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How to Access Camden Infection
Services
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Anna Checkley, Di Robertson-Bell
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Mike Brown
Sarah Logan
Gauri Godbole
Naghum Dawood
Emma Mewse
Susan Hopkins
ID consultant and clinical nurse specialist, UCLH
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Royal Free Hospital
ID Clinical Pathway Coordinator 020 7830 2648 x36285
ID SpR Bleep 1437 (urgent/ emergency referrals only)
Introduction
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What infectious diseases and tropical services are
available in Camden?
How can you access them?
Dr Susan Hopkins
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UCLH: infectious diseases and tropical
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Immediate review (A&E/ tropical walk-in clinic)
Urgent review (Rapid Access ID clinic- 48h)
Planned review (Consultant clinics (ID, tropical, parasitology))
Well patient post-tropical screening
 Di Robertson-Bell, CNS
Travel clinic
 Di Robertson-Bell, CNS
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UCLH Clinical Services
Immediate
Review
Tropical
travel?
Pre-travel
No
Yes
Possible /
confirmed
infection?
Unwell?
Travel clinic
Yes
Non-urgent
Review
Consultant ID or tropical clinic
(usually within 2 weeks)
Likely to need
admission?
No
Yes
How
unwell?
No
Yes
How
unwell?
Needs
admission
Same day
outpatient review
+/- admission
HTD
emergency
walk-in clinic
ID A&E
review
Needs
admission
Non-urgent
Consultant
tropical clinic
Post-tropical
screening
clinic
Same day
outpatient
review +/admission
Non-urgent
RAID
Consultant
ID clinic
ID A&E
review
Well
patient
Tropical
travel within
6 months?
A&E
Yes
No
HTD walkin clinic
RAID
48h
review
(often
same day)
Travel
clinic
Post tropical
screening
Phone: 07908 250924
OPAT
OPAT
http://www.camdenccg.nhs.uk/Downloads/gpdownloads/services/HTDOPDFlowchart300915.pdf
Rapid Access ID Clinic
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Thanks to Maggie Armstrong
Diagnoses seen in RAID: 4 month
snapshot (2011)
Non-tropical patients reviewed promptly & flexibly
Reduces admissions
Shortens in patient stay
Prevents re-admission
Day case procedures (lumbar puncture)
Eligibility :
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Direct GP or A&E referral
Ward discharge (early review)
Ineligible :
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Travel-related illness
Patients likely to need admission (seen by us in
A&E)
Suspected pulmonary TB
RAID prevents admissions
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OPAT
• A&E and GP referrals received
• 4 admitted
• (2 cellulitis, 1 UTI, 1 viral illness)
• Patients managed as outpatients
• Patients referred on to OPAT
↓ Length of stay
↓ Risk of healthcare-associated infections
↑ Patient choice and satisfaction
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OPAT episodes by site of infection
October 2012 – January 2015
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230 patients
On IV antibiotics for 9 days (range 1-175)
Median age 53 (IQR 34-82)
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1 each from Bath, Cambs, Beds, W Sussex
Planned review: consultant clinics
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PHE National Parasitology Reference Laboratory
Hospital for Tropical Diseases
Infectious diseases
 Rashes, pneumonia, possible Lyme disease, cellulitis ,
recurrent herpes, recurrent UTI (S Logan) etc
Tropical
 Returning travellers eg fever, rash, diarrhoea
 Giardia, strongyloides, schistosomiasis, filariasis,
gastrointestinal helminths,
Parasitology
 Hydatid, chagas, others (above)
Clinical Parasitology
Service
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Test selection
Test interpretation
Expert clinical advice
3rd floor, Mortimer Market,
Capper St, London WC1E 6JB
Emergency walk-in clinic
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Self-presentation
Daily clinic
 Monday–Friday 9am–4pm
Criteria
 Travel to a tropical country within the last 6 months.
 Must be symptomatic.
Key Contacts
Consultant Parasitologists:
Prof Peter L Chiodini
Dr Gauri Godbole
Laboratory Manager:
Dr Spencer Polley
T 0203 447 5418/4
F 02073830041
Nurse led Triage
Brief history
 Observations
 All patients offered HIV point of
care test
 Tests ordered (Serum save done so SHO
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can add any tests)
Di Robertson-Bell, CNS
Di Robertson-Bell, CNS
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Travel clinic
Nurse-led interventions
Consultant/ nurse – led (Dr Ron Behrens)
Entry routes:
 Self-referral
 Commissioned clinic for patients with (any) complex medical
need (eg hypertension, heart failure)
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Removal of bot & tumbu flies
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Removal of jigger fleas
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Removal of ticks
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Di Robertson-Bell, CNS
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Di Robertson-Bell, CNS
Summary
Immediate
Review
Post-tropical screening clinic
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Non-urgent
Review
Consultant ID or tropical clinic
(usually within 2 weeks)
Likely to need
admission?
Fbc
Urine dipstick
Schistosomiasis serology (if applicable)
HIV
No
Yes
Well
patient
Tropical
travel within
6 months?
A&E
Yes
No
HTD walkin clinic
RAID
48h
review
(often
same day)
Travel
clinic
Post tropical
screening
Phone: 07908 250924
Di Robertson-Bell, CNS
OPAT
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Thanks to Maggie Armstrong
How to refer
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RAID
phone
email: [email protected] (specify RAID in title)
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OPAT
phone (or VIA RAID)
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Consultant clinics: infectious disease, tropical,
parasitology
referral form (on Camden CCG website)
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If in doubt,
Thank you
Any questions ?
http://www.camdenccg.nhs.uk/gps/infectious
-and-tropical-diseases-service-ucl
Phone: 07908 250924
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http://www.camdenccg.nhs.uk/gps/infectious-and-tropical-diseases-service-ucl
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