It has of course been said before, but here, halfway through 2017, there has probably never been a more challenging time to work in the NHS. An ever increasing number of patients, limited capacity, complex diseases, insufficient social care and inadequate funding require the utmost determination, energy and creativity from all of us to be able to provide the best healthcare for our patients.
But it’s not all doom and gloom - there has never been a more fascinating time to work in medicine and health care, particularly at UCLH. Never before has the surge in biomedical knowledge been so steep. The number of serious, debilitating and, sometimes lethal, conditions that can now be treated with increasing success is endless. Some cancers, for which no treatment could be offered 10 years ago, can now be treated with simple pills. Virtually all patients with rheumatoid arthritis can be effectively treated and do not end up in a wheelchair. Deaf children can hear and speak after implantation of cochlear devices. Hepatitis C, a virus that destroys the liver, can now be successfully eradicated with a simple three-month course of medication without side-effects. It has been estimated that a baby born today has a 50 per cent chance of reaching an age of 100 years - due to advances in medicine.
The only way that we can adapt to all the changes in medicine and healthcare is innovation and adaptation. We need to change, however difficult that may be for all of us. We need to do things another way; we need to work with new colleagues, or other disciplines. We need to use computers, electronic ordering and prescribing and digital health records. We need to do things differently from the way that we have been doing them for decades. Change is the only way we will be able to address all the challenges imposed on us by modern healthcare. As effective communication is so important, it is the right time to change the way we communicate with our colleagues, patients and visitors, so I am very pleased to introduce you to this first issue of our new magazine which highlights just a handful of the great things going on at this fantastic organisation.
I have been chief executive of UCLH since January. It’s been a major life-changing event - coming from Amsterdam, where I spent more than 25 years in “my” hospital. My experience of the last six months has shown me just how much energy change can give you! So, my best advice is: keep moving, keep changing and enjoy all the fantastic mind-tickling and heart-warming things modern health care has to offer to our patients and our staff.
Marcel Levi Chief Executive, UCLH
How UCLH put taxi driver Robert on the road to happiness
When London cabbie Robert Stokes picked up a fare near Regent’s Park one September morning, he had no idea that his life was about to change.
Robert had struggled with his weight for 25 years; his passenger, Andrew Jenkinson, is a leading bariatric (weight loss) surgeon.
Today, Robert is more than 10 stone lighter. And the diabetes that had dogged him for years disappeared within hours of his gastric bypass op.
Robert’s weight started to creep up in his late 20s when he started studying to become a black cab driver.
Long hours, lack of fixed mealtimes and a sweet tooth all took their toll and his weight climbed from 15 to 26 stone.
He developed Type 2 diabetes, was permanently tired and took three tablets a day to keep his blood sugar under control.
Robert, 55, said:
“I had always been biggish but when I became a cabbie, my weight just spiralled out of control.
“I’d asked my GP a couple of times about surgery but been told the answer lay in diet and exercise.
“It is only now, when I feel so well, that I realise that I was in a right pickle.”
Everything changed when Robert got talking to Andrew Jenkinson, of the UCLH Bariatric Centre for Weight Management and Metabolic Surgery.
“He started talking to me about football and, being a gentleman, I started talking back.
“He asked what team I support and if I played myself and I explained that I used to but I was now too big to play.
“He explained that he was a bariatric surgeon and asked if I’d ever considered a gastric bypass.”
Robert, one of three UCLH patients featured in BBC documentary Obesity: How prejudiced is the NHS?, earlier this year, was put on a strict diet and exercise programme and shed eight stone.
Then, in January of this year, he had a gastric bypass, reducing his stomach to a pouch the size of an egg.
“I had a general anaesthetic and was kept in overnight. By the next morning, I felt as right as rain.
“And my diabetes had disappeared. I haven’t taken a diabetes tablet since.
“I now weigh 15 stone 5lb. I feel absolutely amazing – like a new person.
“I have to take vitamin and mineral supplements every day and there are some foods that I have to avoid but if I hadn’t had the operation, I would have got bigger and bigger and my health would have got worse and worse.”
Robert Stokes was one of three UCLH patients to feature in a BBC documentary about access to obesity surgery.
Its presenter, UCLH consultant Professor Rachel Batterham, explored whether “fat prejudice” within parts of the NHS is stopping patients from having potentially life-changing surgery, even when recent research supports it.
She said: “We need to increase awareness that obesity is a chronic serious medical condition similar to heart disease. It needs long-term management and weight loss surgery is the cost-effective solution.”
Bringing advanced cancer care closer to home
An advanced form of radiotherapy is coming to the UK and UCLH. We explore how proton beam therapy will change treatment for rare and complex cancers.
Proton beam therapy (PBT) is a form of radiotherapy used to treat certain complex and hard-to-treat cancers in children and adults. Currently, there are no high energy PBT centres in the UK, so when Stanley Blyth needed PBT, he had to travel to the USA with his family for treatment, funded by the NHS.
Since 2008 more than 1,000 patients have gone abroad for treatment. But it’s expensive, not everyone is well enough to travel and it can take time to arrange. It can also be hard to be without your family, friends and support network at what can be a very difficult time.
The government is investing £250 million to develop two PBT centres in the UK, one here at UCLH the other at The Christie in Manchester.
Lorraine, Stanley’s mum said:
“I think it is amazing and fantastic for children and adults to have a centre in London. It is much easier not having to pack up and leave when you need your friends and family nearby.”
Our centre will be in a new 11-storey building on Grafton Way, next to University College Hospital. The floors above will be home to Europe’s largest blood disorder treatment centre and a short stay surgical service. The centre will open in 2020.
So what is so different about PBT?
Like conventional radiotherapy, PBT releases energy that damages cells and causes them to die. The difference is how the energy is released: protons release energy in one big burst, X-rays (used for conventional radiotherapy) release energy more gradually. This difference means that protons can be targeted extremely precisely to damage a specific area of cells (like a cancer tumour) causing minimal damage to surrounding tissue.
Dr Yen-Ch’ing Chang clinical oncology consultant and lead for PBT at UCLH, says:
"For certain cancers, conventional radiotherapy is the most suitable treatment. But for complex cancers, for instance in the brain, spine or near reproductive organs, and particularly in children, teenagers and young people, PBT has some advantages. The physical properties of protons reduce damage to surrounding normal tissues. This can protect fertility, IQ or growth and reduces the risks of developing a secondary cancer or the need for life-long hormone replacements. It is extremely exciting that UCLH with The Christie is increasing access to this type of radiotherapy."
Building the centre is a significant engineering challenge. With five floors below ground, we are excavating to around 28 metres deep, 86 metres long and 63 metres wide, creating one of the largest holes in London.
This space will be used for four treatment areas, including the machines that deliver the treatment. Each machine will stand three storeys high and weigh 100 tonnes, while the cyclotron, which will generate the protons, is the size of a car, but weighs the same as a Boeing 747.
Kieran McDaid, Director of capital, estates and facilities said:
"This is high-tech, high-spec building at its best."
Meet Melissa, our award-winning doctor
Melissa Whitten was “touched and humbled” to be nominated by her patients for one of our Celebrating Excellence Awards earlier this year.
The annual ceremony honours the wonderful work of UCLH staff - but only one category is voted for by patients.
Melissa, a consultant obstetrician at the Elizabeth Garrett Anderson Wing, was a firm favourite of many new mothers. One described her as “one of the best I’ve ever encountered”. Another patient said Melissa had been “outstanding”.
Just a few months earlier, singer Paloma Faith praised Melissa for the care she gave her when she had her first child.
In a touching handwritten letter, the former judge for the TV talent show The Voice, also said that the “devotion, kindness and commitment” shown by our doctors, nurses and midwives had left her “humbled”.
Melissa, who undertakes complex deliveries, performs C-sections and runs clinics for women with difficult and high-risk pregnancies, is a firm believer in continuity of care.
This doesn’t just mean seeing one woman right through her pregnancy – it can also mean treating the same patient through several pregnancies.
She also makes the time to listen to her patients’ concerns and tries to keep life as normal as possible for the woman, no matter how high risk her pregnancy.
Melissa, who also teaches medical students at UCL, said:
“This award is all the more special because it came from patients.
“Being nominated by staff is a big thing in itself but for a patient to take the trouble to fill in a form and make a nomination is really humbling and touching.
“I am just one part of a team that spans the clinics, delivery suite and maternity ward and it is lovely to know that what we do makes such a difference.”
What the judges said:
“Dr Whitten has consistently gained superb feedback from mothers whom she supported during difficult pregnancies. She is consistently praised on social media by new mothers in glowing terms. Melissa is an outstanding role model and a credit to UCL and UCLH.”
THE MAGNIFICENT ELEVEN
The National Hospital for Neurology and Neurosurgery was the first UK centre to use Magnetic Resonance Imaging (MRI) during brain surgery. We go behind the scenes and meet the team that pioneered the use of this technology.
MEET THE TEAM
This team are about to carry out epilepsy surgery on a patient who suffers one to two seizures a week, despite medication. He was referred for surgery by epilepsy specialist Professor Ley Sander.
The procedure will involve removing an abnormally-formed piece of brain. The patient will go through the MRI scanner during the operation to check that the abnormality causing the seizures has been completely removed. Patients typically spend five to seven days in hospital. The chances of being seizure-free vary but in the best case scenario it can be as high as 70-80 per cent.
A DAY IN MY LIFE
Deborah Edgington is a senior play specialist at University College Hospital. Here she tells us about the job she loves.
My day starts at…
5.30am and I set off by 6.30am. I have a quick bowl of cereal because I don’t know when I’m going to get the chance to eat again. I don’t have a job where I can potter around while my computer warms up - I could be faced by an extremely upset child from the moment I walk onto the ward.
My job involves…
Helping children and young people up to the age of 18 through surgery. I use everything from bubbles to iPads to put them at ease - and even go down to theatre with them. Supporting parents is a big part of my job too - some of them will never have left their child before.
How I became a play specialist…
I was doing a degree in early childhood studies when a play specialist came in to talk to us and I realised that this was something I could do with a passion. I did four years as a general play specialist at another hospital. UCLH is one of the few places to have play specialists just dedicated to theatres and when a job came up in 2012, I jumped at the chance.
On a typical day I…
Start work at 7.30am when the first patients arrive. I play with them at their bedside and use a photo book and teddy bear with everything from a name band to a tube for the anaesthetic to talk them through their operation. Then, I go with them to theatre and use bubbles, breathing exercises and games such as Where’s Wally to distract them while they are having their anaesthetic. On a typical day, I support up to 10 children and their families.
The best thing about my job is…
Every day is so different – that’s the joy of it. I don’t dread Monday mornings – I actually look forward to coming into work!
The worst thing about my job is…
Seeing parents get upset when their child goes under anaesthetic. It still brings a lump to my throat when I see a dad cry.
Supporting parents is a big part of my job too - some of them will never have left their child before.
If I could do something else…
I sometimes wonder what it would be like to have an office job. I’d like to see what it’s like to be an accountant or something similar - although my concentration span is so short that I’m sure I’d be bored within half an hour.
I often go for a swim – it’s a good way of leaving work behind. I like eating out with friends but if I’m eating in, I’ll make something simple like pasta. Then I’ll watch a bit of TV before going to bed at 10.30pm because before you know it, it will be tomorrow again.
Coordinating better care
At UCLH we treat more than a million patients a year across 10 different sites.
Some patients come for planned procedures, others are emergencies or planned admissions that become emergencies – things can change every second.
Staff know when individual patients are being admitted or discharged but keeping track of the occupancy of 1,156 beds across UCLH is a huge logistical challenge.
Our new Coordination Centre Programme will make it quicker and easier to pinpoint everything from empty beds to spare wheelchairs.
Lorraine Walton, operations manager at University College Hospital, explained:
“We don’t have a complete picture of what is happening in real time, which can cause delays for patients and inefficient use of staff time. For example, clinical staff can spend precious time ringing around wards to find out if there’s a bed for a patient, or spend ages looking for an important piece of medical equipment, like an IV pump. The time we are spending doing this could be better spent on patient care. And it will be with the development of our new Coordination Centre Programme.”
Likened by Lorraine to an air traffic control system in a busy airport, our new Coordination Centre Programme will use tried and tested technology to provide a full “real time” picture of what’s happening at any one time. This will enable staff to spend more time caring for patients and less looking for equipment or trying to find beds.
“Understanding what things are looking like across UCLH will improve the patient experience and reduce delays – we will know at the swipe of a screen who’s waiting for a bed, where beds are available and where equipment is located. It will also help to prevent last-minute cancellations for patients coming to UCLH for planned procedures. Patient safety is our absolute priority so we have to ensure that there are recovery beds available for patients after their operation.
Our Programme will help us plan more effectively and reduce short notice cancellations due to lack of post-operative care beds.”
Craig Wood, operations manager at the National Hospital for Neurology and Neurosurgery, added:
“Real-time data will also help our support services work more effectively. The system will assign jobs like bed cleaning to the nearest cleaner who will be notified of where to go via a hand-held device.
The days of ringing and waiting for a porter or bed clean will be a thing of the past.”
The Coordination Centre Programme will be implemented in a phased roll-out with the first elements to go live in autumn 2017.
Student nurses from University College Hospital enjoy some sunshine and relaxation on the roof of their nurses’ home in 1955. Ten years later, the nurse fourth from the left was awarded an MBE for gallantry after she supervised the safe evacuation of patients from a ward in the Obstetric Hospital when a piece of the ceiling fell down - despite suffering from concussion herself after being hit on the head by falling masonry.
JOIN US ONLINE
As well as our official website we are using social media more and more to engage with our patients, staff, GPs and members of the public. We do this through a number of social media channels and it has shown to be a very useful way of engaging with people who use and provide our services.
Our website (www.uclh.nhs.uk) hosts our public-facing information for patients and visitors, GPs and the general public.
The website features news, contact and referral information about all UCLH services and consultants.
CHILDREN AND YOUNG PATIENTS' WEBSITE
Our children and young patients’ website (www.childrenandyoungpatients.uclh.nhs.uk) contains video guides that explain to young people what they can expect when coming to hospital.
We use our @uclh Twitter account to talk about what is happening across UCLH. It’s a great way of engaging with our patients, staff and over 15k “followers”. We tweet daily about news and upcoming events. http://www.twitter.com/uclh
Our Facebook page lets people know what is happening across our sites including any upcoming events and Facebook live events. It’s another great way of engaging with our patients, public and staff. http://www.facebook.com/UCLHNHS
The UCLH Instagram account contains photos and videos from events and campaigns around our hospitals as well as regular updates from our Arts and Heritage team – including some wonderful images from the archives. http://instagram.com/uclh
We have our own YouTube channel where we have videos about UCLH including self-help guides and information for patients with learning disabilities. http://www.youtube.com/UCLHvideo