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Inside Story
Positive response for blood dispenser – page 2
AND
A new dawn for integrated medicine – pages 4 & 5
PLUS
Secret lives: ‘I swam The Channel!’ – page Inside Story is the UCLH staff magazine
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news
Blood on tap
Quicker, safer, cleaner and greener – a
new system launched at The Heart
Hospital brings supplies of donor blood
closer to the patients that need it.
Rather than keeping all supplies of
Karine Pearson, anaesthetic coordinator,
getting blood from the Hemosafe
blood off site, The Heart Hospital now
has an automatic system called a
Hemosafe where blood is dispensed
vending machine-style.
Jenny Berryman, blood transfusion
laboratory manager, said: “This will
completely transform the way we
access and use blood. The Hemosafe
will be stocked with all blood types and
because it is there on site, staff will be
able to take what they need without
worrying that they are requesting too
much or too little – this should mean
less wastage.
“As soon as the group and screen
sample testing is completed by the
laboratory and as long as the patient
has no antibodies, blood can be
dispensed by the fridge as needed.”
Only trained staff will be able to use it
and because the system is fully
automated there will be an audit trail
enabling the laboratory to see who has
taken it, when it was used and how
much was used. This will mean an end
to filling in paperwork and will free up
more time for staff to deliver patient
care.
Dr Daniel Farrar, consultant
anaesthetist and chair of the hospital
transfusion committee, said: “With the
Hemosafe there is no chance of picking
up the wrong bag of blood – this helps
us comply with regulatory requirements
and makes the transfusion process
safer for patients.”
The Hemosafe will also quarantine any
bags of blood that are returned to the
machine so that ‘old’ blood, or blood
kept out of the fridge greater than 30
minutes, cannot be used.
The Hemosafe is undergoing a pilot
trial at The Heart Hospital and if it is
successful it is planned to install the
remote issue blood fridges at all sites
across the Trust by next summer.
Stop the clots
Clinical staff are being asked to
help improve the safety of patients
by assessing the risk of venous
thromboembolism (VTE) and
ensuring appropriate measures
are taken for those at higher risk
of developing clots.
VTE is preventable but kills at
least 25,000 patients across
England every year. Reducing the
risk of VTE is top of the NHS
safety priorities for 2010/11.
All patients should undergo a VTE
risk-assessment on admission to
hospital, and this should be
recorded on the relevant section of
the patient’s drug chart. Patients
at increased risk of developing
VTE are given blood-thinning
injections of heparin and where
appropriate, a pair of compression
stockings to help blood flow
through the veins.
As the risk of clots can change
during the hospital stay, patients
should have the assessment
repeated after 24 hours and
regularly during the hospital stay.
Contact Us
The Trust VTE risk assessment
tool is available on Insight, copies
have been placed in all end-of-bed
folders and it is now available in a
credit card style for all clinical staff.
Dr Hannah Cohen, consultant
haematologist and chair of the
Trust haemostasis and thrombosis
committee, said: “Correct risk
assessment and VTE prophylaxis
could save thousands of lives
across the UK.”
Dr Robert Urquhart, divisional
clinical director clinical support, is
chairing a Trust VTE strategy
group.
Robert said: “Our monthly audits
of VTE risk assessments
demonstrate that we are making
progress. However, there is still a
lot of work to do to deliver on this
important patient safety target. It is
the responsibility of all clinical staff
to ensure that we implement all
the steps to minimise the
avoidable harm that VTE can
cause to our patients.”
Dr Hannah Cohen and Dr Robert Urquhart display the
tools available in preventing VTE
If you have any information you would like included in Inside Story, or on the Trust intranet site
Insight, contact: Communications Unit, 2nd Floor Central, 250 Euston Road, London NW1 2PG.
Email: [email protected], Tel: ext 9897, Fax: ext 9401.
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Front cover: Karine Pearson,
anaesthetic coordinator at The
Heart Hospital
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news
Preserving a moment in time
Photographs, patient stories, historical
documents and details of the latest research and
treatments available on the NHS were preserved
for centuries in a time capsule buried in the
depths of the UCLH Cancer Centre in a special
ceremony last month. The box was buried within
the structure of what will be an operating theatre
on the lower ground floor of the new
development, which is on schedule to open in
April 2012.
The cancer centre exhibition has been
updated to reflect the progress of both the
construction of the centre, and efforts to
improve the patient experience through new
ways of working. To arrange a viewing,
please contact Olivia Mulholland via email.
Charity partners including Macmillan Cancer Support represented by their
development manager Helen Liles (centre, flanked by chief executive Sir Robert
Naylor and Frank Dobson MP) buried a little bit of history about their organisations
which will be preserved for generations to come.
Dates for your diary
Chief executive roadshows:
The Annual Public Meeting is being held on 30
September in the Education Centre at 6pm.
The chief executive roadshows are taking place in
October.
All roadshows take place between 12 midday and
2pm. Check Insight for further details.
14 October
18 October
21 October
26 October
28 October
The Heart Hospital
NHNN and RLHIM
UCH, EGA, HTD and 250 Euston Road
UCH, EGA, HTD and 250 Euston Road
The Eastman Dental Hospital
Turbo booster aids recovery
Patients at UCH are the first in the
country to benefit from the latest laser
technology which unclogs leg arteries
in a matter of minutes.
Short bursts of laser energy blast the
obstructing tissue into microscopic
particles that are absorbed into the
bloodstream – restoring natural blood
flow and bringing rapid relief from
pain, without the need for complex
bypass surgery.
The ultraviolet light is transmitted
through flexible glass fibres which are
guided into place by a catheter which
is advanced through the blockage.
Excimer laser technology with Turbo
Elite® is highly effective for patients
who have developed total blockage of
Members of the multi-disciplinary endovascular team (MET) (l-r): Dr Joe Brookes, clinical director
for imaging and vascular services, Sean Fowler, senior radiographer, Babrah Mohammed, senior
radiographer, Alfred Tan, senior staff nurse, and Dr Julian Hague, imaging and consultant
radiologist.
arteries following previous angioplasty
or stent placement (a minimally
invasive technique to widen narrowed
arteries).
Dr Joe Brookes, vascular radiologist
and divisional clinical director for
imaging and vascular services, said:
“If patients develop a scarring reaction
following angioplasty or stent
placement, unwanted tissue can begin
to build up on the artery wall which
constricts them again. Obviously this
puts the patient at further risk.
“This latest procedure is a very simple
and effective way of vaporising the
tissue in a controlled way to get the
blood flowing freely again. UCH is the
only hospital in the country to offer this
procedure and several of our patients
have already benefited.”
Previously, the options available to
treat blockages in the pelvis and legs
were limited to further attempts at
angioplasty or stenting with
disappointing long-term results,
ultimately leading to bypass surgery.
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RLHIM focus
A new dawn for integrated medicine
This month marks a landmark in the
history of the Royal London
Homoeopathic Hospital with the
announcement that its name has
changed to better reflect the range of
services it provides.
The hospital will now be known as the
Royal London Hospital for Integrated
Medicine (RLHIM).
The change was recommended by
senior staff at the hospital and approved
by the UCLH board of directors.
For more than ten years the hospital has
explicitly focused on integrated medicine
and has long been the UK’s leading
centre for this approach. It is the largest
public sector centre for integrated
medicine in Europe.
For many years after its foundation in
1849 it was a general hospital including,
for instance operating theatres and
surgical wards, and a specialist
homeopathic department. From the
1980s the surgical and other
conventional specialities were replaced
by a wide range of complementary
medicine services including the NHS’s
first complementary cancer care,
acupuncture, musculoskeletal medicine
and herbal medicine services. Work
around the name change has been
supported by UCLH Charity.
Dr Peter Fisher, the hospital’s clinical
director, explains more.
1. What was the driving factor behind
the name change?
“Interest in our services is growing all
the time and our name change
reflects the integration of
complementary and conventional
disciplines.
“For several years, fewer than a
quarter of patients attending the
hospital have received homeopathy
only.
“The name change reflects the
hospital’s role in bringing together
safe, effective, high quality
complementary and conventional
medicine, emphasising the
importance of the doctor-patient
relationship and seeing patients as
active participants, making choices
about their healthcare and lifestyle.”
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Some members of the senior team at the RLHIM
2. Will you still continue to offer
homeopathy?
“We will continue to provide it as long
as patients choose it and it is
commissioned. Homeopathy is an
integral part of integrated medicine. At
present there is strong patient
demand for homeopathy and in an
era of patient choice we are providing
a service that meets that demand.”
3. What is integrated medicine?
“It means putting together the best of
complementary medicine and
conventional medicine to deliver the
best outcomes for patients.
“We work very closely with clinical
partners across UCLH to improve the
patient experience and clinical
outcomes.
“We have developed unique
integrated clinical services including:
an integrated pain service in
collaboration with the Eastman Dental
Hospital and National Hospital for
Neurology and Neurosurgery,
providing acupuncture, hypnotherapy,
homeopathy, and autogenic training
to complement conventional
pharmacological treatments.
“Among many examples of
innovation, the hospital introduced
acupuncture into the NHS as long ago
as 1977. Acupuncture is now
recommended by NICE for the
treatment of low back pain.”
4. What next for the RLHIM?
“We’re really excited about what the
future holds for our newly-named
hospital. We will continue to lead the
way in innovation for integrated
medicine and provide safe and
effective treatments for common,
problematic conditions. Among our
recent innovations are weight loss
and insomnia clinics.
“We have established group
acupuncture clinics, a cost-effective
way of providing acupuncture and set
up the NHS’s first musculo-skeletal
medicine service. The hospital has
among the highest positive patient
feedback scores in the NHS and we
are determined to build on this
success.”
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RLHIM focus
Cancer care – an integrated approach
An integrated approach to caring for those
with cancer appears to have speeded up
the recovery process for patients such as
Martyn Goldsmith. "The results have been
absolutely unbelievable – it has worked
beautifully," he said.
As well as conventional chemotherapy and
radiotherapy to treat cancer of the left tonsil
and lymph nodes, Mr Goldsmith benefited
from homeopathic medicine and
acupuncture at the RLHIM which
Martyn receiving acupuncture from Dr Santosh Patil, dental
dramatically reduced the unpleasant sideacupuncturist
effects he experienced, such as reduced
saliva and difficulty in swallowing.
rehabilitate from the side effects. We often
utilise complementary medicine alongside
He said: "I had about 20 fine hair-thin needles
conventional therapy to facilitate this."
placed on the edge of my ear, in my cheek and
index finger. I had an open mind about it – I just Martyn was referred to Dr Sosie Kassab,
wanted to get better as fast as possible.
director of the Complementary Cancer Service
which offers homeopathy, Iscador (mistletoe
"Following just a few acupuncture sessions
preparation), acupuncture, autogenic training,
there was a marked improvement. After a few
relaxation and visualisation, hypnotherapy,
weeks I was eating solids without difficulty!"
cognitive behavioural therapy, therapeutic
Western medical acupuncture is believed to
massage and aromatherapy, reflexology, reiki,
directly stimulate local nerves around the
art therapy and dietary advice.
salivary glands which improve the function of
Sosie said: "We aim to use complementary
the damaged tissue.
treatments safely and appropriately alongside
Consultant oncologist Dr Dawn Carnell, who
conventional management and guide patients
oversaw his chemoradiation treatment, said:
"Patients need great physical and psychological to sources of high quality information about
effectiveness and safety."
reserves to complete the treatment and then
Autogenic training – ‘it worked for me!’
Katherine with her daughter Thea
After previously suffering a series of
miscarriages, Katherine Small felt
the joy of being pregnant again was
completely overshadowed by
mounting anxiety.
She said: “I felt tearful and
exhausted and I was starting to
suffer from panic attacks and
sleeplessness.”
Mrs Small was referred by her GP to
the Autogenic Training clinic at the
RLHIM and within just a few weeks
her symptoms were back under
control.
She said: “I was amazed at how
quickly it worked. It helped me
literally switch off my anxiety – and
the physical symptoms receded
immediately. Autogenic Training
enabled me to regain the trust that
my body knew how to be healthy and
to bond with my unborn baby.”
Autogenic Training is a structured,
research-based meditative practice:
a sequence of simple mental
exercises which bring about
profound mental and physical
relaxation. The service is lead by Dr
Ann Bowden, a physician with a
strong interest in complementary
medicine.
Update your templates
To coincide with the name change, the Trust’s Use of Logos policy has been revised. New templates for use across the
Trust and within individual hospitals can be downloaded from the front page of Insight. All the templates have been
developed to include an updated ‘footer’ which must be used at the bottom of all Trust correspondence.
The logo policy describes the wording that should appear on our stationery, including letterheads, faxes, memos or
general Trust publications.
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our trust
Meet the new staff governors
Darielle Proctor speaks to UCLH’s new staff representatives
“Now is a good time in my career to give something back to the Trust and the people
who work for it” says Malcolm Barnicoat, the new staff governor for healthcare
assistants, support, scientific, therapeutic and technical. Having worked for the Trust
for 37 years Malcolm feels well placed to represent the views of his constituency. He
joined the microbiology department at UCH in 1973 and since then has worked at
several UCLH sites including a decade at the NHNN. During his time at UCLH
Malcolm has met a great number of people but he says that he is ‘looking forward to
getting to know those that he hasn’t yet rubbed shoulders with’. Outside of work
Malcolm has an active social life and enjoys travelling, the arts, food and wildlife.
Tom Hughes is passionate about improving services for patients and this he feels is
very closely linked with improved conditions for staff. Working in partnership with
Maureen Holas, HR manager, Tom is the new staff governor for the admin and clerical,
estates and ancillary constituency. Tom said: “I hope that working as a team with
Maureen we will be able to make a difference.” Tom has worked at the Trust for 21
years, across many sites and divisions, and feels that he has a good oversight of the
organisation and its workforce and can understand the
issues faced by staff.
Fion Bremner, a consultant in Ophthalmology, is the new staff governor for medical and
dental practitioners. He has worked at the Trust for ten years and thinks it is important that
clinicians are represented on the governing body. Fion works across the Trust with clinics at
Queen Square, UCH and the Hospital for Tropical Diseases and has a good oversight of the
organisation and its staff. Fion said: “I am keen to be involved with how the Trust develops at
a more strategic level, especially given the tough times ahead for the NHS.” Fion trained in
London and has spent his professional career delivering ‘cosmopolitan London medicine’
working at almost every teaching hospital in the capital.
QEP champions
Improvement leads are being recruited
to help transform our services as part of
the quality, efficiency and productivity
(QEP) programme.
They will be part of a Trust wide network
which will give staff support and training
in lean and project management skills.
Up to 50 staff from departments across
the organisation will undergo training
sessions and attend master classes led
by inspirational national speakers.
Attendees will be expected to bring a
project idea with them to work through
over the course of the programme, with
ongoing support.
Lisa Hollins, deputy director of service
transformation, and Donna ElliottRotgans, project manager, are leading
the initiative.
Donna, a former cardiac physiologist at
The Heart Hospital, said: “Frontline staff
6
health and part of the Improvement
are in an excellent position to see how
Network Steering Group, said the Lean
their working environments could be
skill set would ‘prove invaluable’ for the
improved but may not know how to
improvement leads.
bring their ideas to fruition, or
understand how to relate this back to
If you would like to join them please
savings. This project aims to address
contact Laura Alexander on ext 3269.
that.”
Clinical staff and those from corporate
James Anderson, head of operations for teams are particularly welcome.
specialist hospitals clinical board, said
the QEP challenge is to create
sustainable change for the
Simon Hack, quality manager for the stem
future. He added: ”Supporting
cell transplant programme, and nominee for
staff to lead improvement in
the Improvement Network welcomed the
their own departments is the
opportunity. He said: “It’s a good idea –
most successful way of making
much better to have people with local
changes that benefit patients
knowledge about their department or service
and services”.
rather than having to adopt changes from
Kara Gelb,
someone at arm’s length. I think the QEP
divisional
champions will come up with plenty of
manager for
ideas.”
women’s’
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our trust
A flexible approach to improving working lives
Many staff benefit from flexible working at UCLH – and it’s not just about going part-time or job sharing.
Often the arrangements are more informal ones to help someone balance work commitments with personal pressures. For
example, your manager might agree to you coming into work later one morning to give you time to settle your child into
school on their first day. Or perhaps you need to leave work a little earlier or swap a shift for a special occasion. A flight
delay and a last-minute request for an extra day’s holiday is another example of the flexible approach.
Your manager will consider each request on an individual basis – but providing a high quality to patients remains
paramount.
Husband-and-wife team Caroline and
Peter Thould both superintendent
therapy radiographers at UCH are
among those staff who are benefiting
from a more formal arrangement to
flexible working. With two pre-school
children (and another baby on the
way), splitting childcare and work
responsibilities has worked wonders.
Caroline works Mondays and
Tuesdays planning
treatments for patients.
Peter delivers the
treatments on the
following three days.
“It works brilliantly for
both of us,” said Caroline.
“The arrangement means
we don’t have to rely on
childcare. They seem to
thrive on the fact that one
of us is always at home
with them.
“We benefit in other ways too: we can
keep in the loop at work with
advances in technology, changing
techniques and equipment and stay in
close touch with all our colleagues.”
Peter agreed it offered ‘the best of
both worlds.’
Infection control focus on intravenous lines
results appear promising.
Dr Kaur said: “This has the potential to
have a huge impact on rates of
infection and the health of our patients.
In medicine there has been a general
consensus that central lines are a low
risk intervention. It is becoming clear,
that this is not always the case.
“We are taking it incredibly seriously.
The ultimate aim is to reduce the
number of patients contracting bloodborne infections such as MRSA. It’s all
about education and training.”
The project, driven by the
anaesthesia department,
begins with some
fundamental questions. Is a
central intravenous line
really necessary – or is a
smaller, temporary cannula
more appropriate? Have the
strict protocols been
followed to ensure safe and
sterile insertion? Can the
lines be removed sooner,
rather than later? Are there
Project team members Graham Fitzgerald, Annie Poland
and Dr Navkiran Kaur
signs of infection?
The anaesthesia department is
challenging the long-established view
about central intravenous lines as part
of the Trust’s drive to reduce infection
rates.
Dr Navkiran Kaur, locum consultant in
anaesthesia, Annie Poland, physician’s
assistant in anaesthesia, and Dr David
Walker, consultant anaesthetist, have
developed a new evidence-based
protocol, to encourage nursing and
anaesthetic staff to question
procedures at every stage. Early
Around ten patients a week have
already benefited since it was piloted a
few months ago: the number of lines
inserted has been reduced by 25%
with an increased uptake in alternative
lower risk interventions. It is hoped this
will reduce infection and improve
patient health.
A central intravenous line is most
commonly inserted via the neck veins
and guided to a position close to the
heart. It is often used for patients
requiring long term antibiotics or
nutrition. The anaesthetic team is
crucial in IV line management and
nurses play a key role in the project’s
success.
Annette Jeanes, director of infection
prevention and control said: “If we have
the processes in place and adhere to
them scrupulously we can prevent
infection. It is not just for patients, but
also has financial implications.
“We have to change the culture: the
behaviours, beliefs and attitude to the
way we all work.”
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the back page
Secret lives
If Dr Chrissie Thirlwell is having a tricky
day at work, drowning in paperwork
and clinic appointments, there is one
thought that steers her into calmer
waters: “I think ‘well at least I haven’t
been swimming in the cold sea for 19
hours’. That puts it all into perspective.”
After all, if you’ve overcome buffeting
waves, strong swells, seasickness and
28 miles of water stretching ahead,
then life as a specialist oncology
registrar is relatively straightforward.
Chrissie conquered the English
Channel with a black and pink onepiece, swim cap (complete with small
light bulbs), goggles, fierce
determination... and a tub of grease.
“I set off from Dover at 4.30am on a
beautiful September morning. It was a
poignant moment signalling to the
support crew that I was ready to start. I
thought: if I’m ever going to do it, today
is the day.”
For the next 19 hours and
18 minutes, Chrissie
swam through the
sunshine, into the fading
light and eventual
darkness. Her food was
thrown to her on a rope (‘I
felt like a seal’), which she
ate whilst treading water.
“I thought of my
grandparents and how I
wanted to make them feel
proud of me, and I thought
of the cancer patients I was raising
money for.”
There was a slightly troubling moment
when a German submarine popped up
through the waves behind her… but
Chrissie carried on swimming with
barely a backward glance.
She landed ashore in France at
1.30am: the 270th woman to have ever
completed the challenge. Her efforts
raised £7,000 for charity – including
Cancer Research UK.
Chrissie is a clinical lecturer in
medical oncology at the UCL
Institute of Cancer and a specialist
registrar at UCH.
The EDH Penfold postbox
Unbeknown to many staff is the
fact that the Eastman Dental
Hospital houses an iconic and rare
postbox in its courtyard area.
Denis Flower, a member of the
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Letter Box Study Group, has an
interest in Victorian postboxes and
was thrilled to discover that there
was a hexagonal Penfold postbox
at the EDH. Whilst in London for
the day he popped in to
take a photo.
Designed by architect John
Wornham Penfold the sixsided postbox was
produced between 1866
and 1878. In 1986 it was
proposed to install replica
Penfolds in heritage sites
where a modern design
might look out of place. The
Post Office gave its
authority to the idea and in
1988 a fully operational
prototype replica was
produced. The boxes
began appearing in 1989
and one was placed at the
EDH. There are now about
175 Penfolds, both original
and replica in the UK.
Denis assures us that even
he finds it hard to tell the
difference between an
original and a replica
without close examination!
Archives
The London Homoeopathic Hospital was
founded on 10th October 1849, becoming
‘Royal’ by consent of HM King George VI in
1947. It joined the NHS at its inception in
1948 and has been part of UCLH (see
pages 4 & 5).