Haematology

What we do

We look after people who have had blood clots, also known as deep vein thromboses. These are common but can make people very unwell. They usually occur in the veins of the lungs (known as a pulmonary embolism) , legs, arms, brain or abdomen. Occasionally we will also look after people who have had blood clots in other places, for example in the heart, where we would work alongside the cardiology team.

We help the teams on the ward and in A&E decide what treatment to start, then we see patients in clinic and help decide how long treatment is needed, whether any tests are needed for an underlying cause, and what the best treatment is from that point onwards. We help educate and counsel patients about how to use their medicine for blood clots (anticoagulants) safely, and how to lower their risk of further clots in future. Sometimes you will speak to a doctor, and sometimes a nurse or pharmacist, depending on the type of decision or counselling that you need.  

• We also help patients who have an irregular heart rhythm (atrial fibrillation) to start anticoagulants safely, after the decision to start this treatment has been made, usually by a GP, cardiologist or stroke doctor. 
• If a decision is made to start you on warfarin you will be seen in the warfarin clinic.
• Our team is made up of doctors, nurses, pharmacists and scientists, and together we look after patients at the Royal London, St Bartholomew's, Newham and Whipps Cross hospitals, with lots of us working at more than one hospital.

What to expect in our warfarin clinic

You will receive a letter to invite you to a face-to-face clinic at either The Royal London, Whipps Cross, St Bartholomew's or Newham, depending on where you live.

We will explain how to take warfarin safely. You will have your first blood test and be told how much warfarin to take. This will be written in your yellow warfarin record. You will need regular blood tests in this clinic to determine what dose of warfarin you need. If you are housebound, we will try to arrange someone to come to your house to do the blood tests. If you are on dialysis we can do this through the dialysis unit. Some people prefer to buy self-testing kits at home, in which case we can use the blood tests you do yourself to dose your warfarin. Your GP will give you prescriptions for the warfarin tablets but the warfarin clinic will keep letting you know how much to take.

How to cancel or rearrange an appointment or contact the warfarin clinic 

• Royal London/St Bartholomew's: phone 020 3594 1885 or email the team
• Whipps Cross: phone 020 8535 6815 or email the team
• Newham: phone 020 7363 8730 or email the team

What to expect in our thrombosis clinic

If you have been diagnosed with a blood clot, also known as a deep vein thrombosis or pulmonary embolism, you will be given medicine called an anticoagulant to help your body heal and prevent another clot from forming when you are sent home from hospital. Unless advised specifically otherwise, please keep taking your medication until you are seen in thrombosis clinic, with extra prescriptions from your GP if needed. 

You will receive a letter informing you of your appointment, which is likely to be by phone or video the first time, and is usually around 6 to 12 weeks after the clot happened. Please make sure your GP has your correct telephone number and address as we use your GP record to contact you. The doctor in clinic will go over your history and help you decide how long to take the anticoagulant, what the best type of anticoagulant is for you going forwards, whether there was an underlying cause for the blood clot that needs treatment, and what you can do to try to prevent another blood clot in future.   

After an appointment you and your GP will receive a letter summarising what you discussed. If you need another appointment you will be sent another letter letting you know when it will be. Any new prescriptions will be issued from the hospital pharmacy. Sometimes you may need further tests like scans or blood tests. 

Contact us to cancel or rearrange an appointment for thrombosis clinics, including if you would like to request a change to the format of the clinic (phone/ video/ face-to-face).

Contact us for other issues

• Royal London/St Bartholomew’s: phone 020 3594 1885 or email the team
• Whipps Cross: phone 020 8535 6815 or email the team
• Newham: phone 020 7363 8730 or email the team

Further information

• Reducing the risk of Venous Thromboembolism (VTE) [doc] 1MB
• Pulmonary embolism patient information leaflet
• Thrombosis UK: information, videos, events and webinars

We diagnose and manage haematological disorders. We work closely with The NHS East and South East London Pathology Partnership.

What to expect in our clinic

You will receive a letter to invite you to a clinic at either The Royal London, Whipps Cross, St Bartholomew's or Newham, depending on where you live. You will receive a letter informing you of your appointment. The letter will say whether the appointment is by phone, video or face to face. 

After an appointment, you and your GP will receive a letter summarising what you discussed. If you need another appointment you will be sent another letter letting you know when it will be. Any new prescriptions will be issued from the hospital pharmacy. Sometimes you may need further tests like scans or blood tests. 

Contact us to cancel or rearrange an appointment for thrombosis clinics, including if you would like to request a change to the format of the clinic (phone, video or face-to-face).

We look after patients who have been diagnosed with immune thrombocytopenia (ITP). ITP is rare and occurs in about 3-4 per 100,000 adults per year. It is an autoimmune condition defined by low platelet count (<100 x10^9/L) and may cause easy bruising or bleeding if the platelet count is very low (<50 x10^9L).

The ITP clinic at The Royal London Hospital is a specialist clinic. Once a diagnosis of ITP has been made, we provide treatment, if needed, and follow up patients in our haematology day unit and outpatient clinic. Treatment for ITP is individualised and not all patients with this condition require treatment.

In addition to caring for patients with ITP who live near our hospital, we are also a tertiary referral centre for complex patients from other hospitals in the region.

We also offer the opportunity to take part in clinical studies on the causes of or treatment of ITP where we feel this would be suitable.

What to expect in our clinic

We use a combination of face to face, video and telephone clinics. During your first consultation, which may be face to face or virtual, we will discuss your medical history, family history, medication use and review any investigations you have had to date. 

Usually you will have to have further blood tests and sometimes other investigations which help us to make the diagnosis of ITP. These may include ultrasound scans or a bone marrow test. 

Having completed our initial assessment, we will discuss what treatment options, if any, may be required for ITP. We may also discuss studies of new medications (clinical trials) that may be available to you and give you the opportunity to take part if you so wish.

During follow up appointments, we will monitor your blood test results and response to any treatment you are taking for ITP. Subsequent appointments may be virtual or face to face.

We also review patients on our haematology day unit (2^nd floor, The Royal London hospital). Sometimes you may be asked to attend here for a blood test or to meet with a member of the team.

Occasionally you may need urgent treatment and this will be managed either on our haematology day care unit or by an admission to hospital. 

What to expect after an appointment 

After an appointment, you and your GP will receive a letter summarising what was discussed. If you need another appointment you will be sent another letter letting you know when it will be.

How to cancel or rearrange an appointment

• For clinic appointments, please phone: 020 3246 0338/0339
• For haematology day unit appointments, please phone: 020 3594 1855

How to contact us for other issues

• If you are a patient who is bleeding, you must seek urgent medical attention and attend your local A&E. 
• If you have a clinical query that is not an emergency, you can contact us on email or phone the office on 020 3246 0335.

Further information

The clinical team can provide you with information about ITP and treatments when you are seen in the outpatient clinic. 

The ITP Support Association has lots of useful information and support for patients and relatives, including information on Covid-19.

We also host the national registry for adult ITP. This is a study which aims to help us better understand the causes of ITP, responses to treatment and outcomes for patients. Your team will discuss this with you at your clinic appointment.

What we do 

We are a haemoglobinopathy coordinating centre (HCC) for sickle cell for east London and Essex and for thalassaemia and other rare anaemias for London and the South East. The Royal London Hospital is one of three specialist treatment centres for managing red cell disorders for east London and Essex.         

We work closely with our sickle cell and thalassaemia community teams in Waltham Forest, Tower Hamlets, City and Hackney and Newham.

• Our service for adults
• Our service for children
• Our community teams
• Patient information leaflets
• National and international societies

Our service for adults

What to do if you are acutely unwell

In an emergency, please attend the emergency department. If you are presenting with a painful crisis, the A&E team will have access to your protocol and we aim to deliver adequate pain relief within 30 minutes.

If you need to be admitted, you will be seen by the general medical team and transferred to the acute medical unit. The haematology team will see you the next morning but we are on-call and the medical team can liaise with us 24 hours of the day, seven days of the week.

Being admitted to hospital

Our haematology base ward is 13D but if there are no beds on that ward, we will see you wherever you are in the hospital. The haematology consultants will see all the new admitted patients who have come in the night before and will do twice weekly ward rounds of all inpatients. The haematology specialist registrar or senior house officer will see patients daily.

Haematology day units

The Royal London

• Offer top-up transfusions and red cell exchange transfusions
• Visit: The Royal London, 2^nd floor, central tower, 9am-5pm
• Phone: 020 3594 1855

Whipps Cross Hospital

• Offers top up transfusions
• Visit: Woodlands Day unit, closed on Wednesdays
• Phone: 020 8539 5522 ext 5102

You can also contact us on email for non-urgent issues.

What to expect during a clinic appointment

We have a number of clinics which take place remotely via the telephone and video, via Attend Anywhere, and face to face.

At The Royal London, we have late afternoon clinics, twice a month, from 2-6pm on Thursdays. We also have weekly Friday morning clinics from 9am-1pm. We have a monthly dedicated Thalassaemia clinic (located on the day unit to allow patients to combine their transfusion on clinic visit).

We also have a number of specialist joint clinics including:

• Joint liver and haemoglobinopathy
• Joint endocrine and haemoglobinopathy
• Joint Urology and sickle clinic (focus on priapism)
• Joint pain and haemoglobinopathy (focus on chronic pain)
• High risk haematology and obstetric clinic

We work closely with a number of other specialists including renal (via a quarterly MDT) orthopaedics, rheumatology and endocrinology.

At Newham, the clinics happen face to face, over the telephone and using attend anywhere with Dr Barroso and Dr Bennett.

In Waltham Forest, haemoglobinopathy patients are seen at the community-based Wood Street clinic.

What to expect after a clinic appointment 

After an appointment, you and your GP will receive a letter summarising what was discussed. If you need another appointment, you will be sent another letter letting you know when it will be.

How to cancel or rearrange an appointment by location 

For your transfusion appointments at The Royal London, please phone the day unit on 020 3594 1855 (ext 41855).

For your clinic appointments, please email Shireen Begum.

If you are planning on having a baby

For our haemoglobinopathy patients, please let us know if you are thinking of having a baby or when you do become pregnant, so that we can book your follow up in our joint obstetric/red cell clinic. 

Our service for children

The paediatric haematology service based at The Royal London Hospital provides care for babies and children up to the age of 16.

What to do if your child is acutely unwell

In an emergency, please attend A&E or call 999. In normal working hours, you will be reviewed by a member of the haematology team. Out of hours, you will be reviewed by the general paediatric team but they are able to liaise directly with a haematology consultant at all hours.

Being admitted to hospital

Our haematology base ward is 7E, but you may be admitted to any of the wards on the 7^th floor the haematology consultants will do a daily ward round.

Attending the children’s day unit

There is a day care ward primarily for children receiving regular blood transfusion and automated red cell exchange transfusion.

• Visit: 6th floor, children’s day care (6B), 8.30am to 8.30pm. Transfusions are done during the day and late afternoon.
• Phone: 020 3594 1425/6

There is a dedicated paediatric phlebotomy service in clinic 4 on the 7th floor. You can visit between 9am to 4.45pm, Monday to Friday. If your child needs anaesthetic cream or spray prior to the blood test, please let the receptionist know on your arrival.

Attending the paediatric clinic

The general haematology clinic takes place on Wednesday mornings in clinic 4 on the 7th floor, fbetween 9am and 12noon. If your child is unable to attend the clinic it is very important that you ring the clinic reception on 020 3594 41458/9 to cancel the appointment and rebook another one.

How to cancel an appointment

For a day unit appointment, please call the day unit reception on 020 3594 1425/6.

For a clinic appointment, please phone 020 3246 0352.

Our community teams 

The sickle cell and thalassaemia community teams provide specialist community nursing to help patients manage their condition in the community. They work with the hospital services and other community services to help improve our patients’ lives. They also offer pre-natal counselling to those with known haemoglobin variants and after a family has a child with a haemoglobinopathy. They are able to visit patients at home to help support them.

Hackney Sickle Cell and Thalassaemia Centre

457 Queensbridge Road, Hackney E8 3TS

Phone: 020 7683 4570

Newham Sickle Cell and Thalassaemia Centre

19-21 High Street South, East Ham, London E6 6EN

Phone: 020 8821 0800

Waltham Forest Wood Street clinic

6 Linford Road, London E17 3LA

Phone: 0300 300 1710

The Tower Hamlets Sickle Cell Service and thalassaemia service

Tower Hamlets Haematology day unit , 2^nd Floor, Central Tower, Royal London Hospital, London E1 1FR

Phone: 020 3594 1817

Email us

Patient information leaflets

• Blood transfusion in sickle cell disease
• Red cell exchange transfusion
• Receiving a blood transfusion
• Transcranial Doppler information letter
• Tower Hamlets hamoglobinopathy service[docx] 19KB

National and international societies

• Sickle Cell Society
• UK Thalassaemia Society
• Thalassaemia International Federation. This site has many publications on the website these have been translated into many languages including, Turkish and Urdu. Some can be downloaded from the site.