Other Specialist Endocrine Services

The majority of endocrine conditions are managed on an outpatient basis. However, there are times when a patient needs to be admitted, for example for intensive blood testing at dedicated times, or other procedures, many of which are listed below.

Selective venous sampling

• Selective venous sampling of the inferior petrosal sinuses in the evaluation of Cushing’s syndrome
• Selective venous sampling of the parathyroid glands to localise a parathyroid adenoma
• Selective venous sampling with calcium stimulation to localise insulin producing tumours of the pancreas

Nuclear medicine

Nuclear medicine scanning is available at the NNUH, to aid the diagnosis and localisation of thyroid, parathyroid and neuroendocrine disorders. PET CT scanning is also available on site. Radioactive iodine treatment is also available for the treatment of both benign thyroid disease: thyrotoxicosis or nodular thyroid disease, and thyroid cancer.

Specialist surgery

Laparascopic adrenal surgery, minimally invasive parathyroid surgery, thyroid surgery, and hepatobiliary surgery are all available at the NNUH.

Radiotherapy and chemotherapy

Specialist cancer services are available at the NNUH oncology day unit. The Big C cancer information centre is also available to support patients with cancer and their families.

Specialist inpatient services

Endocrine conditions such as Cushing’s syndrome and suspected spontaneous hypoglycaemia often require in patient investigation during a brief admission. All elective admissions are coordinated through CIU and Cringleford ward.

Medical inpatients

Endocrinology is a branch of general medicine. This means that as well as looking after patients with disorders of diabetes or endocrinology, consultants in this specialty also look after general medical patients requiring admission to hospital. The base wards for endocrinology are Cringleford and Langley wards situated on Level 1 East Block.

Junior doctors on the Endocrinology team

As well as the consultants and specialist nurses who are permanent members of the endocrinology team, we also have various junior doctors. Some of these are newly qualified foundation year doctors – FY1 and FY2. They spend most of their time on the wards looking after the inpatients under our care. They are also encouraged to sit in on the specialist clinics though they will not assess patients in these clinics on their own.

More senior doctors used to be called senior house officers (SHOs). They are now called core medical trainees (CMTs) and are more experienced than foundation year doctors, and have started their specialist medical training. After doctors complete their core medical training (usually at least four years after qualifying as a doctor), they can start to specialise in endocrinology and take further postgraduate examinations.

They are then called Specialty trainees (STs) or Specialist registrars (SPRs), though many people still refer to them as registrars. Registrars are already highly trained and so will perform ward rounds and clinics on their own, although they always work under the supervision of a consultant.