Substance Misuse - Self Referral

Patients can refer themselves to Substance Misuse Services (for alcohol or drug misuse) by attending Oxford Corner (formerly New Castle House) on Monday, Tuesday, Wednesday and Friday 10am to 4pm, or Thursday 1pm -4pm.

Oxford Corner

3/3A Oxford Street

Nottingham

NG1 5BH

Tel. 0115 948 5505

Fax. 0115 948 5527

Eating disorders - medical risk

Routine investigations for eating disorders

Local guidelines

First presentation

At first presentation of AN or BN several investigations are required to assess physical well-being. Ideally these should be done by the GP prior to referral.Weight and height to give BMI
Check by professional, not self-reported. Weigh in bare feet and light clothing, repeats preferably on the same scales. Height may change in anorexia.
Blood tests

• FBC U&Es LFTs serum protein
• calcium magnesium phosphate
• glucose TFTs
• zinc B12 folate
• creatinine kinase

ECG
Recommended if BMI less than 15, or if there is any cardiac history.

Monitoring

Investigations should be repeated periodically.
For BMI under 15
Weigh and check FBC U&Es LFTs calcium magnesium phosphate glucose every fortnight. However if the low BMI is long-standing then monthly weight & blood tests may be suffient.
For BMI under 17.5
Weight and check bloods monthly.
Patients who vomit or use laxatives
The potassium level may become dangerously low, frequency of monitoring to be decided on a case-by-case basis.

A guide to the medical risk assessment of eating disorders by Prof. Janet Treasure of King's College London can be downloaded from here:

• Medical Risk Assessment of Eating Disorders

(If the link does not work, try this site and let me know.)

Nottingham Urology Group

For private referrals at The Park and Woodthorpe Hospitals. Also for Choose & Book referrals at Woodthorpe Hospital, Castle Consulting Suite, Ilkeston Community Hospital & Long Eaton Health Centre.

• Mr John Lemberger
• Mr Owen Cole
• Mr Gurminder Mann
• Mr Akhlil Hamid
• Mr Richard Parkinson

Contact Details

The Park Hospital
Secretaries: 0115 966 2112 or 2113 or 2142
Fax: 0115 966 2187

Nottingham Woodthorpe Hospital
Secretary: 07814 497750
Fax: 01636 816907

Advantages

• referral will go to sub-specialist if appropriate
• instant access to consultants
• prompt flexible appointments

Website: www.nottinghamurologygroup.co.uk
Email: referral@nottinghamurologygroup.co.uk
Consultant advice line: 0759 888 7769

Core Four

Palliative Care Anticipatory Prescription

This guide is for dispensing quantities only, not dosages: please see Palliative Care Pocketbook, the latest edition of the Palliative Care Formulary or Liverpool Care Pathway symptom control sheets for breakthrough doses to write on the District Nursing authorisation sheet (DNS1).

Levomepromazine 25mg/ml
3 x 1ml ampoules
DOSE milligrams as directed in anticipation of nausea or agitation

Midazolam 5mg/ml
6 x 2ml ampoules
DOSE mg as directed in anticipation of agitation

Hyoscine butylbromide 20mg/ml
4 x 1ml ampoules
DOSE mg as directed in anticipation of bronchial secretions

Morphine sulphate 10mg/ml, 5 (five) x 1ml ampoules
or
Diamorphine hydrochloride 5mg ampoule, 5 (five) x 5mg ampoules
DOSE mg as directed in anticipation of pain

If patient is already taking this medication orally then the quantity of medication left in the home needs to be individualised and reviewed regularly to ensure correct dose available for parenteral administration.

Source: leaflet, November 2009

Suggested dosages

• levomepromazine 6.25mg - 12.5mg
• midazolam 5mg - 10mg
• hyoscine butylbromide 20mg
• morphine - one sixth of 24h dose

Patient Services

The Patient Services Department moved out of Standard Court over a year ago. Their contact information is as follows:

Patient Services
Byron Court, Arnold Business Centre
Brookfield Gardens
Arnold
Nottingham
NG5 7EW

Telephone: 0115 883 1820 (31820 from VHC)

Medical records tel: 0115 883 1835 (31835 from VHC)

Safe Haven fax: 0115 883 1844

Source: circular November 2009