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Prestigious Award for Diabetes Team

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					trust
            ISSUE 11 JUNE 2012




     KEY INFORMATION FOR PRIMARY CARE PRACTICES AND PRACTITIONERS




                                                                                     TEACHING
 Prestigious Award                                                                   HONOUR FOR
 for Diabetes Team                                                                   LEAD BREAST
                                                                                     SURGEON




   Professor Sarah O’Brien, Diabetes Nurse Consultant
   and Professor Kevin Hardy, Diabetes Consultant


St Helens & Knowsley Teaching             The Diabetes Team’s award-winning
Hospitals Specialist Diabetes Team        education programme, Diabetes
have won yet another national award.      Education through Adult Learning
Winning the Silver Award in the           (DEAL) beat off competition from
Department of Health’s, Diabetes UK       twelve finalists to secure the Silver
and NHS Diabetes sponsored National       Award whilst the North Mersey
Diabetes Quality in Care (QIC)            Diabetes Network, won ‘Partnership         Congratulations to Miss Leena
Programme, in the most ‘hotly’            Working of the Year.’                      Chagla, leading Breast Surgeon
contested category of best initiative                                                at St Helens & Knowsley Teaching
supporting self-care.                                                                Hospitals, following her appointment
                                                                                     as the Quality Assurance Surgeon for

Good News for Patients with                                                          the North-West National Health
                                                                                     Breast Screening programme.
                                                                                     Miss Chagla has additionally been
a real fear for the Dentist                                                          presented with the Liverpool and
                                                                                     North-West Surgical Trainer and
The Trust’s Oral and Maxillofacial        specifically for patients who may be       Teacher of the Year Award at the
Department have introduced a              anxious, phobic or have concerns           Liverpool and North-West Annual
specially designed local IV sedation      regarding undergoing any minor oral        Surgical Dinner held at the Maritime
service to support GPs, dentists and      surgery procedures. These patients can     Museum in December 2011.
nurses with patients who have a           now opt for IV sedation in conjunction
                                                                                     This prestigious award is decided by
genuine fear of minor oral surgery        with local anaesthetic which is an ideal
                                                                                     all the trainees in the North-West and
procedures.                               way of treating these patients instead
                                                                                     the Training Committee, based at the
The good news is that the service         of them having to travel to Liverpool to
                                                                                     Deanery. “It is good to know that the
which is based at St Helens Hospital is   undergo a general anaesthetic.
                                                                                     future of our junior doctors is in safe
                                                                                     hands!!”
  For further information contact: Anita Smith,
  Clinical Services Manager on: 01744 646753
                                               3D/4D
                                               Scan
                                               Packages
                                             This non-diagnostic service will be at
                                             selected appointment times and will
                                             need to be booked in advance. The
                                             best time for this type of scan is between
                                             25 and 30 weeks of pregnancy.
                                             Two packages are available:

                                             Package 1 includes:
                                             • 20 minute scan appointment
                                             • 4 Thermal prints
                                             • CD Rom containing a selection
                                               of 3D images

                                             £60.00

                                             Package 2 includes:
                                             • 20 minute scan appointment
                                             • 4 Thermal prints
                                             • CD Rom containing a selection
                                               of 3D images
                                             • 10 minutes DVD of scan

                                             £85.00




For appointments please
enquire at Maternity
Ultrasound Reception or
Telephone 0151 430 1378
This service is only available to patients
under the care of the Trust.
Laser Developments
LIGHT THE WAY FOR PATIENTS
The Regional Mersey Burns Plastic and Reconstructive Surgery Unit            Together with our internationally recognised clinical expertise we aim
has developed its services to enhance the treatment options available        to offer the very best service with maximum flexibility and minimal
for NHS patients.                                                            downtime.
The laser developments also allow the opportunity to provide a service for   Using innovative multiple laser platforms, we can now treat a
self-paying patients to access services no longer available on the NHS.      remarkably wide range of both medical and cosmetic conditions -
Our new state-of-the art medical and cosmetic laser facilities are           from laser hair removal, vascular and pigmented lesions or blemishes,
unmatched in breadth of applications and efficacy within the region.         tattoos and scars even a verruca on the foot or a wart on the chin.



    The list of available treatments includes:

   Long- lasting hair removal, including those individuals for whom
   this may be available on the NHS such as those with hormonal disorders,
   or for whom stoma care is difficult, as well as general ‘cosmetic’ use for
   legs, under-arms, bikini lines and face. Unlike some high-street services
   run by beauty therapists, the sophisticated range of lasers available to
   our consultant surgeons and experienced medical staff allows safe hair
   removal even for those with darker skin types.


   Vascular lesions including birth marks such as port wine stains,
   thread veins commonly on the face and legs (telangiectasia) or
   caused after radiotherapy of the breast or elsewhere. Rosacea and
   spider veins are other common treatable problems.


   Treatment of scars from any cause including burns, as part of the
   Mersey Regional Burns Unit. Non-genital warts, such as on the
   face and other similar problems such as verrucae, molluscum
   contagiosum, skin tags and xanthelasma (yellow eyelid patches).               Unit welcomes
   Fractionated and resurfacing lasers (Carbon-Dioxide and Erbium)
   which are the lasers commonly used for facial skin resurfacing
   such as "laser face lift" or "laser peel" type treatments, which can
                                                                                 Mr Hamid Tehrani
   help with acne and other types of scars, improve skin tone in sun
   damaged skin, and provide general wrinkle-reduction and skin                                                 The Regional Burns, Plastic and
   tightening. Some types of skin cancers can also be treated with                                              Reconstructive Surgery Unit are
   these lasers, helping to avoid surgery in selected patients often                                            pleased to welcome Mr Hamid
   with excellent cosmetic results. The new generation of                                                       Tehrani as Consultant Plastic &
   fractionated lasers leave microscopic gaps in the treatment areas                                            Reconstructive surgeon.
   so that healing is much quicker, resulting is less "down-time" with                                          With a specialist interest in skin
   accelerated recovery, as well as the option for awake treatments                                             cancer management and Mohs
   using local anaesthetic cream.
                                                                                                                surgery, Mr Tehrani joins the
                                                                                                                Regional Specialist Skin Cancer
   Tattoo removal: our laser suite provides the best opportunity to                                             Multidisciplinary team based
   remove tattoos without the scarring associated with surgery.                                                 at Whiston and St Helens.
                                                                                                                This appointment will further
                                                                                                                enhance the provision and
                                                                                                                range of treatment options
                                                                                 available for patients including tumour resection,
                                                                                 reconstruction, lymphadenectomy and sentinel node biopsy
                                                                                 and combined with expertise from Dermatology, Oncology and
                                                                                 Radiology teams who make up the Regional Specialist Skin
                                                                                 Cancer team.
                                                                                 Having developed his skin cancer interest in London and
                                                                                 Cambridge, Hamid further enhanced his research experience
                                                                                 by completing an MD on non-melanoma skin cancer and has
                                                                                 overseen a number of further research projects and degrees.
                                                                                 He has also published and lectured extensively on skin cancer
                                                                                 diagnosis and management and is a trainer on a number of
                                                                                 undergraduate and postgraduate courses. Following on from
                                                                                 his specialist Plastic surgery training in Liverpool he undertook
For a comprehensive and detailed list of lasers and the conditions               further training and developed his extensive expertise to train
we can treat please email:tracey.walker@sthk.nhs.uk                              in the specialised field of Mohs surgery and histology at the
                                                                                 prestigious Mohs unit of Cardiff University Hospital.
We welcome both written and faxed referrals.                                     Referrals to Mr Tehrani can be made via choose and book,
Fax: 0151 430 1855 email: tracey.walker@sthk.nhs.uk                              letter or faxed referral to 0151 430 1855 For further
For all self-paying patient enquiries please contact Hazel Knowles               information on the Regional Burns Plastic and Reconstructive
                                                                                 Surgery unit please contact Tracey Walker, directorate
via email: hazel.knowles@sthk.nhs.uk or Tel: 0151 430 1901
                                                                                 Manager on 0151 430 1294 or tracey.walker@sthk.nhs.uk



                                                         www.sthk.nhs.uk                                                                              3
    RESUSCITATION TRAINING ON OFFER
    St Helens & Knowsley Teaching Hospitals Resuscitation Services
       Team Invite Nominations to Access its Specialised Training
    You are cordially invited to nominate delegates to          The Immediate Life Support Training (ILS)
    access the Trust’s wide range of resuscitation training     The course provides an individual with essential
    and education packages. This comprehensive                  knowledge and skills to manage an adult in cardiac
    education and training includes bespoke training in         arrest for the short time before the arrival of the
    resuscitation related subjects and the following:           cardiac arrest team or emergency services.
    • Mandatory hospital life support training                  The ILS course teaches the following subjects:
    • Bespoke Training for emergency treatment of               • Causes and prevention of cardio-respiratory arrest
      anaphylaxis                                               • The ALS algorithm
    • Use of automated external defibrillators                  • The ABCDE approach
    • Resuscitation Council (UK) life support courses.          • Initial resuscitation and defibrillation
    • Clinical assistance and guidance to ensure policies       • Airway
      and guidelines are followed.
                                                                • Targeted training (can include Anaphylaxis etc)
    • Compliance to resuscitation policies, techniques
      and practices                                             • Cardiac Arrest Scenario Teaching
    • Resuscitation Audits                                      All successful candidates will receive a Resuscitation
    • Advice and support                                        Council (UK) certificate valid for 1 year.

    Provided by highly qualified trainers with specialised
    qualifications in both adult and paediatric advanced life
                                                                  For further information on courses and fees
    support, the Resuscitation Services Team regularly
                                        support the Medical       please email: resus.services@sthk.nhs.uk
                                        Emergency Team            or telephone 0151 430 1724/1888
                                        within the Trust.




                                                                                            Photos couresy of Alex Rawlings




4                                                www.sthk.nhs.uk
www.sthk.nhs.uk   5
                                                         &
     in on St Helens & Knowsley Teaching
       Hospitals Sexual Health Services
    Having significantly expanded and developed its          to ensure the high quality of care available in our
    wide range of sexual health services across the          current community settings are in place in other areas.
    region including winning the tender for Halton and       Patient can be referred using the current pathways,
    St Helens PCT’s Community Sexual Health and              through choose & Book or by telephone on:
    Sexual Health Improvement services, the team have
    increased health promotion and condom distribution
    campaigns, specialist contraception, HIV care and                0845 155 0156
    psychosexual therapy.                                    The Trusts Sexual Health Department works very
    The department are further developing and                closely with partner agencies including other
    managing ‘GET IT ON’ and ‘CaSH’ websites,                hospital departments, local PCTs and Community
    accessing social media tools and are able to direct      Trusts, GPs, the Local Authorities, the Colleges, the
    the public to specialist, targeted advice and            Voluntary Sector and both of the Universities in
    information. Providing an easy to remember               Liverpool.
    telephone number advising callers of clinic opening
    times and general enquiries .                                                          CaSH provides condoms
    The Team offer a variety of training in sexual and                                     under the national C-
    reproductive healthcare, STI care and HIV including                                     card scheme for 13-19-
    bespoke classroom training qualifications such as                                       year-olds in St Helens
    the Sexual Health and Reproductive Health                                               and co-ordinates a
    Certificate for nurses, and the Diploma of the Faculty                        condom distribution scheme for
    of Sexual and Reproductive Healthcare (DFSRH) for             people of all ages via GP surgeries in Halton
    doctors.                                                 and St Helens. If you are a Halton or St Helens GP
    The sexual health service has a reputable interaction                          not yet in the scheme and would
    with the community through its various services,                                like further information on
    health improvement campaigns, and by participation                                how to provide free condoms
    in research projects. Currently the service is                                     to your patients, please ring
    participating in research into the uptake of                                       0845 155 0156
    Long Acting Reversible Contraception (LARC)
    within Halton & St Helens.
    We have several community sexual health (family
    planning) clinics located across Halton and
    St Helens, including St Helens Hospital which all
    complement each other to provide the full spectrum
    of sexual healthcare. Some of our clinics offer
    specialist services such as young people’s care,
    psychosexual therapy and erectile dysfunction, the
    assessment of unintended pregnancy, HIV care and
    specialist STI or contraceptive care.
    The team are very keen to work with the newly
    formed clinical commissioning groups in all localities



6                                             www.sthk.nhs.uk
    St Helens and Knowsley Teaching Hospitals
    Cytology Service – HPV Testing
Whiston Laboratory has recently introduced HPV testing on
Gynaecological LBC samples taken.
The key benefits of this test are to achieve rapid identification
of high grade disease, reduce anxiety and improve quality of
service to women by improved management of ‘non-
significant’ low grade abnormalities and reduce the number
of follow up smears resulting in shorter overall patient
journey time.
Part of the challenge in HPV implementation has been
informing all user groups of the changes involved. The
Laboratory has been working with North West Cervical
Screening Quality Assurance Reference Centre and PCT leads
to disseminate information. There have been training
events/updates for sample takers at various venues which
have sparked much interest from GP’s and Practice Nurses,
For anyone who has been unable to attend the training days,
there is now online HPV learning available,
via http://nwengland.nhslearn.com/ provided by the NHS
Cancer Screening Programme, North West Cervical
Screening Quality Assurance Reference Centre.
Gynaecological Cytology Services have recently collaborated
with Warrington Hospital and are now reporting approx.
3,600 samples each month whilst continuing to maintain the
14 day target turnaround times (TAT). The lab achieved full
pass/accreditation status with the Clinical Pathology
Accreditation (UK) Ltd and as part of this assessment, a GP         For further information please email:
user satisfaction investigation was carried out which reported      pathology.support@sthk.nhs.uk
‘a seamless changeover of service’ had been achieved during
the combining of services.




  Top Score For                                               Breast Feeding
  Patient Safety                                              Team News...
  The Trust has received the highest ever score
  given to Trust’s in England for patient safety,
  in a NHS Litigation Authority Level 2
  assessment.
   Feedback from assessors was extremely
  positive with them commenting on the warm
  welcome, enthusiasm and high levels of
  motivation in staff they met on wards and in
  departments.
  Having passed Level 2 so well, the assessors
  have recommended that the Trust should                       St Helens and Knowsley Teaching Hospitals
  undertake Level 3 assessment in the coming                   Breast Feeding Team is currently in the process
  year as this would appropriately reflect the                 of progressing through the ‘Baby Friendly
  Trusts commitment to safety.                                 Award’ and will be assessed by the UNICEF
                                                               Baby Friendly Initiative in the next few months.
  The Assessors also praised staff responsible
                                                               AND…. The team were honoured to be invited
  for organising the assessment for the high
                                                               recently to steward the UNICEF baby friendly
  level of planning and organisation of evidence               annual conference, which attracted international
  that had made the assessment                                 speakers and delegates.
  straightforward.


                                             www.sthk.nhs.uk                                                      7
       Spotlight on Radiology....
    The Department of Radionuclide
     Radiology (Nuclear Medicine)
    What’s New?                                             What is Nuclear
    The department has long been one of the busiest
    in the region, but is set to become busier with the
    exciting news that the Trust has invested in the
                                                            Medicine?
                                                            Nuclear Medicine is an integral part of the Radiology
    installation of a second gamma camera early in the
                                                            Team within the hospital and provides an extensive
    spring. This will be situated at the St Helens
                                                            service which uses injected radioactivity to assess
    Hospital site which will improve patient choice and
                                                            patients. A more functional type of imaging than
    will put us on a par only with the Royal Liverpool
                                                            most radiological studies it undertakes the
    Hospital locally in having more than one camera.
                                                            diagnostic test for the most common general
    The new camera will have an integral 4-slice CT         investigations such as bone scans, renograms and
    scanner which helps to improve anatomical               white cell scans.
    localisation and diagnostic confidence in certain
                                                            Some of the department’s more specialised studies
    patients.
                                                            include HIDA scans which assess biliary function;
    Whilst the department has always happily                DaT scans which helps to differentiate Parkinsons
    accommodated GP requests for radionuclide studies       disease from other Parkinsonian-like syndromes.
    this additional capacity will improve patient access    Meckel’s scans, red cell scans which are used to
    and potentially offer the opportunity to you as         assess gastrointestinal tract bleeding, thyroid scans
    primary care clinicians of doing bone scans prior to    and HMPAO scans which look at the activity of
    referral which may help to improve the patient          inflammatory bowel disease. Whilst most of these
    journey in certain patient groups.                      are specialised investigations with quite narrow
    Examples of suitable referrals may include bone pain    referral criteria, requests for bone scans in
    in patients with a previous history of malignancy and   particular are not restricted to secondary care.
    patients with pain around hip prostheses wishing to     Cardiac perfusion studies (which are reported by
    exclude loosening.                                      Consultant Cardiologist) account for a large amount
    As always we are very happy to discuss cases for        of the workload in the department.
    advice about appropriate imaging strategies.            The most significant part of our workload however
                                                            is related to the large regional skin cancer service
                                                            based at Whiston Hospital. Most patients with
    For further information                                 malignant melanoma are offered sentinel lymph
    Tel: 0151 430 1363                                      node biopsy as part of their management and this
                                                            requires complex imaging in our department prior
                                                            to surgery. Whiston is the only centre in the locality
                                                            providing this, not only do we provide this service to
                                                            patients from Merseyside, Cheshire and West
                                                            Lancashire, but also those from North Wales and the
                                                            Isle of Man. Having started with around 40 cases per
                                                            year in 1999, we are now undertake around 250
                                                            cases per year making us one of the largest units in
                                                            the country.




8                                             www.sthk.nhs.uk
Left to right: Jenni Kelly, Senior
Radiographer, Jon Winfield, Senior
Radiographer and Maureen Caffrey,
Superintendent Radiographer




MEET THE NUCLEAR MEDICINE TEAM
     Dr Andrea Howes                                         Mrs Jenni Kelly
     Consultant Radiologist and Radionuclide                 Senior Radiographer
     Radiology Lead / Radiology Lead for skin cancer         Miss Rachel Taylor
     Dr John Herbert                                         Senior Radiographer
     Consultant Radiologist                                  Mr Jon Winfield
     Dr Nirav Patel                                          Senior Radiographer
     Consultant Radiologist                                  Mr Gary Mason
     Mrs Maureen Caffrey                                     Radiographer
     Superintendent Radiographer




                Radiology Services
                Referral Informati GP
                 An expert team pe
                220,000 investigat
                                  on  rforming over
                                                      Along with plain
                                     ions each year                     film imaging,
                for diagnostic, in                    Radiology welcom
                                   terventional and                       es direct
               therapeutic serv                       referrals from GP
                                  ices and using                         's for all imaging
               the latest imagin                     modalities includ
                                   g equipment and                      ing:- CT, MRI,
              techniques.                            Ultrasound, Fluo
                                                                       roscopy, Nuclear
              GP’s requested 48                      Medicine, Dexa.
                                    ,000 radiology
              examinations to                        All requests are
                                 support their                        reviewed to
             on-going manag                         ensure the approp
                                 ement of their                          riate
             patients from Apr                      examination is pe
                                  il 2010 to March                     rformed based
             2011. This is equi                     upon the clinical
                                 valent to 22% of                     information
             all referrals.                         given.




                                     www.sthk.nhs.uk                                          9
       Spotlight on Radiology continued...


     New Developments
     CT Colonography is replacing the Barium Enema because it is a more sensitive
     examination for identifying small polyps. It also has the advantage of being able
     to CT stage patients if a malignancy is found.
                                                   Calcium Scoring
                                                   Because of our new 64 slice CT scanners we
                                                   can provide calcium scoring in accordance
                                                   with NICE guidelines for patients with recent
                                                   onset chest pain. If further investigation is
                                                   required following this procedure this can be
                                                   done through a consultant referral.




10                                   www.sthk.nhs.uk
                              Cut Out and Keep

ACCESS TIMES FOR PLAIN FILM (X-RAY)
              FOR ALL OTHER MODALITIES
CALL: 0151 430 1013 / 01744 646903 FOR AN APPOINTMENT
        Open access for Plain Film Requests is available
               on all sites at the following times.
 Appointments can be given if required by ringing 0151 430 1194
                       (Mon-Fri 9am-5pm)

                            WHISTON HOSPITAL
 9.00am – 4.30pm           Monday – Friday              Out Patients X-ray Dept.
                                                        Level 1 Yellow Zone
 9.00am – 7.00pm           Monday – Friday              Emergency Radiology Dept.
                                                        Level 0 Red Zone
 9.00am – 12 noon          Saturday & Sunday            Emergency Radiology Dept.
                                                        Level 0 Red Zone

                          ST HELENS HOSPITAL
 9.00am – 7.30pm           Monday                       X-ray Dept.
                                                        Ground Floor Orange Zone
 9.00am – 5.30pm           Tuesday – Friday             X-ray Dept.
                                                        Ground Floor Orange Zone
                          MILLENNIUM CENTRE
 9.00am – 6.30pm           Monday - Friday
 9.00am – 4.30pm           Saturday – Sunday
                             NEWTON HOSPITAL
 9.00am – 4.30pm           Monday - Friday

                              WAITING TIMES
           St Helens & Knowsley Teaching Hospitals Diagnostic waiting times are:-
   MODALITY                  AVERAGE WAIT
   Plain film                Open access no wait
   CT                        10 days
   MR                        8 days                                    of GP reports are

   Ultrasound
   Nuclear Medicine
                             9 days
                             7 days
                                                          50%          reported within
                                                                       1 day

                                                                        of GP reports are
   DEXA
   Fluoroscopy
                             7 days
                             9 days                       93%           reported within
                                                                        2 days


                                                                                            11
     IS WELCOMING CLINICIANS TO ATTEND ANY OF THE FOLLOWING FREE

     CLINICAL EDUCATION FORUMS
     DATE                VENUE                              TOPIC                          SPEAKER
                                                                                         Mr Anil Kaul,
                                                                                         Consultant General Surgeon,
                       Lecture Theatre, Education       Upper GI ‘Collaborating
     Wed 11th July     & Conference Centre,             with Primary Care to             Barbara Ashall, Upper
     Evening Event     Whiston                          address a growing problem        Gastrointestinal Nurse
                                                                                         Specialist and other
                                                                                         members of the team

                       Whiston Anaesthetic Seminar      When to refer to                 Julie Dawson
     Thurs 4th Oct                                      Rheumatology                     /Ruth Sephton
                       Room 3 Whiston Hospital

                       Seminar Room 3,                  Neurology Movement               Dr Steiger,
     Wed 17th Oct      Education & Conference           Disorders                        Consultant Neurologist
                       Centre, Whiston
                       Seminar Room 3,                                                   Dr Rikki Abernethy
                                                        Management of Chronic
     Wed 28th Nov      Education & Conference                                            and Rheumatology
                                                        RA in the Community
                       Centre, Whiston
         All forums start at 12.30 with a light lunch, presentations commence at 1pm for approx. 40 – 60 mins.
                              Free parking is available in the Trust’s Multi-Storey Car Park
                     PLEASE NOTE THAT ALL FORUMS ARE BEING HELD IN DIFFERENT VENUES
                     AROUND WHISTON HOSPITAL – PLEASE CHECK VENUE PRIOR TO ARRIVAL.
     To book your free place contact Gaynor Whistlecroft on 0151 676 5938 or gaynor.whistlecroft@sthk.nhs.uk




                                                               Paediatric
                                                               Allergy
                                                              As allergic disease is steadily increasing in children and
                                                              young people, the Paediatric Respiratory Team
                                                              at St Helens and Knowsley Teaching Hospitals recognised
                                                              a need to improve local allergy services.
                                                              In an attempt to support younger patients and their
                                                              families, the team have developed a Paediatric Multi -
                                                              Disciplinary Allergy Clinic.
                                                              There has been investment in staff training and education
                                                              to start a much needed local service for children with food
                                                              allergies led by Consultant Paediatricians ; Dr Amegavie
      AMD Eye Catchers is a support group based within        and Dr Elbadri .
      the Eye Clinic at St Helens Hospital. This group
                                                              They have established a Paediatric allergy service with the
      was set up by both staff and patients who attend        clinical expertise of a Paediatric Dietician, Lucy McAteer,
      the clinic who suffer with Age Related Macular          and the Trust's Paediatric Respiratory Nurse Specialist,
      Degeneration.                                           Michele Harrop.
      Eye Catchers aim to provide support and offer up to     Younger patients and their families now regularly benefit
      date information regarding Macular Degeneration,        from this service and the on-going enhancements made in
      early signs and symptoms and the importance of          providing protocols, investigation pathways, self-
                                                              management plans, all
      early referral.
                                                              of which are designed specifically for each patient together
      Eye Catchers also take part in fund raising events      with the development of specific patient information
      which helps raise money for this valuable service       leaflets.
      for patients living within the St Helens and            Referrals to the Paediatric Allergy Service can be
      Knowsley areas.                                         made via Choose and Book or by fax to 0151 676 5211.
                                                              For further information on the service and the Paediatrics
      Anyone wishing to attend group meetings can
                                                              Units many other services please contact: Sally Duce,
      contact 07580 197537                                    Directorate Manager/Lead Nurse, Paediatrics at
                                                              sally.duce@sthk.nhs.uk or by telephone on 0151 430 2478.


12                                             www.sthk.nhs.uk

				
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