The GiST, issue 37

Welcome

For 20 years Guy's and St Thomas' has been using robotic technology to help treat patients with different types of cancer.

Since introducing the da Vinci robot and recently a Versius robot – our expert surgeons have been able to carry out complex procedures without the need for open surgery, which can have huge benefits for the recovery of our patients.

Our magazine cover star is Professor Prokar Dasgupta who developed our pioneering robotic surgery programme, which is now the largest in the UK.

In this issue of the GiST, we look at some of the different types of life-saving surgery that takes place across the Trust.

The vaccination team at Guy's and St Thomas' has now delivered more than 860,000 COVID-19 vaccines. Read about this incredible team effort.

Our Community Rehabilitation and Falls Service has been helping older people to stay active during the pandemic. Read about the strength and balance classes.

It has been a year since Royal Brompton and Harefield hospitals became part of Guy's and St Thomas', coming together with a shared vision for excellence in heart and lung medicine and research. Find out how our surgical teams have been working together to help patients who need urgent cardiac surgery.

Harefield Hospital began its life as a country house and is now one of the world's biggest centres for heart and lung transplants. Read about its history.

I hope you enjoy this issue of the GiST.

Dr Ian Abbs, Chief Executive
Guy's and St Thomas' NHS Foundation Trust

Words and photos by Matthew Barker, Luke Blair, Sarah Clark, Kelly Cook, Nzinga Cotton, Clare Elliott, Maxine Hoeksma, Daisy Holden, Maxine Lenza, Lynne Nolan, Eloise Parfitt, Joe Parry, Anna Perman and Lesley Walker.

Cover photo by David Tett.

Design: AYA-Creative

Print: O'Sullivan Communications

Front cover: Professor Prokar Dasgupta, consultant urological surgeon

We are delighted that the GiST scooped the award for 'Best Corporate Publication – External' at the CorpComms Awards 2019, and a bronze award for 'Best Branded Content Publication' at the Corporate Content Awards 2020.

Photos within the magazine were taken at different stages of the COVID-19 response when guidance for personal protective equipment and social distancing varied.

If you have any comments about the magazine or suggestions for future articles, please contact the communications department, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, or email [email protected]

Visit the Guy's and St Thomas' website.

Round-up

Evelina London marked the completion of the outer frame of the new Children's Day Treatment Centre with a visit from Florence Eshalomi MP.

The construction milestone was celebrated with a 'topping out' ceremony on the roof of the new building, which is traditionally held to signify the completion of the building structure.

The MP for Vauxhall was joined by representatives from the project to hear about the benefits of the new building, and signed the steel framing.

The new 5-storey multi-use centre will house a family-friendly space with everything required for children's day surgery.

There will be 2 new operating theatres to treat an additional 2,300 children per year, helping to reduce waiting times for surgery. They will also wait less time on the day of surgery, as pre-surgery checks, recovery and preparation for going home can all be done in one place.

The centre will also showcase the latest equipment and child-focused technology to help families with all aspects of their care in a fun and engaging way.

Marian Ridley, Chief Executive of Evelina London, said: "This is an exciting milestone and part of our plans for a bigger and even better Evelina London. This purpose-built, stand-alone facility will transform the experience of day surgery and routine procedures for many of our children, young people and their families."

After nearly 5 years of planning, designing and building, the Royal Brompton Diagnostic Centre has opened its doors to patients.

Construction of the multi-million-pound purpose-built diagnostic centre began in January 2020.

The imaging facilities offered at Royal Brompton and Harefield hospitals provide leading edge services to help diagnose heart and lung disease.

The new diagnostic centre will help expand clinical services, improve patient experience and enhance research, education and training programmes for staff.

Imaging services provided from the new building include magnetic resonance imaging (MRI), computerised tomography (CT), ultrasound, echocardiogram, interventional radiology, transoesophageal echocardiogram, and bronchoscopy scanning.

Piers McCleery, director of strategy and corporate affairs and diagnostic centre programme director, said: "Part of our commitment to improving patient care involves providing the best facilities to deliver specialist heart and lung treatment, and research – and the new Royal Brompton Diagnostic Centre delivers on just that."

The echo and bronchoscopy clinical areas were the first to open with all clinical areas open to patients by Spring 2022.

A round-up of media coverage featuring Guy's and St Thomas'.

ITV News – Professor George du Toit, children's allergy consultant at Evelina London, was interviewed about 2 large peanut allergy trials – the Palisade and Artemis studies – and how these have transformed the lives of some participants. Evelina London patient Emily Pratt, who took part in the trial, explained how the drug Palforzia had changed her life. The story was covered nationally, including by ITV News.

Mail on Sunday – patient Julian Belsome shared his story with the Mail on Sunday of how he is now free from debilitating facial pain after pioneering surgery at Guy’s and St Thomas' helped him to get his life back on track. Julian was cured by a patch of Teflon implanted inside his brain to block the pain messages.

The Times – tests have been underway with an artificial intelligence-based system to see if it could help more quickly diagnose one of the most aggressive forms of breast cancer. Clinicians at Guy's and St Thomas' are working with researchers at King's College London and AI company Owkin to finalise and trial the new device, The Times reported.

An exercise programme could improve the success of chemotherapy treatment in cancer patients, according to results from a study by Guy's and St Thomas' researchers.

The research involved 40 oesophageal cancer patients who took part in a moderate exercise programme, receiving regular training sessions before and during their chemotherapy treatment.

These patients were compared with a group of similar patients.

Those who were part of the exercise programme showed a better response to chemotherapy. Their tumours were shown to shrink more, and were more likely to be 'down-graded' – assessed as being less advanced.

Moderate exercise also reduced some of the negative effects of chemotherapy on fitness.

The study was led by Mr Andrew Davies, a consultant in upper gastro-intestinal surgery at Guy's and St Thomas'.

He said: "This is a small study, but a promising one, as it shows how a moderate exercise programme could help to improve the success of chemotherapy treatment.

"We want to confirm this effect in further studies, but this may benefit patients with other types of cancer and be a cost-effective way to improve the effectiveness of treatment."

We love to hear from our patients, staff and supporters so join the conversation by following us on Facebook, Twitter, LinkedIn and YouTube.

Reena Joseph (letter) I found this rare photograph taken in the East Wing theatres nurse's coffee room at St Thomas’ Hospital in 1976. I am sitting in the centre in my sisters' uniform with theatre nurses in traditional 'greens'. Many staff and patients will remember the uniforms.

@vickeegan (from Twitter) @GSTTnhs Lost for words for the treatment and care I received this week at St Thomas’ hospital after a heavy cold morphed into “community pneumonia”. Thank you all so much. How you do it in such circumstances is almost beyond me.

@soophiecostello (from Twitter) 18 years ago today my mum donated a kidney to me. It was 2004, I was 15 and I still have the fondest memories of all the staff at @GSTTnhs and @EvelinaLondon. Forever grateful to everyone involved in my care back then and

@MissDFoster (from Twitter) Absolutely incredible care from @RBandH for my heart procedure. From the lovely receptionist, ward and recovery nurses, pacing team, surgeon & anaesthetist…to the choice of food! Honestly could not be more grateful and thankful See you in 3 years!

A woman who waited 25 years for a diagnosis of her rare genetic disorder is urging other people not to give up hope when their condition is unknown.

Lauren Elvy, from Rainham in Kent, was a year old when her parents noticed that she wasn't hitting her developmental milestones. She developed multiple medical problems over the years but doctors were unable to confirm her diagnosis.

The 26-year-old, along with her parents David and Lee, signed up at Guy's and St Thomas' to the 100,000 Genomes Project.

The national project was set up in 2013 by Genomics England and involved sequencing 100,000 genomes from people who have a rare disease or cancer. Your genome is your body's instruction manual. It is made up of DNA and there is a copy in almost every cell.

Sequencing of Lauren’s genome and further research revealed that she has CDG – Congenital Disorders of Glycosylation – a large group of rare inherited diseases.

Lauren said: "I feel like I belong somewhere now and I've been able to talk to people with the same condition. It’s something I'd always wanted to know and I hope other people who don't yet have a diagnosis for their condition don’t give up hope."

Dr Rachel Jones, a consultant in clinical genetics and clinical scientist at Guy's and St Thomas', said: "The introduction of whole genome sequencing means we will be able to help many more families find their diagnosis, without waiting as long as Lauren."

2 members of staff from Guy's and St Thomas' were recognised in the New Year Honours list.

Professor Shakeel Qureshi was made a Knight Bachelor for his services to paediatric cardiology and charity.

He is a globally respected consultant paediatric cardiologist at Evelina London Children's Hospital who co-invented the Tyshak balloon catheter which is now used worldwide.

It allows many children and adults to have their heart defect treated without open heart surgery.

Professor Qureshi said: "To have somebody appreciate your work, values and contributions is an amazing feeling, especially when I look back at where I started."

Vanda Fairchild was made an MBE (Member of the Order of the British Empire) for her services to the NHS and to women's martial arts.

She retired from Guy's and St Thomas' in 2021 having been a nurse for 37 years, and had worked in the Trust's transplant, renal and urology team

A Guy's and St Thomas' clinical neuroscientist has been awarded a prestigious research fellowship to improve treatment for facial pain disorders.

The fellowship will see Dr Anna Andreou receive around £300,000 funding from the Medical Research Foundation, to investigate the effectiveness of a new botox like molecule called BITOX to treat headaches and migraines.

Dr Andreou, lead for headache research at Guy's and St Thomas', said: "Chronic facial pain disorders can have a considerable impact on quality of life for patients and their families. However, a lack of awareness and research funding means there are very few studies which have explored long-term treatment options.

"My fellowship offers an opportunity to develop a new treatment for these types of conditions by investigating whether a new botox like molecule called BITOX is an effective treatment. Unlike botox, BITOX doesn't cause any facial paralysis and can potentially be given in larger doses."

Spotlight

Daisy Holden finds out how a new service at St Thomas' Hospital is helping to treat vulnerable patients with COVID-19.

Ann was one of the first patients to benefit from a new specialist service at St Thomas' Hospital after testing positive for COVID-19.

COVID Medicine Delivery Units – also called a CMDU – were set up across the country in December 2021 to offer life-saving treatments to people at high risk of their condition getting worse, reducing the need for them to be admitted to hospital.

4 treatments are currently available for vulnerable patients – either taken at home as a course of antiviral tablets, or given at the unit as an infusion by a drip into the arm.
Ann has an underlying health condition so was referred to the CMDU where she received an infusion.

Retired dentist, Ann, said: "This was the first time I had caught COVID-19. I'm triple vaccinated but it was still a worrying time for me and my family due to our health conditions. Being able to have a new treatment to reduce the severity of my symptoms and to keep me out of hospital has been very reassuring.

"The staff were really kind and efficient, monitoring me over the course of a few hours as I had the treatment, until I was ready to go back home."

After having a treatment, patients receive a follow-up call each day for 14 days.

Dr Anna Goodman, clinical lead for the service, said: "These treatments are a great help for people with underlying conditions, who are not able to respond to vaccines as well as others. Like other units around the country, our CMDU has been exceptionally busy working every day since it opened – apart from Christmas Day and New Year's Day.

"We're delighted that all of the patients we've treated over the past few months have avoided a hospital admission, and made a good recovery at home."

Patients who are eligible include those with genetic disorders, cancers, immune deficiencies or inflammatory conditions, renal or liver disease, neuro disabilities, or who are a transplant recipient.

The service at St Thomas' treats people in south east London who are within 7 days of a positive COVID-19 test.

It is available to those over the age of 12, with Evelina London Children's Hospital looking after any younger patients.

To make sure patients feel safe coming into hospital and to avoid them coming into contact with others, a designated patient transport service has been set up to bring people directly into the CMDU.

Daghni Rajasingam, deputy medical director, said: "Getting the CMDU set up in only a matter of days was thanks to the hard work and dedication of our staff. It was a huge team effort – colleagues from across the Trust came together quickly to enable us to provide this vital support for our local community."

Fast facts

Between December 2021 and February 2022:

  • 307 patients treated with antiviral tablets
  • 35 patients treated with infusions

Royal Brompton Hospital has set up a new service specifically for women with cystic fibrosis who are pregnant. Maxine Lenza investigates.

Emilia Hunt was diagnosed with cystic fibrosis when she was just 8 months old.

The condition causes sticky mucus to build up in the lungs and digestive system, which can cause breathing problems and increases the risk of lung infections.

There's no cure for cystic fibrosis, but a range of treatments can help control the symptoms, prevent or reduce complications, and make the condition easier to live with.

After a long period of ill health, Emilia married her husband Harrison in 2012, and the couple were trying to conceive for almost 10 years.

Within weeks of starting the drug Kaftrio, made available to patients in the UK in 2020, Emilia had a positive pregnancy result and joined the cystic fibrosis maternal health clinic at Royal Brompton Hospital.

The service was created due to the rise in the number of pregnancies in women with cystic fibrosis linked to the availability of the new medication.

In the last year, 44 women have become pregnant and are now cared for in the clinic – previously, the hospital only saw around 7 pregnancies each year.

Emilia, 30, said: "I had always wanted children and I found out I was pregnant on Boxing Day – what a gift. My pregnancy was totally textbook, and Jesse was healthy and thriving when he was born."

The new clinic is the first of its kind and involves a team of specialists, including consultants, psychologists, nurses, dietitians, pharmacists, physiotherapists, and clinical genetic counsellors, who meet virtually with the pregnant women.

This can take the form of group meetings, such as exercise classes, or one-to-ones for more personalised advice on having a healthy pregnancy.

Emilia said: "The clinics worked really well and it was lovely meeting other new mums in the same position as me as we could share advice and compare notes. I can't thank the team at Royal Brompton enough for ensuring I was able to have thedelivery I wanted near to home."

Specialists from the clinic work in partnership with the patient's local midwifery team, to provide all-round care from conception right through to delivery and after the baby is born.

Dr Imogen Felton, a consultant in adult cystic fibrosis and respiratory medicine at Royal Brompton, said: "The rise in pregnancies we are seeing appears to be an unexpected side-effect of Kaftrio. This new medicine stops the build-up of sticky mucus in the organs that causes many of the symptoms of cystic fibrosis."

Dr Felton and her team are now in the process of writing guidelines for other healthcare professionals on how to care for pregnant women with cystic fibrosis.

Fast facts

  • Royal Brompton has around 600 adult cystic fibrosis patients from across the UK, making it one of the largest centres in Europe
  • 17 women have given birth since the launch of the cystic fibrosis maternal health clinics

In focus

Joe Parry meets members of the team who have helped to give among the highest numbers of vaccinations by any NHS trust in the country.

Guy's and St Thomas' began delivering the COVID-19 vaccination in December 2020, giving protection against the virus, as well as hope, to thousands across south east London.

A huge team effort has seen the Trust deliver among the highest number of vaccinations by any NHS trust in the country.

At the time of writing, Guy's and St Thomas' had given more than 860,000 vaccines against COVID-19.

Central to this has been the many vaccinators who joined the Trust, including Stephen May, who signed up after being made redundant.

Stephen said: "I'd worked in the cabin crew of British Airways for 22 years but everything changed when the pandemic hit. I lost my job because of COVID-19 but I managed to turn it into something positive by going to the frontline to become a vaccinator."

Stephen was surprised to find out how many of the skills he developed in his former job were relevant in his new role.

He said: "Being a vaccinator is the perfect job for someone who has worked in cabin crew. Communicating clearly, reassuring people, acting calmly, being able to explain things to different people are things I did as a vaccinator and also did on an aircraft."

He added: "I have also been part of a team that went into schools and pharmacies, as well as visiting homeless people in the local community to give them the jab."

Stephen has since moved on to a new role within the Trust as a patient access coordinator. He said: "I've been able to bring everything I learnt as a vaccinator into my new role. It was such an exciting thing to be a part of."

Tahira Saddique is a senior nurse who has worked at the Trust since 2016. She was redeployed to work in the vaccination team at the beginning of the vaccine rollout.

She said: "When I was asked to work in the vaccination team I was extremely happy as I wanted to make a difference. The feedback from patients, particularly when we first started vaccinating, has been overwhelming. Knowing they felt protected and safe to go about their lives has been so lovely."

Tahira added: "Helping anxious people is a huge part of the job. We've seen some who have been needle phobic their whole lives who we've helped to overcome their fears and go on to become fully vaccinated against COVID-19.

"As a nurse, the small differences that you can make to someone's life are the things that make you proud to do what you do.

"Since I started working in the team, I can't tell you a day that I've not woken up happy to come in to work. The team here are so dedicated and hardworking. I genuinely believe the best of the best are part of Guy's and St Thomas' vaccination programme."

Jo Turville, director of operations for the vaccine programme, said: "Mass vaccination has undoubtedly been key to us managing the response to the COVID-19 pandemic and allowing us to regain our much cherished freedoms. Leading the vaccination service for the last 14 months has been the most rewarding experience of my career to date.

"The challenges have been truly beyond anything any of us would ever have dreamed possible. The people who have worked in the team are phenomenal. Our new recruits have come from different backgrounds to join our own NHS staff and have conquered all kinds of adversity.

"It hasn't all been about volume either. Some of the most enriching work has been serving our local population, like going out to the homeless community or to schools within south east London to vaccinate as many people as quickly and safely as possible."

Fast Facts

  • at their peak, the vaccination team delivered more than 7,500 vaccines per day
  • Guy's and St Thomas' opened 7 vaccination pods across its sites to meet demand
  • since the start of the vaccination programme, the Trust has recruited and trained more than 1,200 vaccinators

Daisy Holden speaks to patients who have benefited from life-saving critical care after getting COVID-19.

Since the beginning of the pandemic, hundreds of staff have sprung into action to help respond to the demands of COVID-19.

Across the Trust, many staff were redeployed to help care for some of the sickest patients in critical care.

Professor Nick Hart, joint clinical director of adult critical care at Guy's and St Thomas', said: "The way staff responded was exceptional, they showed immense bravery in stepping up to a new and unprecedented challenge to make sure we could keep delivering the very best care to our patients.

"More than 1,300 people with COVID-19 have been treated in critical care across our hospitals since September 2020, and it's incredibly heart-warming to hear the stories of patients who have made good recoveries and returned home to their families."

Mike's story

Mike Bainbridge tested positive for COVID-19 in April 2021 after losing his sense of taste and smell.

The 45-year-old started suffering from flu-like symptoms at home, but his condition deteriorated after a week of being unwell.

Mike was taken to the emergency department (A&E) at St Thomas' Hospital and transferred to the intensive care unit, where he was ventilated and put on an EMCO (Extracorporeal Membrane Oxygenation) life support machine to keep his heart and lungs working.

Mike said: "My memory is quite fuzzy of being in St Thomas' – but all of the staff were amazing, I owe them my life. What they do on a daily basis is incredible, such a selfless approach to caring for another person during a pandemic."

After spending more than 2 weeks in hospital, Mike went on to make a full recovery at home with his wife in south London.

Charles' story

Charles tested positive for COVID-19 a week before Christmas 2020 and was transferred to Harefield Hospital to receive specialist care.

Due to his severe respiratory failure, the 57-year-old was put into a coma and mechanically ventilated to help him to breathe. Thankfully, he woke up at the end of January and was able to go home to his wife and three daughters in February 2021.

Charles said: "If miracles exist, then everyone at Harefield is performing them. I have never experienced such care and empathy before – we weren't just numbers to them, the staff treated us like we were family."

He added: "Everyone was just amazing and showed so much professionalism and commitment. The physiotherapists went above and beyond to get me out of bed and learn to start walking again, they helped me find my inner strength.

"I am also very grateful to the staff for speaking to my family and keeping them updated while I was under their care. This hospital is a perfect example of everything good about the NHS."

Fast facts

Across the Trust, between September 2020 and February 2022:

  • 1,311 people with COVID-19 were admitted to critical care
  • 302 people required care using an ECMO machine, which takes over the work of their heart and lungs
  • the Intensive Care National Audit and Research Centre shows that Guy's and St Thomas' has the best COVID-19 critical care survival rates in the country 

Guy's and St Thomas' has launched an ICU Survivorship Project to help support the recovery of patients who have received life-saving intensive care treatment.

It has been developed to transform the ways patients are informed, supported and rehabilitated as they move from the intensive care unit, to the ward and back home.

It combines a specially developed app which patients and care teams have access to, as well as the help of a specialist occupational therapist who takes on the role of ICU recovery coordinator.

The project aims to build a greater understanding of the recovery from critical illness, including COVID-19, and has been made possible thanks to donations to Guy's & St Thomas' Charity.

Kate Brooks, the Trust's first ICU recovery coordinator for the digital recovery pathway, said: "I assess and manage the needs of the individual patient by providing specialist input or supporting with onward referrals and appointments. Through the digital platform, I can provide patients with the tools they need to regain their independence and return to their everyday life."

More than 50 patients have taken part in the project, including Paul Heasman, who suffered multiple cardiac arrests in May 2021 and was in St Thomas' Hospital for 7 weeks.

The 58-year-old said: "It has been a comfort to know that someone is there to help with my recovery. Kate's going through the journey with me and understands physically and mentally what I've gone through and how best to help me."

Lesley Walker meets the first UK patient to have a new type of heart stent fitted, and the surgeon who developed it.

Clive Robinson was the first patient in the UK to benefit from a new technique developed at Guy's and St Thomas' for people with a complex hole in the heart.

Since Clive had the new type of heart stent fitted, the innovative procedure has been used on more than 35 people, which meant they could avoid open heart surgery and recover more quickly.

A stent is a metal mesh which is sometimes covered. Once inside the body it can be expanded to fit the patient and, in this case, close the hole.

Cardiologists at Guy's and St Thomas' are now using a specially designed tube-shaped stent that is custom made.

It has been used for patients who have the congenital heart condition sinus venosus atrial septal defect (SVASD) and partial anomalous pulmonary venous drainage (PAPVD).

This causes breathlessness and palpitations which can lead to an irregular heartbeat and life-threatening clots in the heart. Previously, the only treatment available was open heart surgery.

Guy's and St Thomas' is the largest centre worldwide undertaking this procedure with custom-made stents, and the only unit in the UK doing it.

Professor Eric Rosenthal, a consultant paediatric and adult congenital cardiologist from Evelina London Children’s Hospital, spent 2 years developing and getting approval for the technique, which had only been used once before in India.

For the first time in the UK, the 4-hour procedure was carried out on Clive in March 2016.

Since then, the 66-year-old has had annual checks which have shown his heart to be in good shape and he has been able to enjoy an active life.

Clive, from Ashtead in Surrey, said: "Before I met Eric, I was facing open heart surgery with all that entails plus months of rest and recuperation. This meant no driving and certainly no golf for many months.

"With Eric’s new method I was in hospital for a few nights to allow the incision to start to heal and had no pain. Within a short period of time I felt a surge of energy and was stronger, fitter and was sleeping better. It's amazing."

Professor Rosenthal's new technique was made possible with a 3D print out of Clive's heart thanks to support from Guy's & St Thomas' Charity and the medical physics team.

He said: "We normally look at X-rays, scans and other 2D images but it was only after printing the heart in 3D that the penny really dropped. We were extremely happy with the outcome – as was Clive – and we began to offer it to more patients with the condition."

Nick Byrne works with a small team of experts in the wider medical physics department to create 3D models from scans of the body.

These 3D models allow clinicians to explore the individualities of each patient and to practice new or unusual techniques before they undertake very complex procedures.

It takes about 4 hours for Nick and his colleagues to manually transfer data from a series of patient scans – such as CT scans – to create a digital 3D model. This makes the information in these scans more accessible and understandable.

Clinicians then use the models to try out new procedures, such as the stent in the case of Professor Rosenthal and Clive, to see if they would fit and work.

In some cases, there are some real physical challenges to discover, such as to work out if a parent's transplanted kidney would fit inside a child.

The medical physics team began work on this in 2016 with funding from Guy's & St Thomas' Charity, and since then have produced hundreds of digital and physical models for departments throughout the Trust.

Nick said: "We're always looking at innovative ways to support our services to make best use of their scan data.

"As we work across the Trust, we can help a diverse range of specialties to meet the challenge of image interpretation, capturing the expert's understanding in a 3D model that is accessible and understandable to all."

Maxine Hoeksma finds out how strength and balance classes have been helping older people to stay active.

Retired couple Marilyn and John Davis feel fortunate that they have been able to keep fit and well, despite the lockdowns and COVID-19 restrictions.

The pair credit Guy's and St Thomas' community-based strength and balance classes for playing an important role in keeping them active and positive, especially at times when it was not possible to see family and friends.

Having fallen and fractured her right arm twice, Marilyn began face-to-face classes at the Fire Station in West Norwood in September 2019.

When the classes moved online during the pandemic, she encouraged 74-year-old John, who has muscle ache in his shoulders, to join her.

Marilyn, a former secondary school teacher, said: "When the first lockdown came, we couldn't see family and friends because we're vulnerable, being in our 70s. But we've created our own timetable with exercises and hobbies.

"Monday is our regular exercise time with the online strength and balance class. We go out every day for a walk around the park or the roads near where we live. It gives shape to our day."

The 75-year-old added: "The community team are really caring and give clear instructions. We are asked health questions each week before the start of the class about any changes in medication or falls. It's a really good service and I feel that we are really lucky to be included in it."

According to Public Health England – now the Office for Health Improvement and Disparities – an estimated 110,000 more older people in England will have at least one fall a year because of reduced strength and balance activity during the pandemic – up by 3.9%. They also predict that the total number of falls could increase by more than 250,000.

Due to the COVID-19 pandemic restrictions and lockdowns, many people have been less active, lost confidence and feel less steady on their feet. There has also been an increase in the number of people admitted to hospital after a fall as they get out and about more as restrictions have lifted.

At Guy's and St Thomas', 106 people from Lambeth and Southwark were admitted to hospital with a non-hip related fracture – such as a lower leg, wrist or arm fracture – between April and June 2021, compared with 63 during this period in 2020, and 72 in the same period of 2019.

The Community Rehabilitation and Falls Service provides strength and balance exercises in a variety of settings, including online and in face-to-face groups, for people who have had a fall, nearly fallen or who are worried about falling.

Face-to-face groups are being set up again after enforced breaks due to COVID-19 at a variety of easily accessible locations in Lambeth and Southwark.

Referrals can be made by health and social care professionals, family, carers and through self-referral.

Kate Bradfield, senior specialist physiotherapist at Guy's and St Thomas', said, "What we want to do is work with people before they fall and end up in the emergency department (A&E). We have people in their 90s attending our classes. Anyone can exercise, at any age and anywhere.

"More than 70% of participants see an improvement in their balance after completing one of our group programmes."

Charlotte Williams, deputy clinical lead for the service at Guy's and St Thomas', said: "The message is keep moving as we know that being active can lift your mood and improve your overall health and wellbeing.

"Exercises can be included easily into day-to-day activities, such as simple squats whilst the kettle is boiling. This will not only help you to get fit and active but will also help your strength and balance. It's about doing more of these exercises, a little and often."

Top tips for staying active at home

  • Get up more often and move around frequently. Join your local walking group, take a Thai Chi, yoga or any other exercise class
  • Make your home and garden safer – clear trip hazards particularly on stairs, in hallways and in the garden
  • Get regular checks of your eyesight and hearing, and wear your glasses and hearing aid
  • Check your footwear – your shoes and slippers should fit properly
  • If you have any dizziness or fainting speak to your GP
  • To find out more about the service, call the strength and balance helpline on 020 3049 5424, Monday to Friday, 8.30am to 4.30pm

Trust life

Guy's and St Thomas' is continuing to pioneer the use of robotic technology after almost 2 decades. Matt Barker spoke to one of the latest patients to benefit and the surgeons leading the charge.

Back in 2002, robotic surgery at Guy's and St Thomas' was just a twinkle in the eye of Professor Prokar Dasgupta.

Now, 20 years later, he talks like a proud father about the incredible growth of the programme – the largest in the UK with 6 robots.

Professor Dasgupta said: "My ambition was to improve outcomes for patients. In 2002 we took part in the first trial in the world which involved robotics, between Guy's Hospital and Johns Hopkins Hospital in the USA.

"It showed that a robotic arm was more accurate than a human hand. We realised that we could offer less pain, smaller scars and less time in hospital to our patients. In 2004 we got our first da Vinci robot thanks to a grant from Guy's & St Thomas' Charity and we haven't looked back."

Guy’s and St Thomas' now has 5 da Vinci robots and 1 Versius robot.

Professor Dasgupta said: "When the robotic surgery programme started 1% of prostatectomies (surgery to remove the cancerous prostate gland) were carried out using the robot compared to 94% now. In that time we have trained more than 30 fellows in robotics."

Professor Dasgupta's first fellow was Ben Challacombe who is now the clinical lead for robotic surgery at Guy's and St Thomas'. He said: "The robotics programme started at Guy's for urological surgery and has grown phenomenally from there. We now operate across 6 specialities – urology, thoracic, head and neck, gynaecology, transplant and gastrointestinal.

"Last year 24 surgeons carried out almost 1,300 robotic operations despite all the COVID-19 issues. That is amazing and the most ever in the UK for one Trust."

One of those patients was Tamara Brooks, from Stockwell in south London, after she was diagnosed with bowel cancer.

The 58-year-old was one of the first to benefit after the robotic programme was expanded to include gastrointestinal surgery.

Tamara, who manages a band, had part of her colon removed in an operation led by consultant colorectal surgeon Alexis Schizas.

She said: "When I was told I had cancer I felt shock, disbelief and terror in equal measure. My band had just signed to a record label and I didn't tell anyone at first as I was so busy processing it.

"After I was told how the surgery would be done I felt really optimistic and amazed at the technology and resources available. I joke that Alexis was very excited about his new toy and that enthusiasm was infectious. I felt very confident after meeting him and the team and knew I was in safe hands."

Tamara was able to leave hospital the following day and was even back to work, via Zoom, the day after.

Tamara said: "I feel incredibly lucky to have had the surgery so soon after diagnosis, and that it was so successful I didn't need chemotherapy afterwards. I went on holiday to the Bahamas this winter and never thought in a million years I'd be able to do that when I was diagnosed.

"I am so grateful for the care and attention from all the fantastic professionals who looked after me."

Alexis Schizas is the robotic surgery lead for gastrointestinal surgery. Since starting the programme in May last year the team have already performed around 80 cases.

Conventional keyhole surgery is not always suitable for complex bowel cancer cases and many of them require open surgery. Now a lot of those cases have been converted into minimally invasive robotic surgery.

Alexis said: "I didn't realise we would do this so quickly or how much better it was compared to standard keyhole surgery. You're in better control, your view is better and there is less movement when operating.

"There is definitely a benefit for patients – how long they're staying in hospital, their pain afterwards, and how comfortable they are compared to how we were doing their surgery previously. The length of stay for some of our more complex procedures has gone down from an average of 11 days to between 4 and 6 days.

"It doesn’t just cut down on the time spent in hospital, patients' recovery at home can also be quicker too."

Alan Armstrong, waste manager

Q: What is the role of your team?

A: The waste team ensures that all waste across the Trust is collected, stored and transported in accordance with all regulations. We make sure that waste is something our clinical teams don't have to worry about. Once they've put the items into the correct bin, the responsibility is ours. Safety is extremely important and we make sure relevant safety measures are followed to avoid accidents, such as a needle stick injury if something isn't disposed of correctly.

Q: How has your role changed during the pandemic?

A: It's become a lot busier. There's been immense pressure on the clinical waste industry. Before the pandemic, the NHS would produce nearly 200 tonnes of clinical waste per day, throughout the peak of the pandemic this was approaching nearly 600 tonnes due to an increase in the amount of personal protective equipment being used. We had to put many measures in place to make sure we could adapt to the new pressures. The whole team has really risen to the challenges of the pandemic and I'm extremely proud to lead them.

Q: What do you enjoy about the job?

A: For me it's the little things that people probably don't think of when they hear of waste management. Sustainability is extremely important to our team. We encourage staff to recycle as much as possible and have a furniture reuse scheme. We recycle printer cartridges and get money back to do so, which meant we were able to donate around £700 to Guy's & St Thomas' Charity last year.

We recycle all of the oil which is used in catering and we turn it into biofuel. Sustainability has been a huge change over the last few years and I'm really happy that the waste management team is doing so much in this area.

Irina Ostafi, security officer

I am part of a large team of security officers who work across the Trust's sites, providing a safe and secure environment for all patients and staff 24 hours a day, seven days a week.

I joined Guy's and St Thomas' in October 2020 having previously worked as a security officer for the London Eye.

To become a security officer I got my SIA licence from the Security Industry Authority, which involved training and an assessment.

Some of the most important skills you need to do this role include patience and the ability to remain calm under pressure.You also need to have good communication and customer service skills, the ability to work well with others, be able to pay attention to detail and have good physical fitness.

I have loved working at the Trust since my very first day. No 2 days are the same and our team is like a family, we all help each other.

Our role is very varied – we are responsible for access to every ward and issuing identity cards, monitoring CCTV, patrolling the site, managing the car park, attending major incidents and fire alarms, and responding to calls from staff who need our support.

Our team also investigates any crimes that are reported on site, which involves working closely with Lambeth and Southwark police liaison officers.

I'm really proud of the job that I do and so are my family – my sister says she wants to be like me when she’s older.

The interview

It's been a year since Royal Brompton and Harefield hospitals became part of Guy's and St Thomas' NHS Foundation Trust. Luke Blair spoke to the cardiac surgery teams at Royal Brompton and St Thomas' hospitals about how working together is helping patients.

Why have the cardiac surgery teams been working together?

Mario Petrou, cardiac surgeon: The challenges of responding to the pandemic have made it very difficult to treat some of our patients as quickly as we would like to. Across our different hospital sites, we wanted to make sure that we were making best use of our resources to treat people at the earliest opportunity based on how urgently they needed their care.

Kamran Baig, cardiac surgeon: At certain times there has been particular pressure on the operating theatres at St Thomas' Hospital, so being able to take our team over to Royal Brompton Hospital and work with colleagues there to treat our patients felt like the perfect solution.

Were there any challenges in doing this?

Kamran Baig: In some ways, for the surgeons, it has been like performing any operation, anywhere. It is actually more challenging for the teams who support the surgeons – the anaesthetists, nurses and trainee surgical care practitioners.

Dr Martin John, anaesthetist: Even though it is the same operation, if you are doing it somewhere new then there are different systems, facilities and equipment. When you are dealing with cardiac surgery there are a lot of things you need to get right, so you need to be careful and precise to be safe.

How did you approach this?

Rachael Baines, operating department practitioner: Colleagues at Royal Brompton have been so welcoming and helped show us the new environment and different equipment that they use. It has made it all so much easier, and it's also a good learning opportunity to see how other teams do things.

Kean Chan, theatre sister: Despite everything being done at short notice, we managed to sort out all the practical things like security passes and lockers, as well as show everyone around – we wanted them to feel part of our team.

Connie Koh, senior staff nurse: The whole team connected, meaning everything went smoothly and the patients are doing very well.

Will you be working together again?

Kamran Baig: We've actually been working together in other ways for a number of years, so we will continue to find additional ways to bring together our expertise.

Mario Petrou: There are lots of opportunities for us to look at the strengths and best practice that exist across our services. Working together also supports the development of our staff and allows us to deliver the best possible care to our patients.

Dr Richard Grocott-Mason, Chief Executive of the Heart, Lung and Critical Care Clinical Group: "We always knew that there would be significant benefits in merging our two organisations, but this really sums up what it is all about – bringing together expertise, experience and resources to deliver even better patient care.

"And right now, with the pressures the NHS is facing, the extra capacity we have been able to create for just some of our patients is a great example of those benefits.

"Going forward, as we continue to bring together the clinical and academic services across our hospital sites, there is so much potential for what we can achieve together."

History corner

From country house to one of the world’s biggest centres for heart and lung transplants, Harefield Hospital has clocked up a series of firsts, as Lynne Nolan discovers.

Harefield Hospital began its life in 1915 as a country house – Harefield Park House – and later became a temporary centre for injured Australians during the First World War.

An Australian family, the Billyard-Leakes, owned the land and offered it to the Australian government to treat its injured troops.

The 'Australian Hospital' expanded across more of the estate — 50,000 soldiers were treated there during the war — and it was such a success that King George V and Queen Mary visited on 16 August 1915, speaking to every bed-bound patient.

After the war, the Billyard-Leakes sold the family estate to Middlesex County Council.

As one of the highest points in Middlesex 290ft above sea level, Harefield offered lots of fresh air and sunlight, with the site lending itself to the 'open-air' method of treatment for tuberculosis.

During the Second World War, Harefield dealt with casualties north of the River Thames and, together with St Mary's Hospital, began to deal with general and thoracic surgical war casualties.

Pathologist Sir Alexander Fleming spent time at Harefield during the war, studying the effects of penicillin on a wide variety of infections, including tuberculosis.

With the introduction of the NHS and drugs to treat tuberculosis in the mid-1940s, Harefield became a general hospital with expertise in the treatment of chest, oesophagus and lung diseases.

In 1947, Sir Thomas Holmes Sellors, the first thoracic surgeon at Harefield, performed the world's first direct pulmonary valvotomy, a procedure to open the pulmonary valve.

Appointed as a cardiothoracic surgeon in 1969, Professor Sir Magdi Yacoub and his team launched the paediatric cardiac service and captured global attention after using human heart valves with amazing success. On 8 September 1973, they carried out the hospital's first heart transplant.

In 1976 Harefield pioneered a 2-stage operation for children with a complex condition known as transposition of the great vessels – in which the aorta and pulmonary artery leave the wrong side of the heart. In 1983, Professor Yacoub made British medical history after he carried out the UK's first heart and lung transplant, and the following year he performed a heart transplant on a baby less than a month old.

Opened in 2003, the state-of-the-art ANZAC centre at Harefield remembers the vital contribution made by the troops treated at the first hospital on the site.

The centre accommodates outpatients, blood tests and lung function tests, the transplant clinic, echocardiology and nuclear medicine.

Nicholas Hunt, director of service development at Harefield Hospital, said: "Emergency situations often bring out the best in people and that's certainly been the case for us, as Harefield's transformation over more than a century demonstrates.

"From treating casualties during both World Wars to developing 'artificial hearts', Harefield continues to make medical history to be proud of."

Foundation Trust life

Marcia Da Costa reveals how she helps to give a voice to the public in her role as a governor

Governors play a key role in representing the views of Guy's and St Thomas' patient, public and staff members, ensuring the Trust's services meet the needs of its communities.

The Council of Governors is made up of 10 public, 12 patient, eight staff, 13 partnership and 4 associate governors.

They provide advice and support to the Board of Directors, which is responsible for the overall management and performance of the Trust.

Marcia Da Costa was re-elected as a public governor for a second term in July 2021.
She is passionate about safeguarding children having worked at Lambeth Council and in St Thomas' for many years as a manager in children's services.

Marcia, from Lambeth, said: "It's been a privilege to have this role, and to have been voted in twice. I have the opportunity to help people in the local community and to give a voice to the public who use the Trust's services."

Marcia has volunteered for various organisations for decades. She pioneered a not-for-profit organisation providing services for homeless people, has supported elderly Caribbean World War Two veterans, and supports young people to avoid getting involved with gangs.

During the first COVID-19 lockdown she volunteered at St Thomas' Hospital as chaplain, providing psychological support to staff in the Trust's wellbeing zones.

Marcia said: "I'm a people person and really try to make things work for those who are having a hard time. A key part of my role at the Trust is speaking and asking questions on behalf of service users."

The governors are your elected representatives and are keen to hear your views.

If you have a question, comment or idea please email [email protected] or call 020 7188 7346.

If you would like to vote for your governor representatives, please visit our elections page or email [email protected].

Voting is open from Friday 22 April until Wednesday 18 May.

Ludovic Lesdalon explains how becoming a volunteer at Guy’s and St Thomas’ has changed his life.

As a Foundation Trust, Guy's and St Thomas' has a membership made up of thousands of patients, carers, staff and local people.

The Trust counts on members for feedback, local knowledge and support.

embership is divided into patient, public and staff constituencies, and each constituency votes for its representative on the Council of Governors.

Ludovic Lesdalon has been a volunteer at the Trust for 5 years and recently became a patient member.

He originally volunteered in the garden at Lambeth Community Care Centre and later joined the COVID-19 vaccination team at Guy's Hospital.

Ludovic, from Bermondsey, said: "Guy's and St Thomas' has looked after me extremely well and saved my life on more than one occasion.

"I have numerous health issues but volunteering has been like therapy for me. It's boosted my confidence and given me a role in society."

Ludovic volunteers twice a week as a coordinator in the vaccine centre, greeting patients and showing them where to go.

He said: "I enjoy it a lot because I get to meet lots of people from all over the world. I've embraced this new role with joy and pride – by helping others it takes away the focus of my own health issues. I'm always happy to help my fellow team members who have no idea how much they help me."

He added: "I would recommend volunteering to anyone who has a chronic illness and is suffering in silence. It gives you so much satisfaction and helps you to rediscover yourself."

For more information about volunteering at the Trust, visit our volunteering page.

To become a member call 020 7188 7346, email [email protected] or visit our membership page.

For Royal Brompton and Harefield hospitals call 020 7352 8121, email [email protected] or visit the Royal Brompton and Harefield hospitals website becoming a member page

Do you want to help shape the future of Guy's and St Thomas'?

We're looking for patients, carers and Foundation Trust members to help us:

  • design services for children and young people
  • improve our heart and lung services
  • improve our cancer services
  • design healthcare technology, like electronic records and phone apps
  • deliver our surgical strategy

How do I get involved or find out more?

You can sign up to our mailing list to receive updates on the areas that interest you. To sign up, visit our patient and public involvement page.

If you have any questions, email [email protected] or call 020 7188 6808.

Where will events and activities take place?

You can get involved in different ways. Some of our events will be held online and others face-to-face, always following the advice of our Chief Nurse and Infection Prevention and Control team to help keep everyone COVID-19 safe. We will adapt activities to help you take part wherever we can.

Get involved in COVID-19 recovery projects

During the pandemic we have seen a rapid transformation of services. Visit our recovery programme page to read about 3 new COVID-19 recovery projects that you can get involved in.

For all the latest news about our amazing fundraisers and how you can support us, follow @GSTTCharity on Twitter and @RBHCharity on Twitter and like the GSTTCharity Facebook pageevelinalondonchildrenscharity Facebook page and RBHCharity Facebook page.

Last updated: March 2022

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