We provide a follow-on service for the North Thames screening programme for congenital hypothyroidism.
Current diagnostic rates average 87 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 is provided at GOSH. Patients are reviewed in a dedicated thyroid clinic with same day turn around of thyroid function tests.
Septo-optic dysplasia and hypopituitarism
This is a regional service which has developed over the last 10 years. The service is a joint venture with ophthalmology and neurodevelopmental paediatrics. The process is in place to establish a joint care approach linked with local services for these highly complex patients.
Septo-optic dysplasia (SOD) is a rare condition affecting around 1 in every 10,000 births. We have a dedicated and committed multi-disciplinary team at Great Ormond Street Hospital in order to provide the best care possible to a cohort of approximately 150 highly complex patients.
Members of the multi-disciplinary team include an endocrine consultant, endocrine nurses, ward staff, psychologists, social workers, the developmental vision team, ophthalmology and neurology as required. There is also a close relationship with the sleep clinic at Guys and St Thomas’ Hospital.
Disorders of sexual differentiation and determination
Specialist clinic services are provided for disorders of sexual differentiation and determination. There is a monthly clinic held jointly with urology, psychology, chemical pathology, gynaecology, genetics and diagnostic molecular biology.
Cases seen or discussed on each occasion total five maximum 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 GOSH, which sees between 15 and 20 cases. This service is to be extended further with an adolescent clinic at University College London Hospital (UCLH) where four to six patients, including those with osteogenesis imperfecta, will be seen.
Joint working relationships have been established with neurodisability with respect to the management of osteogenesis imperfecta.
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 neuroendocrine 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 leukaemias. A similar pattern of workload is undertaken in these separate joint clinics held on a monthly basis.
A national and international service for patients with hyperinsulinism is provided by GOSH. Approximately 19-23 new cases per annum are referred.
Practice represents joint working with radiology, chemical pathology, gastroenterology, surgery, histopathology and nuclear medicine.
Find out more about the congenital hyperinsulinism centre at Great Ormond Street Hospital.
Congenital adrenal hyperplasia
Specific interdisciplinary diagnostic and follow-up service for patients with congenital adrenal hyperplasia. The service aims to provide ease of access for information and advice to children and families.
Biannual support group meetings and a range of advice and education leaflets are available.
The diabetes service is centred at University College Hospital (UCH). The service provides inpatient and outpatient care for 354 children and young people with diabetes mellitus in age banded clinics. A full interdisciplinary service of medical, nursing, dietetic, psychology, podiatry and ophthalmology support is provided.
At GOSH, diabetes support and care is provided for children with cystic fibrosis and those where diabetes complicates or develops during their treatment at GOSH for other conditions.