Clinics and Referral information

Patients with Achondroplasia can be referred to this specialist clinic run by Dr. Bridget Callaghan (Consultant General Paediatrician). This clinic is run approximately 5-6 times a year at Great Ormond Street Hospital.

Dr. Bridget Callaghan

Please contact Ms Pamela Senger 0207 405 9200 ext 1269 for the most up to date referral pathway.

FAO Dr. Bridget Callaghan (Achondroplasia Clinic)

Great Ormond Street Hospital for Children NHS Foundation Trust

55 Great Ormond Street level 2,

General Paediatric office,
Great Ormond Street,

London WC1N 3JH

The child and adolescent health mental health clinic provides medical support to patients with existing or suspected mental health conditions. Children and young people with feeding and eating disorders, autistic spectrum disorder and learning difficulties are examples of patients seen in the clinic. In addition, referrals for assessment of children and young people with possible medically unexplained presentations are accepted.

Referrals are accepted from both Paediatric and Mental health teams within and outside GOSH. These can include:

• Children and young people with existing or suspected mental health diagnoses needing general medical input into their care
• Children and young people who have an overlap between possible medical or psychological problems, with unclear (perplexing or medically unexplained presentations)
• In particular, children and young people with feeding and eating disorders who have physical complications needing further assessment and possible intervention around issues such as growth, pubertal development and bone mineral density.
• Dr Hudson welcomes informal discussions from referrers about cases and suitability for referral, via the usual referral pathway.
• Advice can also be provided to health professionals about the acute management of severely underweight children and young people with eating disorders who are either inpatient or outpatient.

Dr Lee Hudson

Please refer to:

Dr. Hudson,

Great Ormond Street Hospital for Children NHS Foundation Trust

55 Great Ormond Street level 2,

General Paediatric office,

Great Ormond Street,

London WC1N 3JH

The General Paediatric Cleft Clinic provides General Paediatric care for children with confirmed cleft lip and/or palate already under the care of the Cleft Team at GOSH. Multidisciplinary clinics are held twice weekly on a Monday afternoon and Friday morning.

Children with cleft lip and/or palate already under the care of the Cleft Team at GOSH.

Dr. Roshni Gohil, Dr. Keir Shiels, Dr. Alexis Bouvier

Please refer to the Cleft Surgical team. Patients within the Cleft service are accepted under a Cleft Surgeon. Learn more about our Cleft Lip and Palate Service.

The General Paediatric team runs twice monthly complex care clinics for children and young people who have multiple health problems requiring specialist input from multiple teams both here at GOSH and locally. They are on the first and third Wednesday of the month.

The purpose of the clinic is to provide a comprehensive family centered overview of the child’s or young person’s needs and liaise with all specialists involved in the child's or young person's care to help optimize their care and limit the number of hospital visits required.

• Internal referrals of patients under at least one surgical specialty with additional medical problems External referrals of patients who fit the above criteria will be considered individually.
• New patients (likely to be under one year of age) on a surgical ward who are identified as having additional medical problems and require a one off appointment to ensure that referrals to appropriate specialist services at GOSH and a local paediatrician are being made.

Dr. Imke Meyer-Parsonson, Dr. Keir Shiels, Dr. Alexis Bouvier

Refer via EPIC: Outpatient referral General Paediatrics, Dr. Meyer- Parsonson, Clinic code GENPDS COMPLEX.

If the lead team would like to have a discussion prior to referring a patient or have some advice, please contact Dr. Imke Meyer- Parsonson or discuss with the attending consultant on bleep 0012.

The Craniofacial Service is a Multidisciplinary Team run as a partnership between the Neurosurgery and Plastic Surgery Departments.

Dr. Keir Shiels is the liaison paediatrician with specialist interest in Craniofacial Syndromology and Medical Complexity. He acts as medical lead for surgical cases with significant underlying medical complexity and forms part of the multidisciplinary assessment team for the follow up of craniosynostosis.

For information on the referral criteria, visit our Craniofacial Department page.

The 22q11 Deletion Syndrome Clinic is a multidisciplinary clinic led by the General Paediatric Team. Members of the team include Consultant General Paediatrician, Consultant Paediatric Immunologist, Specialist Speech and Language therapists and Consultant Psychiatrist. The clinic is designed to ensure every child and young person with 22q11 Deletion syndrome receives appropriate care and long term follow up.

The clinics are monthly on the fourth Monday of the month. We aim to see children at diagnosis and then at important milestones in their childhood, including transitioning to adult health care. This is important because the needs of children and young people with 22q11 Deletion syndrome can change over time.

Children and young adults with 22q11 Deletion syndrome (please include Genetic, Immunology and other investigations in the referral letter).

Dr. Imke Meyer-Parsonson, Dr. Keir Shiels

Refer via EPIC for internal referrals: Outpatient referral General Paediatrics, Dr. Meyer- Parsonson, Clinic code VCF MDT

Refer by letter for external referrals to:

Dr. Imke Meyer Parsonson,

Great Ormond Street Hospital for Children NHS Foundation Trust

55 Great Ormond Street level 2,

General Paediatric office,
Great Ormond Street,

London WC1N 3JH

The newly established Multi-disciplinary, Lower GI Dysmotility, (LIGMOT) reviews children with chronic constipation , unresponsive to optimum conventional therapy over a minimum period of 6months-1 year. The child is referred from the local tertiary centre and would already have undergone standard therapy and dietary input as advised by the NICE and ESPGHAN Guidelines.

The referral undergoes a screening process that involves a multi-disciplinary team before referral is made to LIGMOT for a holistic approach to their management.

The LIGMOT clinic involves a multi-disciplinary team that consists of a specialist Gastroenterology Psychologist, Specialist Dietician, Gastroenterology Clinical Nurse specialist and a Consultant Paediatrician. The team work closely with the Gastroenterology Team to establish the need for further intervention and offer the necessary individualised management. The LIGMOT Team works with the external Teams closely involved in the child’s care, so that there is support provided in the Community setting.

The child is referred from the local tertiary centre and would already have undergone standard therapy and dietary input as advised by the NICE and ESPGHAN Guidelines. The referral information is discussed by a multi-disciplinary team before being accepted to LIGMOT.

Dr. Doris Abomeli

Please refer to Dr. Borrelli (Paediatric Gastroenterologist) LIGMOT clinic, Gastroenterology department.

The RASopathy clinic provides multidisciplinary assessment of children with RASopathies including:

• Noonan Syndrome
• Noonan Syndrome with Multiple Lentigenes (‘Leopard’ Syndrome)
• Costello Syndrome
• Cardio-facial-cutaneous Syndrome

This is a ‘one-stop shop’ that assesses cardiac function, growth, endocrine, learning support, musculoskeletal function, feeding difficulties and genetic implications. Four consultants and a specialist nurse work in this bi-monthly clinic, which hopes to expand in the near future.

We work closely with The Noonan Syndrome Association and follow The Dyscerne Guidelines formulated in association with the University of Manchester.

Children in the service are screened regularly for evolving cardiomyopathy, and we form links with local hospitals to ensure that children with RASopathies have the appropriate follow up to optimise their potential.

Any child with one of the above conditions can be referred into our RASopathy Clinic and inherited cardiomyopathy screening service, at any age.

At present, please refer to:

Dr. Juan Kaski

Inherited Cardiomyopathy and RASopathy Service

Department of Cardiology

Great Ormond Street Hospital for Children

London

WC1N 3JH

The Perplexing Presentation Support Service (PPSS) is available for all inpatient teams to support with cases where there are concerns of a perplexing nature or alerting signs of possible Fabricated or Induced Illness (FII), when the actual state of the child’s physical, mental health and neurodevelopment is not yet clear.

Referrals into the service can be made via an EPIC Safeguarding/Social Work order and further information can be found in the SG appendices or call Safeguarding team on 0207 405 9200
extension 5504.

This is a Paediatric clinic that reviews patients as part of the spinal pathway. The General Paediatrician looks holistically at the child and families holistic needs and priorities. This review is conducted on the same day as multiple other MDT reviews and investigations. This review forms an important part of an MDT collective discussion regarding the suitability and priorities for the patient being considered for spinal surgery.

Dr. Imke Meyer Parsonson, Dr. Alexis Bouvier

For referral information, please visit our Orthopaedic and Spinal Surgery Information page.

To make an internal referral, please bleep the on call attending consultant on bleep 0012.

We provide support to teams at GOSH Monday to Friday between the hours of 0900-1800 and on Saturday 0930-1230 . We do not at present cover Bank holidays and Sundays.

Please update the attending consultant on:

Patients Details: Name, ward, lead consultant and team

Reason and Urgency of the review

Contact details of the referrer

Ms. Pamela Senger (PA to General Paediatricians) can be contacted on: Tel: 0207 405 9200 Ext 1269 or Email: pamela.senger@gosh.nhs.uk

Address for General Paediatric team

Great Ormond Street Hospital for Children NHS Foundation Trust
55 Great Ormond Street (Level 2 Office)
London WC1N 3JH