Nurse-led thyroid telephone consulting

Fiona Anthonypillai, Clinical Nurse Specialist, St George's Hospital, Tooting, London

Patients with thyroid disease are generally referred to an endocrine clinic. Here they are seen by an endocrinologist who then decides on the course of treatment required. . In most departments this entails numerous visits to the clinic for the patient, to review their condition. These visits are often time consuming, costly and inconvenient for our patients. On most occasions, the visit may just be a matter of looking at the blood tests and increasing or decreasing the medication.

To avoid unnecessary clinic visits and reduce waiting lists for patients, a Nurse–led thyroid telephone clinic was set up in 2006. Those patients who are deemed suitable for this service are referred to me by the endocrinologists. The endocrinologists indicate when the patient is to be reviewed and what their present thyroid function blood results are. A starter pack is then sent out which includes a thyroid record booklet, appointment letter and blood test form. The letter introduces the patient to the telephone service and states when their next blood test should be taken. The record booklet briefly explains about the thyroid gland and symptoms of hypothyroidism and hyperthyroidism. The booklet also contains a record sheet for patients to record their results and treatment and any advice given. At the back of the booklet there is a table to record their list of medication and useful information regarding thyroid medication and support groups.

The patient is then telephoned with their results and advice given to change their medication accordingly. This provides the patient with an opportunity to discuss their condition and answer any queries or concerns they may have. The patient is advised that if they wish to be seen by a Doctor in clinic, this will arranged at the earliest opportunity. Should a patient not have their blood test within a week of the appointment date, a letter is sent out to remind the patient of the blood test. A written and an electronic record is kept of the patients results, treatment, correspondence and review date.

At present we have more than 300 patients using this service. It is hoped that this has and will continue to improve the thyroid service offered to patients by St. George’s Hospital NHS Trust and that other departments may develop their service in a similar way.

The award has helped with the costs of producing and updating the thyroid booklet in a professional format for patients and has provided extra recourses for patient support. The future plan will be to audit the use of this service in order to continually optimise patient care.

I would like to thank The British Thyroid Foundation for giving me the opportunity to further enhance the service we offer to thyroid patients.

Patients with thyroid disease are generally referred to an endocrine clinic. Here they are seen by an endocrinologist who then decides on the course of treatment required. . In most departments this entails numerous visits to the clinic for the patient, to review their condition. These visits are often time consuming, costly and inconvenient for patients. On most occasions, the visit may just be a matter of looking at the blood tests and increasing or decreasing the medication. 

To avoid unnecessary clinic visits and reduce waiting lists for patients, a Nurse–led thyroid telephone clinic was set up in 2006. Those patients who are deemed suitable for this service are referred to me by the endocrinologists. The endocrinologists indicate when the patient is to be reviewed and what their present thyroid function blood results are. A starter pack is then sent out which includes a thyroid record booklet, appointment letter and blood test form. The letter introduces the patient to the telephone service and states when their next blood test should be taken. The record booklet briefly explains about the thyroid gland and symptoms of hypothyroidism and hyperthyroidism. The booklet also contains a record sheet for patients to record their results and treatment and any advice given. At the back of the booklet there is a table to record their list of medication and useful information regarding thyroid medication and support groups.

The patient is then telephoned with their results and advice given to change their medication accordingly. This provides the patient with an opportunity to discuss their condition and answer any queries or concerns they may have. The patient is advised that if they wish to be seen by a Doctor in clinic, this will arranged at the earliest opportunity. Should a patient not have their blood test within a week of the appointment date, a letter is sent out to remind the patient of the blood test. A written and an electronic record is kept of the patients results, treatment, correspondence and review date.

At present we have 280 patients using this service. It is hoped that this has and will continue to improve the thyroid service offered to patients by St. George’s Hospital NHS Trust and that other departments may develop their service in a similar way.

The award will help with the costs of producing the thyroid booklet in a professional format for the patients and provide extra recourses for patient support. The service will then be audited through a patient questionnaire and its use reviewed.