How to refer to the WLHCC MDT

The HCC Network Manager (or deputy) will forward out invitations for the scheduled HCC MDT in advance of the meeting, if you are a clinician within the West London HCC and not on the distribution list please contact imperial.wlhccinfo@nhs.net. Included in the invitation will be case referral forms (linked below) and adverse event report form for the MDT and criteria for referral, referrals to the MDT will be submitted at latest the day before the MDT to allow time for the coordinator to collect the case and circulate the cases in advance to the attendees. A reminder/call for cases will be sent out to clinicians two weeks in advance of the HCC MDT occurring. Patient identifiers should be anonymised. Referrals will be collated, anonymised if further required and a patient list created. The HCC Network Manager (or deputy) will respond to referral email with confirmation that patient is on the list.

Click here to access the MDT Referral Form

Any issues with referrals to be clarified with lead clinician and referring team (e.g. doesn't meet the criteria, information not clear). Referrals that don't meet the criteria will be returned to clinician with a request for clarification. It is incumbent on the clinicians referring that they collect all necessary medical information (scans, results, notes etc.) in advance of presenting the case at the meeting.

The Meeting is chaired by the West London HCC MDT Lead or nominated deputy.

Cases are presented by the referring clinician.

In the event of rare or extremely complex cases or the consideration of Novel Therapies cases may be referred through to the National Haemoglobinopathy Panel. https://www.nationalhaempanel-nhs.net/mdtfunction

It is suggested the following cases should be referred to the MDT from Trusts within the West London HCC and from Partner Organisations:

• Management of complex transfusion issues (inc. Hyperhaemolysis)
• Difficult chelation issues
• Complex Psychology/Safeguarding concerns
• Candidates for bone marrow transplant/gene therapy referral
• Peri-operative managment
• Unplanned PICU/ICU admissions
• Missed Children from the newborn screening programme
• Management of Multi-organ failure and Fat embolism syndrome
• Complex transition issues
• Renal Transplant Planning
• Severe Covid-19 complications and potential PIMS-TS cases
• Potential trial/Novel therapy candidates (inc. patients who are legible for Crizanlizumab)
• Pregnancy complications
• Death


Considerations should be made as to the following:

• Consideration of stem cell transplantation

• Plan to commence long term transfusion/change from simple or manual exchange transfusion to automated transfusion

• Lack of response to hydroxycarbamide

• Other chronic/acute complications e.g.:
- Renal dysfunction
- Neurological disease (e.g. stroke, TIA)
- Urological complications
- Respiratory disease
- Pulmonary hypertension
- Obstetric complications
- Orthopaedic disease

Significant complications (known previously on the NHR as adverse events) to be submitted to the MDT for discussion will be derived from the following catergories (please see appendix 1 for full list)

• Cardiorespiratory complications, including:
- Pulmonary hypertension
- Severe acute chest syndrome
- Pulmonary embolism


• Multi Organ Failure, including; Fat embolism syndrome


• Genitourinarycomplications, including:
- Acute renal failure
- Severe Priapism
- Sickle Nephropathy


• Orthopaedic complications, including:
- Osteomyelitis/ Septic arthritis
- Severe AVN associated with significant functional limitation
- Recurrent leg ulcers

• Extramedullary haemopoiesis


• Neurological disorders, including:
- Stroke
- Silent cerebral infarcts
- Visual Loss
- Moya Moya

• Hepatobiliary complications:
- Sickle hepatopathy
- Cirrhosis of liver
- Pancreatitis

• Endocrinopathy due to iron overload or opiod use
• Obstetric/ gynaecological complications, including Intrauterine death
• Severe bacterial or viral infection
• Cancer
• ITU admission
• Severe transfusion reaction including hyperhaemolysis
• Death