The pituitary MDT (Multi-Disciplinary Team) at University Hospitals of North Midlands has been in place for several years, originally set up by Professor Richard Clayton, Mr Vere Carlin and the Late Mr Jagmohan Singh. It provides multi-disciplinary care for pituitary patients across Staffordshire and Shropshire.
Our centre has been at the forefront of adapting state of the art surgical techniques, having been one of the pioneering centres for endoscopic trans-nasal hypophysectomy. We use advanced imaging and digital navigation techniques to enhance the procedure further.
The UHNM MDT has recently developed direct links with the long-established University Hospitals of Birmingham pituitary MDT and pathology departments. We have also joined the Pituitary Foundation, thus ensuring that patients are provided with all the appropriate support throughout their journey from diagnosis to treatment.
The addition of two endocrine nurses to the team has improved the core membership and will provide direct access for patients who have a concern or question about their condition or the treatment. Click here to read our patient leaflet
Meet the team
Dr Biju Jose
Dr John Ayuk
Dr George Varughese
Dr Anath Nayak
Dr Laks Varadhan
Mr Simon Shaw
Mr Natarajan Saravanappa
Dr Changez Jadun
Dr David Wilcock
Dr Jooly Joseph
Pituitary Support Nurses
Miss Gillian Powner
Miss Jessica Wilde
Miss Clare Rowley
Dr Selvaraj Giridharan
Mr Jeremy Bowyer
Single referral point and triage
The referrals from UHNM specialities, GPs or
outside UHNM's area are received by neurosurgery, ENT surgery or Endocrinology.
All referrals are passed on to the pituitary MDT co-ordinator, who with help
from the pituitary endocrinologist will prepare the patient details for
discussion at the next available MDT meeting. Patients may be contacted for
pituitary blood tests, visual field tests and further scans before the case
details can be discussed at the MDT meeting.
Well-established monthly Pituitary MDT
All cases referred to UHNM are discussed at the
monthly multi-disciplinary meeting, usually on the first Monday of every month.
The meeting is attended by the pituitary endocrinologists, neurosurgeon, ENT
surgeon, neuroradiologists and pituitary nurses in addition to trainees in the
The MRI scans, visual field results and pituitary
bloods are reviewed at the meeting and a joint decision is taken after
considering all clinically relevant information in each individual case. Those
who need surgery are brought to the joint clinic attended by the
endocrinologists and pituitary surgeons.
Transnasal Endoscopic Hypophysectomy
For those who do not require surgery, follow-up
is arranged from the endocrinology out-patient clinics to monitor the tumour and
Those patients with recurrent or refractory
pituitary disease often need radiotherapy to the pituitary gland. The MDT has
direct access to clinical oncology services at UHNM to organise assessment.
Pituitary adenoma and other sellar tumours can
affect vision by exerting pressure on the nerve pathways of vision. The MDT is
supported by the ophthalmology services at UHNM.
Medical Investigation Unit
This service is run by our trained endocrine
nurses, who also support the pituitary MDT as core members in their role as
pituitary nurses. All specialised endocrine blood investigations, pituitary
assessments, and clinical reviews are arranged by the nurse team. The
endocrinology registrars review all post-pituitary surgery patients and arrange
post-operative pituitary tests and MRI scans.
Pituitary Nurse Support
Two dedicated pituitary nurses are available to
provide a focal contact point for the pituitary patients. Patients can contact
the pituitary nurses directly for advice on their condition and any concerns
they have about their health. The nurses are supported by consultants and
registrars in endocrinology who can provide urgent input by telephone or in
out-patient clinics as
Documents and links
The UHNM pituitary MDT holds an institutional membership with the Pituitary Foundation and uses its resources in our clinic.
UK Acromegaly Registry
We contribute to the register and are proud to be among the founding centres of the register.