Much of the investigation and care of children with suspected or confirmed immune deficiency at Great Ormond Street Hospital (GOSH) takes place in outpatient clinics.
Each child has a named consultant, who will usually see him/her in clinic, although sometimes a registrar (junior doctor) will see him/her in consultation with the consultant. One or more of the immunology nurse specialists may be involved if an immunodeficiency is confirmed.
The care of all children is also shared with a paediatrician at the local hospital and the GP.
Occasionally it is necessary for children to attend the hospital for one or more days to have investigations, see other specialists or receive some treatment. If there are too many tests and/or consultations to fit into one day, accommodation can be arranged nearby. These visits usually take place on Safari Day Care Unit.
Any child who needs inpatient admission to GOSH under the care of the Immunology department will usually be admitted to Robin Ward, although occasionally other wards are used.
Robin Ward has a team of specialist nurses and doctors. The attending consultant, who is responsible for day-to-day decision making and care of inpatients, usually changes each month, with four consultants taking part in the rota. However, important decisions always involve discussions with a child’s named consultant.
Robin Ward is a specialised unit for children who require protection from infection (and children affected by infectious diseases who need isolation). There are ten individual cubicles. Careful anti-infection precaution must be adhered to and there are important guidelines concerning visitors. Each cubicle contains a bed for one parent to be able to stay with his/her child. Accommodation cannot be guaranteed for more than one parent.
Facilities for parents and children
Robin Ward has a kitchen and sitting room for resident and visiting parents and families/friends. There is a playroom for children who are able to leave their cubicles. Meals are not provided for parents, but food and drink can be bought from the Lagoon cafeteria.
Investigation for possible immunodeficiency always involves blood tests and sometimes X-rays and various types of scan. Occasionally more complicated tests are needed that may require sedation or an anaesthetic.
Information about individual procedures will always be provided, and any possible risks or complications will be explained. Investigations will require a consent form to be signed.
Clinics at GOSH (mornings unless otherwise stated) take place in the Outpatients' Department located in the Royal London Hospital for Integrated Medicine (RLHIM) which is located next door to GOSH. The exception is the Short-term follow-up clinic for BMT which is held in Safari Day Care
|General Immunology||Dr Austen Worth||2nd and 4th Wednesday|
|General Immunology||Dr Cathy Cale||2nd Wednesday and 4th Friday|
|General Immunology||Prof Adrian Thrasher||2nd, 3rd, 4th Friday|
|General Immunology||Prof Bobby Gaspar||3rd Wednesday|
|General Immunology||Dr Winnie Ip||2nd and 4th Wednesday|
|Immunology/Respiratory||Dr Cathy Cale and Dr Colin Wallis||Monday every 3 months|
|Chronic Granulomatous Disease||Prof David Goldblatt||1st Friday|
|Bone Marrow Transplant Short-Term follow-up||Dr Graham Davies /
Prof Bobby Gaspar
|Bone Marrow Transplant Long-Term follow-up||Dr Graham Davies / Prof Bobby Gaspar / Prof Adrian Thrasher||1st Friday|
|VCF (22q11) multidisciplinary||Dr Winnie Ip||4th Monday|
|Hereditary Angioedema clinic||Dr Cathy Cale||Wednesday every 4 months|
The following clinics are held in conjunction with other paediatric centres:
Brighton and Sussex University Hospitals NHS Trust
|Dr Cathy Cale||3 times per year|
|Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's)||Prof Adrian Thrasher||4 times per year|
|John Radcliffe Hospital, Oxford||Dr Cathy Cale||4 times per year|
|King's College Hospital NHS Foundation Trust (Joint Immunology/Liver Clinic)||Dr Graham Davies||3 times per year|
|Nottingham University Hospitals NHS Trust (National Ataxia Telangiectasia clinic)||Dr Graham Davies||6 times per year|
|Royal Free Hospital (Long Term BMT follow-up for patients >16 years)||Dr Austen Worth / Prof Bobby Gaspar||6 times per year|
Outreach clinics allow children and families to be seen for assessment and management by the Immunology Unit in a hospital closer to their homes, avoiding the need to travel to London. In some situations, however, children will still need to come to GOSH for specialised investigations and/or treatment.