News from Guy’s and St Thomas’ Issue 28 | 2018

Here when you need us most Inside our new emergency department THIS ISSUE

Contents

05 Rare Diseases Centre gets royal approval Welcome A specialist service in one place

Helping the homeless Our emergency department (A&E) at 07 St Thomas’ Hospital is one of the busiest in the Health checks for rough sleepers NHS, seeing around 420 patients every day. Over the last four years we have completely redeveloped the department, transforming patient care by creating a dedicated emergency floor that brings together emergency services in a single area of the hospital. Thanks to our wonderful staff, the department remained open as normal while the work was carried out. I am delighted that the rebuild is now complete so we can provide even better care for the 150,000 emergency patients who use the service every year. You can read about HRH The Princess Royal’s recent visit to St Thomas’ Hospital to officially open the emergency department on page 12. 10 Journey of In this issue of the GiST, you can find out how homelessness nurses from a blood sample the Health Inclusion Team are helping rough sleepers by providing same day health checks. Read about their project, which is supported by Supporting vital research homelessness charity St Mungo’s, on page 7. 12 Emergency care You can also read about a life-like simulation manikin called ‘Hal’ that is transformed helping doctors and nurses to safely treat patients in emergency situations. New emergency floor revealed Take a look at how we’re leading the way in simulation-based education on page 8. Our sterile services team provides a crucial service for the Trust, cleaning and sterilising up to 11 million instruments used in operations every year. Find out what goes on behind the scenes on page 22. I hope you enjoy this issue of the GiST.

Amanda Pritchard, Chief Executive 18 The leading edge Guy’s and St Thomas’ NHS Foundation Trust Zapping migraines away

Meet the team TELL US WHAT YOU THINK Words and photos by Marjorie Allen, Matt Barker, Michael Carden, Sarah Clark, Kelly Cook, If you have any comments about the Nzinga Cotton, Cleo Downs, Ciorsdan Glass, magazine or suggestions for future articles, Maxine Hoeksma, Cara Lee, Angie Oakwood, please contact the communications Adeola Ogunlaja and Eloise Parfitt. department, St Thomas’ Hospital, Cover photo by David Tett. Westminster Bridge Road, SE1 7EH, or email [email protected] Design: AYA-Creative www.aya-creative.co.uk Visit us online at: www.guysandstthomas.nhs.uk 22 Behind the scenes Print: O’Sullivan Communications Discover what our sterile services Front cover: team do Matron Anneke Biginton and charge nurse Dee Dhesi outside the emergency department (A&E) at St Thomas’ Hospital.

the GiST is published by Guy’s and St Thomas’ NHS Foundation Trust

2 the GiST ROUND-UP

A genetic IN THE NEWS A round-up of media coverage revolution featuring Guy’s and St Thomas’. for south Evening Standard The Evening Standard reported how Sophie Miles (pictured below) east was saved from suffering permanent brain damage by Genetic testing for people in south pioneering ‘cooling’ treatment at London and south east England is Evelina London Children’s Hospital. set to be transformed with a new To mark Sophie’s fifth birthday, genomics laboratory hub. her dad, Ben, took part in Guy’s Guy’s and St Thomas’ will lead the new genomics laboratory hub A consortium led by Guy’s and Urban Challenge to raise money for St Thomas’ will provide the new service, Genetic testing can be used to find out Evelina London. which will be at the centre of a network made whether or not a person has inherited a up of NHS organisations across the area, specific altered gene (genetic mutation) that including King’s College Hospital, St George’s causes a particular medical condition. University Hospitals, South London and The new service will transform care by Maudsley and Royal Brompton & Harefield allowing clinicians to access testing for more NHS Foundation Trusts as well as Maidstone than 500 conditions seven days a week, with and Tunbridge Wells NHS Trust. some results being available in as little as Known as the London South Genomic three days. Laboratory Hub, it is one of seven newly Dr Ian Abbs, Chief Medical Officer at Guy’s commissioned hubs across the country that and St Thomas’, said: “Our partnership is will not only improve patient access for committed to using genomic medicine to BBC One genetic testing, but will also support the identify diseases earlier and to better BBC One’s ‘One day that changed development of more personalised personalise the treatment and care we my life’ included the story of treatments. provide to our patients.” Bethany. She was filmed at Guy’s Hospital having a blood test to find out if she was a carrier of a faulty BRCA gene, which increases the chance of developing breast and Stress-free scans help young patients ovarian cancer. Roberta Rizzo, genetic Children who need regular scans of their counsellor at Guy’s and St Thomas’, bones are benefiting from a new state-of- spoke to Bethany in the genetics the-art machine at Evelina London clinic before the test. Two weeks Children’s Hospital. later she gave Bethany the good A dual energy X-ray absorptiometry news that she was not a carrier of (DEXA) scan is a quick and painless the faulty gene. procedure that uses low dose X-rays to measure the density or strength of bones. Previously, young patients who needed The Economist highlighted the the scan had to use the adult DEXA scanning dementia-friendly hospital wards in service at Guy’s Hospital. the older person’s unit at Thanks to funding from Guy’s and Elliot Mace with his mum, Amy, and technologist, St Thomas’ Hospital. St Thomas’ Charity, Evelina London now has Ines Baeta, on the new DEXA scanner The unit’s layout and decor has the newest model of the DEXA scanner in a saving families from having to travel been designed for dementia space-themed room, with a ceiling hoist and between hospital sites to attend their patients with improved lighting, an interactive entertainment system. consultant appointments at Evelina London bright colours and large signs. A Dr Moira Cheung, consultant children's and improving the patient experience.” Pets as Therapy dog also visits the endocrinologist at Evelina London, said: “We Elliot Mace, 10, was one of the first unit to improve patients’ mood. can now offer a one-stop shop for our young patients at Evelina London to use the new patients who attend the osteoporosis clinic, machine.

www.guysandstthomas.nhs.uk 3 ROUND-UP P h o t o :

B r e n d a n

F o s t e r

P h o t o g r a p h y

Artwork donated by Tacita Dean Art-felt thanks to hospital An internationally renowned artist has donated 14 handmade prints to Guy’s and St Thomas’ to thank staff for saving her mother’s life. Tacita Dean’s limited edition artwork has been installed on the 1st floor of North Wing at St Thomas’ Hospital. The prints are based on stills taken from her project FILM, which More than 250 supporters and staff took part in London's most thrilling 'urban triathlon' – Guy’s Urban Challenge – to raise funds for Guy’s and St Thomas’ Charity, including Akar Necati who was supported by was exhibited in Tate Modern’s his son Sami. Participants ran 2.4km around Guy's Hospital, spun 15km on state-of-the-art Wattbikes, Turbine Hall. and climbed 29 floors to the top of Guy's Tower. Together with her brother Ptolemy and sister Antigone, Tacita donated the artwork to St Thomas’ We love to hear from our patients, staff in gratitude for the care their Your voice and supporters so join the conversation by following us on Facebook, mother, Jenefer, received in 2014. Tacita said: “Against all odds, my Twitter, LinkedIn and YouTube. mother recovered from her very serious cardiac arrest which she @IamAdaMau @latajulu (from Twitter) had in Tate Modern, in part due to (from Twitter) @GSTTnhs great experience at the the extraordinarily high level of care Karina popped into emergency eye clinic today. Thank you she received in the intensive care @EvelinaLondon to the fantastic Matt and other staff for unit at St Thomas’ Hospital. neonatal as a sorting out my eye! visitor today, 6 “We really wanted to @cathrodgers (from Twitter) acknowledge our gratitude to all the months after she was being cared @GSTTnhs amazing staff, amazing care. staff, and the most obvious way Thank you. The wonderful #NHS was for me to donate an artwork on for there! Dropped behalf of the three of us to off some of her @NeilCook (from Twitter) punctuate those long hospital clothes for other @GSTTnhs Amazing experience at Guy’s corridors. tiny babies! Cancer centre today. Consultation, “I chose FILM Stills because Thank you again to all the wonderful biopsy and bloods within 45 mins... FILM was an emblematic project staff there! @GSTTnhs #NICU #NHS70 phenomenal. The staff were awesome with colourful, bold images that was Maria Savva-Chirambo (from Facebook) made for Tate Modern, and so @anniemaemorris (from Twitter) Visited children’s a and e with my son connecting the museum and the Thank you to the lovely Drs and nurses this morning, great great place can’t hospital.” at Guy’s Hospital for being WONDERFUL fault St Thomas’ hospital in any way Tacita was a Turner Prize whenever I visit @gsttnhs #LoveOurNHS whatsoever. nominee in 1998 and was made an OBE in 2013 for services to British art overseas. Twitter @GSTTnhs facebook.com/gsttnhs @EvelinaLondon youtube.com/gsttnhs

4 the GiST ROUND-UP

Royal opening Meet the for Rare Diseases Snow Fox Centre The Countess of Wessex has officially opened Guy’s and St Thomas’ Rare Diseases Centre. Her Royal Highness met patients who have benefited from the facility and doctors and nurses who work there. She heard how it was designed specifically for patients with a number of complex rare genetic conditions. These include epidermolysis bullosa (EB), xeroderma pigmentosum (XP) and Bardet- Biedl syndrome (BBS). The new Centre brings together several specialist services in one place, saving time Senior nursing assistants Alecia travelling between appointments. The Countess of Wessex with 13-year-old ichthyosis Pitter and Endy Akande on Snow The Countess said: “It is a huge pleasure patient, Zion Semere Fox ward for me to open the Rare Diseases Centre. The testimonies we’ve heard from the patients staff who have worked hard for years to make Evelina London Children’s with different rare conditions make it clear the facility a reality. The Centre means Hospital has a brand new why this was so necessary.” patients now have somewhere permanent ward. Sir Hugh Taylor, Chairman of Guy’s and they can call home.” Snow Fox ward has 19 St Thomas’, said: “We are very grateful to the The Rare Diseases Centre was funded by new spaces for children who patients who were heavily involved in Guy’s and St Thomas’ Charity, the charity need planned care, such as designing the Centre, the generous funders DEBRA, the Four Acre Trust and the minor surgical procedures, who made this possible and the dedicated Photodermatology Charitable Trust. diagnostic tests or scans. Fun, brightly coloured artwork is displayed throughout the ward, including snow foxes for children to find. Father’s walk for ECMO team Debbie Komaromy, head of nursing at Evelina receive life-saving ECMO (Extracorporeal London, said: “The new Membrane Oxygenation) treatment at St ward was designed Thomas’ Hospital last year. specifically with the needs Tom’s family had been told to say their of our young patients in goodbyes to him because his heart and lungs mind. were failing due to sepsis. “The feedback from our He was discharged a few weeks after having patients, including families ECMO therapy and has recently restarted his who have been using our degree. services for years, has been David said: “Tom wouldn’t be alive without very positive. It’s also a ECMO. We were overwhelmed by his wonderful really great environment for care and felt very safe in the hands of the our staff.” Cath, Tom and David Boyce team.” A father walked 171 miles to raise money for David walked up to 30 miles a day for six Find out more about how the team that saved his son’s life. days to complete his ‘Road to Recovery’ Evelina London is growing David Boyce travelled the route that Tom, challenge and raised more than £20,000 for www.evelinalondon.nhs. 19, was taken when he was transferred from the ECMO service at St Thomas’, which is one uk/wearegrowing University Hospital of Wales in Cardiff to of five across the NHS.

www.guysandstthomas.nhs.uk 5 SPOTLIGHT

More than 1,000 patients have been treated with a minimally-invasive heart procedure at Guy’s and “e team at St Thomas’ in the last St omas’ decade. Cara Lee meets were great and a patient who benefited I’m so pleased from the technique. I had this done .”

Celebrating 10 years Norman Brown was treated at St Thomas’ Hospital of pioneering heart care

Norman Brown blamed old age when he valve, using a catheter (a long, thin tube) to adoption of tissue rather than mechanical found himself struggling to walk up the guide it until it is positioned correctly in the valves has transformed the field of valve stairs and becoming increasingly aorta, the main blood vessel from the replacement, saving patients from needing breathless. heart. blood thinning medication. But when the 89-year-old, from Horley It can be done under local anaesthetic in “We’re now on the cusp of open-heart in Surrey, saw a cardiologist at his local around an hour and has a faster recovery surgery becoming a thing of the past and hospital he was told that he had heart time than open-heart surgery. are proud to pave the way with minimally- valve disease. This summer Norman became the third invasive valve replacement options at Norman was referred to St Thomas’ person in to receive a newer form St Thomas’.” Hospital for a procedure known as TAVI of the valve, known as the ‘ultra valve’. The (transcatheter aortic valve implantation), team at St Thomas’ is one of four in the which is a minimally-invasive way to world to use it. replace the aortic valve in the heart Professor Bernard Prendergast, avoiding open-heart surgery. consultant cardiologist at Guy’s and Fast facts This year marks 10 years since teams at St Thomas’, explained: “The new valve is • Around 1.5 million over 65s in the the hospital started carrying out the the next generation of technology in UK have heart valve disease, procedure. More than 1,000 patients have replacement valves. It’s a simplified model which affects heart function now been treated with TAVI at St Thomas’, which makes it a bit quicker to implant. This number is set to double in to improve their quality of life. This makes the procedure shorter and • the next two decades as the Norman is in no doubt about the impact means we are able to carry out an extra population ages the procedure has had on him. case a day.” The great-grandfather said: “I used to TAVI has been shown to have as good or • Symptoms include shortness of get breathless easily and I couldn’t walk better results than open-heart surgery for breath, tiredness, dizziness and around much. It limited what I could do on intermediate risk patients, as well as the chest pain, and the condition can a daily basis. conventional high-risk group. be fatal if left untreated “Since TAVI I can walk longer distances, In the next few years it should be clear I’m not breathless and I have more energy how effective TAVI is for low-risk patients to play with my six great-grandchildren. too. The team at St Thomas’ were great and Mr Chris Young, consultant cardiac I’m so pleased I had this done.” surgeon at St Thomas’, said: “TAVI has To perform TAVI, cardiologists cut a been very successful in the last 10 years. small hole in the groin and insert a new The introduction of this treatment and the

6 the GiST Our homelessness nurses help vulnerable people living on the streets. Maxine Hoeksma finds out about a project in Southwark. More than 1,000 people sleep rough in London each night.

Homelessness nurses Kendra Schneller and Serina Aboim with Graeme Seccombe, street outreach worker from St Mungo’s

Helping the homeless Fast facts • Guy’s and St Thomas’ Health As we head into winter the streets of conditions such as Hepatitis C and kidney Inclusion Team was awarded London will become an even tougher place disease. £5,000 by The Queen’s Nursing for the estimated 7,400 people sleeping “We also provide vaccinations including Institute to run the project until rough in the capital. the flu vaccine, look after wounds, screen December 2018 For some, a visit to the emergency for diseases like Hepatitis B and C and HIV department (A&E) with a minor ailment or and give medication if needed. • The Ministry of Housing, long standing health condition may seem “We’ll even drive people to a local GP if Communities & Local like the only option. they aren’t already registered. We want Government has agreed to Now, thanks to a project set up by people to know they are as entitled to GP continue funding the nurses until specialist nurses from Guy’s and services as everyone is. They don’t need to March 2020 St Thomas’, rough sleepers in Southwark attend the emergency department to get are the first in London to benefit from the care that they need.” immediate, same day health checks and London has the highest number of registration with a GP. rough sleepers in England with more than The group of six homelessness nurses 1,000 people sleeping rough on any given from the Health Inclusion Team take to the night. streets once a month, working alongside In 2016, St Mungo’s found that 49% of outreach workers from St Mungo’s, a their clients who had slept rough had a homelessness charity. physical condition that substantially Kendra Schneller, a homelessness affected their health and required ongoing nurse, said: “Some people feel unable to treatment or medication. get the healthcare they need because the Eammon Egerton, St Mungo’s outreach day centres they visit have restrictions team manager in Southwark, said: “This is around substance and alcohol use. an exciting project that, unlike other health “This is one of the factors that can initiatives, means we’re able to support mean they are more likely to present to the people sleeping rough with healthcare, on emergency department in a state of crisis.” the streets, right there and then. Serina Aboim, Kendra Schneller She added: “Our team of nurses go out “We really value the fantastic skills that and Graeme Seccombe early in the morning, around 6.30am, and the homelessness nurses from Guy’s and start conversations with people sleeping St Thomas’ bring to complement our there. Our aim is to help move people away rough on our streets. We give them advice outreach workers, without being at all from the streets for good, and to have a on how to look after their long-term intrusive. And the support continues from place to call home”.

www.guysandstthomas.nhs.uk 7 IN FOCUS

Kelly Cook discovers how a life-like model is helping doctors and nurses to safely treat patients in emergency situations.

A model patient

‘Hal’ can have a cardiac arrest in the same way as any human. This is when a person’s heart suddenly stops pumping blood round their body A manikin called Hal is taken onto the wards for a cardiac arrest scenario causing them to fall unconscious and stop breathing. Hal can blink, breathe, speak, has Dr Shumontha Dev, a consultant in debrief to discuss what went well and audible heart and lung sounds, a emergency medicine and deputy director what they could have done differently. measurable pulse rate and responds to of medical education at Guy’s and Dr Matthew Hammond-Haley is a junior drugs. If CPR (cardiopulmonary St Thomas’, said: “Every second counts doctor who took part in a simulation resuscitation) is not performed correctly, when someone has a exercise in the his condition deteriorates. cardiac arrest so it’s clinical decision unit Hal is part of a family of sophisticated important that our staff “Every second counts at St Thomas’ manikins that belong to the Simulation are able to handle when someone has a Hospital. and Interactive Learning Centre at stressful and highly- Dr Hammond- St Thomas’ Hospital – one of the largest charged situations. cardiac arrest so it’s Haley, who was first medical simulation centres in the UK. “By taking the important that our to arrive on the Once a month the model is taken onto simulation equipment to staff are able to scene, said: “As a the wards at Guy’s and St Thomas’ to run clinical areas around our handle stressful and junior doctor you a cardiac arrest scenario. hospitals and basing the help to manage very The team of nurses, doctors and other exercise on real life highly-charged sick patients but healthcare professionals – a mixture of scenarios, staff are able to situations.” there’s always so junior and senior staff – are not given any practise looking after much senior prior warning about the exercise. patients in their own support around. A cardiac arrest call is made and the environment. “The simulation exercise was a good staff only know that it is a simulation when “Over the last year the cardiac arrest opportunity to practise what I’m trained to they arrive on the scene to find the model. exercise has helped staff to improve their do and to take on a leadership role for Since training with Hal started in knowledge and has enhanced patient longer than normal in a safe, supportive August 2017, more than 200 staff have safety and care.” environment. taken part in the cardiac arrest exercise. Following each scenario the group “The debrief session was a useful

8 the GiST IN FOCUS

Leading the way in simulation education

Fast facts • Each cardiac arrest scenario lasts up to 20 minutes • Between nine and 24 clinical staff are involved in the scenario • 93% of staff who took part in the exercise agreed it was a worthwhile use of their time

The simulation operating theatre

King’s Health Partners has four state-of-the-art Simulation and Interactive Learning Centres that are based at Guy’s, St Thomas’, South London and Maudsley and King's College learning experience and I feel more Hospital. comfortable about being in that situation More than 4,000 healthcare students and professionals take part in training at the again with real patients.” centres each year. Esther Feleye, a nurse on Stephen ward The centre at St Thomas’, which opened in at St Thomas’ Hospital, was involved in an 2010 thanks to funding from Guy’s and exercise that took place in a day room that St Thomas’ Charity, includes an outpatient is used by both patients and visitors. consulting room, a six-bay ward, an operating Esther said: “Someone could have a theatre, two-bay intensive care unit and a home cardiac arrest anywhere in the hospital environment. and at any time so it was good for us to The centre at Guy's Hospital includes a practise this scenario. training lab and a large surgical simulation “After the room. initial shock of Colette Laws-Chapman, deputy director of seeing that the simulation at Guy’s and St Thomas’, said: patient was “Using these excellent facilities, simulation actually a models and actors, our trainees can experience manikin, real-life scenarios in a safe learning the simulation environment. felt real and has “Simulation-based education has been given me more shown to increase patient safety and improve confidence in clinical and patient management skills.” helping a person in a similar situation.”

www.guysandstthomas.nhs.uk 9 IN FOCUS

The Cancer Biobank collects samples and medical information from patients to support vital clinical research. Journey of a blood sample Based in the Cancer Centre at Guy’s, the Cancer Biobank contains around 370,000 samples from almost 40,000 patients. This includes samples of blood, saliva, urine, bone marrow and tumour tissue. Dr Cheryl Gillett, head of biobanking, says: “The Cancer Biobank helps scientists answer important questions about why conditions occur and who is at risk. The answers to these questions can lead to earlier, more accurate diagnosis and better treatment for patients at Guy’s and St Thomas’ and around the UK.” This is what happens if you are invited to provide a sample.

1 4 A specialist nurse talks 3 to you about what The tubes are placed happens when you give The tubes of blood into a machine that a sample to the biobank are collected by a spins them very fast and how this can help biobank technician so the blood divides clinical research. and taken to the into four parts – red laboratory for and white blood cells, processing. plasma, and serum.

2 With your consent, a little extra blood is taken during your routine blood test.

10 the GiST IN FOCUS

Professor Arnie Purushotham, consultant surgeon at Guy’s and St Thomas’, said: “Research is the only way for us to find and develop better, more effective treatments. The Cancer Biobank is helping scientists to make new and exciting discoveries that can be taken into the clinic to develop more effective cancer treatments and improve patient care. Thanks to research, over the past few decades more targeted treatments have been developed for breast cancer patients according to their specific type of cancer. Herceptin (trastuzumab) is an example of personalised medicine now being used to treat breast cancer in many women.”

8 After using biobank material, researchers have developed a clinical trial for breast cancer patients at Guy’s and St Thomas’. Doctors want to find out whether a device called the LightPath Imaging System can help breast cancer surgeons decide whether they have removed all of the cancer during surgery. 5 Each tube is carefully removed and the 6 different parts of the All the tubes are coded blood are separated so researchers are into several smaller unable to identify you. tubes. For each tube The tubes may be stored of blood donated, in freezers that are kept more than 16 smaller at -80C, sometimes for tubes are created. several years until they are needed by a researcher.

7 Scientists from anywhere in the world who are involved in cancer research can request to use a sample from the biobank. More than 300 studies using the biobank resources have been published in scientific journals.

www.guysandstthomas.nhs.uk 11 IN FOCUS P h

Rebuilding an entire o t o :

L o emergency department is u i s - J a no easy job but doing so c k

H o r t

whilst staying open is even o n - S t harder. To celebrate this e p h e n incredible achievement, s The Princess Royal visited St Thomas’ Hospital to officially open the new Artwork in the children’s emergency department department. Matt Barker joined the royal party.

Emergency care transformed

The emergency department (A&E) at together emergency services in a single St Thomas’ Hospital is one of the busiest in area of the hospital. the NHS. It now takes just five minutes to admit It sees around 150,000 patients a year, patients instead of 30 minutes as the over 400 every day. That’s the equivalent admissions ward has been relocated from of filling Wembley and Arsenal’s Emirates the 9 th and 10 th floors to ground level – Stadium combined. making it easier for staff to transfer But in October, patients and return to the staff saw an emergency department. additional visitor “Now we have a facility Dr Katherine Henderson, come through the that means patients clinical lead for emergency doors who really benefit from a brighter, medicine at Guy’s and stood out from the St Thomas’, said: “I am crowd. more spacious incredibly proud of the new The Princess environment and our department and our Royal was there to staff will find it easier dedicated staff so it was a officially open the to deliver high quality real pleasure to show them new emergency both to The Princess Royal. department. care.” “The old department Her Royal was designed to see a Highness was given a tour of the maximum of 300 patients a day and we department and met staff who ensured it were treating an average of 380 patients a The Princess Royal met patients and staff in remained open as normal, 24 hours a day, day when the rebuild started. the emergency department while the redevelopment was carried out. “Now we have a facility that means She heard how the project has patients benefit from a brighter, more transformed patient care by creating a spacious environment and our staff will dedicated Emergency Floor that brings find it easier to deliver high quality care.”

12 the GiST IN FOCUS

Fast facts 24 hours in the emergency department • 190 patients are seen in our Urgent Care Centre, which deals with urgent minor illnesses and injuries • 160 patients are seen for serious issues or conditions • 70 paediatric patients are seen in the children’s emergency department • 100 ambulance arrivals • 100 emergency patients admitted to our hospitals, of whom 10 are children and young people

The Princess Royal had a tour of the new emergency department

Built by Logan Construction and for patients, especially children, so having designed by architects ADP, the new their own unit is very important. emergency department provides bigger “The art project and app are also great treatment cubicles, better infection opportunities for us to help create a more control and more privacy for patients and relaxed and fun environment.” their families. The Emergency Floor has delivered a It includes a dedicated children’s number of benefits for patients including emergency department and children’s a new 62-bed admission ward with short-stay unit – part of Evelina London ensuite facilities; new majors area with 25 Children’s Hospital – so our youngest treatment cubicles, a more efficient, open patients are treated in a separate area. layout and improved facilities for staff and A colourful design developed with art relatives. consultants, Art in Site, features a ‘family’ It includes an Urgent Care Centre of illustrated characters who act as where patients with less serious Anneke Biginton, matron of the emergency friendly guides around the hospital for conditions can be treated by GPs and department young patients. emergency nurse practitioners. The family also come to life in an There is also an improved resuscitation She said: “The design and artwork interactive app, playable on site, which area with larger treatment cubicles and make it feel so much calmer. It has had a helps to demystify the emergency dedicated trauma and isolation rooms. massive impact on patient experience, in process through interactive animations Artwork funded by Guy’s and an increasingly busy department. that explain clinical procedures, such as St Thomas’ Charity creates a welcoming “It was a very proud moment in my blood tests, injections, and pulse environment and helps patients navigate career to meet the Princess and I thought measurements. their way to the right area. she was lovely. She took time out to talk to Dr John Criddle, consultant Anneke Biginton is matron for the so many of the team which was great. paediatrician at Evelina London, said: emergency department and introduced “The staff work so hard and I’m really “Visiting an emergency department can be Her Royal Highness to staff involved in the proud of them because they make the a frightening and intimidating experience rebuild. department what it is.”

www.guysandstthomas.nhs.uk 13 THE INTERVIEW

You can't open a newspaper most weeks without reading about the latest immunotherapy wonder drug. Matt Barker met Professor James Spicer to find “Immunotherapy is out more. not a fad. It’s already completely revolutionised our standard care for cancer right across the NHS.”

Immunotherapy hype and hope James Spicer, professor of experimental cancer medicine and consultant in medical oncology

What is immunotherapy potentially benefit are expanding all the therapies in this area. Not to mention all Q and how does it work? time, with very recent results adding head the investment by charities and other and neck cancer and some types of breast grant-giving organisations. It’s a new concept for us in cancer to the list. cancer because treatments in the A If you’re the patient whose tumour How long have you been past have all been designed to kill cancer shrinks on immunotherapy then it can be involved in the field of cells directly. The aim here is completely Q life changing because these responses immunotherapy? different because it works by helping the can last for a very long time. That’s the patient’s own immune system recognise We’ve been running the trials unit case for about a fifth of patients. and attack the cancer cells. A at Guy’s Hospital for 12 years. Immunotherapies started to take off What cancers benefit from Is it an exciting time in about seven years ago and now a large Q this treatment? Q cancer medicine? proportion of the drugs in trials across the board are immunotherapies. Lung, melanoma (skin), kidney Totally, it’s transforming our and bladder cancer are some of A specialty. Around 50% of research A and development spend in the What is the future of the the earliest cancers to benefit from this treatment? still-new approach. Previously we haven’t pharmaceutical industry is now in cancer, Q had many good drugs for lung and bladder and pretty much all of that is focused on It seems to be a path of relentless cancers. The patient groups who can immunotherapy. That’s a huge amount of A progress. At the moment we’re effort globally going into advancing doing pretty well with a fifth of the patients

14 the GiST TRUST LIFE

Physio swims English Channel to honour brave patients P h o t o :

R y a n

S h o e s m i t h

Samantha Poulsen

A physiotherapist swam across the English Channel after being inspired by her cancer patients to raise money for Guy’s and St Thomas’ Charity. Samantha Poulsen, from Tower Hamlets in east London, completed the gruelling 21-mile swim from Dover to Cap Griz Nez in some diseases and if you’re one of in in 12 hours and 40 minutes. those then that’s great. Now we need to Thousands of jellyfish, busy shipping lanes, an injured shoulder extend that opportunity to a greater and a water temperature of around 17 degrees – 10 degrees proportion. cooler than an average swimming pool – were just some of the The immunotherapies which are obstacles she faced. generally available now are just the first The 27-year-old looks after patients on Blundell Ward at Guy’s wave. We’ve got a huge amount to do in Hospital, which specialises in caring for people who have had developing newer and better surgery for head and neck cancer. immunotherapy treatments and selecting She said: “I have never come across a more resilient and patients better for those treatments. We inspiring group of patients. I’m blown away by their determination are playing our part at Guy’s and on a daily basis so I couldn’t think of a better group of people to St Thomas’, with new immunotherapies fundraise for.” discovered in the King’s College London Samantha has raised more than £5,400 for Guy’s and labs – already in or moving towards the St Thomas’ Charity. The Charity funds big things and small clinic. touches that make the life-saving care at Guy’s and St Thomas’ Immunotherapy is not a fad. It’s already even better and helps patients and their families to feel really completely revolutionised our standard looked after. care for cancer right across the NHS. For more information about fundraising for Guy’s and St Thomas’ Charity, visit www.supportgstt.org.uk .

www.guysandstthomas.nhs.uk 15 TRUST LIFE

Sainab Jamal, senior practitioner and occupational therapist from the Enhanced Rapid Response and Supported Discharge Team in Lambeth tells Maxine Hoeksma what it's like on the frontline.

Rapid responder Sainab Jamal, senior practitioner and occupational therapist

It is easy to take things for granted until :00am – I’m on shift today and the problems and need up to four visits a day, you can’t do them. 11key worker for any new referrals. tailored to their needs. We work with What if you couldn't do everyday I’m the first point of contact for the social services to address these issues. activities like getting dressed or going to patient, their family and other health On this occasion I send a support the shops because you'd had a fall? professionals and I worker to help the patient Traditionally if someone can't cope at coordinate every aspect of get washed and dressed and home they end up in hospital. the patient’s care. This gives “Our service to carry out exercises to Now, thanks to the Enhanced Rapid our patients peace of mind. runs seven days rebuild strength. I also send Response and Supported Discharge Team, a week, 365 days a nurse to administer people in Lambeth get up to six weeks of :00noon – It can a year.” medication. intensive rehabilitation and support at 12sometimes take up home to help them back to independence. to three hours to do a :00pm – I’m off to see Our service runs seven days a week, comprehensive assessment in a new 3another patient, this time 365 days a year from 8am to 9.30pm. patient’s home to consider all of their as their occupational therapist. I assess We visit within two hours of referral by needs. I look at a range of things including whether a home adaptation will help the health professionals like a GP or hospital the way the patient moves around the patient to get washed and dressed therapist. home, any risks, their memory and how without help. It’s an integrated service which means they complete day-to-day tasks. different health and social care staff work I also check for pressure sores and do :00pm – I’m planning a staff training together to provide the best care for observations like blood pressure. Some 4session tomorrow for our diverse our patients. patients have complex medical and social team that includes therapists, a medical

16 the GiST TRUST LIFE

Eaton Square School’s A+ fundraising

Pupils from Eaton Square School

Eaton Square School in London has raised an amazing £200,000 for Evelina London Children’s Hospital in just two years. Their fundraising mission began in recognition of the care given to a teacher’s baby boy. Ellen Millar worked at the school when her son, William, was born. She and her husband Patrick spent over six months at Evelina London Children’s Hospital with William throughout his Sainab Jamal with occupational therapy student, Audrielle Asuncion short but very special life. Staff, pupils and their parents threw themselves into the fundraising task, holding consultant, nurses, pharmacists, support collections, and arranging events, from toy and workers and social workers. The team cake sales to a quiz night and even a rock reflects Lambeth – we have people from concert. all over the world who speak many They also sold their own handmade bracelets languages. I’m also training my new and designed and sold pencil cases. occupational therapy student, Audrielle Two students who did a sponsored haircut Asuncion, who is shadowing the team. raised £7,000, while a black tie masked gala for parents brought in an incredible £100,000. :00pm – A new referral from the Deputy Head of the school, Emily Peck, said: 5hospital discharge team has come in “All of the pupils, staff and parents have benefited so I’m off to see them. The patient has greatly from their association with Evelina been in hospital for two days and is well London. It has been a real privilege.” enough to go home with support. Fundraising at school is a fun way for pupils, staff and parents to support Evelina London. :00pm – It’s the end of my patient 7visits for today. I make sure the To find out more about how to get your school patients are safe at home with the right involved, visit www.supportevelina.org.uk , support and I leave a clear plan for the email [email protected] rest of the team for tomorrow. or call 020 7848 4701

www.guysandstthomas.nhs.uk 17 THE LEADING EDGE

Nzinga Cotton learns about a pioneering migraine treatment which is only available to NHS patients at Guy’s and St Thomas’.

Barrington Simner with sTMS device Barrington Simner with wife Frances and grandchildren Jamie and Alex

Pioneering treatment zaps migraines away Dr Anna Andreou

Doctors at Guy’s and St Thomas’ are responded well to previous medications painkillers I take and I am now able to using a portable handheld device that or need to avoid taking certain drugs volunteer and spend time gardening. The sends magnetic pulses to the brain to because they have another health treatment has been completely life treat and prevent migraines. condition. changing.” Migraines are severe headaches that Barrington Simner, 72, from Bromley in It is estimated that around 10 million are usually accompanied by additional south east London, has been using the adults in the UK are affected by the symptoms including nausea device for a year after condition. and vomiting, and sensitivity being referred to Guy’s and Dr Anna Andreou, director of headache to light and sound. “e treatment St Thomas’. research at the Headache Centre, said: The Headache Centre, has been Barrington, a retired “sTMS uses a magnet to send very small which is part of Guys and pharmacist, said: “I started electrical currents that stimulates cells in St Thomas' Pain completely life getting migraines in my the outer surface of the brain. This calms Management and changing.” early 50s. Over time they altered brain activity, which decreases the Neuromodulation Centre, is got progressively worse. At severity and frequency of migraines.” the only NHS service in the one point I was getting a She added: “sTMS has been around for UK that can provide the treatment, known migraine twice a week. They were more than 30 years as a treatment for as single pulse Transcranial Magnetic completely debilitating. migraines. Previously, the device could Stimulation (sTMS). “I would get an excruciating pain in my only be used in a hospital setting but now The innovative treatment involves right eye and I would have to spend the that it’s portable, patients can use it at placing the device, which looks like a day in bed. I became very hesitant about home or wherever is convenient. portable radio, at the back of the head for socialising in case I got an attack and I “What’s really great about the device is just a few seconds and pressing a button was dependent on my wife for support.” that the treatment is safe and non- to deliver a painless magnetic pulse into The grandfather added: “I tried lots of invasive. It has been completely life the skull. different powerful painkillers, but the side changing for many of our patients.” The device, which can be used up to effects made me feel drowsy. sTMS is the eight times a day, is prescribed to only treatment that has worked for me. migraine patients who have not “I’ve massively reduced the amount of

18 the GiST MY STORY

After Sofi Berrisford was told her aorta was at risk of rupturing, cardiac surgeon Mr Conal Austin carried out a pioneering procedure to repair it. Cara Lee finds out more.

Mending a broken heart Sofi Berrisford had the PEARS procedure at St Thomas’ Hospital The practitioner Mr Conal Austin The patient Sofi Berrisford

“Sofi was born with Marfan syndrome, a genetic disorder which “My Dad Jim has Marfan syndrome so there was a 50-50 affects connective tissues in the body. chance I’d have it. It can cause the aorta, the largest artery in the body, to stretch His was undiagnosed so his aorta ruptured aged 18 and he and gradually enlarge, risking a life-threatening rupture. subsequently needed three open-heart surgeries, and has to Once at a certain size, patients require open-heart surgery to take warfarin. replace or repair it. I have regular scans of my aorta. It has always grown In February Sofi was told her aorta had grown slowly so it was a shock when I was told it had grown to nearly 5cm in diameter – compared with around significantly. 2.5cm for a healthy aorta – and needed surgery. I always knew heart surgery was on the She was able to have a new procedure known cards but didn’t realise it would be so soon. as PEARS (personalised external aortic root Other people with Marfan syndrome had support), which involves fitting a personalised told me about PEARS and I researched it mesh sleeve over the enlarged aorta so it does online. I was told Mr Austin had carried out not get bigger. many cases so I made an appointment to Unlike conventional surgery, it can be carried see him. out while the heart is beating so a heart-lung He said I was suitable for the treatment and bypass machine, which has a low risk of stroke, is I was in hospital for about a week after having not needed. it. The care at St Thomas’ was incredible. The procedure is quicker and there is less I’d told Mr Austin I wanted a small scar so chance of needing to replace the valve on the he started the surgery in a slightly different affected part of the aorta. position than usual. Traditionally patients have a mechanical valve replacement and It’s such a small, neat scar and I couldn’t have asked for need to take the blood-thinning drug warfarin for life. more. It meant a lot that he took my views into account. Sofi had the procedure in July and since then has made a good My dad wishes the PEARS procedure had been around recovery. when he was younger. My parents liked Mr Austin because he Treating patients like Sofi in such an innovative, beneficial way had a good sense of humour which put us at ease. They is what makes my job so rewarding. knew I was in good hands. Since we started to offer the PEARS technique six years ago we Now I’m back at the University of Leeds where I’m have become one of the world’s biggest centres for the treatment. studying medicine. I have lots of experience of care and Many cardiothoracic surgeons still only offer conventional decided I wanted to be on the doctors’ side as well as being treatment but as patients like Sofi demonstrate, the PEARS a patient.” procedure has considerable advantages.”

www.guysandstthomas.nhs.uk 19 FOUNDATION TRUST LIFE Meet the governors: Why become a patient governor? Placida Ojinnaka , who has been a patient at Guy’s and St Thomas’ for ten years, explains why she stood for election.

Governors and members help to make embraces the diversity of the local Guy’s and St Thomas’ a successful NHS communities it serves.” foundation trust by ensuring we meet the She added: “Our NHS is 70 years old, needs and expectations of our patients. during which time healthcare has made The Council of Governors is made up of life-enhancing leaps and I want to be part eight patient, eight public, six staff and of this for the next 70 years. nine stakeholder governors. “If you think things can be done Placida Ojinnaka has been receiving differently to improve the quality of the treatment in the Lane Fox Respiratory Unit care you and others receive, get involved at St Thomas’ Hospital since 2008. and help to make a difference.” She chose to stand for election as a patient governor for the first time this year The governors are your elected to give something back for the care she representatives and are keen to hear has received and to share her experiences. your views. If you have a question, Placida said: “When I came in for my comment or idea please email first treatment the staff were friendly and [email protected] approachable, which helped to ease the or call 020 7188 7346 . anxious feeling of being in a new environment. To become a member “Being a person with a disability, I am call 0800 731 0319 , email Placida Ojinnaka interested in how the Trust ensures that [email protected] or visit people with disabilities receive fair and www.guysandstthomas.nhs.uk/ inclusive treatment, and how the Trust membership Members’ events Free health seminars have been providing our members with expert advice on key issues. Adeola Ogunlaja looks back at the last year.

One of the benefits of being a member of They also spoke about the hearing distinguished clinicians at the Trust. Guy’s and St Thomas’ is the opportunity to implant treatment options available at They always tell us not just about what is attend regular seminars on a range of Guy’s and St Thomas’, clinical research and possible in their fields now, but also about interesting health issues delivered by future developments. the medical innovation we can expect to experts in their field. Miss Pai said: “It was great to see so see and benefit from in the future. This year members found out about many members at the event – we are so Members really make the most of their hearing loss, sleep disorders, skin cancer glad the audience enjoyed it.” chance to ask questions too, and I have and cardiology. Around 100 people Member John Oliver said: “The seminar found the seminars fascinating and attended each event, which involved a Q&A was well organised and professional and valuable.” with our clinical staff. the Q&A was amazing – there were some During the hearing loss seminar, great questions raised and answered.” To see presentations members heard from Mr Harry Powell and The Trust is currently planning a from previous health seminars, Miss Irumee Pai, both consultant ear, nose programme of events for 2019. Details of please visit and throat and hearing implant surgeons. topics and how to reserve a place will be www.guysandstthomas.nhs.uk/ They explained how human hearing sent to members early next year. seminars works and discussed the types of hearing Devon Allison, lead governor, said: “It is a loss that occurs. real privilege to attend these seminars by

20 the GiST HISTORY CORNER

Ciorsdan Glass explores how Baron Ferdinand de ’s love for his wife led to the foundation of Evelina London Children’s Hospital. T R h e p e

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i v e . A hospital built with love

Evelina London Children’s Hospital cares maternity hospital in honour of his wife for thousands of children and young and child, but he was persuaded by his people every year, including in the friend Dr Arthur Farre, an obstetrician Celebrating community. and physician to the Queen, to open a The current building, which sits children’s hospital for the poor. 150 years of alongside St Thomas’ Hospital, was Children often ended up in the adult opened in 2005, but the hospital is wards of workhouse infirmaries. Evelina London actually nearly 150 years old. Following his friend’s advice, Dr Grenville Fox, consultant It was originally founded in 1869 on Ferdinand built the four-storey Evelina neonatologist, said: “It’s a great time Southwark Bridge Road by Baron Hospital for Sick Children south of the to celebrate the difference we have – in memory of River Thames. been able to make to the lives of his much loved wife, Evelina. It was described as having “the very countless families, thanks to this Ferdinand was born in Paris and latest design concepts”, “with no expense original act of benevolence. educated in Vienna, but on 7 June 1865, spared to make this a model hospital”. Our neonatal unit alone treats more he married Evelina de Rothschild – known In the first year, more than 300 than 1,000 babies a year with medical as Evy – at her parents’ house in children were admitted to the hospital’s advances that would have been , London. 30 beds. inconceivable in the late 1800s. Evy had been his childhood By 1900, bed numbers had doubled, Now co-located with specialist sweetheart, and from the start, it seems with over 1,000 admissions and more children’s services on the site of to have been a very happy marriage. than 20,000 children visiting the hospital St Thomas’ and directly linked to During their honeymoon, Evy wrote to each year. maternity services, we’ve been able to her parents that Ferdinand was “a dear Sir and Lord Fink, continue the legacy of Baron Ferdinand old duck” and she quickly became President of Evelina London, led the de Rothschild in a way in which we pregnant with their first child. campaign that made the current award- hope would make him proud.” However, Ferdinand and Evy’s winning hospital building possible. Evelina London will be celebrating happiness was tragically short-lived. Their More recently, the Eranda Rothschild its milestone 150 years throughout son was stillborn on 4 December 1866, Foundation has supported the new Fetal 2019 with opportunities for staff and and Evy died later the same day. Cardiology Unit by providing specialist supporters to get involved. To find out The shock for Ferdinand was intense heart scanners. more, please visit and he never remarried. Evelinalondon.nhs.uk/150years Originally, he had thought to open a

www.guysandstthomas.nhs.uk 21 FOUNDATION TRUST LIFE

Behind the scenes Anne-Marie Watts , head of sterile services at Guy’s and St Thomas’.

What does sterilised and returned to theatres. It Q your team do? sounds simple but it’s actually really We clean and sterilise all the complex – our technicians train for a A reusable instruments for minimum of two years to ensure the operations performed within the Trust. highest possible standards of quality Each type of procedure, including our and safety. Throughout the whole dental surgeries, has a different set of process we track each instrument instruments and our role is to process and can identify which patients it How do you and return these to the theatres so has been used with. Q do it all? Sterile services received some they can be used again for the next investment a few years ago operation. We have 130 staff Why is it A and we’ve transformed how we work. processing approximately 8 million Q important? It’s a critical service to the Trust. We now routinely turn instruments instruments a year for Guy’s and Without it our hospitals around in about eight hours, which is St Thomas’ and external contracts A wouldn’t be able to run for more than fantastic as it helps our operating take our total to 11 million a year. a day or two – if theatres don’t have theatres to run as efficiently as How does the equipment they need, our possible. We also run two services, Q it work? surgeons can’t operate. It’s also vital one at each hospital, so even if one Firstly, instrument sets are for infection control, giving our work a site goes down temporarily we have A cleaned in a giant dishwasher direct link to our patients, even capacity to keep going. Otherwise it before each piece of equipment is though the majority won’t know we’re would mean operations would need checked by a member of our team, down in the basement hard at work. to be cancelled.

From the suffers in the UK and 10,000 of them are in London. Sickle cell can cause ‘crisis’ episodes frontline of extreme pain and, in the past, it was common for sufferers to spend more Neill Westerdale , time in hospital than at home and we specialist sickle cell nurse had no specialist teams to support them. at Guy’s and St Thomas’. The condition can have a massive effect on people’s relationships and I have worked at Guy’s and St Thomas’ lifestyles and it’s common to have for 25 years and was the country’s first more than one sufferer in a family. clinical nurse specialist for sickle cell These days we have a dedicated based in a hospital. team of consultants, nurses and, As the original member of our sickle importantly, psychologists who help cell team at the Trust, I take a huge our patients cope physically and be done in two hours. amount of pride in saying how much mentally with what can be a very My job is extremely rewarding. I feel things have improved since I first debilitating disease. so lucky to be able to build these lasting started looking after these patients. Technology and treatment options relationships with my patients and their Sickle cell disease is an inherited have also improved. Full exchange relatives. condition which affects red blood cells, blood transfusions (replacing the I’ve treated some of them since they particularly in those with African or patient’s blood with donor blood), were babies and seeing them grow up, Caribbean backgrounds. which would have taken a two-day be able to manage their condition and There are around 15,000 sickle cell stay in hospital in the past, can now have families of their own is fantastic.

22 the GiST TRUST LIFE

What’s On Competition Until 16 June 2019 12 December Free exhibition: Carols by Candlelight Spanish Flu 7–8.15pm Florence Nightingale Museum St George’s Cathedral Call 020 7188 4400 or visit Lambeth Road SE1 6HR florence-nightingale.co.uk For tickets visit www.supportgstt.org.uk/carols Free Public Tours (weekly event) 1 December We have a pair of tickets to Kino Bermondsey Cinema. Florence Nightingale Museum World AIDS Day To be in with a chance of winning, simply complete the Mo n–Fri 3.30pm, 1–31 January wordsearch below. Sa t–Sun 11.30am Dry January and 3.30pm (alcohol awareness) A J P O C M B V W L V W Call 020 7188 4400 or visit 9/23 January D O O W Y L L O B X B C florence-nightingale.co.uk Friends of Guy’s and St Thomas’ Hospitals B Q P B O X O F F I C E 6 December book sale K V C R S Q C T C F R D Friends of Guy’s and 10a m–3pm St Thomas’ Hospitals Birdsong Corridor F T O B A F K C O I I G book sale and Christmas St Thomas’ Hospital Market S C R E E N B M M R T E 11a m–3pm 4 February Central Hall World Cancer Day E L N A S E U O E E I M St Thomas’ Hospital 7 February Q K E R I S S C D Y C P Time to Talk Day (mental health awareness) U R Y Y I L T M Y O K I E R A C S O E O A F E Q

Free film screenings: L W A S R O R R A C T H MediCinema ([email protected]) shows D L P T L X Z Y S D G Y the latest releases for patients and staff Guy’s Tuesdays, 1.30pm and Thursdays, 7pm Blockbuster Comedy Foyer Popcorn Sequel St Thomas’ Saturdays, 7pm and Tuesdays, 7.30pm Bollywood Critic Musical Romcom Ticket Evelina London screenings on Wednesdays, 6.30pm Boxoffice Director Oscar Screen Trailers

Free lunchtime concerts: Name Mondays 1–2pm, Central Hall, St Thomas’ Address Wednesdays 1–2pm, Atrium 1, Guy’s Telephone Raise money for your hospitals Email Send your entry by 11 January 2019 to the GiST competition, and community services Communications Department, 4th floor, Staircase C, South For all the latest news about Wing, St Thomas’ Hospital, Westminster Bridge Road, SE1 7EH; our amazing fundraisers and how you can support or you can email communications @gstt.nhs.uk . Guy’s, St Thomas’ and Evelina London, The winners will be selected at random and notified within follow @SupportGSTT seven days of the draw. The result will be final and we will not and like facebook.com/SupportGSTT enter into any correspondence regarding the competition and facebook.com/SupportEvelina winners. The prize is non-transferable.

www.guysandstthomas.nhs.uk 23 Think you need medical help right now? Call 111 You can help us help you get the right medical attention urgently. Our fully trained advisors are available 24 hours a day and can put you straight through to healthcare professionals.

Heidi Nielsen,

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