Hospital and Clinic Issues

Follow the Our Team link to find out about the staff who work in the Diabetes Unit.

Clinics

There are many different clinics and activities which take place within the Diabetes Unit and at other locations within the Countess of Chester Hospital site as well as at other locations such as Ellesmere Port and Deeside Community Hospitals. These can be found in the clinics section.

What to expect in clinic

Diabetes give you the chance to meet medical experts who can check that you're well and give you highly specialised advice on how to control your diabetes - follow the link to find out how they work.

A tour of the department

The new dedicated Diabetes Unit is located within OPD3 (Outpatients Department 3) on the Countess of Chester Hospital site. It was opened in the Spring of 2004.

Dr Richard Worth (MD,FRCP) Consultant Diabetologist Richard trained in Sheffield, Hull and Newcastle before coming to Chester in 1984 where he worked as a single handed consultant until 1994. He was successful in persuading the hospital of the value of the Diabetes Specialist Nurses and our first, Ann Nicholson was appointed in 1985. Richard played a lead role in lobbying for and then designing the new Diabetes/Endocrine unit which opened in the spring of 2003.

Dr David Ewins (DM, FRCP) Consultant Diabetologist. David trained in Southampton, King's College London and at the Manchester Diabetes Centre. He has been a consultant in Chester since 1994. He is currently Clinical Champion on the local diabetes management team (Diabetes LIT) and is actively involved in setting up the computerised district diabetes register and the digital photographic eye screening programme.

Dr Niru Goenka Consultant Diabetologist Niru graduated from Liverpool Medical School in 1994, and trained in Liverpool, South Wales and Leicester, following which he obtained a research fellowship in diabetes at the University of Warwick. After completing his doctorate, Niru came back to Liverpool to finish his training before being successfully appointed to substantive Consultant post in Diabetes & Endocrinology at the Countess of Chester. Niru's predominant professional interests are clinical diabetology, nephropathy, hypertension management, and cultural influences on diabetes care. Niru considers his primary role to be improving the delivery of service for patients with diabetes. Niru is married with three children (all boys) and spends most of his free time with his family. Niru has a keen interest in DIY, cinema, computers and cooking and is a lifelong fan of Liverpool Football Club.

Consultants All 3 consultants run the joint diabetes service, carrying out clinics in general diabetes care as well as specialist clinics such as the Young Persons' Clinic, the Antenatal Clinic and the Foot Clinic. In addition they carry out the regular Endocrine Clinics and both Dr Ewins and Dr Rutter currently have General Medical clinics and in-patients at the Countess of Chester Hospital.

Dr Noel Murphy (MD, FRCP) Consultant Paediatrician. Noel was appointed as a Consultant Paediatrician in 1985 having previously worked as a Senior Registrar in the Mersey Region and been a Resident at the Hospital for Sick Children in Toronto. He set up the Paediatric Diabetes Clinic in 1986 and has been running children's clinics and young peoples' transition clinics ever since. He has a special interest in education and teaching in diabetes and in the psychological aspects of blood glucose control.

Dr Joanne Davies Consultant Obstetrician Joanne has recently taken over from Mr John Williams as the consultant obstetrician with an interest in diabetes. She runs the Joint Diabetes Antenatal Clinic which is held in the Womens and Childrens hospital every Monday afternoon.

Dr Geoff Hayle Hospital Practitioner Dr Tim Watkins-Jones Clinical Assistant Dr Ceri James Clinical Assistant Geoff, Tim and Ceri are local GPs with a special interest in diabetes who help with the adult diabetes clinics at the Countess of Chester Hospital.

Jeff Pond Diabetes Specialist Nurse Jeff trained at Chester College and qualified as a Registered General Nurse in 1993. He has worked on several medical wards at the Countess of Chester Hospital and has been working as a Diabetes Specialist Nurse since 1999. He regularly works in the Young Persons' Clinic. Jeff has a strong interest in diabetes and physical activity, his hobbies include golf and keeping fit. He recently successfully completed the London Marathon.

Karen Perkins Diabetes Specialist Nurse Karen has been a Diabetes Specialist Nurse since 2001. Prior to this she worked on Ward 49, the main Diabetes/Medical ward at the Countess of Chester Hospital. She works in Annual Review Clinics, Telephone Triage and Drop-in clinics at the Countess of Chester and Ellesmere Port Hospitals. Karen has a huge interest in wound care and diabetic foot problems, and helps run the regular Diabetic Foot clinics.

Alison Wylie Diabetes Specialist Nurse Alison has worked in diabetes for the past 11 years formally at the Royal Liverpool Hospital and then here at the Countess for the past eight years. She currently works part time as a Diabetes Specialist Nurse within the Diabetes Unit. Her main responsibilities include the management of patients with diabetes when they are admitted to hospital, and the care of young women with diabetes before, during and immediately after pregnancy.

Deborah Johnson Diabetes Specialist Nurse Deborah has worked as a Diabetes Specialist Nurse in Oldham since 2003, prior to that she worked in diabetes care at the Royal Liverpool Hospital. She joined the diabetes team at the Countess of Chester Hospital in February 2005. Deborah works in the Antenatal and Young Persons' Clinics and has experience in insulin pump therapy. She also helps run the education sessions for people with diabetes.

Paul Langridge Paediatric Diabetes Specialist Nurse Paul has worked at the Countess of Chester Hospital since 1988, initially as a staff nurse on the children's medical ward and since 1993 as a children's community nurse, primarily working with children with diabetes and their families. Paul moved to Chester following training at Manchester Children's Hospital and working on the Children's Unit in Blackburn.

Natalie McKeown Diabetes Dietician Natalie joined the team as diabetes' dietitian in December 2004. She has worked in diabetes care for over seven years at a number of hospitals, mainly in the south of England. At the Countess she sees patients who attend the Young Persons' Clinic and Antenatal Clinic. She is also available at all Annual Review Clinics. She has an interest in group education and is hoping to develop this service further with the introduction of an insulin dose adjustment programme.

Alison Cater Diabetes Podiatrist Alison Cater has been with the diabetes department for 8 years now and has been practising podiatry for almost 20 years. She enjoys doing up her old cottage on the Horseshoe Pass in North Wales - this basically involves everything from gardening to plumbing and pointing. She also enjoys music and has been seen doing favourable renditions of rock and roll songs (she does a great impression of Tina Turner). Unfortunately Alison is presently without a band.

Janet Jones Psychotherapist Janet is an experienced Psychotherapist who has worked in various aspects of mental health in Chester. She works with members of the Diabetes Team and also with individuals who attend the service. Janet works in partnership with individuals using psychological approaches aimed at helping them gain a better understanding of their difficulties, which may relate to managing diabetes or more general issues. She also supports individuals in making positive changes in how they think, feel and behave.

 

There are many different clinics and activities which take place within the Diabetes Unit and at other locations within the Countess of Chester Hospital site as well as at other locations such as Ellesmere Port and Deeside Community Hospitals. These are listed below.

Main Diabetes Clinics

These clinics are for the follow-up and annual review of people with diabetes. They are usually staffed by:

• 1 or 2 Consultants with Specialist Registrar and/or Clinical Assistant (an experienced GP with a special interest in diabetes)
• Clinic Nurse and Health Care Assistant
• 1 or 2 Diabetes Specialist Nurses
• Diabetes Dietitian
• Diabetes Chiropodist

Specialty Diabetes Clinics

These clinics are for patients requiring closer supervision. This includes the Young Persons' Clinic, Foot Clinic, Antenatal Clinic and Renal Clinic. These clinics are usually staffed by:

• One Consultant, with or without a Registrar
• A single Diabetes Specialist Nurse
• Diabetes Dietitian and/or Chiropodist as required

New Patient Clinic

These clinics are for patients recently diagnosed with diabetes or referred up by their GPs for specialist advice. The clinics are usually staffed by:

• A single Consultant with Specialist Registrar and/or Clinical Assistant (an experienced GP with a special interest in diabetes)
• Clinic Nurse and Health Care Assistant
• Diabetes Specialist Nurse
• Diabetes Dietitian
• Diabetes Chiropodist

Adult Diabetes Clinics

Time	Monday	Tuesday	Wednesday	Thursday	Friday
am	Renal Clinic	Annual Review Clinic	New Patient Clinic	-	Elderly Clinic (monthly)
pm	Antenatal Clinic	-	Annual Review Clinics (alternate weeks)	Foot Clinic	Annual Review Clinic (alternate weeks)

Please arrive 10 minutes early for appointment to allow time for HbA1c to be measured.

Paediatric/Young Persons′ Diabetes Clinics

From the age of 13 - 15 the Paediatric Diabetes Clinic is held within the Diabetes Unit, OPD3 so that patients become acquainted with the adult facilities and staff. Transition to the Young Persons' Clinic usually occurs around the 16th birthday but this can be flexible depending on individual circumstances.

Age	Day	Time	Location	Team
Under 13	1st Monday of month	1:30-4pm	Children's Unit	Dr Murphy
Under 13	3rd Monday of month	1:30-4pm	Children's Unit	Dr Murphy
13-15/16	3rd Tuesday of month	4-6pm	Diabetes Unit	Dr Murphy
15/16-20	4th Wednesday of month	4-6pm	Diabetes Unit	Adult Team

Please arrive 10 minutes early for appointment to allow time for HbA1c to be measured.

Specialist Nurse Clinics

These clinics are run by individual Diabetes Specialist Nurses and take place either in the Diabetes Unit or in the local community hospitals. Details of the regular nurse led drop-in clinics are listed below, in addition pre-booked appointments are available at specific times to supervise insulin starts and regular reviews of specific problems.

Countess of Chester Diabetes Unit (all Specialist Nurses)

Day	Time	Clinic	Booking
Mon & Thurs	10-12 am	Drop-in	Just turn up or ring Jill or Yvonne 01244 363779
Mon-Fri	Various am & pm	Pre-booked	By appointment

Ellesmere Port Hospital (Karen Perkins)

Day	Time	Clinic	Booking
Tuesday	1.30-4.15	Drop-in	Just turn up or ring 01244 363779
Wednesday	2.00-4.30	Pre-booked	By appointment

Deeside Community Hospital (Jeff Pond)

Day	Time	Clinic	Booking
Friday	2.00-4.00 pm	By appointment and Drop-in	Just turn up or ring 01244 363779

Tarporley Cottage Hospital (Deborah Johnson)

Day	Time	Clinic	Booking
Thursday	2.00-4.00 pm	By appointment and Drop-in	Just turn up or ring 01244 363779

Foot Clinics - Countess of Chester Hospital Diabetes Unit

Day	Time	Clinic	Booking
Monday	2.00-5.00 pm	Nurse/Podiatrist - led clinic	By appointment
Thursday	2.00-5.00 pm	Consultant - led clinic	By appointment

Urgent appointments for the Foot Clinic are made via GP or practice nurse - with faxing of referral form.

Dietician Clinics

Direct referrals from clinic doctors and specialist nurses.

Countess of Chester Hospital Diabetes Unit

• Every Tuesday and Thursday morning
• Every Wednesday morning (with Main Diabetes Clinic)
• Alternate Wednesday and Friday afternoons (with Main Diabetes Clinic)
• Ellesmere Port Hospital - Second Thursday of every month, 2-5 pm
• Deeside Community Hospital - Second Friday of every month, 2-5 pm

 

 

Diabetes give you the chance to meet medical experts who can check that you're well and give you highly specialised advice on how to control your diabetes - here's how they work.

Why do I need to go?

If so much of looking after your diabetes is up to you, you may wonder why it's worth going to a diabetes clinic. One of the reasons is to help find out things you don't yet understand. Clinic staff bring with them the benefit of years of experience specialising in helping people with diabetes. It's the kind of expertise that you're unlikely to find in a GP or practice nurse who deals in general healthcare. Clinic staff are there to check out your diabetes control, help you with any difficulties, and attempt to pre-empt any health problems you might otherwise develop in the future.

Who's who?

Here's a quick guide to the various medical experts from your healthcare team who'll help you manage your diabetes:

YourGPwill be responsible for your diabetes care at the surgery, helped by thepractice nurse. GPs are not experts in diabetes in teenagers so they will refer you to the hospital clinic.

Someone who does have specialist knowledge, though, is thediabetes specialist nurseorDSN. They only work with people with diabetes. They can give you advice and may also visit your home or school.

Diabetologists / Paediatricianshave expertise in diabetes and are usually based at a hospital clinic or special diabetes centre.

You may receive advice about your diet from a registereddietitian. Their job is to help you to eat healthily and you may see them about twice a year. Talking to apsychologistabout any problems or how you are feeling may help.

You may see achiropodistorpodiatristwho looks after your feet to prevent problems in later years.

You will start having eye examinations from the age of twelve onwards. An optometrist may screen you for retinopathy (a condition that effects the seeing part of the eye). There are no obvious symptoms of retinopathy, which is why you should have your eyes regularly checked.

How often do I go?

After your first visit, you'll probably be returning on a regular basis - usually after 3-6 months. Every year you'll have a big check-up (annual review) to look you over completely. You will be asked to have some blood tests before your clinic appointment which will help the doctors and nurses advise you on how best to manage your diabetes.

Going it alone

Depending on how old you are, you'll probably be going to the clinic with one of your parents initially. But there may be parts of your clinic visit that you want your mum or dad to come in, and other parts when you want to be alone. Whichever way you do it, the important thing is to get all your questions answered.

What and why are they testing?

Eye tests

Some people who have had diabetes for many years find that the tiny blood vessels at the back of their eyes get damaged. It's hard to spot problems with sight so the doctor will check the back of your eyes (the retina) to ensure all's okay.

Weighing and measuring

This is done to make sure you are a healthy weight and to see whether you are growing taller at the right rate.

Urine tests

Some people who have had diabetes for many years have problems with their kidneys. Protein in the urine may be a very early warning sign of this, and it's a good way for clinic staff to treat any problems as early as possible.

Blood tests

The tests you do give an immediate idea of your blood glucose level. The tests at the clinic will give an idea of your long-term control. The HbA1c test gives a guide to your blood glucose level over the previous 2-3 months.

Blood pressure

This is checked to make sure your heart is working properly. High blood pressure can have a bad effect on your heart and your kidneys.

Checking legs and feet

If you've had diabetes for several years you may have the nerves in your feet and your circulation checked. A doctor or nurse may do this.

Common clinic complaints

I don't want to go

Some people don't attend their clinic appointments. This is often because they may feel self-conscious or not want to face up to certain issues. However, it is better to turn up anyway than to not to go. People often come away from these clinics surprised at just how much they've learnt and at how much hassle they've saved themselves in the long term by having a problem or two saved.

I can't be bothered to tell the truth

Some people do feel tempted to change their log book so that it looks as though they have better control than they really do. If you don't keep accurate records your healthcare team might not pick up on simple problems they could help with and prevent something worse happening in the long term.

I can't make the appointment

If you are unable to keep your clinic appointment for whatever reason please let us know. Either ring the receptionist in the diabetes unit (01244 363779) or the Diabetes Specialist Nurses (01244 363061, this is an answerphone but leave a message giving your name and message). We will be able to arrange another appointment but in the meantime the DSNs will contact you to check all is okay.