Hepato-Pancreato-Biliary (HBP) Support Team

We are a dedicated team committed to supporting patients and their loved ones who have been diagnosed with cancer of the liver, gallbladder, pancreas or bile ducts.

Where we are based

Our main office is at The Royal Oldham Hospital. However, we provide support to inpatients at Fairfield General Hospital and Rochdale Infirmary.

Your complete care team

Your care journey involves many specialists, and we are here to make sure they all work together smoothly. We will be your direct nursing contact and link you with key cancer treatment centres like Manchester Royal Infirmary and The Christie Hospital (where you might receive chemotherapy or radiotherapy).

HPB patient is supported by two dedicated roles:

HPB Macmillan Clinical Nurse Specialist (CNS): Your main point of contact for expert advice, support, and guidance on your specific condition and treatment plan.
Macmillan Cancer Support Worker: They assist with practical needs, emotional support, and connecting you with community resources.

Our extended network

We also work closely with many other professionals to give you complete care, including:

Specialist Doctors and Surgeons
Community Macmillan Nurses
Palliative Care Teams (who focus on comfort and quality of life)
Hospital Acute Oncology (AO) Nurses
Dietitians (to help with nutrition)
Occupational Therapists (to help with daily living)
District Nurses (for care at home)

We are committed to making your care experience as seamless and supportive as possible.

Comprehensive care throughout your journey

We provide support at all stages of your pathway, from your initial referral and investigations, through to specialist treatment and recovery. This support is available as an inpatient or outpatient from the Macmillan HPB clinical nurse specialist (CNS) and Macmillan HPB cancer support worker (MCSW) from initial referral, during investigations to diagnosis until care is transferred to the surgical team who are based at Manchester Royal Infirmary (MRI), oncology (cancer) team at The Christie Hospital or back to the GP and community teams. However, support is always available at all points of the patient pathway.

Weekly HBP multi-disciplinary team (MDT) meeting

All patients with a confirmed HBP cancer are thoroughly reviewed and discussed at our dedicated, weekly HBP Multi-Disciplinary Team (MDT) meeting, which takes place every Wednesday.

The purpose of the MDT

The MDT is the core decision-making forum where a collective group of experts collaborates to determine the optimal diagnostic and treatment plan for each individual patient.

Patient impact statement

The purpose of this form is to give you the opportunity to let the MDT know what is important to you right now. By asking what you think about and want now and in the future helps us to understand support decisions when planning your care.

The team of specialists

The MDT ensures every angle of a patient's case is considered by bringing together the following essential specialists:

Specialist	Role
Surgeons	Experts in surgical intervention.
Hepatologist	Specialists in liver disease.
Macmillan Clinical Nurse Specialists (CNS)	Nurses providing dedicated support and expertise for HBP cancer patients.
Oncologists	Experts in cancer treatments (e.g., chemotherapy, radiotherapy).
Radiologists	Experts in interpreting scans and X-rays.
Pathologists	Experts in examining biopsies and cells to confirm diagnosis.
Other Professionals	Specialists with specific knowledge relevant to HBP conditions.

This comprehensive approach ensures that every patient receives a treatment plan tailored by a wide range of professional perspectives.

Your HBP Nursing Support Team

We are a dedicated team based at The Royal Oldham Hospital, here to provide you with help, support, and a direct point of contact throughout your HBP journey.

Where We Provide Care: We offer clinics at Oldham and Bury and visit inpatients at Rochdale Infirmary and Fairfield General Hospital (Bury).

Our Comprehensive Support Network: We work closely with our surgical colleagues at Manchester Royal Infirmary and with consultants here at The Royal Oldham.

When you need specialist treatments, we coordinate your care with The Christie Hospital for Chemotherapy and Radiotherapy.

More Than Just Treatment: Our core focus is providing care and comfort. This includes Best Supportive Care, where we proactively manage any symptoms you may have, even if you are not undergoing active treatment. We ensure seamless care by liaising with your GP, the District Nursing teams, and Specialist Palliative Care in your community.

Enhancing Best Supportive Care (BSC)

Our commitment to patients receiving Best Supportive Care (BSC) involves providing key tools to ensure your needs are met and you feel informed and supported:

Holistic Needs Assessments (HNA)

We offer a Holistic Needs Assessment (HNA), which is a straightforward questionnaire designed to identify any concerns you are currently experiencing. This allows us to focus our support specifically on your most pressing needs, whether they are physical, emotional, social, or spiritual. You will receive a copy of your care plan which is shared with your GP and community teams.

End of treatment summary

We provide an End of Treatment Summary, a crucial document created for you that summarises your care journey. This document includes:

Key Information: Details about your investigations, treatments received, and potential long-term side effects.
Knowledge and Empowerment: It is designed to improve your understanding of your condition, the care you've received, and the choices made.
Coordination of Care: It clarifies who the best person is to contact for help and can be easily shared with your GP and other healthcare professionals involved in your care.

Extended support network

We maintain close links with invaluable external resources to ensure all your needs are addressed:

Macmillan Information Centre: Provides extensive resources and information.
Maggie’s Centres: Offers a wide range of practical, emotional, and social support to all cancer patients and their families.

These resources work together to ensure you have comprehensive support, clear information, and easy access to help throughout your time with the service.

Community and well-being support

To further enhance patient support, the team facilitates regular events focused on peer connection and holistic well-being:

Monthly Patient Support Group: The team hosts a support group on the last Thursday of every month at the Maggie’s Cancer Centre located on The Royal Oldham Hospital site. This provides a consistent space for patients to connect, share experiences, and receive mutual support.
Bi-Yearly Health and Well-being Event: A larger health and well-being event is organised twice a year, offering broader resources and focus on holistic health.

Maggie's Centre Network

The team utilises the local Maggie's Centre on The Royal Oldham Hospital site for their monthly group. It's important to note that Maggie's also has a centre located at The Christie Hospital, along with other sites across the country, forming a wide network of support available to cancer patients.

Tests we may offer our patients include:
Blood tests- Blood may be taken and tested
Gastroscopy- A procedure that looks inside the oesophagus (gullet), the stomach and the first part of the bowel called the duodenum. Biopsies can also be taken during this procedure if needed.
CT scan (computed tomography) - This allows doctors to get detailed pictures of the inside of the body. This test is not painful or invasive.
Ultrasound Scan (USS) A scan which shows the structures in the body by using sound waves.
PET Scan (positron emission tomography)- This type of CT scanner that provides a different type of picture to a normal CT scanner. This scan can be performed at several sites for example, The Christie Hospital, Wigan Infirmary, The Community Diagnostic Centre (CDC) in Oldham, Manchester Royal Infirmary.
Endoscopic Ultrasound Scan (EUS)- Similar to Gastroscopy, where a flexible camera is inserted to allow doctors to look at the pancreas in detail, this camera has an ultrasound probe at the end, and a biopsy is usually taken during the procedure.
Liver biopsy -This is a day case procedure in the X-ray department; it involves taking a biopsy with local anaesthetic of the liver under ultrasound (USS) guidance.
Drainage of ascites (fluid in the abdomen (tummy) – This procedure takes place in the x-ray department; it involves placing a small drain into the abdomen under ultrasound (USS) guidance. This drains a buildup of fluid; the drain is left in for a few hours until all the fluid has drained. The option of a long-term drain is available for certain patients.
MRI (magnetic resonance imaging)- similarly to CT scans, this allows doctors to get detailed pictures of the inside of the body, but can sometimes provide further detail.
CPEX Test (cardio-pulmonary exercise test)- This is performed at Manchester Royal Infirmary for patients prior to major surgery.

Treatments may include:

Surgery, Chemotherapy, Radiotherapy or a combination of these treatments. We also provide a service for the treatment of jaundice (yellowing of the skin) caused by a blockage in the biliary system, ERCP. This often involves inserting a stent (small metal or plastic tube) into the bile duct in the liver or the bile duct, which drains bile from the liver to the small bowel.

Your first steps with the HBP team

Following the MDT meeting you will be invited to attend clinic to guide you through the next phase of your care designed to guide you through the next phase of your care:

Specialist Nurse Clinic

You will be invited to a clinic with one of our Specialist Nurses. This introductory appointment is designed to:

Introduce you to our dedicated team.
Discuss what you can expect in the coming weeks.
Assess your fitness for potential treatments.
Discuss your preferences and wishes regarding your care.

You will also be offered an outpatient appointment to meet with one of our Nurse Specialists. The primary goal of this meeting is to discuss the outcome of your weekly MDT meeting and outline your personalised treatment plan.

Preparing for your consultation

These consultations are important and can be lengthy (around 60 minutes). To help you get the most out of your time with us, we strongly advise the following:

Bring Support: We will likely be discussing sensitive information, including a potential cancer diagnosis. We advise that you bring a relative or friend along for emotional support.
Specialist Nurse Support: A Macmillan HBP Specialist Nurse will also be present during the consultation to offer you direct support and answer any nursing-related questions.
Medication List: Please bring a current list of all your medications. This is essential for us to accurately plan your future care.
Hospital Transport: If you require hospital transport to attend your appointment, please contact the nursing team directly to arrange this.

Please Note: While we schedule appointments for approximately 60 minutes, they may not always run exactly to time. We dedicate the necessary time to ensure all patients have the opportunity to express their worries, concerns, and ask all their questions to the consultants.

Upper GI and HPB office, Marjorie Lees Building, The Royal Oldham Hospital, Rochdale Road, Oldham OL1 2JH

Accessing the HBP Service: Your Referral Pathway

Patients are typically referred to our HBP Service through two main routes:

1. GP Referral

If your GP believes your symptoms require specialist investigation, they will refer you to our service. What happens next is determined by the nature of your symptoms:

Initial Appointment: You will receive an appointment with a member of our team. This consultation may be held face-to-face or via a telephone appointment.

2. Internal Referrals

We also accept referrals from our internal hospital colleagues, including: