 2010 Page 40 of 71 and improve the patients quality of life. It involves working closely alongside other members of the multi disciplinary team to provide a holistic and effective service to patients with upper GI problems. The specialist nurse will provide a link for the patient between the hospital and community to provide and maintain continuity of care. The specialist nurse will provide up to date information, support and education for all health care professionals in the care and management of upper gastrointestinal problems. Research and audit to facilitate best practice and standards are also key aspects of the role. CONTACT DETAILS: Jane Osbourne Tel: 0191 565 6256 Ext: 47746 Bleep: Directory of Cancer Services - Reviewed & Updated November 2010 Page 41 of 71 UROLOGY CANCER SERVICES Since April 2006 Urology services at Durham, South Tyneside and Sunderland have been amalgamated. Sunderland is the hub and there are spoke sites at South Tyneside General Hospital, University Hospital North Durham, Bishop Auckland General Hospital, Shotley Bridge General Hospital and Chester-le-Street Hospital. Across the sites a multidisciplinary approach is used to establish both diagnosis and treatment of cancers within Urology, supporting patients and their carers throughout the cancer journey. At Sunderland we offer: Fast Track Haematuria Clinic (Monday a.m.), Benign Prostatic Hyperplasia Clinic (Wednesday PM.) Trans-rectal Ultrasound (Thursday/Friday) Andrology Clinic (Thursday a.m.) Multi-Disciplinary Meetings are held weekly. The urology outpatient department also administers intra-vesical chemotherapy and immunotherapy. Clinic Times Sunderland AM PM Monday Mr Johnson Mr Keegan Dr Pedley Dr Azzabi (Oncology clinics Miss Kirchin (alternate weeks) Tuesday Mr Menezes Wednesday Mr Sheikh Miss Kirchin Mr Johnson Mr Menezes Thursday Mr Sheikh Friday Mr Green/ Mr Sheikh Mr Green For details of off-site activity please contact the urology department. CONTACT PERSON (S): Mr. D. Green – Lead Clinician Consultant Urologist Secretary - Andrea Hubbard ext. 42191 PERIPATETIC SERVICES City Hospitals Sunderland patients have the benefit of a Peripatetic Urology Nurse Specialist. The Peripatetic Team is accessed by internal referral only within urology services by completing the referral form. Patient‟s benefit by having selected treatments in their own homes that have previously required hospitalisation. Treatments include: Trial Without Catheter (TWOC) with bladder scan monitoring, zoledronic acid infusion every four weeks for patients with metastatic prostate cancer, zoladex injections and intermittent self catheterisation education. Directory of Cancer Services - Reviewed & Updated November 2010 Page 42 of 71 UROLOGY CORE MULTIDISCIPLINARY TEAM Title Name Ext Lead Clinician Mr. D. Greene 42191 (sec) Consultant Urologist Mr. P. Johnson Mr P Menezes Miss V Kirchin Mr P English Mr P Keegan Mr P Richmond Mr T Armitage Mr C Roberts (BA) Mr B Jenkins 41393 (sec) 42197 Associate Specialist Mr. N. Sheikh 42758 (sec) Oncologist Dr. I. Pedley Radiologist Dr. R. Marsh 42988 (sec 42181) 41308 Pathologist Dr. M. Theodosiou Dr V Prabhu 41371 47476 Specialist Nurse Nicola Elves (CHS) 42606 53448 (Bleep) Haley Laws 52448 42197 Gayle Adams (STFT) 08448113030 Bleep 532 Ext 2238 Jeannette Maughan (UHND) 0191 3332772 Bleep 4402 Tim Thornhill (UHND) 0191333 2772 Nurse Cystoscopist Sandra Hargreaves 41967 52377 (Bleep) Peripatetic Nurse Gary Musgrove 52180 Research Nurse Susan Asterling 49869 Urology Department Manager Sister Anita Briggs 41725 Directory of Cancer Services - Reviewed & Updated November 2010 Page 43 of 71 MDT Co-ordinator 47441 Susie Blyth Directory of Cancer Services - Reviewed & Updated November 2010 Page 44 of 71 UROLOGY SPECIALIST NURSE The role of the Macmillan Urology Nurse Specialist is to act as the key worker in the primary diagnosis of a Urological cancer. This involves supporting patients with cancer from initial diagnosis through to treatment and follow up review, until such a time the patient is discharged back to their GP or to Palliative care. The aim of the service is to enhance the existing establishment in good inter-professional care and management of all five Urological cancers. (Prostate, bladder, renal. penile and testicular) This will be achieved by the successful integration and co –ordination of the care of patients with a urological cancer, by liaising with the designated consultant and rest of the multi disciplinary team involved in their care in and around the hospital setting. The specialist nurse is available in new breaking bad news clinics and review Consultant clinics to offer support to patients and carers. In an attempt to ensure a high standard of care the well being of the patients with a urological caner this is dependent on the provision of information with evidence- based care in order to provide continuity throughout their care. The Specialist Nurse will contribute to the in put of pre assessment clinics and visits patients in the pre and post operative period. The urology specialist nurse holds a weekly prostate clinic (currently Thursdays) for long-term prostate cancer review. The Nurse Cystoscopist is the key worker for superficial bladder cancer patients and has two flexible cystoscopy lists that are review following bladder cancer CONTACT PERSON (S): Hayley Laws Bleep: 52448 Nicola Elves Bleep: 52508 0191 565 6256 Ext: 42606 Gayle Adams (STFT) Bleep: 532 08448113030 Ext: 2238 Jeannette Maughan (UHND) Bleep: 4402 0191 3332772 Tim Thornhill (UHND) 0191333 2772 Sandra Hargreaves 41967 Nurse Cystoscopist 52377 Directory of Cancer Services - Reviewed & Updated November 2010 Page 45 of 71 SPECIALIST PALLIATIVE CARE SERVICES The Specialist Palliative Care Team influences patient care by a variety of means and the role encompasses clinical, consultative, teaching, leadership and research functions. The primary aim of the teams is to bring about the highest standard of clinical care directly to the patient / carer by offering psychological support and expert advice on treatment options / symptom control or by indirectly acting as a resource to other professionals, who are likely to be the patients key worker. Specialist palliative care offers specialist expertise in symptom control and holistic care to patients along with their families and carers. Services available include: Hospice Inpatient care Day Care Unit 24 hour specialist advice line Overnight Nursing Service Community Nursing Team Hospital Nursing Team Specialist Nursing for care homes Lymphodema service Education Department Domiciliary specialist palliative care Outpatient Consultations Ward Consultations Bereavement service / family support Specialist Palliative Care is provided by the Consultants in Palliative Medicine and Specialist Palliative Care Nursing Services supported by the admin team. The team also include Physiotherapists, Occupational Therapists, Specialist pharmacist Clerics, Dieticians and Social Workers. Directory of Cancer Services - Reviewed & Updated November 2010 Page 46 of 71 SPC MULTIDISCIPLINARY TEAM Role Name Tel Lead Clinician/ Consultant in Palliative Care Consultant in Palliative Care Dr Peter Robson 0191 5699987 Dr Mark Lee Dr Lisa Baker Dr Vicky Hewitt 0191 5699987 0191 5699987 0191 5699987 Kath Henderson Kirsty Curran Julie Dagg Lynn Stronach 0191 5699191 0191 5699191 0191 5699191 0191 5699199 Maureen Wilson 0191 5699199 Wendy Ward Johnson Sue Whitehead 0191 5699199 Jenny White 0191 5699199 Julie Lamb 0191 5699199 Linda Newton 0191 5699199 Associate Specialist in Palliative Care/ Hospice Director Senior Nurse Business Manager Modern Matron Specialist Palliative Care Co-ordinator Specialist Palliative Care Nurses (Community) Specialist Palliative Care Nurses (Community) 0191 5699199 Specialist Palliative Care Nurse(Hospital) Carolyn Wills Sonia Thompson Inpatient Unit Manager Chris Allison 0191 5656256 ext 47337 0191 5699195 Inpatient MDT co-ordinator Day Care Unit Manager Day Care MDT co-ordinator Lynn Jackson Joy Mc Donald Laura Wyness 0191 5699195 0191 5410031 0191 5410031 Lymphoedema Specialist Nurse 0191 5699759 Out of Hours team manager Lesley Holmes Ann Thompson Chris Alder Sue Tibbett Julie Newby Occupational Therapist Frances Storey Social Worker Stephen Holmes Specialist Pharmacist Inga Andrew 0191 5656256 ext 48237 0191 5656256 ext 49197 0191 5699195 Chaplain Caroline Worsfold 0191 5656256 Physiotherapist Directory of Cancer Services - Reviewed & Updated November 2010 0191 5656256 ext 48237 0191 5410055 Page 47 of 71 SPECIALIST PALLIATIVE CARE NURSING SERVICES The specialist palliative care nurses work to improve the quality of life of people over 16 years of age, with cancer and other progressive diseases. The role of the team is to provide specialist advice and support to patients, carers, and healthcare professionals across primary and secondary care including care homes when the patient‟s symptoms and carers issues become more complex. The service is available from Monday to Friday 8.30 am to 5.00 pm. Any advice outside of these hours can be accessed via St Benedict‟s Hospice on tel. 5699195 or internal ext. 49195. The aims of the team are to 1. Receive referrals for patients with specialist palliative care needs when symptoms become a problem to manage. 2. To assess complex symptoms and advise on their management. 3. Offer advice either by telephone or face-to-face when a referral or patient assessment is not required e.g. advice on drug conversion, alternative drugs to manage symptoms etc. 4. To provide emotional, psychological and spiritual support to patients and carers, incorporating bereavement support. 5. To provide education to patients, carers and other health care professionals. Referral to the Palliative Care Nursing Service can be made at any point throughout the patient‟s illness. Referrals are accepted from other health care professionals with permission of the patient and GP or consultant. Directory of Cancer Services - Reviewed & Updated November 2010 Page 48 of 71 OUT OF HOURS PALLIATIVE CARE NURSING SERVICE The aim of the Out of hours palliative care nursing service is to enable patients to be cared for in their own homes by responding to and managing pain and other symptoms. They provide advice and support to the patient, carer and other professionals. The out of hours Palliative care team are based at St Benedict‟s Hospice and are available from 5pm -8.30am. Two Registered nurses are on duty each evening and overnight. Referrals can be made by GP Primecare District nurse/ 24/7 team Patient Carer Marie Curie service A&E department at Sunderland Royal Hospital. Any member of the specialist palliative care team Visits can be planned or in response to an urgent/crisis request CONTACT PERSON: Julie Newby St Benedict‟s Hospice Tel: 0191 5410055 Mobile Telephone: 07798 925 128 Fax 0191 5410055 / internal 49198 Directory of Cancer Services - Reviewed & Updated November 2010 Page 49 of 71 OUTPATIENT CLINIC (PALLIATIVE CARE) An out-patient clinic is held each week on a Wednesday afternoon and Friday morning at Monkwearmouth Hospital. The clinic is led by a Consultant in Palliative Medicine Referrals may be made to the clinics by:- General Practitioners Hospital Consultants Specialist Palliative Care Nurse Team Out-patient clinic appointments may be made by referral letter or fax to St Benedict‟s Hospice on Tel. 0191 5699253 ST BENEDICTS HOSPICE DOMICILIARY VISITS On request from a General Practitioner, a home visit may be made by a Consultant in Palliative Medicine or another member of the medical team to a patient who, for some reason, finds it difficult to attend one of the out-patient clinics. Requests for a home visit should be made by the General Practitioner to medical staff at St Benedict‟s Hospice. If at all possible, domiciliary visits will be made within 2 working days. Tel. 0191 5699253 Directory of Cancer Services - Reviewed & Updated November 2010 Page 50 of 71 ST BENEDICTS HOSPICE – 24 HOUR Advice line The purpose of the 24 hour advice line is to provide specialist advice to any health care professionals, patients and carers requiring help and information regarding palliative care issues TEL: 0191 5699195 Contacting the advice line Contact the above telephone number and provide the hospice nurse with background information i.e. patient‟s details/problems and telephone contact number. The nurse will then contact the Doctor on call and agree action plan. You will then be called back by a member of the Palliative Care Team as soon as possible with this information. A record will be kept of the enquiry and be the subject of team discussion, in order to provide educational and administrative/service information. Directory of Cancer Services - Reviewed & Updated November 2010 Page 51 of 71 SPECIALIST SOCIAL CARE TEAM – PALLIATIVE CARE This team provides a specialist social care service for adults with advanced progressive illness in hospital, community or hospice. The care that can be provided includes information about services and support available, help with personal care or practical tasks at home, help with leaving hospital, or help in arranging care in a care home or day activity centre. Help is also provided for family members and carers. The Specialist Social Care Team can also offer psychosocial support and help with bereavement. People being referred must be residents of the city of Sunderland. There are no restrictions on who can make a referral to the team. Health and Social Care colleagues using Liquid Logic Single Assessment Process can make referrals via the Social Services, Specialist Social Care Team Admin Tray. Due to Fieldwork commitments it is usually best to contact the team members between 9am and 10 am CONTACT PERSON (S): Team Manager Specialist Social Care Team Monkwearmouth Hospital Sunderland Tel 0191 5699197 Fax No 0191 5169496 Email [email protected] Directory of Cancer Services - Reviewed & Updated November 2010 Page 52 of 71 PALLIATIVE CARE EDUCATION The Sunderland Palliative Care Team provides a range of educational initiatives for all health and social care staff within the City. Flexible training programmes are available through a range of study days and courses to meet specific individual or group requirements. There is a full time senior lecturer based at St Benedict‟s Hospice working between there and the University of Sunderland. The specialist palliative care team contribute to all educational activities. There is a library on site with a range of up to date resources available to staff on any course at the Hospice. CONTACT PERSON (S): Gail White Senior Lecturer Practitioner St. Benedicts Hospice Tel: 0191 5656256 ext 48302 Fax: 0191 569 9253 Directory of Cancer Services - Reviewed & Updated November 2010 Page 53 of 71 CHAPLAINCY SERVICES City Hospitals Sunderland (covering Sunderland Royal Hospital and Eye Infirmary) The chaplains offer care and support to patients‟ relatives and staff on a 24/7 basis. A chapel and Muslim prayer room are situated opposite reception at the main entrance of Sunderland Royal Hospital. The chaplains can act as a link with local church ministers and leaders of other faith communities. Please make contact with the office with any enquiry relating to spiritual issues. Contact Details: Telephone:- 5699180 answer phone is available. Daytime ( 9 – 5 pm): Duty bleep for all spiritual needs – 51596. Out of hours contact Church Of England/Duty chaplain via switchboard – 0191 5656256. St. Benedicts Hospice The chaplains offer care and support to patients relatives and staff. The chaplains can act as a link with local church ministers and leaders of other faith communities. Contact Details: Revd Caroline Worsfold C of E Tel 5656256 ext. 43370 Directory of Cancer Services - Reviewed & Updated November 2010 Page 54 of 71 CLINICAL PHARMACY Pharmacy provides support to cancer services through the provision of chemotherapy and the medicines management service on ward E55. Chemotherapy The Production Unit provides individualised chemotherapy in a ready to use form to both in-patients on E55 and out-patients on the Chemotherapy Day Unit. All prescriptions are clinically checked by a pharmacist before preparation to ensure drugs and doses are appropriate for the patient. The chemotherapy is then aseptically prepared by pharmacy technicians in an isolator to ensure sterility. Contact Karen Shield Production Manager Ext 41101 Medicines Management The medicines management service was introduced to improve the pharmaceutical care of inpatients. Pharmacists work along with pharmacy technicians to ensure that “the right patient gets the right drug at the right time.” A Pharmacist will speak to every new patient admitted to E55 to discuss what medication they have been taking prior to admission. This is compared with their current prescription on EP and any discrepancies discussed with the medical team. A supply of medication is sent to the ward and placed in the patient‟s individual medication locker in preparation for discharge. This greatly reduces the length of time that patients need to wait for discharge medication prescriptions. Patients are counselled about their medication on discharge to explain any changes, the reason for the changes and how to take any new medication. Pharmacists also provide information for the patient‟s GP regarding medication changes to ensure that the correct medication is continued at home. Contact Julia Dorward Senior Clinical Pharmacist Bleep 51648 Directory of Cancer Services - Reviewed & Updated November 2010 Page 55 of 71 DISTRICT NURSING The District Nursing Service provides expert and specialist nursing care and advice for people at home who are acutely or terminally ill. Initially, the nurse may offer psychological support to the patient and their family and are able to refer to other agencies. In addition they will also monitor symptom control. When intensive nursing is needed at home, the District Nurse may provide general nursing care, pressure area care, wound care, management of pain and any other symptoms including the use of syringe drivers if needed. The District Nurse co-ordinates care with the GP and makes maximum use of available resources including: Palliative Care Specialist Nurse Home Support Nurses Marie Curie Service Breast Care Nurse Stoma Care Nurse Social Workers Domiciliary Care Team Community Equipment Store Local Pharmacist Hospice, In-patient & Day Care facilities Voluntary Services Specialist Palliative Nurses District Nursing provides a 24hr service and can be contacted either at the appropriate Health Centre 8.30am to 5.00pm or their mobile phone number. Between 5pm to 9pm the 24/7 team on (0191) 5252363. Mobile number depends on the area - North area 07766 408718 South area 07766 408719 West area 07766 408720 Between 9pm to 8am the Overnight Palliative Care Team may be contacted on 07798925128 or (0191) 5656256 and ask for bleep 52434 Directory of Cancer Services - Reviewed & Updated November 2010 Page 56 of 71 Health Centres Tel Nos Speed-Dial Fax Nos Bunny Hill Primary Care Centre 519 5847 Southwick Health Centre 549 0960 1212 516 9644 Monkwearmouth Health Centre 514 0431 1207 567 6394 Hendon Health Centre 567 8911 1202 567 8911 519 5801 (including *Deerness Park DNs) St Bedes Medical Centre 565 5281 510 2495 Deerness Park Medical Centre 567 0961 565 0075 *Deerness DNs are now based at Hendon health centre – details above Pallion Health Centre 565 6256 Springwell Health Centre 528 2828 1020 522 9311 Silksworth Health Centre 521 2873 1211 521 0063 Millfield Medical Centre 5679179 514 7452 Old Forge Surgery 510 9393 510 9595 Pennywell Medical Centre 534 7924 534 3279 Ryhope Health Centre 521 0668 1210 523 8510 Hetton Medical Centre 526 3657 1203 526 2244 Galleries Health Centre 416 6880 1201 417 4105 Directory of Cancer Services - Reviewed & Updated November 2010 569 9290 Page 57 of 71 Victoria Road Health Centre 416 2120 1213 415 1002 Houghton Health Centre 584 4566 1205 512 1168 Murton Clinic 526 1761 1215 517 0471 Seaham Clinic 581 2461 1214 581 2461 Directory of Cancer Services - Reviewed & Updated November 2010 Page 58 of 71 LYMPHOEDEMA SERVICE The lymphoedema clinic operating Mon-Fri 9am-5pm. is a nurse led service located within Monkwearmouth hospital providing support, advice and treatment to patients suffering from primary or secondary lymphoedema. Maintenance treatments for non-complicated lymphoedema encompass skin care, exercise, massage and compression garments. Intensive treatments include multi-layer bandaging, and manual lymphatic drainage. It is recommended that patients have an initial medical screening to rule out other possible causes of oedema before referral to the lymphoedema clinic. While medical assessment cannot be undertaken, medical advice from hospice staff is available and treatment changes implemented, but only in consultation with the referring Doctor. Referrals must be made in writing and can be sent or faxed to 0191 5699759 Referrals can be received from: GPs Hospital Consultants Hospice Team/specialist palliative care nurses with consultant consent CONTACT PERSON (S): Ann Thompson / Lesley Holmes Lymphoedema Nurses Monkwearmouth Hospital Tel: 0191 5699759 Fax: 0191 569 9759 Directory of Cancer Services - Reviewed & Updated November 2010 Page 59 of 71 NUTRITION & DIETETIC SERVICES This service can be provided to all cancer patients at any stage from diagnosis to palliation. The service includes assessment and dietary advice for healthy eating, weight reduction or building up, as well as during surgery, chemotherapy or radiotherapy. The service is delivered to in-patients, outpatients and at times in patient‟s homes. CONTACT PERSON (S): Stella Wilson Clinical Head/Manager Carol Springnett Senior Dietician – Nutritional Support Tel: 0191 569 9013 Direct Line, Dietetic Department Directory of Cancer Services - Reviewed & Updated November 2010 Page 60 of 71 OCCUPATIONAL THERAPY The occupational therapy service provides assessment and treatment of functional difficulties to enable individuals to live as independently as possible, in the environment of their choice. Using meaningful activity as a therapeutic medium, consideration is given to emotional and psychological difficulties. Advice and education is provided to patients, relatives and carers. The need for specialist equipment and alterations is assessed, and requirements arranged. CONTACT PERSON (S): Miss Linda M Colquhoun Deputy Clinical Occupational Therapy Manager Occupational Therapy Department Sunderland Royal Hospital Tel: 0191 565 6256 Ext: 47114 Directory of Cancer Services - Reviewed & Updated November 2010 Page 61 of 71 PHYSIOTHERAPY This service provides a generalised input throughout the acute, chronic and palliative stages. Exercise to improve overall mobility, pain relief and relaxation techniques are employed as well as management of lymphoedema or neurological impairments. Programmes are individually tailored to patients who with new carers often require elements of education and training. Mobility and equipment needs are addressed in collaboration with Community services where necessary. CONTACT PERSON (S): Christine Alder / Sue Tibbett Senior Physiotherapists – Physiotherapy Monkwearmouth Hospital Tel: 0191 569 9095 Ext: 49095 Christine Scott Senior Physiotherapist Sunderland Royal Hospital Tel: 0191 565 6256 Ext: 42398 Sue Tibbett / Gillian Oliver Senior Community Physiotherapists Monkwearmouth Hospital Tel: 0191 5699095 Ext: 48222/49095 Directory of Cancer Services - Reviewed & Updated November 2010 Page 62 of 71 SPEECH AND LANGUAGE THERAPY This service provides assessment, diagnosis and treatment of people with speech, language, voice and swallowing problems who have been affected by cancer. Patients may be seen in both inpatient and outpatient environments, multi disciplinary clinics, hospice and on domiciliary visits. Patient referrals may originate from any source including patients themselves, carers and any members of the primary care team. (N.B. Head and Neck Cancer patients are part of a sub regional service) CONTACT PERSON (S): Jo Patterson Macmillan Speech and Language Therapist Speech and Language Therapy Department Sunderland Royal Hospital Tel: 0191 569 9009 Fax: 0191 569 9790 Ruth Rayner Head of SALT SRH Ext 49009 Directory of Cancer Services - Reviewed & Updated November 2010 Page 63 of 71 OFFERING OPTIONS PATIENT AND CARER SUPPORT NETWORK A network of Voluntary Sector agencies offering a range of support services to patients, their carers and family members, from a single access point. Network members include the Sunderland Counselling Service, Sunderland Carer‟s Centre, Sunderland Minster, Eye Believe Support Group, Sunderland Laryngectomee Club, Breast Care Support Group, Roy Castle Lung Cancer Foundation (Sunderland), Sunderland Prostate Cancer Support Group, and the Sunderland Vulvectomy Group. Links with other local and community groups, including ethnic communities, offer additional support to meet individual needs. Initial contact may be through staff at Sunderland Counselling Services or direct to the named contact for specific support groups detailed overleaf. The counselling service are contactable during normal office hours 9-5pm (extended on Monday and Tuesdays until 8pm) 24 hour Answer phone messages responded next day. Directory of Cancer Services - Reviewed & Updated November 2010 Page 64 of 71 NETWORK / SUPPORT GROUP CONTACT/TEL Sunderland Counselling Service Supportive and confidential service for adults and children „living with cancer‟ Brenda Charlton-Hands 0191 514 7007 Sunderland Minster Christian spiritual support for cancer patients, carers and family members. Revd. Martin Anderson 0191 565 4066 Sunderland Carers Centre Information, advice and support (including Advocacy services) for carers and families Maeve Cuthbertson 0191 567 3232 Sunderland Laryngectomee Group Information and support to those affected by laryngectomy. Ethel Culling 0191 536 9655 Breast Care Support Information and support to women affected by breast cancer. Sheila Brown 0191 567 8203 ‘Eye Believe’ Support Group Information and support for people affected by Eye cancer. Bernie Greener 0191 549 2651 Carol Weatherstone 0191 569 9950 Roy Castle Lung Cancer Foundation (Sunderland) Sue Pollock Information and support for those affected by 0191 565 6256 Lung Cancer. Paul Robson 0191 415 7321 Sunderland Prostate Cancer Support Group Information and support for men affected by Prostate Cancer, and their partners. Nicola Elves 0191 565 6256 Vulvectomy Group Information and support group for women affected by vulval cancers Karen Phillipson 0191 565 6256 Directory of Cancer Services - Reviewed & Updated November 2010 Page 65 of 71 NETWORK MEMBER DETAILS CONTACT/TEL Sunderland Counselling Service Supportive and confidential service for adults and children „living with cancer‟ Mary Potts Sunderland Minster Christian spiritual support for cancer patients, carers and family members. Rev. Derek Rosamond 0191 565 4066 Sunderland Carer’s Centre Information, advice and support (including Advocacy services) for carers and families. Ailsa Martin 0191 567 3232 Breast Cancer Survival Trust Practical support and financial grants to women affected by breast cancer Meg Robertson 0191 549 1179 Coping with Cancer Information and support for cancer patients, carers and families. Jennie Smith 0191 521 3436 Laryngectomy Group Information and support to those affected by laryngectomy. Ethel Culling 0191 536 9655 Mastectomy Group Information and support to those affected by breast cancer. Betty Heskett 0191 522 0348 Vulvectomy Group Information and support group for women affected by gynaecological cancers Norma Hudson 0191 417 4696 Directory of Cancer Services - Reviewed & Updated November 2010 0191 514 7007 Page 66 of 71 LOCAL AND NATIONAL SUPPORT SERVICES LOCAL „ Breathe Easy Sunderland Group support and visiting service for people suffering from lung disease, including cancer. ([email protected]) CONTACT/TEL NO. (Internet Address) Lynda A Riddell 0191 565 3785 Coping with Cancer (N.E) Emotional support, practical help and information to people with cancer, their friends and family. Dr Judith Woodruff 0191 268 0011 Marie Curie Centre (Newcastle) Practical support and nursing care Ebbie Hulland 0191 256 7228 or 0207 599 7266 Ovacome Margaret Borthwick Regional support group for those concerned with 0191 387 5363 ovarian cancer, sufferers, their families, friends, carers and health professionals Sunderland Volunteer Bureau Supportive services include „respite at home‟, „Driving‟, Handyman‟. Directory of Cancer Services - Reviewed & Updated November 2010 David Curtis 0191 567 8902 Page 67 of 71 NATIONAL CONTACT/TEL NO. (Internet Address) Breast Cancer Care Information and support to those affected by breast cancer. (www.breastcancercare.org.uk) 0808 800 6000 Cancerbackup (British Assoc. of Cancer United Patients) Information and support on all types of Cancer (www.cancerbackup.org.uk) 0808 800 1234 Lymphoma Association Information and support to those affected by lymphatic cancer. (www.lymphoma.org.uk) 0808 808 5555 Macmillan Cancer Support (Adult helpline) Specialist care for people with cancer; (Youth helpline) provides financial support. (www.macmillan.org.uk) 0808 808 2020 Marie Curie Centre Provides hands-on palliative care. (www.mariecurie.org.uk) 0191 273 7931 0808 808 0800 Ovacome Louise Bayne (Ovarian Cancer Support Group) 07071 781 861 Nationwide support group for all those concerned With ovarian cancer, including sufferers, their families, Friends, carers and health professionals. (www.ovacome.org.uk) Prostate Cancer Support Association National information network (www.prostatecancersupport.org.uk) 0845 601 0766 Roy Castle Lung Cancer Foundation Information/support helpline (www.roycastle.org) 0800 358 7200 Sargent Cancer Care for Children Support for children and their families, including practical help and holidays. (www.clicsargent.org.uk) 0800 197 0068 Directory of Cancer Services - Reviewed & Updated November 2010 Page 68 of 71 Tenovus Cancer Information Centre Information and support on all types of cancer. (www.tenovus.org.uk) 0808 808 1010 Urostomy Association Offers information and support (www.uagbi.org) 0124 522 4294 British Colostomy Association 0118 939 1537 Help in rehabilitating after colostomy, resulting from cancer of the colon. (www.bcass.org.uk) Lymphoedema Support Network Advice and support through helpline and local groups. (www.patient.co.uk) 0707 122 4760 The Ileostomy and Internal Pouch 0800 018 4724 Support Group Support for people following surgery. (www.ileostomypouch demon.co.uk) Leukaemia Care Society Information and support services for suffers and family members. (www.leukaemiacare.org.uk) 0800 169 6680 Gynae C 0179 349 1116 Confidential Helpline supporting women affected by gynaecological cancer. (www.patient.co.uk) Help Adolescents With Cancer (HAWC) Telephone support, group meetings, workshop ventures/holiday s. (www.hawc-co-uk.com) (www.patient.co.uk) Directory of Cancer Services - Reviewed & Updated November 2010 0161 688 6244 Page 69 of 71 COMPLEMENTARY SERVICES Through partnership and lottery funding arrangements, a range of Complementary Therapies can be offered to people living with cancer. Aromatherapy, Reflexology, Various Massage Techniques, Reiki and Shiatsu are available from highly skilled, accredited professional therapists. Sessions will normally take place in the dedicated room at Sunderland Counselling Services, Angel House (2nd Floor), Borough Road, Sunderland but, where travel is difficult, home visits can be arranged. Used alongside conventional medical treatments, pain and symptoms may be relieved, whilst overall wellbeing may be improved. Services can be accessed directly by patients or carers themselves, providing they are not undergoing active treatment (in which case a professional referral is required) or by referral from their GP or District/Specialist Nurse with their consent. An information booklet is available. CONTACT PERSON (S): „Caring Together‟ Sunderland Counselling Services Angel House (2nd Floor) Borough Road Sunderland SR1 1HW Tel: 0191 514 7007 Directory of Cancer Services - Reviewed & Updated November 2010 Page 70 of 71 AMENDMENTS/UPDATES The Directory of cancer services will be subject to a biannual review. Any amendments or updates concerning roles, responsibilities or contact details should be notified to: - Denise Inskip Cancer Services Manager City Hospitals Sunderland Chester Road Sunderland Tel. 0191 565 6256 EXT 41960 Email: [email protected] Directory of Cancer Services - Reviewed & Updated November 2010 Page 71 of 71