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Country: United Kingdom
City: London
IHTC:
Katharine Dormandy Haemophilia Centre and Thrombosis Unit
Royal Free Hospital
Pond Street
Hampstead, London, NW3 2QG, UK
Tel.: 44 020 7472 6830
Fax: 44 020 7472 6759
Email: melanie.prentice@royalfree.nhs.uk
Website: www.royalfree.org.uk/
Director: Edward Tuddenham
Responsible for training: Edward Tuddenham, Pratima Chowdary, Alex Gatt, Christine Harrington (nurse consultant).
Fellowship logistics coordinator: Melanie Prentice
Year of IHTC designation: 1970
Areas of specialty:General hemophilia care; pediatrics (jointly with GOS); physiotherapy (part time); dental (part time); orthopedic surgery; laboratory diagnosis (not genetics); genetic diagnosis; psychology; nursing; social work.
DESCRIPTION OF TRAINING PROGRAM
Clinical activities: The trainee will be involved with all aspects of our clinical work, such as ward rounds (daily), out patient clinics (at least six per week), case discussions, special clinics and so on. The centre cares for 1,723 patients registered with inherited bleeding disorders, of whom over 200 are classed as severe. Many patients with rare bleeding disorders are sent for diagnosis and management to the centre. We have large cohorts of patients with factor XI deficiency, von Willebrand disease, and platelet disorders. Our advice is sought for diagnosis and management of acquired bleeding syndromes such as DIC, autoimmune factor deficiency, pregnancy related bleeding, and liver disease in the context of the many specialized services that are provided in this large multi-faculty teaching hospital.
Children under five with bleeding disorders are cared for by our partner institution, the Hospital for Sick Children, Great Ormond Street. A joint appointee between the two centres, Dr. Mary Matthias holds clinics for children with hemophilia aged 5 to 16 at the Royal Free Hospital and facilitates adolescent transfer from GOS to RFH. Arrangements could be made for visitors to attend GOS during their stay in London if desired.
Laboratory activities/research: There are purpose-built designated laboratories which manage the tests required for the treatment of haemophilia, the diangosis of new bleeding disorders and the molecular basis of bleeding disorders with provision for ante-natal diagnosis. The laboratory also provides a routine haemostasis service for the Royal Free Hospital.
Laboratory result meetings are held regularly to discuss the ongoing work up of the complex cases that are sent to this tertiary referral centre. Several research areas are always active. Currently gene therapy, global hemostasis assays, and aspects of inhibitor development are being investigated by full-time research staff. This work is presented and discussed in seminars that the trainee will be encouraged to attend.
Multidisciplinary activities/research: Our orthopedic colleague, Mr. Nick Goddard, is an international authority on joint surgery in hemophilia. We have a part-time physiotherapist attached to the unit. The nursing staff includes a nurse consultant (Chris Harrington), community outreach nurse (Debra Pollard), clinical nurse specialist (Barbara Subel), pediatric lead nurse (Paul Thurlow), plus three more nursing staff. The dental work is undertaken by a hospital clinical assistant (Mr. Ishaq). Our psychosocial team comprises Mrs. Riva Miller and Ms. Nicola Dunn. The women’s clinic with Ms. Kadir has an international reputation, with very many publications that are considered authoritative for this relatively new area of attention in the field of clinical hemostasis. We have a major initiative in gene therapy for hemophilia with the first U.K. trial in hemophilia B due to begin in spring of 2007. We are developing protocols for preclinical trials of gene therapy for hemophilia A.
Additional information: Over past years we have had many international visitors and contacts at various levels with Iran, Pakistan, the Philippines, Malaysia, and South Africa, to name only a few. The centre can train up to two fellows annually. There is no particular time specificied for training, but during August some staff are on leave and the clinic is generally quieter so that there is less opportunity for supervision and patient-related activity to be observed.
DESCRIPTION OF IHTC FACILITIES
Location:In Hampstead, one of the most pleasant parts of London, near shops and other facilities such as Hampstead Heath.
Climate: Summers are usually cool and wet; winters are usually cold and wet. The skies are usually grey. However with global warming this is changing, with long warm dry spells not unusual now.
Accommodation (residence, meals, etc...): Wide availability of commercial rental flats in the area. The hospital has a canteen. Muslim visitors or others with special requirements are asked to make this clear before arrival so that we can accommodate their needs.
Transportation: Excellent public transport connections to all parts of London.
Language: English, Spanish, French, Arabic, Turkish, Chinese, Tagalog, Portuguese, Italian
Financial assistance: Dependent on WFH funds.
Cost of living (per week): 500 USD
Communications tools for trainees: Computer, Internet access, telephone.
Other local support provided for trainees: London has communities from every country and area in the world. Everyone is able to find support from their own group in this highly cosmopolitan city if they need it.
RELEVANT PUBLICATIONS BY IHTC STAFF
Kadir RA, Kingman CE, Chi C, O'Connell NM, Riddell A, Lee CA, Economides DL. Screening for factor XI deficiency amongst pregnant women of Ashkenazi Jewish origin. Haemophilia. 2006 Nov;12(6):625-8.
Lee CA, Lillicrap D, Astermark J. Inhibitor development in hemophiliacs: the roles of genetic versus environmental factors. Semin Thromb Hemost. 2006 Jun;32 Suppl 2:10-4.
Sabin CA, Phillips AN, Yee TT, Griffioen A, Lee CA. Twenty five years of HIV infection in haemophilic men in Britain: an observational study. BMJ. 2005 Oct 29;331(7523):997-8.
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