Each month we produce a newsletter for our local GP community called "GP News". You can read the latest articles on our website by clicking here.
May 2013
Chronic Pelvic Pain In Women
Chronic pelvic pain is defined as pelvic pain lasting more than 6 months, not occurring exclusively with menstruation or intercourse. However, in most women with CPP, dysmenorrhea and dyspareunia are a major part of their problems.
CPP presents in the primary care as frequently as migraine or back pain and can affect the woman’s quality of life drastically with a very significant financial burden on both the patient and the society ... read more
Announcing a Specialist Knee Clinic at Ashford Hospital
As part of a review of our Orthopaedic services we have decided to provide a dedicated Knee Clinic at Ashford Hospital run by Mr.Hossam Roushdi. This service is aimed at improving outcomes for patients in two specific groups and by offering fast effective treatment this will reduce pressure on resources overall
The clinics are going to be held weekly on Tuesday afternoon and Wednesday afternoon at the Ashford Hospital Outpatients Clinic department. We intend that this will enable these patients to be seen quickly ... read more
Urology Service Returns to Walton Community Hospital
A weekly Urology outpatient service for patients aged from the age of two and upwards is now running at Walton Community Hospital and accommodates routine, urgent and TWR referrals.
Referrals can be made both using Choose and Book (routine referrals) or by all other usual modes of referral ... read more
Update on Anti-Coagulation Clinic Capacity Issues
Over the last year we have seen a significant increase in referrals from GPs to our anti-coagulation clinics. We believe that this has been caused by a variety of factors including changes in the GP QOF indicators for Atrial Fibrillation for 2012/13 which encouraged increased use of anti-coagulation therapy based on CHADS2 scoring. The criteria of patients considered suitable for warfarin has also been extended and we have a general increase in demand due to the steady increase in the age of our population ... read more
Accessing Phlebotomy Services
The walk-in phlebotomy service runs at Ashford Hospital only on a daily basis Monday to Friday. Patients are seen in order of arrival and they should be prepared to wait - waiting times are kept to a minimum but may be up to 40 minutes on busy days. Patients should arrive between 8.30am (8.00am on Wednesdays) and 4.30pm to ensure that their bloods can be taken before the final collection of the day.
The service at St. Peter's is for patients coming from Outpatient clinics only and is not available for GP walk-ins. Please tell patients this and advise them of their alternatives ... read more
Infusion Suite Opens to Direct Access Referrals
The suite opened in October 2012 and is open between 8am – 8pm Mon-Fri. Referrals should be made by fax using the referral form which can be downloaded here.
Please note that referrals will not be accepted unless the form is fully completed.
The suite consists of 8 electric reclining chairs, and can be separated into male and female sections as required. All of the chairs have oxygen and suction call buttons, and each has its own equipment trolley and a locker for patients’ personal effects ... read more
April 2013
The Second Francis Report - Our Next Steps
This landmark report follows the 14 month enquiry led by Robert Francis QC on how poor care and treatment provided by Mid Staffordshire NHS Foundation Trust between 2005 and 2006 was not detected by the many systems in place intended to protect the public and makes a total of 290 recommendations.
After the publication of the first report in 2009, Ashford and St Peter’s developed a detailed action plan in response and much of this work has now been embedded into our working lives and practice through programmes such as Best Care, Living our Values and this year our Team ASPH programme. We are steadily improving our identification and reporting of incidents and our general approach to openness and transparency. This includes our work to collect and use patient feedback, to improve our responses to complainants and to increase the time we spend meeting patients and carers and discussing their experience, concerns and issues ... read more
Haematuria in Children
Haematuria is relatively common in children, and it is one of the most important signs of renal or bladder disease. The physician should ensure that serious underlying causes are not over looked, arrange relevant tests or further referral where appropriate.
Macroscopic haematuria is visible to naked eye, but Microscopic haematuria is usually detected by a dipstix or microscopy of span urine sediment. It is defined as presence of > 40 red cells when tested with flowcytometry (or 5-10 RBC under high power field of microscope). An absence of red cells in the urine with positive dipstix suggests haemoglobinuria or myoglobinuria ... read more
Introducing the Butterfly Scheme
The Butterfly Scheme offers a straightforward but clear approach to caring for patients with dementia and other forms of memory loss and confusion. Not only does this mean care that is focused on what is right for patients, it also helps to reduce the length of time spent in hospital which is not in their best interests.
It is an ‘opt-in’ scheme which uses simple butterfly symbols to show staff patients are asking for additional help and support. Simple actions such as reminding patients where they are, and why, can help to reassure them and prevent them feeling frightened. Arranging familiar items, such as a favourite mug, their glasses, a bag and so on, also help to make an unfamiliar setting more comforting. Staff are also reminded that they must remember to carry out additional care checks as often patients with dementia will not remember or be able to ask for help. Butterfly champions have been identified for our wards who will be responsible for signposting the scheme to patients and carers so they can opt in if they wish, and we are working hard to roll the scheme out over the coming weeks.
Accessing Phlebotomy Services
The walk-in phlebotomy service runs at Ashford Hospital only on a daily basis Monday to Friday. Patients are seen in order of arrival and they should be prepared to wait - waiting times are kept to a minimum but may be up to 40 minutes on busy days. Patients should arrive between 8.30am (8.00am on Wednesdays) and 4.30pm to ensure that their bloods can be taken before the final collection of the day.
The service at St. Peter's is for patients coming from Outpatient clinics only and is not available for GP walk-ins. Please tell patients this and advise them of their alternatives ... read more
A Further Accolade for the Ashford and St. Peter's Hospitals Nursing Home Project
The Foundation Trust Network have been using the case study on the Ashford and St. Peter's Nursing Home project as an example of best practice in outreach and proactive care in several forums, and a clear example of how acute care is a set of skills that do not need to be tied to a particular physical care setting. Most recently it was included anonymously in the Payment by Results guidance as an example of the sort of scheme that CCGs should invest in using the withheld funding from the marginal rate for emergency admissions (page 30 case study 1 ... Guidance Document 2013/14
February 2013
Percutaenous Renal Denervation now offered at Ashford and St. Peter’s for Resistant Hypertension
Hypertension can often prove difficult to manage despite lifestyle and dietary changes and a trial of various medications. Data extrapolated from Primary Care in 2008 suggests there may be 0.5 million hypertensive patients resistant to such therapy.
Without treatment these patients will continue to be at increased risk of heart disease, stroke, peripheral vascular disease or renal failure. Up to now medical therapy has been the mainstay of treatment for patients with hypertension and this is often associated with significant side effects and cost ... read more
Two Week Rule referrals - Could You Tell us More?
Ashford and St. Peter’s Hospitals continue with their excellent performance against the cancer wait time standards. Achieving these standards are a high priority within the Trust as efficient and effective pathways ensure patients are seen, diagnosed and treated as quickly as possible.
To help us to continue to deliver this efficient service we require your support to ensure that we have sufficient information about your patient's condition and any tests which have been carried out recently. We have had a number of instances where a form has been sent with only a box ticked and no further clinical information included. In the worst cases this causes a delay in treatment for the patient as the team have to chase information and test results prior to the patient being seen ... read more
Surgical Podiatry Clinic now Available
Mr Nicholas Masucci has now joined the ASPH Orthopaedic team. Examples of the procedures which he will be undertakes include
Great toe - hallux rigidus/degenerate big toe joint
Correction hallux valgus
Correction lesser toes
Lesser matatarsal osteotomy
... read more
Pioneering Knee Surgery at Ashford and St Peter’s Hospitals
With the increase in patient numbers having flexible sigmoidoscopy we have become aware that patient experience could be improved regarding having bowel preparation.
Currently the patients have use of a purpose built ensuite room in the Endoscopy Unit, for use with enema preparation.However we only have 2 of these and we see dozens of patients daily who need enema preparation.
The result can be long and anxious waits for the patients to get ready for the procedure and use the toilets ... read more
Change of venue for Ashford Breastfeeding Clinic
Local patient Debbie Wragg from Shepperton is the first to have pioneering knee replacement surgery on the NHS, thanks to consultant orthopaedic surgeon Mr Hossam Roushdi.
The new surgery uses computer technology to scan a patient’s knee so that a whole new joint, or parts of the joint, can be made to exactly the same size and shape as the original – a real bespoke service. Whilst the scan takes place in hospital here, the images are sent to a specialised company in the United States who make the new joints and then send them back over to be fitted ... read more
KnowledgeNet now optimised for Mobile Devices
KnowledgeNet, the online arm of Ashford and St Peter’s Hospital Health Sciences Libraries, has now been optimised for use on mobile devices, such as Smartphones and Tablets. KnowledgeNet currently offers access to a wide selection of online library resources including:
a book and journal database
links to full-text journals
book, journal article and literature request forms
website links for medical students
literature searching workshops
NHS news and bulletins
... read more
January 2013
Christmas opening times
As usual the Trust will be closing some departments over the Christmas break, but this is being kept to a minimum with the majority of departments offering a normal service every day except for the Bank Holidays.
Click here to download a copy of our opening times over the Christmas period.
The GP Relationship team at Ashford and St. Peter's would like to wish everyone a very happy Christmas and New year.
Changes to our Peterbus Service
At Ashford and St Peter’s Hospitals, putting patient care first means making the right investment decisions so we can continue to develop high quality local health services.
For some time now, our Peterbus service – originally set up to help patients travel to and from St Peter’s from villages across our catchment area – has been running at a considerable financial loss. Falling passenger numbers and high fuel and maintenance costs mean it is now costing the Trust £130,000 a year to subsidise - equivalent to four nurses or 43 hip replacement operations ... read more
Trust Welcomes Mr. Andrew Cruise to the ENT Team
Andrew Cruise recently joined the Trust as an ENT consultant with a special interest in otology, complementing the current team of three ENT consultants, John Hadley, Pandora Hadfield and Lisa Pitkin. He comes from having spent a year as a locum consultant at Princess Alexandra Hospital, Harlow.
Andrew undertook his specialist ENT training in North London spending time at the Royal National Throat, Nose and Ear Hospital, Barts, Charing Cross, The Royal Free and St Mary’s Hospitals ... read more
Bowel Prep for Patients undergoing Colonoscopy and Flexible Sigmoidoscopy
With the increase in patient numbers having flexible sigmoidoscopy we have become aware that patient experience could be improved regarding having bowel preparation.
Currently the patients have use of a purpose built ensuite room in the Endoscopy Unit, for use with enema preparation.However we only have 2 of these and we see dozens of patients daily who need enema preparation.
The result can be long and anxious waits for the patients to get ready for the procedure and use the toilets ... read more
Change of venue for Ashford Breastfeeding Clinic
The breastfeeding clinic currently running from the Topaz suite at Ashford Hospital is moving to Clarendon Childrens Centre, Knapp Road, Ashford from 7th January 2012. The timing of the clinic will not change.
We would be grateful if you could display the poster which you will be sent to help us make all mums aware.
If you have any queries about this please contact Kim McHarg, Infant Feeding Advisor by e-mail at
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New Consultant Podriatric Surgeon starts in January
Mr Nicholas Masucci will be joining the ASPH Orthopaedic team in January. He is currently working at Newham University NHS Trust. Examples of the procedures which he will be undertaking include
Great toe - hallux rigidus/degenerate big toe joint
Correction hallux valgus
Correction lesser toes
Lesser matatarsal osteotomy
Referrals can be made to him either via Choose and Book (service awaiting approval by Mr. Masucci before publishing), or send referral letter addressed to him at the Rowley Bristow unit, or send an email referral to
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
December 2012
Waking Up To Sleep Apnoea
Obstructive Sleep Apnoea (OSA) is part of a spectrum of Sleep-disordered breathing (SDB), ranging from uncomplicated snoring through OSA to frank nocturnal hypoventilation in Obesity Hypoventilation Syndrome (OHS).1
OSA syndrome comprises symptoms due to repetitive transient upper airway closure during sleep, in which airflow either stops (apnoea) or is reduced (hypopnoea). This is often, but not always, associated with a drop in Oxygen Saturation (SaO2). Theobstructive episodes are terminated by arousal, during which control of airway muscle is regained, occasionally resulting in waking from sleep ... read more
Change of Referral Process for Dietetics
As from Monday 26th November all referrals to the Dietetics team will need to be processed via the Appointments Centre. This change is being made to make the referral process quicker and more convenient for patients and GP Practices alike.
Phone: 01784 884351
Fax: 01784 884291
Referrals can also be sent by e-mail to:
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Please ensure that the new forms are used as, apart from a change of contact details, the service is no longer available at certain locations listed on the old forms ... read more
Trust Achieves Best Practice Tariff for Paediatric Diabetes
Ashford and St. Peters are one of the few Trusts nationally who have achieved the Best Practice tariff for Paediatric Diabetics. Children with diabetes seen at the Trust are now only seen by one of our two consultants, Dr Shailini Bahl or Dr Gillian Baksh, which enables patients to see the same doctor every time they attend and helps to build relationships with both patients and parents alike.
24 hour on-call cover is provided (including weekends) which allows access to specialist advice for patients who are newly-diagnosed out of hours ... read more
Care of the Elderly team win HSJ award
You will have read in our October edition that the Care of the Elderly team were nominated for an HSJ award for their work on the Nurisng Homes Project aiming to improve healthcare for elderly nursing home residents and reduce emergency admissions to hospital. We are delighted to announce that they won their category.
The ceremony was hosted by BBC Presenter Huw Edwards, and a team of four Elderly Care Consultants collected the award: Dr Keefai Yeong, Dr Radcliffe Lisk, Dr Raad Nari and Dr Bhaskar Mandal ... read more
New Virgin Care Clinics Supported by ASPH
Following a formal process run recently by NHS Surrey Virgin Care have been appointed as a Qualified Provider for pathways of care in Dermatology, ENT, Gynaecology, Ophthalmology, Orthopaedics & Urology. To meet NHS Surreys requirements Virgin Care had to provide community based outpatient clinics in conjunction with an elective provider to identify where patients would receive any onward treatment required. ASPH have agreed to be a subcontractor supporting this new Virgin Care service. In addition to providing any elective treatment required we are also providing our consultants to run clinics at the initial location in Woking ... read more
November 2012
New Infusion Suite Opened at Ashford Hospital
The new Infusion Suite at Ashford Hospital opened on Monday 8th October to provide enhanced infusion services to local patients. It is located between Main Outpatients and the Jasmine Suite, where breast and gynaecology clinics are held.
Initially the unit will be open from 8am – 8pm Mon-Fri, staffed by two trained nurses (Team Leader Gemma Forde plus one other) supported by nurses on rotation from OPD. It will offer all types of infusions, including Rheumatology, blood transfusions and breast chemotherapy. It also offers the possibility of repatriating the patients currently travelling to St. George’s hospital for Tysabri infusions, although this is still to be confirmed ... read more
Are You Using the New MAU Referral Process?
The new process for referring patients to the MAU was launched on Monday 8th October. Some practices are still not using the updated process, which is causing delay to treatment of their patients.
When you call the MAU, the Patient Navigator will answer your call and will discuss the referral with you. She will ask you a number of questions about your patient. These are recorded on this form and are designed to help decide the pathway which is best for your patient. Please make sure you have a look at this form as we think it will be helpful if you know in advance the questions that we will be asking you when you call ... read more
Changes to Radiology Services
In response to requests from local GPs, the non-urgent Direct Access Ultrasound Service can also now screen lumps and bumps. To access this service you will need to download an updated copy of the form here.
Please ensure that all forms are completed before being given to the patient and that the patient takes the form to the appointment with him.
Failure to complete the form or have it available for the appointment causes a delay to the service and extra work for practices ... read more
Trust Top for Hip Fractures
Latest figures from the National Hip Fracture Database (NHFD) Report for 2012 show that Ashford and St Peter's Hospitals NHS Foundation Trust is the best in the country for providing top quality care for patients with hip fractures.
Consultant Orthogeriatrician at the Trust, Radcliffe Lisk, explains more:
“At Ashford and St. Peter's we work very hard to ensure that this group of patients get the care and treatment they need and I'm very proud that we came top nationally in providing best practice to our hip fracture patients." ... read more
Trust Welcomes Mr Magdy Moawad
Ashford and St. Peter’s Hospitals NHS Foundation Trust are delighted to welcome Mr Magdy Moawad to the Vascular Surgery team.
Mr. Moawad has a Masters degree in general surgery and gained his FRCS (Ed) in 1999. He also gained FRCS (Gen.Surg) in vascular surgery in 2009.
Magdy has advanced training in vascular surgery, and has worked in many eminent Regional Vascular and Endovascular Units such as St. Thomas’, St. George’s and Royal Free hospitals in London. This has enhanced his skills and has allowed him to become familiar with different and diverse surgical practices ... read more
October 2012
Metal on Metal Hip Replacements
Metal-on-metal (MoM) devices have been implanted into over 60 000 patients in England and Wales since 2003 when the National Joint Registry first began to record procedures.
Metal-on-metal hip implants were re-introduced after observing damage caused by polyethylene debris in standard hip replacements. Advances in manufacturing technology ensured that MoM hips produced the least amount of wear debris. Furthermore MoM implants allowed for larger femoral head sizes offering greater stability and lower risk of dislocation ... read more
Care of the Elderly Team Shortlisted for HSJ Award
The Ashford and St Peter's Trust Care of the Elderly Team have been shortlisted for a prestigious award from the Health Services Journal (HSJ) - the Oscars of the healthcare world - for their initiative on reducing emergency admissions from nursing homes.
The shortlisting for the HSJ award for Managing Long Term Conditions comes in the wake of a reduction of 40% in emergency admissions from participating nursing homes. ... read more
Acute Diabetic Foot Problems
Foot problems can affect anyone with diabetes, whether they are being treated with insulin, tablets or diet. Patients with diabetes are more likely to be admitted to hospital with a foot ulcer than with any other complication of diabetes.
Diabetic foot complications affect over 3 million people in the UK.
It is the most common cause of non-traumatic amputation for patients ... read more
Trust Fully CQC Compliant
On Tuesday 11th September Ashford and St. Peter’s received another unannounced visit from the CQC. Following on from their last report, where they had noted concerns around record keeping, they visited 6 wards across St Peter's Hospital and examined around 30 sets of patient notes. We are pleased to say that all our hard work to improve this area has paid off and we were given a clean bill of health. We are now fully compliant with CQC standards, which is great news.
Pregnancy Dermatoses - What to refer
The new Pregnancy Dermatoses Clinic will be on the first Thursday of every month. I am keen to see women who are either pregnant or post-partum with skin problems such as:
Polymorphic eruption of pregnancy (PEP)
Pemphigoid gestationis (PG)
Eczema
Psoriasis
Other Miscellaneous skin diseases (e.g. rosacea, acne, urticaria) ... read more
September 2012
Heavy Menstrual Bleeding
Most medical treatments for Heavy Menstrual Bleeding (HMB) can be commenced in the primary care, without the need for further investigation.
Management of Heavy menstrual bleeding (HMB) has changed dramatically with the advent of endometrial ablation and the levonorgestrel-releasing intrauterine system (Mirena) over the past two decades ... read more
Two Week Rule referrals - Are Patients Aware?
Ashford and St. Peter’s Hospitals continue with their excellent performance against the cancer wait time standards. Achieving these standards are a high priority within the Trust as efficient and effective pathways ensure patients are seen, diagnosed and treated as quickly as possible.
To help us to continue to deliver this efficient service we require your support to ensure that patients are aware that they are being referred to rule out a cancer diagnosis ... read more
Important Information - GP Radiology Requests
We would be grateful if you could note and action two key changes in our Radiology Services.
1.Direct Access Non Urgent Ultrasound Service now within 7 Days NOT same day
2. Walk-in Same Day Direct Access X-Rays
read more
New AAA Screening Service
The NHS Abdominal Aortic Aneurysm (AAA) Screening Programme is being introduced gradually across England and is led and coordinated nationally. Phased implementation began in March 2009 and coverage across all of England will be achieved by 2013. Screening is delivered locally in line with national quality standards and protocols and there will be around 42 local screening programmes in total once national implementation is complete ... read more
Invitation to Ashford Hospital GP Evening - 26th September
Planned topics to be discussed are: Ashford Outpatient Department Refurbishment, Breast One-Stop Clinics, Rapid Access Services, Paediatric Services, Cardiology Services.
If there is any service not on this list which you would like to know more about please contact us at
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Welcoming Dr. Jan Coebergh
Born in the Netherlands, Dr Coebergh trained at Newcastle medical school and returned to the Netherlands to complete his specialist training in neurology after being a house officer.
He has now returned to the UK with his English wife to be closer to the family and continue his career in clinical neurology. He started at Ashford and St. Peter’s as a Locum Consultant in January and the Trust was pleased to confirm him in post in June ... read more
August 2012
Management of Gastro-Oesophageal Reflux Disease
Gastro-Oesophageal Reflux Disease is one of the most common health problems and its treatment accounts for the biggest single pharmaceutical expenditure to the NHS. There were 36 million prescriptions written for PPI’s in the UK last year- a threefold rise since 2000 ... read more
A New Look for Ashford Hospital Outpatients Department
The long-awaited £2.8 million refurbishment of Ashford outpatients department started on 23rd July. The new department will provide a modern, comfortable and therapeutic environment. Walls will be opened out and glazed to give more external views and natural light, allowing people to orientate themselves inside the building more easily. The entrance lobby and reception will also be modernised with glazed walls to let in more light ... read more
Invitation to Ashford Hospital GP Evening
Planned topics to be discussed are:
Ashford Outpatient Department Refurbishment
Breast One-Stop Clinics
Rapid Access Services
Paediatric Services
Cardiology Services
If there is any service not on this list which you would like to know more about please contact us at
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New Midwife Led Unit Will Offer More Choice for Local Women
The Trust Board at Ashford and St Peter’s Hospitals has approved plans to build a new Midwifery Led Unit, which will be located in Abbey Wing at St Peter’s Hospital alongside the existing maternity facilities. Sandra Houston, Head of Midwifery, said: “This is absolutely fantastic news for local women and our midwives can’t wait to see the new unit built. It’s all about offering a choice of birthing experience to women and providing different facilities to enable that choice." ... read more
Patients wanted for COPD Study
Ashford and St Peters Hospitals NHS Foundation Trust are involved in a number of Clinical Trials. We especially require your assistance to identify suitable patients for a COPD study we are now recruiting to. We have only a few months to recruit 10 patients to this 6 month study which compares the efficacy and safety of Indacaterol (Onbrez Breezhaler) with salmeterol/fluticasone propionate (Seretide Accuhlaer) in patients with moderate COPD. Therefore, we would very much appreciate your assistance in identifying suitable patients ... read more
Physiotherapy First Appointment Booking Line
As an initiative to reduce the DNA rate for physiotherapy appointments at ASPH, an appointments phone line was opened on Monday 2nd July, for a 4 month trial period. The phone line is open from 8-10am Monday to Friday for first appointment bookings only. Patients are sent a letter inviting them to call the dedicated phone line to book their appointment ... read more
July 2012
Why Choose to Refer for Bariatric Surgery?
Bariatric Surgery is one of those areas where many people wonder whether it should be provided on the NHS. Surgery always carries risks and many people see it as a drastic option for dealing with obesity. However the outcomes can be compelling and that is why Ashford and St Peter’s NHS Hospitals Foundation Trust has been accredited by specialist commissioners to deliver this service to patients in Middlesex, London, Surrey, Hampshire, Kent and Sussex. We have opened a dedicated Bariatric Unit (the WREN unit) recently to provide specialist care to this group of patients ... read more
Abdominal Aortic Aneurysm Screening Programme
The NHS Abdominal Aortic Aneurysm (AAA) Screening Programme is being introduced gradually across England and is led and coordinated nationally. Phased implementation began in March 2009 and coverage across all of England will be achieved by 2013. Screening is delivered locally in line with national quality standards and protocols and there will be around 42 local screening programmes in total once national implementation is complete ... read more
New GP Link Email Newsletter
We are going to start sending our regular newsletter to GPs by email. It will be emailed out to Practice managers and we would be very grateful if they would forward it to all relevant colleagues ... read more
Are You Using Our GP Browser?
Included in the tools and information on our online GP Resource Centre – www.asph.nhs.uk/gp - is the GP Browser. This tool has been available from ASPH for some years but usage has been dropping so we thought it would be helpful to give you a reminder of what it can do for you. It’s available for all our local GPs and Practice Managers to use ... read more
Dates for your Diary
Join us for our educational events ... read more
Welcome to Mr Pasha Nisar
Ashford and St. Peter’s NHS Foundation Trust are delighted to welcome Mr Pasha Nisar to the Colorectal Surgery team at the Trust. He qualified in medicine in 1998 from Trinity College, Cambridge and Addenbrooke's Hospital ... read more
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