The evening rapid access arrhythmia clinic is entirely consultant-delivered and unique in London. With short waiting times and accessible via e-referral, we aim to quickly establish whether a patient’s symptoms are caused by an important arrhythmia. If so, Dr Julian Jarman, consultant cardiologist and electrophysiologist, will suggest an appropriate treatment plan.
Clinic appointments last for half an hour and include:
- Assessing the patient
- Performing an electrocardiogram (ECG)
- Producing a report with recommendations
Sometimes an echocardiogram may also be indicated. If this is the case, we will arrange for it to be performed earlier on the same day as the clinic appointment. If further tests are needed, we will liaise with the patient’s GP and help in arranging these tests.
All arrhythmias are managed via this clinic, including atrial fibrillation, all other tachyarrhythmias, and all bradyarrhythmias. A comprehensive range of investigative and treatment options can be accessed via the clinic, including all types of catheter ablation and device implantation.
When should you refer a patient?
- With new symptoms, if you suspect a patient’s symptoms may be caused by arrhythmia requiring further assessment
- With established arrhythmia, if you feel further specialist investigation or treatment is required, including ablation or device implantation
How to refer a patient
You can refer a patient via e-referral. Alternatively, you can email your referral securely and confidentially to Janet Harrison, medical secretary to Dr Jarman, at j.harrison@rbht.nhs.uk or call 020 7352 8121 ext 2514.
Rapid access arrhythmia clinic contact details
Consultant in cardiology and electrophysiology
Dr Julian Jarman
Clinic times
Wednesdays 5:30 pm - 9 pm
Outpatient appointments
020 7351 8011
Janet Harrison, medical secretary to Dr Jarman: j.harrison@rbht.nhs.uk
Telephone: 020 7352 8121 ext 2514
Rapid access chest pain clinic at Harefield
The rapid access chest pain clinic is led by Alison Pottle, nurse consultant in cardiology, and the clinical nurse specialists in cardiology. The clinic is run twice weekly (Mondays and Fridays) and has been in operation since 2000. We follow the guidance issued in the National Service Framework for Coronary Heart Disease regarding the management of patients with chest pain.
Patients are offered an appointment within two weeks of referral and many are seen within one week of referral. We aim to establish if the chest pain is likely to be caused by a cardiac problem – and if so – suggest an appropriate investigation and treatment plan.
What happens in the clinic?
The appointment takes approximately two hours and includes:
- Assessment
- Electrocardiogram (ECG)
- Chest X-ray
- Report with recommendations for future treatment or investigations
Depending on the assessment, a CT scan (to assess levels of calcium in the arteries that supply the heart), may also be included.
Sometimes other tests, such as an echocardiogram, may be indicated. If possible, this will be carried out during the clinic visit, but it may be necessary to arrange this at a later date.
If additional tests are needed, which cannot be carried out on the same day, we will discuss these tests and dates during the clinic.
Who should be referred?
Any patient with new chest pain that you suspect may have a cardiac cause.
Patients who already have a cardiac diagnosis should be referred back to their individual cardiologist.
How to refer a patient
Download the RACPC referral form and fax the completed referral form to Alison Pottle on 01895 828 962.
RACPC contact details
Alison Pottle, nurse consultant in cardiology
Telephone: +44 (0)1895 823 737
Fax: +44 (0)1895 828 962
Rapid access heart function clinic at Harefield Hospital
If you are a GP and have a patient with suspected heart failure, you can refer them to our clinic for a full and rapid assessment.
A consultant and clinical nurse specialist lead the rapid access heart function clinic.
We will see your patient within two weeks of referral and offer a full assessment. We also prepare individual management plans for patients diagnosed with heart failure.
Symptoms
Do any of your patients have:
- Recent onset of breathlessness?
- Reduced exercise tolerance?
- Fluid retention?
- Fatigue?
We offer a wide range of diagnostic investigations to confirm whether your patient has heart failure or not, including:
- Specialist invasive and non-invasive investigations to define underlying pathophysiology of heart failures, such as BNP, echo, chest X-ray, full blood screening and ECG
- Assessment of severity of heart failure
- Risk stratification and patient prognosis
- Further referrals to other sub-speciality cardiology or other consultants
Results of tests are available on the same day as the clinic appointment.
Treatment
We offer a wide range of treatment options, including:
- Medication
- Cardiac rehabilitation
- All forms of coronary intervention
- Arrhythmia management including ablation, cardiac resynchronisation therapy (CRT) and implantable cardioverter defibrillators (ICDs)
- Cardiac surgery, including transplantation and ventricular assist devices
- End-of-life management and palliative care
Your patient will receive specialist assessment and information, an individual management plan, and referral to the community heart failure team (if required).
Key benefits to GPs:
- It provides a robust referral pathway and one-stop-shop for GPs.
- The number of patients who are successfully diagnosed with heart failure after an echocardiogram and specialist assessment has six QOF points for the GMS contract 2011/2012.
- Our aim is to assess patients, with suspected heart failure and who have had a previous myocardial infarction, within two weeks of them being referred to us.
- Patients and GPs receive a fast and professional service. The individual care plan and medications deemed necessary by the consultant is faxed directly to the referring GP.
The rapid access heart function clinic is available via e-referral.
Rapid access heart function clinic contact details:
Our heart failure specialist nurses are:
- Marcia Singleton
- Jaqueline Marchant
- Hiba Yusuf
- Nicky McNulty
They can be contacted via:
Telephone: +44 (0)1895 828 916
Fax: +44 (0)1895 828 737
Switchboard: 01895 823 737
Bleep: 6155
Email: rbh-tr.harefieldheartfailureanddevices@nhs.net