Clinical Immunology - Salford Royal

The Clinical Immunology department at Salford Royal Hospital, Salford Care Organisation, is one of the four referral centres for Adult Immunodeficiency and Allergy. It is a part of North West Allergy and Clinical Immunology network. Our lead consultant is Dr Archana Herwadkar (Consultant Clinical Immunologist). We hold a number of specialist Immunodeficiency and Allergy clinics and liaise closely with other specialists in local hospitals. We do not see children in our department.

Specialist Immunology laboratory investigations are provided by Greater Manchester Immunology services laboratory based at Manchester University NHS Foundation Trust (Central site). 

 We are committed to training the next generation of doctors and nurses and regularly have medical and nursing students in clinic and day units. We are also are recognised centre for Specialist Registrar training scheme for Immunology trainees. 

Service Aim: Our aim is to provide quality assured service of the highest standards for our patients and in line with the Trust’s values of: Care, Appreciate, Inspire.

Service Accreditation 

We had a successful visit for QPIDS (Quality in Primary Immunodeficiency Service) on 28 March 2019.

Our last visit for QPIDS (Quality in Primary Immunodeficiency Service) on 28 March 2019. Comments from the assessment team included “the service is well led and patient centred”.  The assessors congratulated the team on excellent team working as well as effective networking across the region.  Our service has maintained accreditation status following annual assessment since 2019. Our next inspection is due in March 2024. 

We need patient volunteers to speak to our assessors. Please complete this form and return to us if you can participate.

Your views on the Immunology Service

 We are committed to continually improving our service. We conduct regular patient satisfaction surveys. We always happy to receive feedback and ensure the patient voice is at the heart of the care we deliver. You can provide the feedback using the contact details on the right or by completing a patient satisfaction survey after your appointment.

If you are a patient under our service with Hereditary Angioedema or Immunodeficiency and would like to join our patient representative group then please also get in touch.

Please get in touch with us if your expectations of care and treatment are not being met. If you still feel you need advice after speaking to us, you can contact PALS.

Here are some handy tips to keep yourself healthier and better informed this winter (and beyond).

General tips:

Check out the NHS Live Well website. 

Make sure that you:

  • receive your flu jab from your GP surgery if offered
  • have the contact numbers of the delivery service handy (if you receive home delivery for your immunoglobulin)
  • Contact your GP or other out of hour’s services as appropriate if you are unwell between appointments.

   If you suffer with chest infections, it is important that you:

  • Start your antibiotics at the earliest sign of infection. Remember that it is important to treat infections early.
  • If you have arrangements with the hospital or your GP surgery to get sputum tested, take a sample before you start taking the antibiotic.
  • Stop your regular antibiotic if you prescribed them
  • Complete the course of antibiotic prescribed by your GP as per advice in your clinic letter
  • Restart your regular antibiotic once the course is completed.

    Immunoglobulin infusions during infections:

  • Postpone your immunoglobulin treatment until you have completed at least 3 full days of antibiotic treatment and you start to feel better (if you are on home therapy or receive your infusion on a day unit)
  • If your immunoglobulin treatment is hospital based, call the day unit/coordinator where you have your infusion to make sure that your infusion can be postponed if necessary.
  • If you don’t start to feel better within 3 days of starting your antibiotic, please make sure that you contact your GP for advice
  • Please contact us if you are admitted to another hospital, to ensure specialist input is provided if necessary. Always take a copy of your clinic letters for any hospital visits.

Consultants and medical staff

Dr Archana Herwadkar Consultant Immunologist

Dr Sai Murng Locum Consultant Immunologist

Dr Samuel Chee Senior Immunology Trainee (ST7)

Dr Mahetab Moustafa Senior Clinical Fellow

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Nursing staff

Lucy Common (Acting Nurse Consultant)

Ivonette Jones (Senior Immunology and Allergy Nurse Specialist)

Vicky Blakeley (Immunology and Allergy Nurse Specialist)

Melanie Fernandez (Immunology and Allergy Nurse Specialist)​​​​​​

Laura Benjamin Immunology staff nurse

With assistance from the nursing and support staff on our Day case

Unit and Outpatients Department

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Quality Lead Nurse

Maria Fernandez

Lead Nurse

Yvonne McGee

Pharmacist 

Jincy Thomas (covered by James Elliot during leave)

Secretary

Jane Blaylock

Co-ordinator

Paula Munro

PALS (Patient advice and liaison service) 0161 206 2003 (Monday-

Friday 8.30am-4.30pm excluding bank and public holidays)

If you require advice regarding your condition outside the working hours, seek assistance from your GP or local Emergency Department. Call 999 for emergencies or 111 for NHS telephone advice.

 

Pictured: The team at the BSI Clinical Immunology Network (BSI-CIPN) conference in Belfast in December 2023.

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Click below to read the latest news from the department:

The department regularly participates in research studies and patients may be invited if suitable. Recent studies include COVAD study (SARS COV2 response to vaccination in patients with Immunodeficiency) and APEX-N study on long-term safety of Berotralstat (a medication for Hereditary Angioedema patients).

We offer patients the opportunity to take part in:

Patient events both locally and regionally

The national database for immunodeficiency (UKPID registry)

Education and training

The department is actively involved in the delivery of educational sessions for various medical and nursing professionals and students.

Our team members are also involved in speaking, presenting and producing posters at national and international conferences.

 

The Clinical Immunology Service provides facilities for the investigations, diagnosis and treatment of primary immunodeficiency diseases including (excluding immunodeficiency secondary to HIV):

  • Antibody deficiency 

  • Combined immune deficiency 

  • Neutrophil defects 

  • Complement deficiency

  • Other primary immunodeficiencies

  • Hereditary angioedema (C1 esterase inhibitor deficiency)   

One of our specialist doctors or nurses will first take the full details of your symptoms and how they have affected you.  A medical examination might be necessary. Your safety, privacy and dignity are paramount to us. You will be offered a chaperone if you are examined.

It is likely that you will have some blood tests and possibly some lung function tests, ECG (tracing of the heart) if required.  There is a phlebotomy service based within the clinic.

Since these conditions tend to be complex, the appointments are necessarily thorough and long. Please allow 1-2 hours for your first appointment with us.

In order to prepare for your clinic appointment, we recommend you read the following:

Clinic information

Our service is mainly delivered in Outpatients (Area 2) and the day unit at Salford Care Organisation site.

Following positive patient feedback, we continue to offer telephone appointments if appropriate as well as face to face appointments.

It is important that you contact our appointments centre with appointment changes or cancellations. We are under extreme pressure for appointments and to provide timely reviews, we need to utilise them as best we can.

Telephone appointments

Telephone appointments can work well, however please check the following points to make sure you get the most from your appointment:

  • we have the correct phone number
  • your phone is working and has reception
  • your phone accepts calls from unidentified numbers
  • you are in a quiet place, where you can talk privately
  • for young adults we need you to be on the call.  You are welcome to include your parent or guardian on speaker phone

We will often try and call back if we do not initially get a response.  However, this is not always possible as we have a timeslot for each patient in the clinic. 

If you are unable to attend your appointment, please call the number on your appointment letter or the appointments centre 0161 2064100.

Face to face appointments

Face to face appointments are useful, especially if you need examination.  Sometimes interactions and conversations work better when you are there in person, but we understand this may vary for patients depending on circumstances.

For information about car parking, visit our getting here section.  Allow plenty of time for finding a space at busy times and sufficient change for car parking.

Day Unit

Immunoglobulin infusions are given on the day unit (Brooke treatment unit) by the Immunology Nurse Specialists, or the Renal unit nurses trained in administering Immunoglobulin. We also carry out training to patients self-administering Immunoglobulin or medications for Hereditary Angioedema (HAE).

The majority of people who need support from NHS staff do so in a respectful way. Our staff have a right to care for others without fear of being attacked or abused. To successfully provide these services a mutual respect between all the staff and patients has to be in place. All our staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances.

General Practitioners (GPs) may refer through the Electronic referral system.

The warning signs of possible primary immunodeficiency include any two or more of the following: 

  • Four or more new ear infections within one year 
  • Infections in multiple anatomical sites 
  • Two life threatening infections per lifetime  
  • Two or more serious sinus infections within one year 
  • Two or more months on antibiotics with little effect 
  • Two or more pneumonias within one year
  • Recurrent, deep skin or organ abscesses
  • Persistent thrush in mouth or elsewhere on skin
  • Need for intravenous antibiotics to clear infections
  • Two or more deep-seated infections
  • A family history of primary immune deficiency 

External Referrals – salfordcareorgb&s@nca.nhs.uk

Booking Enquiries –   Booking&SchedulingOutpatientsSCO@nca.nhs.uk 

Admin Enquiries – AdminCentreReferralsSCO@nca.nhs.uk

Patient Organisations

Immunodeficiency:

Immunodeficiency UK: www.immunodeficiencyuk.org/ 

European Society for Immunodeficiencies (ESID): http://www.esid.org/  

Hereditary Angioedema - www.haeuk.org

International Patient Organisation for Patients with Primary Immunodeficiencies (IPOPI): http://www.ipopi.org/  

UKPIPS: http://www.ukpips.org.uk/  

Chronic Granulomatous Disorder Society - www.cgdsociety.org

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