The GiST, issue 39

Welcome

Evelina London’s neonatal unit is the largest in London, caring for more than 800 premature and sick babies each year.

In this issue of the GiST, you can find out how our staff support families through every step of their journey, empowering parents to feel confident in caring for their baby on the unit and preparing them to go home. Meet some of the families whose babies have received life-saving care.

A new fixit service is helping our patients return to safer homes after a hospital stay. Read about the Safe2GoHome team.

Our neighbourhood nurses have been trialling electric bikes to visit their patients. Find out how this is helping to lower pollution, improve staff health and wellbeing and reduce the travel time between appointments.

A revolutionary treatment is helping to target infections that are hard to treat with traditional antibiotics. Find out how faecal microbiota transplantation completely changed the life of one of our patients.

Our Trust is one of the first in the UK to pilot new resources to improve support for Black women who are pregnant. Read about how we are working with the campaign group Five X More.

A ground-breaking intensive rehabilitation service at Evelina London is helping children with movement difficulties. Find out more about the REACH programme.

You can also learn about the work of cardiothoracic surgeon Mr Donald Ross, who pioneered a procedure whilst at Guy’s Hospital that has saved thousands of lives.

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 Kelly Cook, Nzinga Cotton, Clare Elliott, Azmina Gulamhusein, Maxine Hoeksma, Daisy Holden, Joe Parry and Lesley Walker.

Cover photo by David Tett.

Design: AYA-Creative

Print: O'Sullivan Communications

Front cover: Baby Olivia-Grace being cared for in Evelina London's neonatal intensive care unit.

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

Breathe Arts Health Research celebrated 10 years working with Guy’s and St Thomas’ in style, through a series of events and performances throughout the Trust.

Breathe supports the Trust by designing and delivering research based creative programmes to improve the health and wellbeing of patients and staff.

To mark this decade, they organised a day of uplifting activity across several hospital and community sites.

Live music courtesy of Breathe’s resident musicians filled the corridors, while staff, patients and visitors could take part in relaxing creative workshops and collaborative art projects.

People were offered time to experience something new, including a harp workshop and vibrant South Asian dance performance. Mindful drawing activities also took place in the Florence Nightingale Garden at St Thomas’.

Yvonne Farquharson, Founder and Managing Director of Breathe Arts Health Research, said: "I am so grateful to the Trust and Guy’s & St Thomas’ Charity for their generous support, for believing in our vision and transformative arts and health programmes and committing to make it part of their culture."

Medical teams from Guy’s and St Thomas’ have been helping to improve healthcare for pregnant women and newborn babies in West Africa.

A team of 15 nurses, surgeons and doctors from the neonatal unit at Evelina London Children’s Hospital and King’s College London travelled to The Gambia to support the Edward Francis Small Hospital.

They joined ward rounds, assisted clinics and supported 19 operations, including bowel and abdominal surgery, and the removal of a tumour from a baby. The team also provided training for junior doctors and donated medical equipment.

Seven obstetricians, midwives and researchers also travelled to Sierra Leone to set up lifesaving projects to improve maternal and neonatal healthcare.

The team are working with clinicians, community leaders and policy makers to understand and reduce the barriers pregnant women face when accessing healthcare.

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

Daily Mail - The Mail online and Metro online ran a story about Rebecca and Tom Golding who have tattooed images of a feeding tube on to their stomachs to support their two children who have both been fitted with one. Tom undertook a bike ride across the Scottish Highlands in the summer to raise money for Evelina London Children’s Charity.

Daily Mirror - A yachtsman who had a heart attack and cardiac arrest during a sailing competition was saved thanks to the quick actions of his crewmate, sailing club members, paramedics and hospital staff. Norman Khine had a bypass at St Thomas’ Hospital, and the Daily Mirror reported that he recovered with no damage to his heart.

BBC Radio 4 - Women’s Hour on BBC Radio 4 covered a new study from Royal Brompton and Harefield hospitals and Imperial College London, which found that thousands of British women are being denied the best treatment for heart attacks due to sexism in medicine. The paper, published in The Lancet, suggests that nearly 12,000 women in the UK should have been identified as being highrisk and missed out on appropriate care over the past two decades.

A new Chairman has been appointed to lead Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts from December 2022.

Charles Alexander was the Chairman of The Royal Marsden NHS Foundation Trust and The Royal Marsden Cancer Charity, roles he has held since 2016.

He succeeds Sir Hugh Taylor, who has served as Chair of Guy’s and St Thomas’ since 2011, and King’s College Hospital since 2019.

Charles said: "It is a great privilege to have been entrusted with this position by two of London and the UK’s most distinguished healthcare institutions, and I thank them warmly. I share the values and ambitions of both as they take forward plans for better healthcare for all in the communities they serve."

Dr Ian Abbs, Chief Executive Officer of Guy’s and St Thomas’, said: "I am delighted to welcome Charles to our organisation, and look forward to working with him as we take forward our ambitious agenda. Working together with colleagues, both at King’s College Hospital and more widely across London, we have a real opportunity to transform the care we provide to our local population.

"I would also like to thank Hugh for his exceptional and dedicated service to Guy’s and St Thomas’."

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

@RoDavies71 (from Twitter) - @GSTTnhs once again we had a fantastic appointment in your children’s allergy centre. Dr Chan, Ami (the pinpricker!) and the phlebotomist were so helpful. As son is soon to be 16, this was our last appointment in the unit.

@madgwick_marcus (from Twitter) - @GSTTnhs thank you to the urologist team and nurses on Florence ward for your amazing care for me over the past week. You really are an amazing team of wonderful people.

@FrancisCoach01 (from Twitter) - Thank you to wonderful staff @EvelinaLondon hospital, especially the radiography team - a very smooth appt for daughter's MRI today #lovenhs

@P_Gavioli (from Twitter) - We went back to the @GSTTnhs today! Daniel had a food challenge to pistachios and he passed! Hooray. Again thank you to Dr Swan, the nurses and everyone at the @EvelinaLondon

@kama_ashton2 (from Twitter) - @RBandH I'd just like to say how wonderful my visits have been to this hospital. Truly helpful, professional, and friendly staff! I hope the boss is very proud!

Guy’s and St Thomas’ and Guy’s & St Thomas’ Charity have joined forces with four local NHS trusts and their charities to make sure people living with long COVID can get the very best care.

The five charities and NHS Charities Together will fund a UK initiative that will harness the expertise of individual NHS trusts in south east London to develop a ‘gold standard’ of care.

Long COVID is the name given to a variety of symptoms that persist after a person has recovered from COVID-19. The main symptoms include fatigue, shortness of breath and ‘brain fog’.

South east London has some of the most diverse communities in the UK – with people from Black and other ethnic minority communities more likely to live with pre-existing long-term health conditions, live on low or fluctuating incomes and work in frontline ‘key worker’ roles – all factors which can make people more vulnerable to long COVID.

Professor Nick Hart, deputy medical director of the heart, lung and critical care clinical group at Guy’s and St Thomas’, said: "Thanks to generous donations by the public, we will be setting up a dedicated, evidence-based treatment pathway to ensure people from all communities living with long COVID get the very best care, co-designed by patients themselves."

The lessons learnt through the programme will help shape pathways to treat other long-term conditions.

Guy’s and St Thomas’ has been using virtual reality technology to help prepare and train its surgeons of the future.

The Trust held the largest virtual reality surgical training event in Europe, with more than 30 junior surgeons from across London, faculty members and industry colleagues.

The leading edge simulation technology allows trainees to practice and develop their surgical skills in a safe environment before they go into a real operating theatre.

The event was set up by Mr Adil Ajuied, consultant specialist knee surgeon, Mr Wathik El Alami, orthopaedic surgeon, and Dr Paul Kelly, consultant anaesthetist.

Mr Ajuied said: "Virtual reality is not just for gamers entering an electronic world. This type of surgical training is very much like an aviation simulator – pilots learn how to fly airplanes on the ground before they ever get onto an airplane with passengers.

"The benefit for our patients is that they will be cared for and treated by surgeons who have had the opportunity to rehearse, practice and run through their surgical procedures."

More than 70 school students attended Harefield Hospital’s annual ‘Your Heart Hospital’ event that aims to educate young people about the importance of cardiopulmonary resuscitation, known as CPR.

CPR is when someone gives chest compressions to a person in cardiac arrest to keep them alive until emergency help arrives.

The event also provided an insight into the wide range of careers in cardiovascular healthcare.

Dr Miles Dalby, consultant cardiologist at Harefield Hospital, said: "Our key aim is to explain what goes on in a heart hospital likes ours so we improve understanding about the causes, prevention and treatment of heart disease.

"In this way we can educate young people about the importance of resuscitation training. Most cardiac arrests occur in the home or at work, so learning how to do CPR and how to do it effectively could potentially save someone’s life."

Spotlight

Guy’s and St Thomas’ has become the first NHS trust in the UK to use a pioneering implant device to treat severe sleep apnoea.

Sleep apnoea is when your breathing stops and starts while you sleep. It can lead to more serious problems, such as heart disease, if left untreated.

The condition can sometimes be treated by making lifestyle changes but many people need to use a continuous positive airway pressure device, called a CPAP machine, which gently pumps air into a mask that you wear over your mouth or nose while you sleep.

Matthias Winker suffered with severe sleep apnoea for more than four years and conventional treatments had failed. He was one of the first patients to receive hypoglossal nerve stimulation at Guy’s and St Thomas’ to treat the condition.

The 40-year-old said: "Without using a CPAP machine I was having over 40 episodes an hour and would stop breathing for up to 45 seconds at a time. This major disturbance in sleep meant I didn’t feel myself, and left me tired and with low energy throughout the day.

"In the long term I was at higher risk of having a stroke and heart disease, and a generally poorer quality of life. My wife was really worried and encouraged me to look into other treatment options."

Hypoglossal nerve stimulation involves implanting a device under the skin in the chest with a lead that goes under the chin.

The device delivers mild stimulation to the hypoglossal nerve that controls the movement of the tongue and other key airway muscles, allowing the airway to stay open during sleep.

It is controlled by a small handheld sleep remote, which the patient turns on before bed and off in the morning when they wake up.

Nothing is visible externally and the implant looks similar to a pacemaker, around the size of two 50p coins.

Matthias said: "This therapy has been a tremendous success. I now only have 2 or 3 episodes per hour for a few seconds at a time, and then the device jumps in so I can breathe. It took some time to get used to but now it’s comfortable and doesn’t wake me up in the night."

The father-of-two added: "It’s had absolutely fantastic results – I’m more energised, I have a better quality of sleep, I’m more alert and my concentration is much better. My general mood has also improved because I’m not constantly tired."

Mr Yakubu Karagama, consultant ear, nose and throat surgeon and laryngologist at Guy’s and St Thomas’, said: "Sleep is very important for physical and mental health and general wellbeing so it’s essential that we are able to help patients with sleep apnoea.

"This treatment isn’t suitable for everyone and many people will benefit from proven, conventional treatments such as a CPAP machine. In a small group of patients who have moderate to severe sleep apnoea, where other treatments have failed, this new device could be a solution. I’m delighted that it is making a huge difference for our patients, and that Matthias has seen such positive results."

Fast facts

  • Around 25,000 implants have been fitted worldwide including in the USA, Germany and Netherlands
  • So far 3 patients have had the device fitted at Guy's and St Thomas'

Patients are now able to return more quickly to safer homes after a hospital stay, thanks to a new service being offered by Essentia, which is part of Guy’s and St Thomas’.

The Safe2GoHome team provide services like cleaning, removal of furniture and decluttering of homes to reduce the risk of falls and fire.

More than 250 patients have been helped by the scheme since it began in January 2022.

The Safe2GoHome team works closely with the hospital-based therapists and discharge teams to determine what support is needed.

They are a mobile team working across London so can carry out the necessary works quickly. While most patients are from Lambeth and Southwark, the team have travelled up to 38 miles to improve the home environment for those who need it.

Roger Miantezila, a facilities technician with the Safe2GoHome team, said: "Some patients are unable to do the work themselves, so we get the job done for them. The quicker we do the job the quicker patients can get home from hospital, which is better for them.

"We always put the patients first. Sometimes they cry with happiness when they see how much their home has changed. If they are happy, I'm happy."

The Safe2GoHome team can also help therapy colleagues and save time by taking photos of the layout and furniture in a patient’s home during their visit.

This can help the therapists decide whether there is sufficient space for any recommended equipment and the best position for it, avoiding the need to send numerous staff to a patient’s home.

Teresa Meldrum, clinical specialist occupational therapist, said: "The service is incredibly responsive. We’ve made referrals in the morning and the team has gone out that afternoon.

"This means we’re not having to wait a day or more for an external agency to move furniture, check lights and the heating, and whether a patient has hot water before being able to go home.

"Our patients can be transferred back into their own homes quickly, which makes for a better experience for them than staying in hospital."

Christine Kelly, from Embankment, has benefited from the new service. She has several health conditions including tremors, mobility and breathing problems and a rare skin condition.

The 70-year-old said: "The apartment felt very cluttered. I had two chair recliners which were very big and wide, and there were lots of things on the balcony including tins of paint, dog cages and beds.

"The occupational therapist arranged for a new riser-recliner chair which is softer. I’m very grateful to the Safe2GoHome team because I was worried about falling over, and now I feel safer walking around the flat."

In focus

As the whole country – and rest of the world – learnt the sad news about the death of Her Majesty Queen Elizabeth II, staff across Guy’s and St Thomas’ took time to reflect on and commemorate Her Majesty’s life.

The late Queen visited staff and patients many times including for the opening of Guy’s House in 1961, North Wing at St Thomas’ Hospital in 1976, and Sydney Wing at Royal Brompton Hospital in 1991.

Dr Ian Abbs, Chief Executive Officer of Guy’s and St Thomas’, said: "We were deeply saddened to hear the news that Her Majesty Queen Elizabeth II had died. Her Majesty visited our staff and patients during her incredible 70 years on the throne. Over the years we have welcomed many members of the Royal family to sites across the Trust, and we will always value and appreciate these important connections and the ways in which they have supported our work."

Fast facts

Royal visits to the Trust over the years have included:

  • In 2017, King Charles III visited St Thomas’ Hospital to celebrate the 70th anniversary of the British Geriatrics Society
  • The new Princess of Wales became Patron of Evelina London in 2018
  • The new Prince of Wales met staff at St Thomas’ Hospital in 2017 to thank them for their live-saving efforts during the Westminster terror attack
  • In 2006, The Queen Consort visited Guy’s Hospital as President of the National Osteoporosis Society to open a new scanner
  • The Princess Royal opened Evelina London Children’s Hospital in 2006, the emergency department (A&E) at St Thomas’ Hospital in 2018, and the Diagnostic Centre at Royal Brompton Hospital in 2022
  • In 2016, the Duke of Sussex took a rapid HIV test at Burrell Street Sexual Health Centre to normalise and de-stigmatise testing
  • The Countess of Wessex opened the Rare Diseases Centre at St Thomas’ Hospital in 2018

Nurses from Guy’s and St Thomas’ have been piloting electric bikes to visit their patients, as part of an initiative to lower pollution, improve staff health and wellbeing, and reduce travel time between appointments.

Members of the Mawbey Brough neighbourhood nursing team usually drive, walk, use public transport or use their own push bikes to get to their patients in Lambeth.

They can now sign up to a pilot project trialling an electric bike – known as an e-bike – which has a cargo hold for their rucksack and equipment.

As well as reducing emissions and congestion on London’s busy roads, it is hoped that the e-bike will improve staff physical and mental health. Using the e-bike also involves fewer parking restrictions and reduces costs.

During this small pilot, staff have covered around 575 miles and saved around 136kg of CO2 when compared to making a car journey – this translates into more than six fully grown trees absorbing carbon for a full year.

Cheyenne Morgan has been a community nurse at Guy’s and St Thomas’ for two years. She sees up to 10 patients a day in their own homes and provides a range of support, including help with insulin, wound care, catheter changes and palliative care.

Cheyenne said: "I love riding a bike and prefer it to using the bus or walking. It reduces the time it takes to get to my patients, and I don’t feel the weight of my rucksack because it can go into the cargo hold. It’s a great alternative to driving and reduces our carbon footprint while helping me to keep fit."

Neighbourhood nurse Sunday Falolu, who joined the Trust in 2022, added: "I used to walk everywhere so now that we have the e-bikes I get to where I need to much more quickly.

"It’s faster than being in a car – while they are stuck in traffic I can get through to my destination without any delays. I’ve become fitter using the e-bikes, and they don’t produce any gases so we’re helping the environment."

In 2021, Guy’s and St Thomas’ unveiled its sustainability strategy which sets out a clear path towards more sustainable healthcare for the next 10 years.

The Trust has already made the switch to cargo bikes when transporting some blood and other samples for testing between Guy's Hospital and St Thomas' Hospital, replacing vans and motorbikes.

Lawrence Tallon, Deputy Chief Executive Officer at Guy’s and St Thomas’, chairs the Trust’s Sustainability Steering Committee.

He said: "Electric bikes are a speedy, eco-friendly and healthy way for our staff to get around.

"This initiative supports our ambitious plan to reach net zero carbon emissions from our own vehicles and to see significant reductions in emissions from staff and patient travel by 2031."

The project was made possible thanks to generous supporters of Guy’s & St Thomas’ Charity and funding from Impact on Urban Health.

Kieron Boyle, Chief Executive of Guy’s & St Thomas’ Charity, said: "We’re delighted to work with Guy’s and St Thomas’ NHS Foundation Trust to improve air quality in Lambeth. By supporting nurses to switch to cargo bikes instead of driving polluting vehicles, we are protecting the health of patients, hospital staff and people living in our communities."

Fast facts

  • The neighbourhood nurses are trialling two Tern HSD P9 electric cargo bikes
  • Those who take part in the pilot project must complete at least one cycle training session, and wear a helmet and hi-vis vest when using the e-bike
  • The Trust has six air quality monitoring sensors across its sites
  • Across Guy's and St Thomas' vehicle fleet, including cars provided to staff through a salary sacrifice scheme, 42% are now either fully electric or hybrid

When Carol Goble was diagnosed with another Clostridioides difficile infection, she was desperate to find a treatment that worked.

The gut bacteria – also known as Clostridium difficile, C. difficile or C. diff – can live harmlessly in your bowel along with lots of other types of bacteria.

But sometimes taking antibiotics can change the balance of bacteria, causing C. diff to increase in numbers and produce a toxin that leads to diarrhoea, a high temperature, loss of appetite, feeling sick and a stomach ache.

Carol, a retired secretary, said: "I suffered with recurrent C. diff infections and tried every suitable antibiotic and probiotic but nothing worked.

"I became frightened to go out and spent my life in doors going back and forward to the toilet. I was scared to eat and ended up losing three stone."

In April 2022, while Carol was being treated at St Thomas’ Hospital for a heart condition, doctors discovered that she had another C. diff infection.

However, this time she was offered a new treatment to fight the infection called faecal microbiota transplantation – or FMT.

It involves taking the healthy bacteria, viruses and fungi – known as microbiota – from a donor’s poo sample, processing it into a treatment, and transferring it into a patient’s gut.

The revolutionary treatment is recommended by the National Institute for Health and Care Excellence for people who have been treated for two or more C. diff infections without success.

Carol, who has two children and three grandchildren, said: "Having FMT didn’t faze me at all because I had tried everything else and I felt like this was the only option left. The capsules had no taste or smell and were similar to swallowing an antibiotic tablet."

The 76-year-old added: "It has completely changed my life and I feel like I’m back to myself again – it’s amazing. I can eat whatever I want, whenever I want."

A detailed screening process takes place to ensure healthy individuals are eligible to become FMT donors – around 2% of the population could be suitable.

Ciara Harrison has been donating to Guy’s and St Thomas’ every week since May 2022.

The 25-year-old said: "I first heard about FMT on a podcast and was amazed at how it had completely changed the patient’s life. A few months later I got an email about a clinical trial looking at how FMT could help people with liver disease, so I decided to get in touch."

She added: "It takes so little effort for me but can make such a big difference to someone’s life – so it was a no brainer to get involved. It’s really nice to hear when it’s been an effective treatment for someone."

Dr Blair Merrick, a clinical research fellow at Guy’s and St Thomas’, has been coordinating a study into FMT and antibiotic resistance.

Dr Merrick said: "This innovative treatment is thought to be more effective than treating recurrent C. diff with antibiotics because it can restore the balance of bacteria in the patient’s intestine, which stops the C. diff coming back.

"Our results suggest that patients get better around 70% of the time after receiving one dose, and this figure is even higher after a second dose. It is the most effective treatment we have available for recurrent C. diff infection."

He added: "Historically, FMT needed to be given as a liquid via a tube, but it can now be given in a capsule like any other medication in suitable patients. It’s an exciting area of research and we’re supporting a number of trials investigating FMT to see if it can help treat conditions other than C. diff."

Fast facts

  • Around 20 patients receive FMT each year at Guy's and St Thomas' for recurrent C. diff infection
  • The Trust is recruiting donors to the FERARO trial which is looking into antibiotic resistant bacteria in the gut
  • Guy's and St Thomas' is involved in making FMT for four other clinical trials
  • If you're interested in becoming a donor, contact [email protected]

Guy’s and St Thomas’ has become one of the first trusts in the UK to pilot new resources to help reduce the risk of death in childbirth for pregnant Black women.

The Trust has partnered with the campaign group Five X More to introduce their Colourful Birth Wallets for Black women who are pregnant.

The A4 sized plastic wallets are given to women to hold medical notes they need to bring to their antenatal appointments.

Both sides of the wallet contain information to empower Black women to make informed decisions about their maternity care.

They include 6 recommendations – speak up, find an advocate, seek a second opinion, trust your gut feeling, do your research and document everything.

Five X More was set up in 2019 by Guy’s and St Thomas’ Maternity Voices Partnership co-chair Clotilde Abe and Tinuke Awe to help address Black maternal health inequalities.

Although Black women who are cared for by the Guy’s and St Thomas’ maternity team receive very specialist care, across the UK Black women are 4 times more likely to die during pregnancy and childbirth compared with white women.

In 2019, they were 5 times more likely to die which is where the name of the campaign group comes from.

Mercy Ughwujabo, consultant midwife at Guy’s and St Thomas’, said: "We are very proud to support Five X More and we are delighted to be one of the first trusts in the UK to pilot their Colourful Birth Wallets for pregnant Black women.

"All patients, no matter their background, deserve to receive the very best care, but we know that Black women can experience racism, discrimination and unconscious bias leading to poor maternal health outcomes.

"We serve a very diverse patient population and our Trust is committed to supporting inclusion and equality. It’s really important to us that we are doing everything we can to improve care for Black women.

"As a Black woman myself this campaign is very close to my heart and I have really enjoyed working with Clotilde and Tinuke to raise awareness of these issues across our Trust."

Clotilde, a mum-of-two, said: "I hope that our Colourful Birth Wallets will enable women to feel empowered and that they can speak up. During my own pregnancy experience I didn’t know that I could seek a second opinion, that I should trust my gut or that I could document everything.

"So this is a reminder to say this is what you’re able to do, and this is what your rights are."

Last year Five X More partnered with Guy’s and St Thomas’ to pilot their ‘I am here to listen’ staff training scheme.

During the pilot, staff were taught Five X More’s 5 steps for healthcare professionals to ensure safer care for Black women. The training was developed together with the Royal College of Obstetricians.

After the training, staff received a ‘I am here to listen’ pin badge to wear on their uniform to highlight to pregnant women that they have been trained by Five X More.

Fast Facts

  • More than 6,000 babies are born at St Thomas' Hospital every year
  • Guy's and St Thomas' runs specialist antenatal clinics for a range of conditions including diabetes, epilepsy and heart disease
  • The Trust also runs a pre-conception counselling service for people with pre-exisiting conditions wishing to get pregnant

Guy’s and St Thomas’ hosts the south east London maternal medicine network.

The network supports healthcare professionals across south east London, Kent and Sussex to improve care for pregnant women with medical complications and long term conditions such as diabetes, asthma and epilepsy.

Dr Sonji Clarke, consultant obstetrician at Guy’s and St Thomas’, said: "We are delighted to host the maternal medicine network. It was set up to help address health inequalities and improve care for women with complex pregnancies, who often need support from a wide range of health services, as well as maternity.

"By supporting healthcare professionals across the south east region, the network will help ensure people with complex pregnancies receive joined up, high quality care."

Trust life

Having a premature baby is an extremely worrying and anxious time for families.

Evelina London’s neonatal intensive care unit – known as NICU – looks after babies and their families, empowering and supporting them at every step of their journey.

Kirsty and Oliver Pritchard spent three months on NICU with their baby Hugo, after he was born at 29 weeks via an emergency caesarean section at St Thomas’ Hospital.

Kirsty said: "We had quite a difficult time at the beginning when Hugo was transferred to NICU. I was quite poorly and needed to recover on the postnatal ward, and Oliver had caught COVID-19 so he couldn’t visit.

"Being away from Hugo was difficult, but the nurses and midwives were amazing, they shared updates and photos of him, which was a great reassurance."

Last year, the neonatal team launched Family Integrated Care – a new way of working that involves families in caring for their baby, in partnership with the clinical team, from the very beginning.

Parents and carers are supported to learn about their baby’s care, including feeding via a specialist tube and the importance of skin-to-skin contact. This helps them to have greater confidence in caring for their baby throughout their time on the unit and to prepare for returning home.

Kirsty said: "It was an emotional time for us when Hugo was born prematurely. The family psychology service was a great help when I started to find things a bit tough."

She added: "The staff supported Oliver and I to feel comfortable holding Hugo with all his tubes, being able to have that special skin-to-skin contact was so important to us. They helped us to really get involved with Hugo's care, and it gave us the confidence to know how we could help.

"All the nurses encouraged us to join in and checked what we felt comfortable doing. It gave us a little sense of normal parenting."

Elaine Wood, neonatal sister at Evelina London, said: "Having a baby on NICU is often unexpected and overwhelming. By working collaboratively to care for their baby, we can ease some of the anxiety and enable parents to feel like parents."

In May 2022, baby Margot unexpectedly arrived early at 23 weeks, and weighed only 1lb 3oz.

Her dad Stuart Crush said: "When my wife April went into labour prematurely, it was a huge shock for us. Margot was delivered at our local hospital and was eventually transferred for specialist care at Evelina London’s NICU.

"Margot needed emergency surgery to repair her bowel. However when we arrived she was so poorly, the emergency surgery took place on NICU as there wasn’t time to transfer her to the operating theatre. They saved her life."

Before being well enough to go home, Margot had heart surgery to close a valve and to help her lungs develop.

Stuart said: "We didn't know this world existed until we were thrown into it. It was incredibly daunting and overwhelming at times. We were on the unit for four months and the staff became our family. They taught us how to care for Margot, and made us experts in caring for a premature baby.

"They got Margot through something we never thought she could get through, and also got us through it too."

Fast facts

  • Evelina London's neonatal unit is the largest in London and has some of the best survival rates in the UK
  • More than 800 babies are cared for on the unit each year
  • Evelina London hosts the London Neonatal Operational Delivery Network, which unites all neonatal units in London to provide co-ordinated care

Evelina London Children’s Charity is raising money to help create a home from home on the neonatal unit.

For many families, the hospital becomes their new home for many months.

With your support, the neonatal team can create welcoming spaces that offer solace to parents coping with the trauma of seeing their baby in intensive care.

A sanctuary that brings families together to create precious moments and build everlasting bonds.

Jenny Michel, a neonatal sister at Evelina London, said: "I am proud of the care we provide to families on the neonatal unit. But I want us to be able to do even more for them, so that we can give them the best possible start to their lives together."

To find out more or donate to this vital appeal, visit the Evelina London Charity website.

James Calvert, oncology and haematology clinical trials manager.

Q: What is your role?

A: I am responsible for overall operational oversight of all aspects of clinical research in the service. We have around 70 members of staff who coordinate more than 200 clinical trials involving over 500 patients. I ensure we have the staff, infrastructure and processes in place – with the help of my team – to bring together everything we need to deliver leading-edge clinical trials in a safe and effective way.

Q: How does your role benefit patients?

A: My role exists to ensure we have the resources in place to offer as many trials as possible to patients, so they can benefit from a wide range of treatment options during their cancer journey. This can include access to promising new drugs, or new combinations of existing therapies.

Q: What do you enjoy about your role?

A: The role is hugely varied and no two days are the same, which keeps things interesting. I really enjoy being part of a team that is so passionate about research, and cares so deeply about our patients – the best part of this role is the people I get to work with every day. It’s a real privilege to work with such a dedicated group of colleagues who will always go the extra mile for our patients.

Q: What inspired you to get into the role?

A: Like many people, I have been personally affected by cancer, as my mum was diagnosed more than a decade ago. She’s now cancer free, so I know firsthand how advances in treatment can help patients. I was proud to take part in a campaign for Guy’s Cancer Charity and recently raised money for them by running the London Marathon.

When Isabella Dominguez was born prematurely at just 26 weeks, she had a brain injury that caused her to have limited movement of her left side – a condition called hemiparesis.

At two-years-old, she was referred to the REACH programme at Evelina London Children’s Hospital, a groundbreaking intensive rehabilitation programme that helps children with hemiparesis to improve the use of their affected arm and hand.

Pioneered by Dr Anne Gordon, a consultant occupational therapist at Evelina London, the REACH service is the first of its kind in the UK to offer intensive upper limb rehabilitation in partnership with the child, their parents and local therapy team.

Isabella’s mother Chanel, from Bromley in south east London, said: "When Isabella was born prematurely, it was a worrying time as we didn’t know what her future would look like.

"When we found out about the REACH service and Isabella was referred for treatment, we hoped she would gradually gain some movement. But we are shocked at the huge difference it has made. Before she received the therapy, she had no use in her left arm and hand and I didn’t think she would ever be able to use them.

"Now Isabella is like a different child and is much more independent. She can do everyday tasks such as drinking from her water bottle, feeding herself with a knife and fork, and playing with her toys and younger brother Sonni."

The service offers arm and hand focused intensive rehabilitation programmes for children aged from 6 months to 16 who have, or at risk of, hemiparesis.

Dr Gordon said: "Evidence shows that for hand and arm function, intensive bursts of therapy work best. We have created the REACH programme to enable children to access this intensive course of- therapy, targeting their individual needs.

"The programme combines weekly face-to-face and virtual sessions with the REACH team, and weekly appointments with a child’s local therapist. The remainder of the sessions are delivered at home, led by the parents who we coach throughout the programme. This is really important as we work in partnership with the family and local therapist throughout."

When referred to the REACH service, children receive a detailed assessment to determine the most appropriate support based on their needs. Individual goals are set with the child, their family and community therapist, which aims to give them the best outcome.

Dr Gordon said: "During the sessions, children are typically seated, so they can see both of their hands as they're playing and moving, and can learn about what their hand can do. This is really important but we also want children to have fun through the programme as motivation and practice helps to develop their skills."

Chanel said: "We can now take Isabella to the playground and let her play with other children and use a climbing frame without worrying that she might lose her balance and fall.

"Isabella still has some difficulties with movement in her arm and will continue to require support, but the improvements she’s made so far are life-changing and have made a massive difference to our family."

She added: "I’m extremely grateful to everyone in the team. They were absolutely brilliant. Isabella loved going to her sessions at Evelina London, they made it really fun and for her it was just playtime. She was given toys to play with that forced her to use her left arm. It became like a second home.

"The team were also really supportive to me as a parent. I could email them at any time with questions which they always responded to. They even provided advice on what types of presents to get Isabella for her birthday and Christmas to help her use her arm. I couldn’t thank them enough."

The service is available to children and young people across London, Kent, Surrey and Sussex. The team also offers one-off consultation and advice appointments for children outside of these areas.

Karson Wong, children's occupational therapist at Evelina London.

I have worked in the Evelina London community children’s occupational therapy team at Sunshine House since 2015.

My role is to help children who have difficulties with daily activities to learn everyday skills and become more independent. I also support their families to develop problem-solving and coping skills.

An example of my work is supporting the family of a child with autism. The child might need extra help with learning how to get dressed, to do leisure activities or to manage in a classroom.

We also work with children who have complex physical needs, such as those with cerebral palsy.

During the COVID-19 pandemic we set up an online coaching group for parents to support their children’s goals, which has now become part of our core services.

Every parent comes to the group with a daily activity goal for their child. We coach them to find ways to achieve this goal. The most rewarding part of my job is when parents can find solutions to problems themselves.

Our team also works closely with children’s specialist doctors to assess and diagnose children with developmental coordination disorder, known as DCD. This condition affects children’s movement and coordination.

In July 2022, my colleague and I presented at the International DCD Conference in Vancouver. It was great to share our work with other doctors, researchers and families from around the world.

My work as a children’s occupational therapist is diverse. The most important qualities are empathy, a sense of fun when working with children and being able to comfort families who face challenges.

History corner

The pioneering work of a cardiothoracic surgeon at Guy’s Hospital paved the way for modern-day techniques and procedures which have saved thousands of lives.

This year marks the 60th anniversary of a landmark procedure which is one of many surgical world-firsts for former Guy’s Hospital surgeon Donald Nixon Ross.

In July 1962, he used a donor human heart valve, known as a homograft, for the first time.

Mr Ross was operating to repair a patient’s diseased aortic valve when it disintegrated, leaving a hole and a life-threatening situation for the patient. Artificial valves were in their infancy and were not as sophisticated as they are now.

To save his patient, Mr Ross used a donor human heart valve, which he had frozen in his research lab.

The patient not only recovered well, but his operation received international attention and it became the basis for the development of more complex procedures. To this day, surgeons still use a homograft in the rare occasions of a bacterial infection in the aortic valve, or for children who have cardiac defects.

Mr Ross was born in South Africa in 1922 to Scottish parents. After studying in his home country, he travelled to the UK in 1949 and in 1953 joined Guy’s Hospital as a cardiovascular research fellow. He worked closely with the pioneering cardiac surgeon Lord Brock and in 1958 he became a consultant at Guy’s.

Building on the success of his homograft operation, in 1966 Mr Ross further developed the procedure to use a donor valve when a patient is born without the valve which connects their heart to their lungs.

Just two years later Mr Ross replaced a patient’s diseased aortic valve with their own pulmonary valve, in what became known as the Ross Operation. This procedure is still performed by surgeons at Evelina London Children’s Hospital and Royal Brompton Hospital today, particularly on children and young active adults.

Through his career, one of Mr Ross’s most well-known achievements was leading the team which undertook the UK’s first heart transplant in 1968, while he was working at the National Heart Hospital.

Mr Ross died in 2014 at the age of 92 and few could rival for his pioneering surgical legacy.

David Anderson, professor of congenital cardiac surgery and consultant paediatric cardiac surgeon at Evelina London, learned the Ross Operation from Mr Ross when he returned from retirement to teach it at Guy’s.

The first patient Mr Anderson performed the procedure on, with Mr Ross in 1991, has needed no further surgery on his heart in the 31 years since.

Mr Anderson said: "Donald Ross was truly world famous among cardiac surgeons and made a massive contribution to modern cardiac surgery. I and colleagues have done many Ross Operations at Evelina London and it has made a real difference to the lives of all the babies and children we look after, as well as their families."

Foundation Trust life

Governors play a vital role in ensuring that local people, staff and all those who use Guy’s and St Thomas’ services have a say in how the Trust is run.

John Powell was elected as the new lead governor in July 2022 having been a patient governor for three years.

John, from Petts Wood in Bromley, said: "I enjoy being a governor and consider my new role to be an honour. The Council of Governors play an important part in helping the board to understand what local people need, and can help pick out any issues that need to be addressed for patients and staff."

John has a strong connection to the Trust, having first been treated for cancer at Guy’s Hospital in his early 30s and again in 2018.

He said: "My life at Guy’s began in 1992 when I was initially told that I had four to six months to live, but thanks to a pioneering new type of bone marrow treatment and the fantastic medical expertise of the staff I am still here today. Becoming a governor was my way of giving something back."

John stayed in touch with one of his nurses who encouraged him to become a member, before he stood for the Council of Governors elections.

He said: "Becoming a member is a great opportunity to learn more about the Trust and the NHS and what makes it tick – I find it fascinating. You can provide feedback on services and hear about what goes on behind the scenes."

John, who was made an MBE for his services to athletics in 2013, brings a wealth of knowledge to the role having worked for the Metropolitan Police for 30 years before retiring in 2011 as a superintendent.

He said: "I want to help in guiding the Trust towards delivering a world-class health service."

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.

Guy’s and St Thomas’ counts on its members for feedback, local knowledge and support.

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

Aruna Patel, from Harrow in north west London, has been a patient of the Trust for more than 20 years.

She’s received care from a range of services at Guy’s Hospital and St Thomas’ Hospital.

Aruna, who volunteers for several charities, said: "I’ve been under the care of the Trust for a long period of time so I’m aware that some patients suffer in silence because they don’t want to speak up. I want to use my role as a member to help other patients have their voice heard."

She added: "One of the ways I’m hoping to improve things for other patients is by getting involved with the Patient-Led Assessments of the Care Environment (PLACE). This involves local people going into hospitals to assess how the environment supports clinical care, looking at things such as privacy and dignity, food, cleanliness, general building maintenance and support for those with dementia or with a disability."

Aruna is encouraging other people to consider becoming a patient member. You can apply if you are over 18 and have been a patient or have provided care for a patient of the Trust in the last five years.

Aruna said: "There’s a benefit to knowing what is happening at the Trust. Having different people bring their ideas to the table can only be a good thing. It can also help to ensure that any problems are resolved at the earliest opportunity."

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

Last updated: November 2022

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