Commissioned by Brent Clinical Commissioning Group

Brent
Integrated
Diabetes
Service
Commissioned by Brent Clinical Commissioning Group
Contents
Acknowledgements……………………………..…………………………………………………………………………………………………………………………………..3
What’s New in Brent Integrated Diabetes Service? ……………………………………….………………………………………….…….…..5
How do I make a referral to the new Brent Integrated Diabetes Service? ………..………..……....…..…………...…………….5
What will happen in the Community Clinics..............................................................................................................5
What will happen after the Community Clinic appointment?...................................................................................4
The Link Diabetes Specialist Nurse ……………………………………………………………………………………………………………………..7
In-Practice Joint Consultation Clinics……………………………………………………….…………………………………….…………….………5
Link Nurse Allocation List by Locality……………………………….…………………………………………………………….……………….…….8
Your Diabetes Service is changing
Virtual Clinics…………………………………………….…..…………………….….……….………………..……...…..9
Clinic Arrangements……………………………………………………..…..…………….………….……..…..………9
Diabetes Patient Groups………………………………………..……..…….………….…….………….…..…..…….9
Diabetes Themes and Topics…………………………..…..…………….……….………….….….….….…….…..9
New enhanced Primary Care-led Integrated Diabetes Pathway……………..…….……………….10
Diabetes Referral Information
Referral Criteria……………………………………………………………………………………….…..………..…12
Referral Forms Tier 3……………………………………………………………………….…………...…..…..…13
Referral Forms Tier 4…………………………………………………………………………………...…….…....14
Diabetes Clinic Addresses
Wembley Clinic………………………………………………………………………………………..……...……...16
Willesden Clinic…………………………………………………….……………………………….……...…..…...16
Monks Park Clinic……………………………………..……………………………………………….….…………17
Jeffrey Kelson Centre for Diabetes Endocrinology………………………………………..………..…17
Clinic Location, Day, Times………………………………….…………………………..…………………………………….……….…….………18
Diabetes Education Courses
Desmond Course Overview………………………..………………………………..………….……19
Desmond Referral Form……………………….…………………..………………….…………..…..21
Diabetes Podiatry Information…………………..…………..……………………………………….……………...…….23
Brent Integrated Diabetes Service Team Members Contact Details……………….…………..……………………24
2
Acknowledgements
I would like to extend my profound thanks and gratitude to Yvonne Leese, Vince Baxter, Nina
Patel, Dr Koteswara Muralidhara, Dr Ajit Shah, Dr Daniel Darko, Jonathan McInerny, Rakhee
Shah, Farhat Hamid, Maeve Quinn, Nikesh Karunanithy, Tony Afuwape, Melissa AllisonForbes, Michele Nelson, Jeanette Downer, Dr Joan St John and all of the new Brent
Integrated Diabetes Team. I would also like to humbly acknowledge the dedication and
commitment of the Brent Primary Care Teams and the Specialist Diabetes Team at the Jeffrey
Kelson Centre, Central Middlesex Hospital who continually improve the health and lives of all
our diabetic patients in Brent.
3
New Service
Overview
4
This pamphlet serves as a point of reference to enable everyone to use the new Brent Integrated
Diabetes Service effectively.
Brent CCG has commissioned a new Consultant led diabetes service aimed at providing high quality
specialist diabetes care in the community and closer to the homes of patients. The new diabetes
service is designed to provide the same level of specialist care, as can be expected from secondary
care but closer to the homes of patients. This service will offer Specialist Diabetes Clinics across all
Brent localities and aims to support GP Practices in providing enhanced diabetes care.This service will
be run by The Brent Integrated Diabetes Team and work in partnership with Jeffrey Kelson Diabetes
Centre at Central Middlesex Hospital.
What’s New in Brent Integrated Diabetes Service?
The new Brent Integrated Diabetes Service (BIDS) aims to support both the diabetes patient and also
the Practices more comprehensively and seeks to reduce the high volume of diabetes numbers in the
borough of Brent.
The existing diabetes services are well attended and currently offers a range of services which includes
Specialist Diabetes Clinics in Wembley Centre for Health and Willesden Centre for Health as well as the
weekly DESMOND education sessions.
The BIDS Service aims to fully integrate the diabetes services in Brent. The focus will be on managing
most of Type 2 diabetes patients in Primary Care and Community settings using optimal use of
resources and innovative models of care, which includes:•
•
•
•
•
•
•
•
•
In-Practice Joint Consultations
Diabetes Virtual Clinics
Link Diabetes Nurse
Email/telephone support for GPs,Practice Nurse,Patients
Group insulin starts
Enhanced Specialist Dietician
Psychology Support
Additional Desmond Educational Classes
Patient Forum and much, much more
The new BIDS Team consists of a Diabetes Consultant in the Community, 2 General Practitioners with
Special Interest in Diabetes (GPwSI), 5 Diabetes Specialist Nurses, Dietician, Podiatrist, Psychologist,
Associate Specialist Consultant, Specialist Diabetes Consultant and Diabetes Service Management
Team.
How do I make a referral to the new Brent Integrated Diabetes Service?
All patients are referred to the BIDS team by the patient’s GP. Once the referral form is received a letter
offering an appointment to attend the nearest clinic to the patient’s home address. It is possible to
request an alternative Community Clinic, if more convenient.
A telephone or text reminder is sent to the patient a few days before the clinic appointment day.
What will happen in the Clinic?
The first appointment with the BIDS team enables the patient to be seen by a Diabetes Specialist
Dietician who will discuss the patient’s diet. At the same appointment, all of the multidisciplinary team
members will screen the patient and offer lifestyle changes advice and determine a clinical direction for
the patient follow. After the initial diabetes screening process all the information gathered will be tailored
to support the individual patient’s needs with a clear care plan.
What will happen after the Community Clinic appointment?
All patients will be discharged back to the GP with a clear tailored care plan and it is likely that most
patients will only need to be seen once. Follow-up appointments will be arranged in the Community
Clinics for people with complications as necessary. The appointment will be made at one of our
Community Clinics or in the GP Practice jointly seen by the Practice Nurse and one of the Diabetes
Specialist Nurses. An onward referral to the local hospital would be made by the General Practitioner as
necessary.
5
Your Diabetes
Service is
Changing
6
Link Nurses Allocated to each locality in Brent
Nina Patel
Kingsbury
Lucy Ogida
Willesden
Julia Anthony
Wembley
Margaret Carroll
Kilburn
Fiona Hughes
Harness
No of diabetes
patients:4592
No of diabetes
patients:4255
No of diabetes
patients:4098
No of diabetes
patients:4110
No of diabetes
patients:4160
Forty Willows
Surgery
St Andrews Medical
Centre
Sudbury and
Alperton M/C
The Lever
Medical centre
Church End Medical
Practice
Stag Hollyrood
Surgery
Willesden Medical
Centre
Stanley Corner
Medical Centre
The Law
Medical Group
Acton Lane Surgery
Ellis Practice
Gladstone Medical
Centre
Lancelot Medical
Centre
The Windmill
Medical Practice
The Stonebridge Practice
Chalk Hill Family
Practice
The Sheldon Practice
Hazeldene
Medical Centre
Park House
Medical Centre
Harness Harlesden Practice
Fryent Way
Practice
Primary Care Medical
Centre
Lanfranc Medical
Centre
The Lonsdale
Medical Centre
Askyr Medical Practice
Brampton Health
Centre
Neasden Medical
Centre
The Sunflower
Medical Centre
Kilburn Park
Medical Centre
Brentfield Medical Practice
Stag Lane Medical
Centre
Crest Medical Centre
Alperton Medical
Centre
The Clarence
Medical Centre
Church Lane Surgery
Beechcroft Medical
Centre
St Georges Medical
Centre
The Eagle Eye
Staverton Surgery
Freuchen Medical Centre
Preston Road
Surgery
Chamberayne Road
Surgery
Preston Medical
Centre
Blessing Medical
Centre
Oxgate Gardens Surgery
Tudor House Medical
Practice
The Village Medical
Centre
Integrated Health
CiC
Chichele Road
Surgery
Park Road Surgery
Kings Edge Medical
Centre
Burnley Practice
SMS Medical
Practice
Peel Precinct
Surgery
The Surgery
Uxendon Crescent
Surgery
Roundwood park
Medical Centre
Pearl Medical
Centre
Willesden Green
Surgery
Hilltop Medical Practice
Wembley Park Drive
Medical Centre
Willow Tree Family
Practice
Premier Medical
Centre WCHC
Walm Lane
Surgery
Fryent Medical
Centre
Brent GP Access
Unit
Buckingham Rd
Surgery
7
The Link Diabetes Specialist Nurse
A named Diabetes Nurse per locality will be helping the Practices to manage more diabetes patients
within the Practice utilising the following methods:
•
•
•
•
•
•
•
•
•
Virtual Clinics with Practice Nurse
Joint Consultation with Practice Nurse
Providing a Care Plan for complex patients by discussing with Diabetes Consultant/s
Facilitating a locality diabetes Monthly Diabetes Group session.
This will be in the form of Virtual Diabetes Clinics which will be attended by the diabetes
Consultant and will be held once a month at each locality. Each MDG will have time slots for
3-4 sessions in neighbouring Practices so that each Practice will be able to attend the MDG
once every 3 - 4 months. If the LCGs or Networks prefer Virtual Clinics in individual Practices
rather than neighbouring small locality groups, the number of clinics per Practice would be
reduced to 2-3 sessions per year.
Upskilling Practice Nurse/s in insulin initiation / GLP-1 starts
Helping the Practice to identify patients who can be stepped up to Tier 3 (MDT locality HUB
clinics ) or Tier 4 (Secondary Care)or stepped down from Specialist Care to in-Practice
Management
The Link DSN will provide telephone and email support to the Practice Nurse and patients as
required
The Link Diabetes Nurse will be visiting each Practice once every 6-8 weeks (this may be more
or less based on the amount and type of support needed)
Each Practice to identify a 2-3 hour slot, between 9am and 5pm between Monday and Friday,
either in the morning or afternoon for the Link DSN visit. Please see the Link Diabetes Nurse
allocation list for details below.
In – Practice Joint Consultation Clinics
The purpose of these clinics is to engage and encourage Practice Nurse and GPs to manage more
complex diabetes patients and to increase the uptake of in-house insulin and GLP-1 starts.Joint
Consultation should be Practice led with support from DSN and doctors for BIDS Diabetes Team as
requested.The Link DSN would facilitate these clinics and ensure that they blend well with the overall
pathway and do not create unnecessary additional work.
Clinical Governance
The Implementation Plan for each locality will be agreed with the Locality Diabetes Lead and the
participation from each Practice will be reported to the Locality Lead and the CCG Lead for Diabetes.
Prospective and retrospective data analysis will be done using various tools that will be reported to the
Practice and the relevant leads in a timely manner to discuss and implement remedial measures as
required.
8
The new and enhanced Integrated Diabetes Service introduces the use of Virtual Clinics to Brent, as
detailed below:-
Virtual Clinics
These are clinics where Primary Care colleagues can discuss patients with a diabetes expert, without
the patients present. The aim is to plan the management of more complex patients in Primary Care
settings.
Clinic Arrangements
GP Practices will identify patients suitable for discussion in the Virtual Clinic. This could be patients with
poor glycaemic control, poor blood pressure control or any other diabetes patient who the Practice
thinks may benefit from discussion with diabetes experts.
The locality Link DSN will liaise with neighbouring 3-4 GP Practices to arrange a Virtual Clinic with a
diabetes Consultant 3-4 times a year.
The Link DSN will facilitate preparation of a list of patients for discussion in advance. It may be possible
to discuss up to 15-20 patients in 2-2.30 hours. This time can be divided to discuss different diabetes
themes or topics. As this is a clinical session akin to managing patients, it is preferable to allocate a
dedicated 2-3 hour period in a morning or afternoon session.
Here are some examples of high-risk patient groups and diabetes topics that have been found useful for
discussion in Virtual Clinics:
1) Diabetes Patient Groups
•
•
•
•
•
•
•
High HbA1c
Recurrent Hypoglycaemic episodes
Poor compliance or poor specialist clinic attenders
Diabetic renal disease – CKD stage 3 or other co-morbidities
Poor BP or Lipid control
GLP-1 non-responders
Housebound patients
2) Diabetes themes and topics
•
•
•
•
•
Newer medications
Renal complications of diabetes
Management of Diabetic Neuropathy
Hypoglycaemia and driving regulations
Managing diabetes in patients with co-morbidities
3) Diabetes Psychology Support
•
•
•
Providing a direct clinical service for patients with diabetes and their families / Carers, should
there be complex management or psychological issues.
Provision of expert advice to other clinicians re the psychological management of patients with
diabetes to enable them to improve their wellbeing and facilitate their ability to self-care
management.
Provision of organisational consultation from a psychological perspective to enable those that
currently deliver in the diabetes pathway to refine the pathway, understand gaps and improve
outcomes.
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WHAT’S CHANGED?
KEY QUALITY IMPROVEMENTS
Enhanced DSN capacity & role in
localities to build capability in Primary
Care
Improved patient experience & equity of
access to care
Reduction in unscheduled A&E
attendances & admission
Reduction in New: Follow Up ratio
Faster through-put of patient
GP informed within 24 hours
Discharge summaries 48 hours
Improved electronic communication links
– DOCMAN
Evidence-based packages of care
Outcome-based clinical care
Improve access/capacity for DESMOND
Rapid access to clinical advice
Equitable access for all patients e.g.
disabilities, housebound
Improved self-management
Psychological support
Enhanced Podiatry & Dietetics services
NICE compliant care plans
Local Diabetes Managed Clinical
Network (LDMCN) – at the Centre of
Clinical Care. Focus on safety, quality,
effectiveness, patient experience &
access
TIER 3 Community Services Managed Intermediary Care
Multidisciplinary Clinics;
Consultant- led support;
Access to Specialist Diabetes Dieticians, Podiatrists or other
Specialists;
Patient Education (DESMOND);
Insulin titration;
Family Planning &Pregnancy Planning Advice;
Psychological Support;
Research & Development and Training;
Healthcare Professional Education.
Tier 3 Referral Criteria:
Education (DESMOND)
CKD 3 (e-GFR 30 – 45) with Poor glycaemic &/or BP control (poor
glycaemia control defined according to co-morbidities & age)
R3 retinopathy with Poor glycaemic &/or BP control
Preconception, Women of Child Bearing Age & HbA1c > 48 mmol/L
(6.8%)
Dietician/Weight Management for BMI >35 (or for South Asian BMI
> 30) with Poor glycaemic&/or BP control
Podiatry – Grade 2 and those with previous Grade 3: for foot care
plan (refer patient via Traffic Light Chart)
Housebound for home visit by DSN – poor glycaemic control &
related co-morbidities
Agreed at MDG
LAS call out for Hypoglycaemia (fax urgent) – DSN to contact
patient within 2-3 days
Psychology Services
Discharge Criteria:
1.Max. 1 – 4 visits in intermediary care OR
2.Referral to Tier 4 OR
3 Non-attendance without cancellation (at clinician’s discretion)
At discharge, all patients will have:
1.Care Plan modified / updated
2.Insulin Titration formulated
10
Diabetes
Referral
Information
11
Referral Criteria
Tier 3 Referral to Community Intermediary Care:
Tel: 020 8453 5965. Fax: 020 8453 5972
Education (DESMOND)
CKD 3 (e-GFR 30-45) with *Poor glycaemic &/or BP control
R3 retinopathy with *Poor glycaemic &/or BP control
Preconception, Women of Child bearing age & HBA1c >48mmol/L (6.8%)
Dietician/Weight Management for BMI>35 (or for South-Asian BMI >30) with *Poor
glycaemic &/or BP control
Podiatry -Grade 2*** and those with previous Grade 3: for foot care plan.
House bound for Home visit by DSN * poor glycaemic control & related co-morbidities
Agreed at MDG
LAS call out for Hypoglycaemia (Fax urgent) for DSN to contact patient within 2-3 days
Psychology Services
Tier 4 Referral To Secondary care:
e.g. Central Middlesex Hospital: Tel: 020 8453 2401, Fax: 020 8453 2415
or By Choose and Book NWLH NHS trust
Education (DAPHNE)
Children
Adolescent/ Transitional
Type 1 Diabetes
Hypo-unawareness
CSII Pump Therapy
Antenatal
CKD4-5 (e-GFR <30) with Poor glycaemic &/or BP control:
Complex multiple co-morbidities *Poor glycaemic &/or BP control
Agreed at MDG
Podiatry -Grade3***
Please call 020 8453 2401 or Fax: 020 8453 2415 for advice/ referral***
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REFERRAL FORM FOR DIABETES CARE Tier 3
GP details / stamp (including, patient, name, address, telephone number,
fax):
Brent Community Services
Diabetes Care
Long Term Conditions Centre - Diabetes
Monks Park Primary Care Centre
Monks Park, Wembley. HA9 6JE
Tel: 0208 453 5965, Fax: 020 8453 5972
E-mail: [email protected]
or: [email protected]
Referral made by:
Patient Name:
DOB:
Signature:
Date:
Sex: Male
Female
Contact Tel Number/s:
NHS Number:
Address:
Postcode:
Ethnicity:
Type of
Diabetes
Housebound?
Language:
Interpreter Required: Yes
No
Year of Diagnosis of Diabetes
Type 1
Type 2
Others
Medications:
Please
enclose:
Oral Anti-glycaemics
Insulin/s
Other medications
(Please enclose full details: name, doses and frequency)
Tier 3 Referral to Community Intermediary care: Tel: 020 8453 5965. Fax: 020 8453 5972
1- A copy of
completed
care plan
from GP
(mandatory
section 1
and section
5)
Education (DESMOND)
CKD 3 (e-GFR 30-45) with *Poor glycaemic &/or BP control
R3 retinopathy with *Poor glycaemic &/or BP control
Preconception, Women of Child bearing age & HBA1c >48mmol/L (6.8%)
Dietitian/Weight Management for BMI>35 (or for South-Asian BMI >30) with *Poor glycaemic &/or BP control
Podiatry -Grade 2*** and those with previous Grade 3: for foot care plan.
2- Copy of
House bound for Home visit by DSN * poor glycaemic control & related co-morbidities
all
Agreed at MDG
medications
/
LAS call out for Hypoglycaemia (Fax urgent) for DSN to contact patient within 2-3 days
prescription
Psychology Services
printout or
enter below /
separately
Specific questions /
Other Medical Conditions:
problems:
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Clinical Findings:
Weight:
BMI:
Waist Circumference:
Blood Pressure:
Please see discharge
criteria in Brent Community
services Diabetes Care
chart.
Please repeat bloods if not done in the past 3 months and kindly enclose results below :
HBA1c:
Creatinine:
e-GFR
Urine Albumin/Creatinine:
Total Cholesterol:
HDL:
LDL:
AST (LFT’s):
Smoking status:
Triglycerides:
TSH:
Never smoked
Current
___ / day:
Stopped
(date) __ /__ /__
***PODIATRY – Refer patient via Traffic Light Chart RETINAL SCREENING – Refer NEW patients to Brent Screening
Programme Tel: 020 8795 6499
13
14
Diabetes
Clinic
Addresses
15
Wembley Centre for Health & Care
http://www.localdatasearch.com/search?Loc=HA0+4UZ&Key=Wembley+centre+for+health
Wembley Centre for Health & Care,
116 Chaplin Road,
Wembley,
Middlesex HA0 4UZ
Tel: 0208 7955 6001
The designated DSN for Wembley Locality is Julia Anthony on 07919046765
Willesden Centre for Health & Care
http://www.streetmap.co.uk/map.srf?X=522710&Y=184161&A=Y&Z=110
Willesden Centre for Health
Robson Avenue
London
NW10 3RY
The designated DSN for Willesden Locality is Lucy Ogida on 07789906168
The designated DSN for Kilburn Locality is Margaret Carroll on 07767671322
16
Monks Park Clinic
Brent CCG Long Term Conditions Centre
Monk’s Park Primary Care Centre
Monks Park
Wembley
HA9 6JE
Tel: 0208 453 5971
To find out more about Desmond, please contact - Mimoza Kola
Tel: 0208 453 5965, Fax: 0208 453 5972
New Email Address : [email protected]
New e-mail : [email protected]
Please contact Julia Anthony DSN for Wembley on 07919046765 for further information
Jeffrey Kelson Centre for Diabetes and Endocrinology,
Central Middlesex Hospital
http://www.localdatasearch.com/search?Loc=HA0+4UZ&Key=Wembley+centre+for+health
Jeffrey Kelson Centre for Diabetes and Endocrinology
Central Middlesex Hospital, Acton Lane, London NW10 7NS
Telephone: 020 8453 2401 Fax: 020 8453 2415
Or By Choose and Book LNWH NHS Trust
To contact the Diabetes Lead Consultant – Dr Koteswara Muralidhara, please call
0208 453 5965 / 07944068563
17
Clinic location, days and time
Location
Time
Days
Levels of Service
Wembley Centre for Health
and Care,
9.00am -13.00pm
Fridays
Multidisciplinary Diabetes
Clinic – Tier 3
Diabetes Consultant
GPwsi
DSN
Dietician
Podiatry
Psychology
9.00am -13.00pm
Tuesdays
Multidisciplinary Diabetes
Clinic – Tier 3
Diabetes Consultant
GPswi
DSN
Dietician
Podiatry
Psychology
9.30 - 4.30pm
Mon - Fri
116 Chaplin Road,
Wembley,
Middlesex
HA0 4UZ
Tel: 0208 795 6001
Willesden Centre for Health,
Robson Road,
London
NW10 3RY
Tel: 0208 438 7006
Jeffrey Kelson Centre,
Diabetes and Endocrinology,
All Tier 4 Clinics
Central Middlesex Hospital,
Acton Lane,
London
NW10 7NS
Tel: 020 8453 2401
18
Desmond
Educational
Courses
19
DESMOND Diabetes Educational Courses in Brent - Overview
The DESMOND Diabetes Education courses was originally developed five years ago to help and
support people with diabetes and their Carers to understand and manage the long term condition. The
Desmond courses are designed to empower the patient to cope more effectively with a greater
emphasis on self- management and the long term benefits of altering their lifestyle to include healthier
diet and exercise. At present, there are three sessions delivered each week by the BIDS Nursing Team
but due to the high demand for these educational courses more will be delivered in the near future.
The majority of the DESMOND educational courses take place at Monks Park Clinic on Mondays and
Thursdays. The Saturday DESMOND courses are held at Wembley Centre for Health & Care. Each
course is intensive and starts at 9.30am – 3.30pm.The courses are accessed by GP referral only using
the referral form below.
Venue
Time
Mon
Monks Park
9.30am-3.30pm
X
Wembley
9.30am-3.30pm
Tues
Wed
Thurs
Fri
Sat
X
X
The Desmond educational course is facilitated by the Diabetes Specialist Nurses, Dietician, and in the
near future the BIDS Team Psychologist.
Desmond is a provision of training for patients/carers to support them in managing their diabetes
possibly in collaboration with other educators. The course offers patients a range of diabetes care
modules to support and empower them to cope and manage their long term condition more effectively.
The Desmond course content emphasises the need to put into effect a balanced and controlled diet
which is supported by the Specialist Dietetic Service within the Diabetes Pathway
Diet is the cornerstone of diabetes care, and as such the Specialist Diabetes Dietician makes a significant
contribution within the multidisciplinary team.
Following dietetic consultation (either through DESMOND or 1:1 support), the patient will develop their selfmanagement skills. Examples of when a patient will benefit from dietary advice include:
Newly diagnosed with diabetes
Patient wishing to improve their diabetes control
Change in management of their diabetes e.g. insulin initiation.
Overweight and motivated to lose weight
Related co morbidities such as diabetic nephropathy
Dyslipidemia
•
•
The dietary resources are all evidence-based and appropriate for Brent’s diverse population.
The Specialist Diabetes Dietician is an expert resource for the whole of the Diabetes Team and Primary
Care to make sure consistent dietary messages are given.
Another key part of the course is the clinical psychological management of diabetes and the provision of
training in the psychological impact of diabetes. The course aims to help patients come to terms with
their diagnosis and enable them to self- care to improve their wellbeing. In addition, the Desmond
course offers the provision of training for patients/carers to support them in managing their diabetes in
collaboration with other educators.
20
Referral Form Desmond Educational
Long Term Conditions Centre - Diabetes
Monks Park Primary Care Centre
Monks Park, Wembley. HA9 6JE
Tel: 0208 453 5965, Fax: 020 8453 5972
New Email Address:[email protected]
New e-mail:[email protected]
Patient Name:
Patients Address:
Telephone No:
Date of Diagnosis:
Date of birth:
Ethnicity:
Male/Female
NHS Number:
Referred by
English Spoken Yes
HbA1c:
Date:
Biomedical Data *All must be completed or attach result print out
BP:
Total Cholesterol
HDL Cholesterol:
LDL Cholesterol:
Height:
Waist Circumference:
Smoking Status:
Fructosamine:
Body Weight:
Medication and Dose
Specific questions / problems:
21
Diabetes
Podiatry
Information
22
23
Brent Integrated Diabetes Service Team Members Contact Details
Title
Name
Telephone No
Email Address
DSN Kingsbury
Nina Patel
07747751902
[email protected]
DSN Wembley
Julia Anthony
07919046765
[email protected]
DSN Willesden
Lucy Ogida
07789906168
[email protected]
DSN Kilburn
Margaret Carroll
07767671322
[email protected]
DSN Harness
Fiona Hughes
0208 453 5965
[email protected]
Dietician
Julia Freshwater
0208 453 5965
[email protected]
GPwSI
Dr Joan St. John
020 8903 4848
[email protected]
GPwSI
Dr Sangita Godambe
020 8453 2401
[email protected]
Hospital Consultant
Dr Daniel Darko
020 8453 2401
[email protected]
Diabetes Lead
Consultant
Dr Koteshwara
Muralidhara
07944068563
0208 453 5965
[email protected]
Associate Specialist
Dr Camelia Kirollos
020 8453 2401
[email protected]
Admin Team Lead
Mimoza Kola
0208 453 5965
[email protected]
Administrator
Dilani Wanniarachchige
0208 453 5963
[email protected]
Service Manager
Margaret Mclennan
07771816131
020 3114 7246
[email protected]
General Manager
Vince Baxter
020 3114 7272
[email protected]
For further information contact Melanie Britton on 0203 114 7196 or [email protected]
http://www.lnwh.nhs.uk/services/brent-community-services/diabetes-service-brent/
24