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GNews from Guy’s and StST Thomas’ Issue 7 | 2013

Safe in our hands celia interviews Bare bones of her favourite nurse orthopaedics 20th birthday of Guy’s and St Thomas’ this issue round-up

In the news A round-up of media activity over the past few months that has featured the Trust.

Trial for new arthritis therapy Researchers from our NIHR 08 Biomedical Research Centre have begun a ‘first-in-human’ trial of a new drug for rheumatoid arthritis which could provide a long-lasting and cost effective treatment. The trial is the result of 15 years of work, and was the main story on the front page of the Daily Express. Transplant Mr Martin Drage removed It was also covered by the Welcome Alan’s kidney and transplanted it into his wife Ann 11 16 Daily Mail, Sky News, and international media. …to our magazine for staff, patients, Preventing premature carers and Foundation Trust members. Contents BBC documentary features labour In this issue we explore our trauma The preterm surveillance and orthopaedic services, and Malnourishment 20th anniversary 05 10 clinic at St Thomas’ has celebrate the 20th anniversary A hidden health problem Celebrating 20 years of Guy’s and St Thomas’ recently received a lot of of Guy’s and St Thomas’ hospitals in our community the merger of Guy’s and media attention, following coming together. St Thomas’ hospitals Camera crews were stationed transplant operation at Filming took place in Newborn imaging an NHS innovation award for In an interview with consultant 06 across the Trust on one day in Guy’s, the emotional hospitals across the country, A state-of-the-art MRI imaging Trauma and its success in reducing the Dr Mark Kinirons, he explains the 12 October to film a ‘snapshot’ of experiences of a family in the but more of our departments centre will improve the lives of orthopaedics number of premature births steps we are taking to put patients the NHS over a 24-hour period neonatal unit at St Thomas’, were filmed than in any other our smallest and sickest babies Discover why our services in south east London. The first and our continuing work to for a national documentary. and the behind-the-scenes hospital trust. are in increasing demand Times, Evening Standard, improve our care for patients The interview BBC’s Keeping Britain work of our pathology and The first episode was aired 08 BBC London News, BBC with dementia. Dr Mark Kinirons talks about Obesity uncovered Alive series featured a kidney mortuary teams. on Tuesday 26 March on BBC1. 16 5Live, and BBC Breakfast Towards the end of the magazine improving care for patients Find out how we are helping covered the story. you can see what actions we are with dementia and delirium to reduce the obesity epidemic taking to help people with obesity. Cartoons at Evelina I hope you enjoy this issue. Caring for young people’s careers More than 350 young people employment. This year our in the local community have ambition is to increase the Tell us what been helped into employment diversity and number of Meet the team you think by our apprenticeship and apprenticeships offered. Produced by: Front cover: Patient Celia Lewis work placement schemes. One success story is Nicola If you have any comments The communications with ward sister Joyce Kakala. about the magazine or We have almost 60 Spencer, a maternity support department Ron Kerr Pick up your copy: The GiST suggestions for future apprentices currently getting worker who completed an Design: bn1creative Ltd magazine is for our patients, articles, please contact hands-on experience at apprenticeship in 2011. Nicola Chief Executive www.bn1creative.co.uk local people, staff, members and the communications supporters of Guy’s and St Thomas’. the Trust in a number of (pictured with a patient) was Guy’s and St Thomas’ Print: O’Sullivan department, St Thomas’ Hospital, Westminster Bridge professional areas such as interviewed for ‘Learning at NHS Foundation Trust Communications The South London Press Road, London SE1 7EH, business administration, Work Day’ which promotes or email [email protected] reported that huge cartoon , customer service, workplace learning. The GiST is published by Guy’s and characters are helping Visit us online at: engineering, hospitality, programmes have helped After a successful St Thomas’ NHS Foundation Trust. www.guysandstthomas.nhs.uk patients and families find paediatrics, midwifery and existing staff to further their apprenticeship Nicola joined their way around the Evelina transport services. skills and local people to the midwifery team and is now Children’s Hospital. Follow us on Twitter @GSTTnhs Our apprenticeship find a route into sustained in her second year of training.

2 The GiST www.guysandstthomas.nhs.uk 3 round-up round-up Spinal implant eases back pain Evelina’s Guides and Scouts unit All about apps Many of our staff are keeping A new device helps reduce up with technology and severe back and leg pain to wins brownie points with patients developing pioneering mobile improve people’s quality of life, The Evelina Children’s Hospital phone apps to help improve according to research from has launched a Guides and care for our patients. our pain management and Scouts unit for its patients Pharmacist Rebecca Chanda neuromodulation centre. and their siblings aged from won an ‘Oscar’ at the National The technology is a new six to 18 years. Thrombosis Awards last month type of spinal cord stimulation, Joining forces with for the launch of her app which in which small leads implanted Girlguiding, the Scout will help clinicians manage near the spinal cord send high Association, and Westminster patients’ thrombosis more easily frequency electrical pulses School, staff and volunteers will when out on their rounds. that disrupt pain signals bring some fun into the hospital Paediatrician Dr Ranjit Singh Survey shows to the brain. every Monday evening. is also working with the charity “This technique uses high The Evelina unit will ensure Best Beginnings to develop staff have frequencies to stimulate the that patients do not miss two new apps that will offer spinal cord and relieve back out on the fun their friends tips and guidance for young confidence in pain more effectively,” said are having while they are mothers who are going through Dr Adnan Al-Kaisy, who led in hospital. the emotional and physical our services the study. Some children are in transition into parenthood. The researchers tested 82 per cent of our staff would hospital for a long time and Both apps are being trailed the device in 83 patients. Dr Thomas Smith, consultant had the spinal cord leads recommend our hospitals to they look forward to every for two months by our After six months on the trial, in pain medicine. “Back pain fitted two years ago. “For me, their friends and relatives as visitor and activity that takes community midwives in their average pain score can be debilitating, so being the implant has been a huge places to receive treatment, their mind off their treatment. and . dramatically dropped from able to relieve people of success,” says Charles. “I’m according to the recently Staff at the Evelina understand 8.4 to 2.7 out of 10. constant pain makes a big getting much more sleep and published NHS staff survey. that patients must feel they “These kinds of results difference to their lives.” I’m no longer on any regular This is much higher than are living as much of a normal Evelina Hospital are almost unheard of,” says Charles Holleyman, 62, pain medication.” the national average of 60 per life as possible, despite being School is top of cent of NHS staff in hospitals in hospital. the class who agree with the statement Deputy Director of Mya Quinlan enjoys the first pilot session of the new group Our school for inpatients, “If a friend or relative needed Operations, Nicola Grinstead, The hidden health problem of malnutrition outpatients or siblings treatment here, I would be who pioneered the project, supports young people to possibility of extending this of patients based at happy with the standard of care Last July 83-year-old Dennis Dennis is not alone. An With this startling figure said: “Through providing fun learn new skills, make friends opportunity to those young the Evelina Children’s provided by this organisation.” Mahoney from Rotherhithe estimated 45,000 people in in mind, our experts have and interactive activities, and develop confidence. We people who are patients in Hospital has been rated as We also received one of the was admitted to Guy’s Hospital south London are malnourished begun a project to find out the Guiding and Scouting are really excited about the our care.” ‘outstanding’ by Ofsted. highest scores nationally for with pneumonia. The medical and prone to hospital exact extent of malnutrition Each year the school staff recommending the Trust team soon discovered that he admission, longer hospital in Lambeth, Southwark and teaches around 1,500 as a good place to work. was severely under-nourished, stays, and a poorer quality Lewisham so that they can pupils aged two to 19, and Chief Nurse and Director weighing just nine stone. of life. improve the care of people Preserving fertility before cancer treatment all groups, including those of Patient Experience, Eileen at risk. with disabilities and special Sills, said: “These are fantastic Dennis said: “I had lost my Our Assisted Conception Dr Reddy said: “This service educational needs, make results, and it’s encouraging to appetite and started to miss Unit is home to one of the offers patients the chance outstanding progress during see that we have improved in meals. I found myself getting UK’s few dedicated fertility to have a family of their own their stay. some areas since last year.” weaker and had to crawl up the preservation services for once they’ve completed their To ensure pupils do not fall There are of course always stairs on all fours.” people who are about to have cancer treatment. It gives behind with their school work, areas we need to work on, With the support of the Trust’s cancer treatment that could them hope for the future.” patients too unwell to come including improving the dietitians and nurses, Dennis affect their fertility. Since the clinic opened in to school are taught at their work-life balance of staff as began to eat again and is now a Cancer treatment should 2008, around 340 women bedside, and children who there has been an increase in much healthier 12.5 stone. begin as soon as possible have been seen in the clinic An embryo under the microscope regularly come in for dialysis staff reporting that they are after diagnosis, so fertility to decide if they want to have are taught on the dialysis unit. working extra hours. We are Find out more preservation must happen with the cancer services team their eggs or embryos frozen, “Pupils say they feel in the process of developing a To find out more about this within a very short timeframe. to ensure as many patients and 87 of them have done so. happy, safe and secure at the Trustwide action plan which our issue, contact Dr Liz Weekes at Dr Nivedita Reddy leads the as possible are given rapid More than 700 men have had Dennis Mahoney with research dietitian Dr Liz Weekes school,” said Ofsted. staff will hear more about soon. [email protected] clinic, which works closely access to this service. their sperm stored.

4 The GiST www.guysandstthomas.nhs.uk 5 spotlight Spotlight

“By the time a baby is Preparing parents born key connections Inside the between nerves have for a ‘heart baby’ already been made, so we When she was 20 weeks into their baby’s first months and are looking at babies in her second pregnancy, Jo juggling family life.” Wilson had devastating news The parents also have a developing the womb. This will help – her baby had a serious and tour of the newborn intensive us to understand complex complex heart condition. Like care unit. many ‘heart parents’, Jo felt “Intensive care is an alien neurological conditions.” isolated and reluctant to go to world to most people, and it’s brain antenatal classes. intimidating and frightening at “A close friend was also first. Having a chance to look A state-of-the-art MRI imaging facility pregnant. She was excited and around, meet the staff, and hear will improve the care given to the full of hope and expectation. I from other parents about their was excited but terrified. I’d been experience and how supportive smallest and sickest babies. looking forward to my antenatal the clinicians are makes such a classes but after the diagnosis difference,” says Jo. The Evelina Newborn genetic variation or problems I couldn’t face going,” says Jo. The class also gives parents Imaging Centre is in the like premature birth. They will Not attending the classes the chance to meet others newborn intensive care unit also test new treatments to help means parents – particularly in the same situation, and at St Thomas’. This location babies with brain damage. first time parents – miss vital several strong friendships means that premature or ill This work forms part of the information about the stages have developed. babies – those most in need – Developing Human Connectome of labour, breathing, pain relief, Around 600 parents have can have their brain scanned Project which has been and breastfeeding. now attended the class, which soon after they are born. awarded €15 million by the Jo became involved with runs every six weeks and is Previously, the babies European Research Council. Evelina Children’s Heart open to all parents expecting would have had to wait until It will look at how regular Organisation (ECHO) in 2000 a ‘heart baby’ at the Trust. they were well enough to be brain development compares when her daughter Cissy was taken to a scanner elsewhere with brain development after A scan of nerve fibre bundles in a six-months-old. Six years ago, Jo Find out more in the hospital, which could premature birth and in babies newborn baby’s brain, coloured according and the Thames/Tower specialist ECHO is run by, and for, families take weeks. with neurological conditions. to which direction the nerves run midwife team at St Thomas’ with ‘heart babies’. Professor David Edwards, As autism is passed on came up with the idea of holding www.echo-evelina.org.uk consultant neonatologist, genetically in about a third specialist antenatal classes. says: “The most vulnerable of cases, the researchers can To make it workable for babies will have access to these follow pregnancies where parents travelling long distances “An ECHO parent world-leading facilities, and it’s the child is more likely to be they decided that a one-off talks through their these infants who we need to affected. The project will session was most practical. experience of dealing know the most about in order involve 1,500 babies. “To fit everything into a day to develop new treatments for Professor Edwards, who is did you know? we picked out the key essentials with the diagnosis, brain damage.” also the Director of the Centre and added in specialised for the Developing Brain and is The Developing Human Connectome information about having a the challenges of Brain development leading this research, says: “We Project is an exciting six-year ‘heart baby’,” says Jo. “An ECHO their baby’s first before birth want to learn more about how research programme involving parent talks through their What is extraordinary is the human brain assembles 1,500 babies. experience of dealing with the months and juggling that the scanner can also be itself and to map the nerve It involves a multi-disciplinary team of diagnosis, the challenges of used to image the brains of connections that form as the family life.” • imaging and computer scientists babies while they are still in brain grows and develops. • neuroscientists the womb. “By the time a baby is born • clinicians Researchers from King’s the brain is well developed College London’s Centre for and key connections between The project will lead to major the Developing Brain, working nerves have already been advances and increase our with our clinicians, will use the made, so we are looking at understanding of what makes us MRI scanner to investigate babies in the womb. This will uniquely human and will set the normal brain development help us to understand complex stage for further research studies. Professor David Edwards including how it is affected by neurological conditions.”

6 The GiST www.guysandstthomas.nhs.uk 7 the interview my surgery We talk to Dr Mark Kinirons, consultant in general and geriatric medicine, about how Guy’s and St Thomas’ is improving care for patients with dementia and delirium. Mr Ben Challacombe prepares the robot for surgery with dementia and delirium so they can learn from each other, share information, and support other staff who feel our input could improve a patient’s care.

How does the DaD team help Q patients with dementia? Staff working anywhere in the Trust A can access the expertise of the DaD team. They might want to get some advice about a patient’s care over the phone, request some input from a therapist, or in more complex situations they could ask a member of the DaD team to come onto the ward to meet a patient and provide what we call a ‘clinical review’. Kidney op is UK first Almost 10,000 of our 12,500 in the department at Q staff have now watched ‘Barbara’s Story’ (the Trust’s Guy’s recently performed the UK’s first dementia training film), what robotic kidney removal through just a single impact has it had? ‘Barbara’s Story’, which follows a cut next to the patient’s belly button. A fictional patient with dementia during her hospital visit, has had a transformational The 80-minute robotic procedure, also “Doctors at Guy’s and St Thomas’ impact on the culture of the Trust by known as a total nephrectomy, offers told me the kidney was failing and emotionally engaging with our staff. considerable benefits for patients had to be removed. I was petrified ‘Barbara’s Story’ has made the job of compared to traditional open surgery about the scars I’d be left with, but the DaD team much easier because there or even standard keyhole surgery – Mr Dasgupta told me about a is much better awareness and so we are during which several holes are made in technique that hasn’t been used pushing at an open door when we talk to the skin to remove the kidney. in the country before and which would staff about caring for people with dementia. Consultant urologist Professor mean I would only have one small scar says: “This on the outside of my belly button. How do you hope dementia procedure is much less invasive. “It was obviously daunting as I was Q care will improve in the future? Making only one incision using the the first person in the UK to have In the short-term I am hopeful that accurate tools of the robot means the this procedure performed by a robot, Team effort improves A the work of the DaD team will patient will have a smaller wound and but we went ahead a month later and improve the knowledge, awareness and scar, and therefore have less risk of thankfully the operation went well. The skills of all our staff so they are able to infection and post-operative pain. doctors were amazing and so helpful. provide the best possible care for patients “With the aid of the robot, the kidney “I’m finally feeling much better. I am dementia care with dementia. is removed through a small hole the looking forward to getting my life back In the longer term, although there size of a 50 pence coin. The patient on track and continuing to study for What does your How big an issue What are we doing to is no ‘cure’ in sight for dementia, I am usually recovers quickly and can go my accountancy course.” Q job involve? Q is dementia? Q improve care for patients passionate that we can improve life for home after 24 hours in hospital.” Surgeons Mr Ben Challacombe I am the Trust’s clinical lead for It is a major issue because a quarter with dementia? people living with dementia. 19-year-old Jaspreet Virdi from and Professor Prokar Dasgupta used A dementia and delirium which A of patients in UK hospitals have a We have established the DaD This means staff in hospitals, Greenwich, who hopes to become an the state-of-the-art Da Vinci Si HD means that I lead our multi-disciplinary form of dementia, and this number is A team which includes not only the community healthcare, GP practices, accountant, had her kidney removed dual console robot – one of only care for people with memory problems. growing. People are living longer and staff mentioned above but also other social services and the voluntary sector using the new technique because she two in the UK – to perform the It is a real team effort and I work closely this means that dementia is affecting an specialists including pharmacists, working together to not only provide had one kidney smaller than the other operation. During the procedure, four with two clinical nurse specialists – increasing number of older people. psychiatrists, physiotherapists, better care for people living with dementia – a condition that affects around one in instruments pass through a special Bridget Fordham and Liz Ford – and with Dementia may not be immediately occupational therapists, dietitians, and but also help them and their relatives 1,000 people. “All my life I suffered with porthole placed by the belly button, consultant physician Dr Tom Ernst and obvious, which can mean people are not speech and language therapists. navigate what can be a very confusing recurrent kidney infections. As I got including one with a camera which the rest of the Dementia and Delirium diagnosed and so their care needs are The DaD team brings together all the system – there is lots of support out there, older, it got worse, and I had unbearable acts as the surgeons’ ‘eyes’ and a right (DaD) team. not addressed in the right way. experts involved in the care of patients we just need to help people find it. pain in my lower back,” she says. and a left robotic arm.

8 The GiST www.guysandstthomas.nhs.uk 9 Inside out Better together – 20 years on

As we celebrate the 20th anniversary of the merger of Guy’s and St Thomas’ hospitals, we look at some of the people and events that have shaped the Trust. 2007 2009 Gill Hicks says thank you The Trust leads the way on green to the staff who saved initiatives and becomes one of the first 2000 her life and helped her to generate its own electricity using recover from devastating combined heat and power (CHP), Beatrice Kaunda, district nurse Work begins on a major 2004 injuries suffered during saving a staggering £1.5 million a year. building programme to the July 7 bombings in On 1 July, Guy’s and St Thomas’ 2011 2013 improve our hospitals 2005. Gill was cared 1998 becomes one of the first NHS following a £100 million for by staff from A&E, Community Work begins on a £160 Foundation Trusts. Her Majesty investment – £50 million intensive care, Luke services in Lambeth and million new Cancer Centre The Queen opens from the Department of The UK’s first adult to child keyhole Ward and the therapies Southwark join the Trust at Guy’s. Due to open in Thomas Guy House Health and £50 million kidney transplant is carried out by department where she giving us the opportunity 2016, it will transform at Guy’s, now called from Guy’s and transplant surgeon Mr Nizam Mamode learned to walk again to improve services for patient care and enhance Bermondsey Wing. St Thomas Charity. at Guy’s and St Thomas’. using prosthetic limbs. Ed Miliband opens CHP unit at St Thomas’ our patients. our research facilities.

1993 1999 2002 2006 2008 2010 2012 Guy’s and Consultant cardiothoracic A £15.6 million state- Sir Michael Parkinson launches a King’s Health Partners – our Guy’s and St Thomas’ Charity St Thomas’ hospitals surgeon Mr David Anderson of-the-art women’s national Dignity in Care campaign academic health sciences gives a £10.6 million grant merge following the performs heart surgery on his and neonatal centre at St Thomas’. He said: “I learned centre – is one of just five to to support the development Tomlinson Review smallest ever patient, baby Louis opens its doors at more about what dignity is in a receive formal Department of Southwark and Lambeth of health services Dacre, who weighed just 3lbs. St Thomas’ at 8am on half hour meeting with staff and of Health accreditation. Integrated Care – a unique in the capital. Louis’ operation took five hours Saturday 31 August. patients up on the ward than It was created to improve project to improve care for and he made a full recovery. Rhys Jayson Nunoo anything I could read in books. I’ve patient care by bringing older people and people with A minor injuries is the first baby to just seen ‘best practice’ in practice.” clinical services, teaching long-term conditions locally. Our staff treat casualties from unit opens at Guy’s, be born in the new and research more closely a series of nail bomb attacks in replacing the A&E centre at 9.10am. together. Our partners are , Brixton and Brick Lane. department. King’s College London and BBC1’s City Hospital King’s College Hospital and arrived and broadcast A&E staff South London and Maudsley more than 500 hours fast facts NHS Foundation Trusts. of live television from Each year our 12,500 staff: our hospitals over the London’s first new children’s next few years. • provide 1.6 million patient contacts hospital for over 100 years is opened by HRH The Princess • deliver 6,400 babies Royal. The Evelina Children’s • treat 150,000 patients in our Hospital was designed with help A&E department from young patients and won a prestigious Royal Institute of Guy’s and St Thomas’ is one of the largest British Architects award for its health providers in the UK. innovative design.

10 The GiST www.guysandstthomas.nhs.uk 11 in focus As demand for trauma and orthopaedic services at Guy’s and St Thomas’ increases, we find out how our specialists care for patients of all ages.

Meet the bone doctors

As one of London’s biggest trauma and “We have world-class surgeons at orthopaedic services, our specialist adult Guy’s and St Thomas’ and we carry out “We have world-class care team are offering treatments which many specialist procedures which are surgeons at Guy’s and are more effective than ever before, not available at other hospitals – further leading to a drastic rise in people seeking reasons why our services are so sought St Thomas’ and we carry out their specialist skills. after,” adds Brian. many specialist procedures “We are on a mission to become one of the world’s leading providers About our patients which are not available at of orthopaedic care,” says Director of “In the adult service we treat patients other hospitals – further trauma and orthopaedics, Brian Wells. aged 20 to 90,” says Mr Steven Corbett, “Over the past year alone the consultant orthopaedic surgeon reasons why our services adult department has seen a 33 per and Clinical Lead for trauma and are so sought after.” cent increase in patients wanting a orthopaedics. consultation with one of our surgeons. “We want to improve the quality of “A couple of years ago we were our patients’ lives, and there are lots of struggling to meet the increasing demand minimally invasive treatments we can “A new initiative means that on our services and patients were waiting a now carry out that mean our patients patients can now leave hospital number of months to receive treatment. will be back on their feet quickly. up to four days earlier, where it is “As a result we have taken steps “We have experts who specialise in clinically safe for them to do so. to dramatically reduce waiting times a wide range of orthopaedic problems, “This is possible thanks to our and our patients can now have a first and our special interests include hip fantastic outreach team – consisting consultation and an operation within a fractures, complex spinal surgery, of physiotherapists, occupational couple of weeks.” complex lower limb and upper limb joint therapists and nurses – who provide Our adult service provides planned operations, as well as surgery for hip the same level of dedicated care and operations on patients bones and joints, disorders in young adults.” supervision in the patient’s own home with all surgery taking place at Guy’s. as they would receive in hospital. The service also cares for trauma You said, we did “In addition, patients receive an patients who have come through the The team is constantly seeking innovative information pack and access to an Accident and Emergency department ways of working that will provide the best interactive website where they can at St Thomas’ and who need immediate experience for patients. track their progress with exercises, treatment. “We asked our patients how they and they can keep in contact with Changes in the population have led to thought we could improve the service,” the team. an increasing demand for orthopaedic explains Brian. “They told us that they services, particularly as people live longer wanted to leave hospital earlier. As a and with the rise in obesity. People are result we set out to determine whether fast fact more likely to have problems with bones we could help patients recover from The team operates on 6,000 adult Mr Steven Corbett, consultant and joints as they get older, and the joints surgery feeling completely supported patients a year orthopaedic surgeon and Clinical of obese people are under greater strain. and cared for, but not in hospital. Lead for trauma and orthopaedics

12 The GiST in focus in focus

“Thanks to new care for older people to prevent and children with congenital spinal them to straighten their spines and treat fractures. This is something that deformities whose spines have not correct deformities. technology, modern our fracture clinic, part of our trauma developed properly. We see children “The results can be truly life-changing,” hip replacements and orthopaedic service, is keen to who have neuromuscular conditions he adds. “We see patients between three do in collaboration with our elderly such as cerebral palsy, which can cause and 21-years-old from south London, are far more durable care department. the bones in their spines to collapse. Kent and Sussex, as well as patients from than traditional hip All patients who attend the fracture And we see children who have developed as far away as Scotland.” clinic are screened by a specialist nurse a curved spine in childhood or when they The team holds special outreach replacements, so we and orthopaedic surgeon to see if they are teenagers, although we do not know clinics in local schools which teach now expect them to last are at risk of osteoporosis or having the cause of this.” children with multiple disabilities. During more falls. Osteoporosis is a condition Mr Lucas and the team have seen the clinics, the team identifies pupils who for many decades” that affects the bones, causing them nearly 2,000 children and teenagers in might benefit from spinal surgery. “By to become weak and fragile and more the last year suffering from problems visiting children in their schools, we can likely to break, particularly when a with their spines, and performed save families from making the journey to patient has a fall. groundbreaking surgery on 160 of the hospital,” Mr Lucas adds. Consultant orthopaedic surgeon Mr Peter Earnshaw with patient Maureen Janes on the ward If a patient is identified as being at risk, an in-depth assessment is made “Normally when patients leave to look at the bones inside our patients to many decades. This means our which includes bone density scans and before after hospital following an orthopaedic find out what is causing the problems. We younger patients not only have the blood tests. A nurse also makes sure operation, they don’t come into contact then perform keyhole surgery to make option of having a life-changing joint each patient gets the right treatment, with medical staff again until their slight changes to the hip joint, or we use replacement but also they will need fewer including a referral to other services six-week check-up. This new initiative traditional open surgery to realign or replacements throughout their lifetime.” they might need in the hospital or in gives our patients access to our experts replace the joint. The Young Adult Hip service sees more the community. immediately as the patient or their carer “Surgery can transform the lives of than 400 patients with hip problems “Access to a specialist nurse is vital can pick up the phone to us at any time. these patients, freeing them from pain each year. to successfully preventing patients “At the moment this is a pilot project and allowing them to lead normal lives,” having fractures,” says Dr Finbarr Martin, for patients who have had hip or knee adds Mr Bankes. Preventing falls consultant geriatrician. replacements, but it is proving very “Thanks to new technology, modern Almost 90,000 hospital admissions in Specialist nurse Temptations successful so we hope to be able to hip replacements are far more durable England each year are as a result of falls Mambiravana says: “The orthopaedic extend the programme,” adds Brian. than traditional hip replacements, and fractures and this is mostly in older and elderly care departments work “As far as we are aware, this is the first so we now expect them to last for people. There is a national need for better closely together to provide ongoing service of its kind in the country.” support for patients at risk of falls X-rays of Chantelle’s spine A physiotherapist and nurse or fractures.” before and after surgery Young adults help get patient Maureen Janes In addition, we offer a one-stop clinic ready to leave hospital Traditionally it is thought that only older where patients can have all the tests Chantelle’s story consultant orthopaedic surgeon people need joint replacements, but the they need carried out in one day. They Chantelle Thompson from Kent had Mr Jonathon Lucas explained that Young Adult Hip service that we run is also receive their results on the same spinal surgery at the Evelina Children’s she needed two operations to straighten evidence that this is not the case. day, and a doctor or nurse will discuss Hospital two years ago when she was 15. her spine. Consultant orthopaedic surgeon the next steps with them, reducing the “My ballet dance teacher noticed I After the first operation she had to Mr Marcus Bankes provides the Young number of appointments they need. had a curved spine when I was eight,” lie on a special bed which gradually Adult Hip service for south London says Chantelle. stretched her spine. She then had and the south east with his colleague Children’s bones “As I got older, it got worse and began another operation to screw her spine Mr Marc George. At the Evelina Children’s Hospital, our to be painful. I also became more self- into its new position. “The service typically sees patients in paediatric spinal service is dramatically conscious about it.” She explains: “Seeing myself after the their 20s and 30s, although we do see changing children’s lives. Chantelle was diagnosed with operations was quite a shock – I’d grown patients approaching middle age,” says “We are one of the leading services scoliosis – a curved spine – and 11 centimetres!” Mr Bankes. “We see patients with injuries in the country for children’s spinal caused by repetitive activities such as deformities,” says Mr Jonathan Lucas, sport, hip dysplasia – a genetic condition one of four orthopaedic surgeons at fast facts where the hip has not formed properly – Guy’s and St Thomas’ who operate on The children’s spinal team sees 2,000 children with spinal problems a year and early onset arthritis. spinal deformities in children. “Patients come to us complaining of “There are three main reasons for They operate on 160 children a year groin and hip pain. We use a tiny camera spinal deformities,” he says. “We see

14 The GiST www.guysandstthomas.nhs.uk 15 Trust view trust view Obesity – solving a supersized problem

Every year, up to 30,000 people in the UK die prematurely from obesity-related conditions.

Dr Jude Oben, a consultant “This is a non-surgical way support after the balloon is Side effects are very rare, gastroenterologist at Guy’s to treat patients and often inserted on their appropriate with the most common and St Thomas’, tells us what has good results for most food choices, portion control complaint being patients he and the team of dietitians people. The balloon makes and lifestyle changes to aid feeling nauseous. are doing to help reduce the people feel full and reduces successful and long-term Dr Oben says: “We know size of the obesity epidemic. how much food they absorb. weight loss.” that this procedure is a “We know that 60 per Some patients lose 30 per popular choice. It can really cent of adults in the UK and cent of their excess body Treatment options change people’s lives.” 30 per cent of children are weight in just one year. One of Dr Oben says: “Surgical overweight or obese. This our patients had two balloons options include having a Obesity Action Campaign presents a huge challenge for over 12 months and lost 70kg gastric band that reduces the Dr Oben helped to launch the the NHS,” he says. “The annual (11st, 3lb), which is amazing,” size of the stomach, meaning Obesity Action Campaign at cost of obesity to the NHS is says Dr Oben. less food can be eaten. the House of Lords in 2011 and a staggering £5.1 billion and is has recently been invited to predicted to rise to £15 billion join the All Party Parliamentary in the next 20 years. “We ask patients to lose about five Group on Obesity as an advisor. “After I became a consultant per cent of their excess body weight here in 2005 I began to see Find out more a growing number of obese by changing their lifestyle and diet www.obesityac.org patients. Surgery cannot be before we insert the balloon. This offered to all patients, so I looked into what else we could do.” shows that they are motivated, The most important things which improves the chances of the for managing weight are a healthy diet and exercise, procedure being successful.” but for some people this is “We ask patients to lose Although we don’t perform this not effective. about five per cent of their here, we work closely with our fast facts excess body weight by colleagues at King’s College • We are the largest UK Bringing new procedures changing their lifestyle and Hospital where this procedure service offering the intra- to the Trust diet before we insert the is performed. However, surgery gastric balloon for NHS Five years ago Dr Oben began balloon. This shows that they can be a daunting option for patients offering the intra-gastric are motivated, which improves some people. balloon procedure. A balloon • Obesity is now the most the chances of the procedure “I perform the intra-gastric is put into the stomach and common cause of chronic being successful.” balloon procedure on six filled with salt water. After liver disease in the UK Olivera Kegey, bariatric patients every week who stay six months it is removed. dietitian, says: “We work with in hospital overnight. A new • Obesity can also cause It can be used as a standalone Dr Oben to offer advice on endoscopy unit is opening arthritis, diabetes, treatment for patients who healthy eating to our patients at St Thomas’. We then gallstones, heart disease, are not medically fit for to ensure that they are ready hope to be able to offer high blood pressure, surgery or as an aid to help to have the balloon inserted. this procedure without an indigestion and infertility. Dr Jude Oben prepares to them lose weight before they perform the intra-gastric We also provide further overnight stay in hospital.” have surgery. balloon procedure

16 The GiST www.guysandstthomas.nhs.uk 17 trust Life trust Life

why I fundraise

Role reversal Patient Celia Lewis interviews her favourite nurse, Alexandra Ward Sister Joyce Kakala.

How long have you patients feel better and putting their Gavin Tiffin, Q been a ward sister? families at ease is what nursing is all about. hospitality manager. For almost two years but I’ve A been a nurse for 13 years. You work as a great team, Gavin Tiffin took on a marathon Q what is the secret? mission last month, cycling 280 miles What does a ward We are very close and all support each from London to Paris and running four Q sister do? A other like a family. We understand that marathons across Europe. Every penny I plan patient care and support my the more you put in, the better the rewards raised will go to Evelina Children’s A nurses to deliver the best possible are, and here we all get stuck in. Hospital which treats nearly 55,000 care helping with their development. children every year. I am also involved in the training of How do you relax after busy Gavin’s Herculean efforts have student nurses on placement. Q shifts? raised almost £2,000 and are being I like to go home and spend time supported by the fundraising team at What made you want A with my family, or go to the gym or Guy’s and St Thomas’. Q to go into nursing? for long walks. I really enjoy coming into Gavin says: “Training is the hardest There was a hospital next to my work though. part, but if the money I‘ve raised makes A school. It was from then on that a difference to even one person’s life it I always wanted to care for people. If you could give any advice has to be worth it.” It really is a childhood dream for me. Q to any aspiring nurses, what would it be? Fundraising Have you always wanted to It’s the little things we do that make To find out how you can fundraise Q work with older patients? A our patients feel safe in our hands. for Guy’s and St Thomas’ visit I’ve worked on children’s and Get to know them, remember the things togetherwecan.org.uk, email A maternity wards, but elderly care they like, the things they enjoy, and what [email protected]. is where my heart is. Watching patients they like to talk about. uk or call 020 7848 4701. become more mobile, eating well and feeling better before they leave hospital Above: Celia and The older person’s unit Joyce became good “I’ve worked on children’s and maternity is a special journey I go on every day. friends while Celia • Joyce oversees a team of 23 nurses and seven nursing assistants was a patient on wards but elderly care is where my heart What is the best part on Alexandra Ward Alexandra Ward is. Watching patients become more Q of your job? • The Older Person’s Unit at St Thomas’ includes Alexandra Ward, I enjoy getting to know my patients. mobile, eating well and feeling better Anne Ward and Henry Ward A After their contributions to society before they leave hospital is a special in their younger years, it’s my turn to give • Our older patients are treated for multiple medical conditions. something back. Knowing I am making journey I go on every day.”

18 The GiST www.guysandstthomas.nhs.uk 19 trust Life trust Life Say Delivering outstanding care Where is your We find out what? Q favourite place? who has been Staynton Brown, At the bottom of the Associate Director, A street of my childhood successful in the Equality and home in Dudley there is a most recent round Human Rights. nature reserve with canal locks, lakes and woodland. of Care Awards. The monthly Care It’s still my happy place to go awards are open to both When growing up, what back to. Senior Biomedical Scientist, volunteers and staff Q did you want to be? Alan Drew (right) was working at the Trust. Something similar to If you could have a nominated by numerous Nominations can be A what I’m doing now. Q superpower, what colleagues in the Haemostasis made by colleagues, I always knew I wanted to would it be? Laboratory for his exceptional patients, visitors and help and give a voice to A I’d just like to be able dedication and outstanding the public using paper important issues. to turn the sun into a giant support for his team. He is a or online forms. Visit disco ball. How much prime example of a member www.guysandstthomas. If you could learn happier would the world be? of staff who demonstrates nhs.uk/careawards for Q one thing.....? What’s the best advice Who would you say the Trust’s values – taking more information. I’m slowly learning Q you could give someone? Q is your hero? Tell us something about pride in what he does and A to play the piano. Be the change you want My mum for raising four Q you we don’t know? always striving to be the best. Lee Liang Makin, medical Being able to read music and A to see, don’t stand on the A of us alone, studying, I have played football Dr Helen Oram and her secretary in paediatrics, play instruments is sidelines, go and get involved. holding down two jobs, and A with Tony Hadley from team in the Haematology won a Care Award in March. an amazing skill. And choose to be happy. becoming a teacher. Spandau Ballet. Day Unit received a Care One colleague described Award in February for her as “the most incredibly delivering outstanding care hardworking, dedicated and to a pregnant woman with committed medical secretary Nursing assistants play a vital role a rare, and potentially life- helped ensure the woman was excellent service she provides one could possibly imagine”. threatening, blood disorder. able to delay giving birth for to the children of staff at the Patients often leave messages Nursing assistants, formerly be recognised as an integral She had already lost her first four weeks, giving her baby a Trust. One mother commented: of thanks and praise the known as healthcare assistants, part of the nursing team and baby and delivered her second much better start in life – an “Knowing my child is in her support she offers. Lee’s play a vital role in delivering given a clear identity within prematurely, so the team went extraordinary result with a caring, capable hands allows me diligence and dedication excellent care to our patients. the organisation. Staff were above and beyond to ensure very happy outcome. to concentrate 100 per cent on makes a huge difference – not Every day, they have direct asked to vote for what their new her most recent pregnancy Louise Brown is a key my patients. Louise is amazing only to parents and patients, contact with patients and their name should be and they chose could be extended as far as worker at St Thomas’ nursery and truly cares for each and but also to the rest of the families, caring for them when ‘nursing assistant’ as it helps possible. Their excellent care and won a Care Award for the every one of those children.” general paediatrics team. they are often at their most patients to understand their role.” vulnerable. They look after Training for nursing assistants patients’ nutrition and help with covers a wide range of areas, “Knowing my child washing and personal care including infection prevention is in her caring, History corner while maintaining patients’ and control, and they also dignity and privacy. attend the Trust’s nursing and capable hands They often become the voice midwifery induction. Individual allows me to John Keats (1795 -1821) collection of poetry followed of patients as they hear directly study days focus on personal became a pupil at Guy’s in 1820. Tragically he died of how the patient feels and can development and well-being. All concentrate 100 per Medical School in 1815 and tuberculosis the following year. refer these concerns to senior nursing assistants now have the cent on my patients. lived close to the hospital at Six years ago, Guy’s and members of staff. opportunity to take a diploma 6 St Thomas Street with his St Thomas’ Charity unveiled a Ciara Rooney, Acting Head of in healthcare, while being fully Louise is amazing friend Henry Stephens. life-size bronze figure of Keats Nursing in abdominal medicine supported by the Trust. and truly cares for After just one year, Keats in the courtyard of Counting and surgery, said: “The Trust We currently employ 580 Find out more left Guy’s to concentrate on his House at Guy’s and this has took the decision to change the nursing assistants and the next each and every one passion, writing poetry. become a popular landmark. Visit www.guysandstthomas.nhs.uk/nursingassistants name of healthcare assistants recruitment campaign will take His first work was published for further information. of those children.” Taken from ‘My Ward’, written to ensure that they would place in June. in 1817 and a second by Wendy Mathews.

20 The GiST www.guysandstthomas.nhs.uk 21 My view

From the frontline Competition Site Portering Manager Barry Sawyer

“Our porters take around experience and making their 7,000 steps a day to ensure our hospital stay easier in some patients find their way to and way is the most rewarding from the x-ray department and part of the role. Many patients around the hospital safely. are really grateful for their “Patients and their relatives help getting around our put a great deal of trust in hospitals and when they us getting them to where may be going through a they need to be. So all our difficult time.” porters need to be physically To be in with a chance to win a free haircut at fit to be on their feet all day, FAST FACTS Michael Barnes Hairdressing on Shaftesbury Avenue, but must also be caring and What’s on treat our patients with dignity • There are 30 porters simply complete the word search below. 4 June 10 – 16 June and respect. Many porters at Guy’s and 80 at Southwark and Lambeth National Glaucoma go above and beyond the call St Thomas’ S M I E N Z N V W A I J Integrated Care seminar Awareness Week of duty by coming into work • Each porters helps to (for Foundation Trust Call 01233 648 170 or visit on their days off when they T E O S W O D A K B C W transport 40 patients a day members), St Thomas’ www.glaucoma-association.com are aware of particularly Call 0800 731 0319 busy times. • Porters walk up to 14 June S K L K L Y L U O D E T to book your place “Knowing they are making 12 miles a day. World Blood Donor Day L A S P A D E E H R C E Barry Sawyer with three of our porters a difference to the patient’s 1 – 30 June 24 – 30 June Motor Neurone Disease Deafblind Awareness Week S U N G L A S S E S R K (MND) Awareness Month Tel/textphone: 01733 358 100 Call 08457 626262 or visit or visit www.deafblind.org.uk A R I D H G H K A C E C www.mndassociation.org Ask us: Should I vaccinate my child? 1 – 31 July 9 – 15 June H T E C C O U M F C A U Sickle Cell Awareness Month Cervical Screening We speak to Dr Dharma Shakya, immunisation lead for Southwark Call 020 8961 7795 or visit Awareness Week U O A M L A W P E G M B www.sicklecellsociety.org My child has always Is it safe to vaccinate A medical paper was Call 0808 802 8000 or visit P E D I M R S N Q S A R been healthy so why my child? published in 1998 which www.jostrust.org.uk 8 – 14 July bother to vaccinate? Vaccines are only given to suggested that autism could National Transplant Week 9 – 15 June B D D V D U A T B J B X Thanks to our clean water children once they have been be caused by the MMR Organ Donor Line: Diabetes Week supply and effective childhood reviewed by doctors and vaccination. The good news is 0300 123 23 23 or visit Call 0845 120 2960 or visit O A M U R T S Z L M C D vaccination programme, healthcare professionals. that several research studies www.transplantweek.co.uk www.diabetes.org.uk outbreaks of childhood Vaccines are very safe and since have found no link 28 July Y L L U G A E S V E Y C diseases such as diphtheria serious side effects are very between the two. World Hepatitis Day and polio are rare these days, rare. However, some babies Beach Icecream Spade but they can still happen. may have minor side effects Are there any other Every Monday: Bucket Sandcastle Summer In Lambeth and Southwark after vaccination such vaccines my child Free lunchtime concert we offer routine childhood as redness, swelling and should have? Holiday Seagull Sunglasses 1-2pm, Central Hall, St Thomas’ vaccinations to all babies which tenderness. They may also We offer babies under one the Send your entry by 28 June to The GiST competition, can save lives and prevent feel irritable or have a high BCG vaccine which protects Every Wednesday: Communications Department, 4th floor, Staircase C, serious illness and disability. temperature. against tuberculosis, an Free lunchtime concert South Wing, St Thomas’ Hospital, Westminster Bridge Road, infection which mainly affects 1-2pm, Atrium 3, Guy’s SE1 7EH; or you can email [email protected] How will I know when to What about the MMR the lungs, as well as Hepatitis vaccinate my child? scare? B, an infectious disease The winner will be selected at random and notified within Your doctor’s surgery, health The MMR vaccine combines that affects the liver. seven days of the draw. The result will be final and we centre or clinic will send you three vaccines and protects Raise money for your hospital will not enter into any correspondence regarding the an appointment when your children against measles, Find out more www.togetherwecan.org.uk competition or the winner. The prize is non-transferable. baby is due for immunisation. mumps and rubella (German More information is available from the Lambeth, Southwark and Childhood vaccinations are free. measles) in a single injection. Lewisham Immunisation Helpline: 020 7138 1444.

22 The GiST www.guysandstthomas.nhs.uk 23