I am a firm supporter of our values (safety, kindness, teamwork, improving). They are the cornerstones of our culture and help us deliver our vision of top-quality patient care, excellent education and world-class research.
Sometimes you are part of a team that may be bigger than you realise. A good example is the care we deliver for patients who need immediate treatment. The traditional way of thinking is that it is the job of our Emergency Department (ED) and acute medical wards to care for these patients.
I am very proud to see the vast amount of work that is done every day by those teams, sometimes under tremendously difficult circumstances and extreme pressures. We have a very resilient ED team that delivers fantastic care (with the highest ratings for patient satisfaction in London) and they are always looking at ways to improve. We have carried out major building work to extend the department and move the entrance to Gower Street, which opened in January. Improving is another of our values!
However, the number of very sick patients who come to UCLH every day is increasing and it is tough to adequately care for them all. Our ED can only flourish if all teams throughout UCLH pull together to make sure that patients are cared for on the right wards, at the right time. In this respect, we are one big team.
There are many ways we can work together better to benefit our acute patients. As you can see on page 14, our brand new electronic Coordination Centre will make things easier for us to plan and respond to the challenges of life in a busy hospital.
On a day-to-day basis we all have a role to play to free up beds for patients waiting to move out of our Acute Medical Unit and Intensive Care, so that these beds are available for new patients who need immediate care and attention. We need to discharge patients when they no longer need to be in a hospital bed and the majority of patients welcome the chance to go home.
We are all players in the team that cares for acute patients: let’s keep on living our values!
Marcel Levi, Chief Executive, UCLH
Healing broken smiles
Ieva Prieskentye’s smile looks incredibly natural. But, in fact, it is the result of years of painstaking dental treatment. Ieva is one of the hundreds of thousands of Britons who have hypodontia, a condition in which some teeth simply never grow.
Sometimes baby teeth don’t fall out – meaning they enter adulthood with rows of small, pointy, misshapen teeth. And if the baby teeth do fall out, adult teeth may not take their place – leaving them with big gaps.
In severe cases, someone may only have four or five teeth in their entire mouth. This can affect the ability to eat and speak – and have massive effect on self-confidence.
Priti Acharya, a consultant orthodontist, said: “The playground can be a cruel environment – especially in a world that is so driven by aesthetics and everyone has a smartphone with a camera on it.
“Patients tell us that they want to be able to eat and chew. They aren’t looking for a Hollywood smile, they are just looking to be normal.”
The hypodontia clinic at the Eastman Dental Hospital, which is part of UCLH, specialises in rebuilding such fractured smiles.
Orthodontists, restorative dentists, paediatric dentists and dental nurses work closely together to provide the highest standard of care.
Our orthodontists use braces to move the teeth the patient does have, closing gaps and creating a foundation to which implants, dentures and bridges can be added by our restorative dentists.
Prabhleen Anand, part of the paediatric team that treats patients up to the age of 16, said: “Some patients first attend the clinic when they are as young as seven and don’t complete their treatment until they are in their 20s.
“Some will be missing a lot of teeth, others just one or two, but each tooth means a lot to each child.”
Look at her now
When Sam Ahern was born 21 years ago, she was the smallest baby our neonatal unit had ever looked after. Now an accomplished musician and fine art student, she has gone back to meet the team that helped her win her fight for life.
Delivered 16 weeks early, Sam was barely bigger than her grandfather’s hand.
She weighed just 480g (a touch over 1lb) – less than half a bag of sugar and an eighth of the weight of the average healthy baby. Her lungs were so underdeveloped that she spent the first 15 months of her life in hospital.
Even when her parents were allowed to take her home, they had to take an oxygen cylinder with them whenever she went out in her pram.
Now, two decades later, Sam has returned to our neonatal unit, where many of the team that looked after her still work. This includes Judith Meek. Now a consultant paediatrician, she was a junior doctor in 1996.
Judith said: “I was present at Sam’s birth and helped care for her in the months afterwards.
“We just weren’t used to such exceptionally tiny babies 21 years ago. Even today, we only treat a handful of such very, very small babies a year. The next time I saw her, she was five years old, taking part in a fun run and beating a lot of the other children."
“For me, it was a real light bulb moment – the fact that you could be in hospital for over a year, go home on oxygen and yet run so beautifully.”
Despite that early success, Sam’s health was far from perfect as a child and she underwent a range of treatments, including speech therapy and physiotherapy. She also has autism, which is more common in very premature babies than in the general population.
Now a happy and confident 21-year-old, the fighting spirit she showed as a baby still shines through today. A talented guitarist and clarinettist, Sam has given talks to MPs, had two plays performed at a central London theatre and is making a documentary about our neonatal unit for her degree project.
Sam, who lives in north London, said: “My family still marvel at the fact that I was that small and still survived.
“And other people often say to me, how do you do so much?
“I tell them that I realised early on that many things are easier for others and so I have to stay two steps ahead to stop them from catching up with me.”
THE ROBOTIC REVOLUTION
We performed more than 500 robot-assisted operations on men with prostate cancer last year – making us the UK’s biggest robotic surgery centre. Find out how robotic surgery is giving men their lives back.
It looks like a giant spider, with a tangle of arms hovering over a patient as he lies on the operating table. But this piece of equipment is a life-saver.
The tiny instruments wielded by the robotic arms can cut out diseased tissue with more control, precision and flexibility than conventional surgery – reducing complications and enhancing recovery.
At University College Hospital at Westmoreland Street, part of UCLH, robotic surgery has been a game-changer in the treatment of prostate cancer.
Professor John Kelly, consultant urology surgeon and clinical lead, said: “Conventional prostatectomy – removal of the prostate – is a major procedure taking three to four hours and involving a two to three night stay in hospital and a lengthy recovery.
“Although it removes the cancerous tumour, patients are left with life-changing after-effects like incontinence and impotence which can be devastating.
“Robotic surgery has changed that – it gives us the precision to remove the cancerous tumour preserving the tissues and functions around it.
“It gives men their lives back.”
The surgeon “drives” the robot with his hands and feet from a control panel up to 8 feet from the operating table.
A camera mounted on one of the arms provides a high-definition 3D view of the prostate and the custom-built instruments are moved in ways impossible with the human wrist alone.
The incisions required to insert the instruments are small and the surgery is extremely precise.
As a result, patients can expect to leave hospital the day after their operation and be back to their day-to- day lives in a fortnight.
Last November, our annual total for robot-assisted prostectomies surpassed 500, a national milestone that made front page news in the Evening Standard.
Professor Kelly said: “None of this would have been possible without teamwork.
“Everyone from our team of consultants to our clinical nurse specialists, theatre scrub team and admin staff has played a huge role in the service’s success.
“Our growing expertise means we can treat the most complex cases and the outcomes for patients are getting better and better.”
Consultant urological surgeon Greg Shaw told the Standard: “We are at the start of this technology. It’s only going to get better.”
GIVING THE SPEECHLESS A VOICE
The work of our world-leading neuro-rehabilitation service was showcased in a recent BBC documentary, Speechless. Here we introduce you to patient Barry Lampert and his wife Lynda.
Around one in three stroke patients suffers aphasia, in which damage to the parts of the brain involved in speech leaves them struggling to understand others and to express themselves.
Barry Lampert is one of the 80 people who learn to speak again each year, with help from the highly-trained staff at the National Hospital for Neurology and Neurosurgery’s (NHNN) Neuro-rehabilitation Unit and aphasia outpatient clinic.
A gym-loving property landlord, Barry was just 55 when he had a stroke. His wife Lynda realised something was wrong when he didn’t come home one evening.
The next morning he was found slumped in his van at the side of the A1.
With vital brain tissue damaged by the stroke, Barry couldn’t walk or talk. Even something as seemingly simple as stirring a cup of tea was impossible.
Now, after six months of intensive rehabilitation at the NHNN, part of UCLH, he is back in his north London home.
He has learnt to walk again and can even climb stairs – albeit slowly. He can also feed himself using his left hand, if someone prepares his food.
Lynda said: “The team at the NHNN – the doctors, nurses, healthcare assistants, physiotherapists, speech therapists, occupational therapists, social workers, everyone – is exceptional.
“It is clearly not just a job for them – their commitment and dedication is phenomenal.”
But while Barry has made huge progress, every word is still a struggle and some topics and conversations are just too difficult to follow.
In the documentary Speechless, Lynda, 55, said: “Barry was always a real people person, full of life, a bit of a lad.
“But if he can’t fully understand what people are saying and can’t find the words to join in when he does, he must feel very lonely, very isolated at times.”
How UCLH inspired me to change my life
As an assistant producer on the documentary Speechless, Laura Sunnucks met some of the neurologists and speech and language therapists who help people with aphasia learn to speak again.
Laura was so moved by what she saw that she applied to join them and now works at the NHNN’s Neuro-rehabilitation Unit (NRU) as a speech and language therapy assistant.
Laura, 28, said: “Helping someone directly and being there for them when they may be at one of the most difficult points in their lives is a real privilege.”
Laura moved into TV after studying biology at university and first became interested in aphasia when working on a programme about political journalist Andrew Marr and his recovery from a stroke.
Her curiosity was further whetted when she joined Speechless as an assistant producer.
Now, her work ranges from admin to doing one-to- one language drills with aphasia patients and helping run support groups for their relatives.
Laura, who hopes to do a Masters in speech and language therapy, said: “Seeing the speech and language therapy team and the work that they do really made me think that there was something much more important that I could be doing with my life.
“I really look up to the speech and language therapists in the unit - to have that kind of career would be an amazing thing.”
A DAY IN MY LIFE
From maggots to malaria, holidaymakers can bring back all sorts of unwanted souvenirs. Senior nurse, Lucy Eastgate tells us how she sends tropical diseases packing.
My day starts at…
6.15am, courtesy of my 16-month-old baby Olive. We have a little chat – she’s such a cutie! I then take the train from the Buckinghamshire countryside to Euston.
On a typical day I…
Triage and treat patients who’ve returned from the tropics. Our walk-in emergency clinic at Mortimer Market sees around 3,600 patients a year. They might say “Oh gosh, I swam in the Nile”… or “I slept in the rainforest and now I have a strange rash”. We can request tests for malaria and get the results back within an hour. If it’s a positive, it’s a judgement call whether we admit or prescribe medication and monitor them closely as an outpatient. I also give travel vaccinations and antimalarial medication.
The best thing about my job is…
It’s endlessly fascinating. Our patients are a lot of fun to work with and many have been to places I’ve never heard of and are always interested and curious about their diagnosis.
Anything particularly tricky?…
One of our tasks is to remove parasites, including myiasis, a type of maggot that has grown under the skin. They have tiny hairs that grip onto the flesh and can put up quite a fight when we try to get them out! Some tropical diseases are not easy to identify but if you have strange symptoms after travel to the tropics you’ve come to the right place!
Words of advice…
Road safety (or lack of it) is the biggest risk when you travel – so don’t be too relaxed. And always wear flip flops on tropical beaches. They don’t just look pretty – they can protect you against cutaneous larva migrans, a parasite in dog poo that gets under the skin – literally.
How I became a travel medicine specialist…
I first became interested when I worked as a nurse in a high security prison and saw people with untreated tropical diseases. After studying tropical medicine, I worked in Cambodia, Uganda and Afghanistan in remote clinics.
I like walking, rock climbing, playing with Olive and geeky things like playing Scrabble with my lovely husband John.
HOSPITAL FOR TROPICAL DISEASES: THE FACTS
- It is the national referral centre for patients with infectious and tropical diseases such as malaria, dengue, typhoid and leprosy. It is also the home of the UCLH Infectious Diseases Service, covering a wide range of suspected or confirmed non-travel-related infections.
- Offers a 24-hour consultant-led emergency service.
- Provides travel advice and can dispense anti-malarial drugs and vaccines.
- Offers a specialist clinic for those travelling with diabetes, HIV, cancer or other complex health conditions.
- Sells mosquito nets, water treatments, health packs and other travel-related goods.
Better care at the touch of a screen
Our new Coordination Centre is the heart of UCLH. Based in a small room near the main hospital campus, it provides minute-by-minute updates on hospital life: which beds are available, how many patients are being admitted to and leaving the wards, what equipment is available, and where.
Like air traffic control, it allows our team to plan, manage and co-ordinate the constant arrivals and departures so we can give the best care possible to our patients. With just a quick tap of a computer screen, large electronic whiteboards display the facts.
The centre’s advanced technology, provided by TeleTracking, uses a real- time locating system wristband for patients at University College Hospital, the National Hospital for Neurology and Neurosurgery (NHNN) and the Elizabeth Garrett Anderson wing. When a person is discharged and their wristband is removed, the system immediately triggers a message to the bed cleaning team so that the bed can be quickly prepared for the next patient.
Dr Richard Cohen, clinical director for the Coordination Centre and operational excellence, said: “With more information available to us about our patients in terms of their progress and treatment, the care we provide can be quicker and safer and the health outcomes much better.
“As the system becomes fully embedded into UCLH life we’ll be able to concentrate even more on our vision to provide top-quality patient care. In time
we will be able to treat many more patients without needing to expand our current facilities.”
Porters are also booked through the system. Staff can see when a porter is on their way and when, for example, a task to move a patient has been completed.
Around 2,000 items of medical equipment have been tagged so it is quick and easy to check where they are located, to save staff time in looking for them.
So how is our brave new world?
The Coordination Centre is still in the very early stages, and like many major projects there are challenges, but already some of the benefits are being seen.
Kate Petts, deputy divisional manager at the NHNN, has responsibility for managing patient flow. She said: “It has been a big culture change but our teams are embracing it and we are beginning to see changes in the way we work.”
It’s also resulting in a calmer atmosphere on the wards because staff need to make fewer phone calls to arrange porters, cleaners or enquire about equipment. “It’s much quieter which is good for our patients,” said Kate.
The Coordination Centre programme (enabled by TeleTracking) is just one part of UCLH’snew digital strategy. UCLH is also working with Atos, our digital transformation partner, to improve our technology infrastructure and services, and Epic, the supplier of our electronic health record system (EHRS), to further improve patient safety, research and integrated care with external partners.
This photo shows a little girl undergoing dental work in the main treatment room at the Eastman Dental Clinic. The clinic opened in 1930 and was the brainchild of George Eastman, a philanthropist who made his fortune from the Eastman Kodak Company. He believed that all children should have access to free dental care – something he had not had as a child – and donated money for the foundation of a number of dental clinics.