Endocrinology services at Great Ormond Street Hospital (GOSH) are provided under the umbrella of the London Centre for Paediatric Endocrinology and Diabetes (LCPED). This page includes information on how to refer a patient to GOSH.
Please see our admission criteria for information about the diagnoses treated by the Endocrinology department at GOSH.
How to refer a patient
For an outpatient appointment
Referrals should be sent to the Endocrinology Department at GOSH. Referrals should be tertiary or quaternary ie from other paediatric or paediatric endocrine centres. Direct GP referrals are only accepted if they request a second opinion or if they are of a sibling of a patient that is already being seen at GOSH.
Inter hospital transfer
a) Emergencies – patients that need life or limb saving treatment at GOSH within a few hours
b) Urgent – patients that need transfer to GOSH but not in the emergency category
Emergencies commonly referred to Endocrinology include hypopituitarism, adrenal insufficiency, congenital hyperinsulinism or other disorders associated with hypoglycaemia, congenital hypothyroidism, disorders of sex development, diabetes mellitus or diabetes insipidus. It is expected that any referral will contain full and detailed information.
The referral should be made via the SpR on call for endocrinology (Bleep 0281) or the clinicians assistant.
In the event of the above pathways being unavailable, the on call endocrinology consultant should be contacted via switchboard.
How to get advice
For patients known to GOSH
Advice for patients known to GOSH can be obtained from:
Clinical Nurse Specialist Team 020 7813 8214
Specialist Registrar: bleep no. 0281
For patients not known to GOSH
Advice for patients not known to GOSH can be obtained from specialist registrar: bleep no. 0281
Clinical nurse specialists
Services and facilities
The LCPED, in conjunction with adult endocrine services, provides the largest endocrine service for children in Europe, covering all aspects of paediatric endocrine disorders in a multidisciplinary setting and promoting the concept of endocrine care from cradle to grave.
The LCPED serves both Thames regions and receives national and international referrals. The Thames population totals 18 million. The aims of the department are to provide efficient, high quality, multi disciplinary care to children with endocrine disorders.
The department offers sub specialist expertise in the areas of disorders of sexual differentiation and determination, calcium homeostasis, neuro-oncology, pituitary development including septo-optic dysplasia, congenital hyperinsulinism, adrenal disorders including congenital adrenal hyperplasia and complex diabetes mellitus.
Seven to 12 outpatient clinics per week are run on each site with monthly/fortnightly speciality clinics in haematology, brain tumours, pituitary disorders including septo-optic dysplasia, calcium & bone, complex diabetes, intersex disorders, congenital adrenal hyperplasia, Turner syndrome and eating disorders as well as three to four monthly clinics in pancreatic disorders, paediatric gynaecology and skeletal dysplasias.
A National and International service for patients with hyperinsulinism is provided by GOSH, funded by the National Commissioning Group. Practice represents joint working with radiology, chemical pathology, gastroenterology, surgery, histopathology and nuclear medicine. Clinical exposure includes daily work in a high dependency area.
Septo-optic dysplasia/combined pituitary hormone deficiency
This regional service provides a multidisciplinary approach and the endocrine department work closely with the Ophthalmology and Neurodevelopmental Paediatric Services. The clinical service is linked to research at the ICH into the neurodevelopment and molecular genetics of this disorder.
The centre provides a follow-on service for the North Thames screening programme for congenital hypothyroidism. Current diagnostic rates average 80 new cases per annum and an integrated service is provided between chemical pathology, nuclear medicine, audiology and endocrinology for the initial assessment of these individuals.
Patterns of care are then established with either local paediatricians with a special interest in endocrinology or further care provided at the Great Ormond Street site. Patients are reviewed in a dedicated thyroid clinic with same day turn around of thyroid function tests.
Adolescents with thyroid disorders are reviewed at UCLH in a joint clinic with adult thyroid specialist input.
Disorders of sexual differentiation and determination
Specialist clinic services are provided for disorders of sexual differentiation and determination. There is a monthly multidisciplinary clinic held jointly with urology, psychology, chemical pathology, gynaecology, genetics and diagnostic molecular biology.
Cases seen on each occasion total five maximum with further discussions and these patients represent follow-on clinic consultations from referrals to the endocrine or urology services.
Calcium metabolism and bone disorders
A special clinic for disorders of calcium metabolism is provided in a once monthly clinic at the GOSH site. Joint working relationships and clinics have been established with neurodisability with respect to the management of osteogenesis imperfect, with the recent award of funding by AGNSS.
Late effects of oncology therapy
The provision for the endocrine follow-up of children who received oncology therapy is divided into two sections. Craniopharyngiomas and solid brain tumours are handled in the neuro-endocrine service
Cases are discussed at a weekly multi-disciplinary meeting held at GOSH. A similar service largely located on the GOSH site is provided for patients with Langerhans cell histiocytosis and the leukaemias. Inpatient peri-operative endocrine care is provided for children who have neurosurgical procedures at GOSH.
Children with adrenal disorders are seen by all endocrinologists but increasingly within dedicated clinic space. The clinic provides a joint meeting of families with clinician and nurse specialist to allow for information exchange and in particular to negotiate the interface between child, family and educational institutions.
Children and adolescents with type 1 and 2 diabetes are managed at UCLH which provides secondary care to the local area and specialised tertiary care to the region. The service is one of the largest diabetes services in the country with over 300 patients with diabetes. Over half of these patients are managed using insulin pump therapy.
This interdisciplinary diabetes service includes specialist consultants, clinical nurse specialists, a paediatric dietitian, psychologists, a podiatrist and ophthamologists. Standard clinics are held twice weekly along with nurse led clinics and special one-to-one education and training sessions.
Pump therapy is delivered using a care pathway approach culminating in therapy commencing within the setting of a two day pump school. A parallel service for complex diabetes mellitus is being established at GOSH, with specialist services to patients with Bardet-Biedl syndrome and patients with cystic fibrosis.
Many of the patients with Turners syndrome seen at GOSH and UCLH are reviewed in dedicated clinics.
A specialist service for adolescents with obesity has been set up at UCLH with the emphasis on dietary and lifestyle adjustments.
This service is funded by the National Commissioning Group and is one of two centres for the paediatric management of this condition in the UK. This multidisciplinary service involves assessment by genetics, renal, ophthalmology, psychology, dietetic and endocrine services.
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