Haematology

Haemoglobinopathies such as sickle cell disease and thalassaemia are lifelong conditions with individuals requiring on-going specialist care throughout their lifetime. Sickle-cell disease is one of the most common severe monogenic haemoglobinopathies and affects people of many different races. Most commonly affected are individuals with ancestors from Africa, India, parts of the Caribbean, Mediterranean countries such as Greece, Turkey and Italy, the Arabian Peninsula and some areas of South America. Thalassaemia is a genetically inherited blood disorder and predominantly affects those of Asian and Mediterranean origin.

Psychological therapies have focused on helping individuals to manage life with their conditions with a focus on interventions that minimise the distress, disability and reduced quality of life that can result from painful crises, organ damage, infection and complications associated with blood transfusions and other medical treatments. Interventions also focus on helping individuals and families to better understand the conditions that affect them and self-management can be a target intervention.

Psychological input within the Whittington haematology psychology service is offered: (1) Individually (2) with relatives or significant others or (3) as part of groups � for example a transitions group for clients transitioning from child to adult services and skills workshops/ groups for young people, adults and families. Therapy approaches include Cognitive Behaviour Therapy (CBT), Acceptance and Commitment Therapy (ACT) mindfulness and motivational interviewing, with systemic approaches also used. Cognitive assessments are also offered to paediatric clients who are at risk of stroke, this can involve liaison with schools and educational institutions.

All referrals are considered and attempts are made to engage clients through existing relationships within the haemoglobinopathy teams where required � sometimes this includes work with clients while they are on inpatient wards or in routine clinic appointments to facilitate engagement and promote the understanding of psychology.

Haematology Medical Teams

Often engagement with psychology will occur via one of the clinicians from the red cell haematology MDT. The haematology psychology department is part of this red cell MDT with haematology psychologists embedded within the medical and community haematology teams and working closely with these care teams.

Referrals

Referrals can be made by the following Whittington teams:

Whittington Hospital Teams: Paediatric Haematology (Sickle Cell Disease Service), Adult Sickle Cell and Thalassaemia service to hospital haemaglobinopathy team;
Community Team: Adult Community Sickle Cell and Thalassaemia Service

Referrals are accepted for any individual (adult or child) who is a patient at the Whittington Hospital and has sickle cell disease and/or thalassaemia.

Referrals tend to be made by members of the specialist sickle cell and thalassaemia multi-disciplinary team (MDT), however any patient who is experiencing mental health problems, emotional/ psychological distress or any difficulties adjusting to life with their illness can be referred to the service as long as they are patients of the Whittington hospital and have a sickle cell disease and/or thalassaemia � clients previously known to the haematology psychology service are welcome to refer themselves to the psychology department via phone or email (as above).

If you are a member of the Whittington MDT and would like to make a referral please search for �haematology psychology� under requesting on Anglia ICE and complete your referral on ICE. Alternatively, please use the link to our haematology referral form and return via email.

Haematology Psychology Referral Pathway

Haematology Psychology Referral Form

Waiting time

Referrals are made by members of the MDT or discussed in MDT, following which clients are contacted by phone/email/letter or seen in routine clinic appointments at the Whittington Hospital
When contacted, clients are offered an �opt-in� to the next available appointment slot which is known as an initial assessment
The waiting time from referral to the first contact/first appointment offered is within 2-weeks (the target is less than 6 working days for inpatients OR less than 4 weeks for outpatients)
The waiting time from the first appointment (initial assessment) to second (therapy) appointment is less than 12 weeks (this is our target waiting time to start treatment).