BUILDING EXPERTISE IN ENDOCRINOLOGY LIFESAVING STEM CELL INNOVATION FRIENDLY FACES TO IMPROVE CANCER SUPPORT ISSUE 10 AUTUMN 2016

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1 ISSUE 10 AUTUMN 2016 BUILDING EXPERTISE IN ENDOCRINOLOGY LIFESAVING STEM CELL INNOVATION FRIENDLY FACES TO IMPROVE CANCER SUPPORT Endocrine consulting team

2 WELCOME DR TALHA ELYAS Head of the International Patients Office People travel from overseas to undergo treatment at Imperial Private Healthcare every day. As head of the International Patients Office, I frequently see how we have built an enviable global reputation for the quality of our service. By sharing knowledge between our private and NHS teams, we are able to deliver the right treatment to all our international patients. GET IN TOUCH This publication is produced by the communications directorate at Imperial College Healthcare NHS Trust. For feedback, suggestions or further information regarding this publication, please contact the marketing team: +44 (0) For information on any of the services or projects featured in this issue, contact our customer relations manager on +44 (0) Our excellent clinical outcomes and commitment to continual improvement shine through. The services and research highlighted in this issue of Inside Private Health show how Imperial Private Healthcare is going from strength to strength, and explain why we are seeing an increasing number of international patients. The Imperial Centre for Endocrinology, for example, is world-renowned for diagnosing and treating rare and complex conditions that aren t recognised by many consultants in other countries (pages 8 9). Our size, the volume of patients we see and the expertise of our multidisciplinary teams enables us to care for patients who have received a diagnosis, or not responded to treatment, elsewhere. At Imperial Private Healthcare, we are continually expanding our offer. On page 5, we report how two new renal dialysis machines are enabling us to treat a wider range of patients and offer continuity of care to those who need dialysis. On page 10, we look at how our specialist nurses and support navigators are guiding people with cancer through their treatment. These experts make life easier for patients, and their families and carers, by acting as primary contacts for any questions about clinical or practical elements of their treatment or our facilities. In this issue, our feature on our state-of-the-art stem cell lab explains how we are saving lives through innovative research and by manufacturing cells that boost patients immune systems (pages 6 7). We also meet one of our dedicated physiotherapists, who tells us about the skills she needs to help patients with serious injuries get moving and back to work (page 4). All these articles demonstrate why the quality of our service is second to none. Through effective working relationships between departments and by sharing knowledge between our private and NHS teams, we are able to deliver the right treatment to all our patients. Dr Talha Elyas 2 INSIDE PRIVATE HEALTH ISSUE 10

3 NEWS IN BRIEF Consultant recognised for contribution to clinical trials Mr Ahmed Ahmed, a consultant in upper gastrointestinal surgery and lead bariatric surgeon at Imperial College Healthcare NHS Trust, has been recognised for recruiting the first patients onto a trial to test a specialist stapler used in weight-loss surgery. Receiving the award from the National Institute for Health Research (NIHR), Mr Ahmed said: I can only do this with the immense generosity and courage of patients who agree to take part in clinical trials. The credit goes to those whose participation in clinical trials has led to some of the biggest clinical breakthroughs of our time. Specialist with rare pelvic floor surgery skills joins the team Consultant laparoscopic and colorectal surgeon Mr George Reese has joined Imperial Private Healthcare, working at Charing Cross Hospital and The Lindo Wing. Mr Reese specialises in both functional pelvic floor disorders and recurrent pelvic cancers. He also has a special interest in colorectal cancer and hernia surgery, while his other clinical work includes elective and emergency general surgery and upper and lower GI endoscopy. His research at Imperial College London is in the field of colonic imaging and he has been involved in setting up the colorectal pelvic floor service at Imperial College Healthcare NHS Trust. Mr Reese is also a consultant adviser to the charity Bowel Cancer UK. Ahmed Ahmed George Reese Jamie Murphy New appointment brings expertise in bowel and lower intestinal surgery Colorectal surgeon Mr Jamie Murphy, who has trained extensively in lower intestinal surgery and complex/recurrent cancer, has joined the team at The Lindo Wing. Mr Murphy completed his medical training at the University of St. Andrews, Harvard University and St John s College, Cambridge. He has received a PhD in colorectal molecular oncology and undertaken specialist training in areas including advanced minimally invasive surgery and the use of chemotherapy during surgery to treat cancers that otherwise cannot be removed. Dental service supports private patients with their dentistry needs Imperial Private Healthcare now offers private dental services at Charing Cross Hospital. Miss Ulpee Darbar, a consultant in restorative dentistry, is supporting existing inpatients who require any dental treatment as part of their overall care because of either a pre-existing condition or a complication caused by other treatment. CONTENTS: 3 News in brief 4 In the spotlight: Angharad Holland 5 Dialysis service 6 Stem cell innovation 8 Endocrinology expertise 10 Friendly faces for cancer support 11 How to find us INSIDE PRIVATE HEALTH ISSUE 10 3

4 IN THE SPOTLIGHT: ANGHARAD HOLLAND Physiotherapist Angharad Holland joined Imperial Private Healthcare in May. She offers the full range of rehabilitation treatments to improve patients mobility and quality of life. Angharad Holland, one of Imperial Private Healthcare s dedicated physiotherapists, is passionate about helping patients become as active as possible. Based at St Mary s Hospital, Angharad sees every patient in The Lindo Wing who requires physiotherapy. Her special interest is orthopaedics, but she covers a mix of specialisms vascular, trauma, respiratory, postnatal, post-surgical and medical, to name a few. Having worked around the UK and in private facilities in Australia and New Zealand, Angharad has extensive experience of all physiotherapy treatments, including muscle-strengthening exercises, stroke rehabilitation and balance, chest physiotherapy to reduce the risk of infections, walking assessments and pain management. Angharad sees some patients for just a day or two, and others over several months. For instance, she carries out detailed ongoing assessments of stroke patients to establish their needs, and helps elderly patients with broken hips to regain normal movement and ensures their home set-up is appropriate. One of Angharad s recent trauma patients had a leg amputation and severe hand injury. It s a long process for me to get a patient with serious injuries moving and back to work, she explains. I worked with an occupational therapist and hand therapist to increase the patient s function and independence. Offering advice and reassurance Angharad adds that soft skills are also vital: A big part of my job is educating and motivating patients around being active, which can be difficult when some patients find it hard just getting out of bed. I look for signs that a patient is struggling to cope with their situation. I spend a long time with patients every day for several weeks and they feel safe talking to me about their anxieties. As she sees her patients through all their physiotherapy needs, Angharad provides continuity of care. It s reassuring for patients to have that relationship with me from start to finish. They also don t have to repeat their case history or goals to multiple people. Angharad says she is driven to help people with complex mobility issues regain their independence: I wanted to work here, in a large teaching hospital, surrounded by innovative research, so that I could expand my knowledge of patients with highly critical needs. I can get advice from experts in their field and, likewise, share my findings with them. That s great for me and for patients. A big part of my job is motivating patients to be active I spend a lot of time with patients and they feel safe talking to me about their anxieties. 4 INSIDE PRIVATE HEALTH ISSUE 10

5 DIALYSIS SERVICE INCREASES CAPACITY TO SUPPORT PATIENTS New facilities are enabling Imperial Private Healthcare to treat more patients with ongoing renal conditions and complex health problems. Private patients who require dialysis can now receive continuous care on site with the arrival of new dialysis machines. Two rooms within the Robert & Lisa Sainsbury Wing at Hammersmith Hospital have been set up with sophisticated dialysis equipment. This is a significant enhancement to Imperial Private Healthcare s offer, says head of nursing Teresa McHugh: It gives us greater flexibility to treat a wider range of patients who need dialysis both existing renal transplant patients and private patients with other secondary conditions, such as cardiac problems. Continuity of care The service also benefits private renal transplant patients who need dialysis, adds lead nurse Itziar Atucha: The process of live kidney donation is complex from exhaustive clinical assessments of the donor and recipient through to recovery from surgery. It is an advantage to the patient that they can now receive continuous care in one location, as we can now support them through every stage of their treatment. This also makes it easier for kidney specialists, renal physicians and other professionals to be involved in their care. A dedicated private dialysis nurse has also joined the team. Sister Amrita Acharya has eight years experience and will provide a one-to-one approach, building trusted relationships with patients. She will work closely with other NHS colleagues from Imperial College Healthcare NHS Trust, which is Europe s largest dialysis service. Miss Atucha says: Across the Trust, we have highly skilled and trained renal nurses and international experts carrying out innovative research in renal conditions and treatments, and the new equipment will also benefit their work. Our private clinical staff can call on their support if we need it and tap into that specialist knowledge to ensure our care is of the highest quality. Running since November, the service can be tailored to the patient s needs and schedule, and enables patients to have their dialysis in the comfort of their own room. There are benefits to staff, too. Ms McHugh adds We are able to support any patient requiring dialysis through their whole care journey. That s really fulfilling. The new service gives us greater flexibility to treat a wider range of patients who need dialysis both existing renal transplant patients and private patients with other secondary conditions. INSIDE PRIVATE HEALTH ISSUE 10 5

6 STEM CELL INNOVATION FOR ADDED PROTECTION TO TRANSPLANT PATIENTS Imperial College Healthcare NHS Trust s state-of-the-art John Goldman Centre for Cellular Therapy is delivering unique treatments that provide greater protection to patients recovering from blood and bone marrow stem cell transplants. One of the UK s most advanced stem cell laboratories is saving lives by delivering outcomes of revolutionary research straight to patients. John Goldman Centre for Cellular Therapy at Hammersmith Hospital is leading the way in the UK by manufacturing cells that enhance a patient s immune system to protect against infections. This complements a world-class transplantation programme and improves the safety of these complex procedures, especially in patients without a fully-matched donor. This stem cell laboratory is one of a small number in the UK with a licence to provide medicinal products, in particular for cellular therapy, which involves infusing living cells into patients. As an academic health science centre with close access to Imperial College London, the Trust has researched this field extensively. Many of our private patients come from abroad and belong to ethnic groups that are not common in the UK, explains Dr Jiri Pavlu, consultant haematologist. If they are not fortunate enough to have a fully matched relative, we often struggle to find a matched unrelated donor for them. It is the recent advances in cellular therapy that enabled us to use mismatched donors more safely. Our people are knowledgeable about all blood-derived malignant disorders. The benefit to patients is that we work as an integrated team, sharing this expertise, and passing research into practice. 6 INSIDE PRIVATE HEALTH ISSUE 10

7 Life-saving research Currently, the team is using a new way of manufacturing cells that fight specific viruses the first time this new advanced technique has been used in Britain. The body naturally produces lymphocytes white cells that develop an immune response to a virus, says Anne Bradshaw, head of operations and regulatory affairs. ANTIVIRAL CELL TREATMENT IS UK FIRST If that virus reappears, your body usually recognises it and fights it. That s how your immune system develops. A patient who has had a stem cell transplant loses these cells and they are no longer immune to anything, so a virus that the patient has had before can reactivate, making an already unwell patient very sick. The team has found a way to harvest these cells from a donor and give them to a patient. To date, the stem cell lab team has carried out trials on three transplant patients, where specific antiviral cells from their donors have been infused to treat three different viral infections all successfully. State-of-the-art facility The lab exceeds regulators requirements. Mrs Bradshaw says: Most similar labs monitor pressure levels and dust particles weekly or daily, but ours does this continuously, which gives us total confidence in the cleanliness of the environment. Our people are highly-skilled in related specialisms haematology and paediatrics, for instance and knowledgeable about all blood-derived malignant disorders. The benefit to patients is that we work as an integrated team, sharing this expertise, and passing research into practice. Patients with immune systems weakened by stem cell transplant treatment can avoid secondary infections thanks to a novel technique developed at Imperial. Researchers from the Trust s stem cell lab have found that infusing patients with antiviral T-cells enriched by a novel technology can stop a reactivated virus before it makes a post-transplant patient seriously ill. In the lab, T-cells from the patient s donor often a relative are mixed with an antibody specific to a virus the patient has contracted. These cells are then isolated and given to the patient, which will then neutralise the virus. So far, three patients have trialed the process at St Mary s and Hammersmith hospitals, and all improved quickly. This is a safe process that can prevent patients becoming more sick, which ultimately means that they can return home much quicker: says consultant paediatric haematologist Josu de La Fuente. Stem cells preserved in liquid nitrogen remain viable for many years INSIDE PRIVATE HEALTH ISSUE 10 7

8 BUILDING ON THE FOUNDATIONS OF ENDOCRINOLOGY EXPERTISE The endocrinology unit s expert team has unrivalled knowledge and experience in the management of hormone-related disorders. Recognised internationally for more than 40 years, the Imperial Centre for Endocrinology is a world-class clinical, academic and teaching unit under the experienced leadership of Professor Karim Meeran. The team of renowned physicians and surgeons has the experience and state-of-the-art techniques available to diagnose and treat any endocrine condition. Ongoing research and the expertise gained from seeing a high volume of patients have made the department a leading centre for many endocrine diseases and it is especially well equipped to deal with complex and rare problems. The conditions managed include the excess or insufficient production of hormones and all Photo above from left to right: Dr Florian Wernig, Dr Harvinder Chahal, Dr Jeannie Todd, Professor Sir Steve Bloom, Professor Karim Meeran and Dr Channa Jayasena disorders of the adrenal, thyroid, parathyroid and pituitary glands, infertility, neuroendocrine tumours, hypertension and genetic endocrine conditions. Complex cases are discussed in weekly multidisciplinary team meetings. Specialists collaborate from diagnoses to final treatment. Consultant endocrinologist Dr Florian Wernig explains: We have some of the world s most experienced and innovative consultants in their field, each with their own specialism. Constant peer review of our own practices guarantees a high standard of care. Active and close collaboration with our research endocrine group, led by Professor Sir Steve Bloom, puts us at the forefront of endocrinology, which is a huge benefit to patients. People come from all over the world for second opinions, says consultant endocrinologist Dr Harvinder Chahal: We have the expertise to diagnose conditions that others haven t been able to identify. Particularly, this helps patients from countries that don t have resident clinicians with in-depth experience of the most complex endocrine disorders. In-depth diagnostic testing With an endocrinology investigation unit, a state-of-the-art laboratory and uniquely skilled interventional radiologists on site, the team s diagnostic capabilities are first-rate. Many symptoms of endocrine conditions are nonspecific tiredness, for example so testing is key. The golden rule of endocrinology is to first establish a firm biochemical diagnosis, says Dr Wernig. We go above and beyond to ensure subsequent diagnostic and treatment processes deliver the best possible outcomes. 8 INSIDE PRIVATE HEALTH ISSUE 10

9 The centre offers fast diagnostic tests, many of which involve precise or extensive techniques that can only be carried out in a specialist centre. Some patients need multiple tests over several days. The centre has the capacity to carry out all these in one location, overseen by consultants and trained endocrine nurses. A range of treatments A wide range of treatments are available, from surgery to hormonal therapies. In the 1970s, Hammersmith Hospital formed the UK s first endocrine surgical unit. Endocrine surgeon Mr Fausto Palazzo explains: Hammersmith was the cradle of endocrine surgery. Few centres have such an effective close interaction between endocrinology and endocrine surgery. This has helped the centre become the UK s largest for thyroid, parathyroid and adrenal surgery and, thanks to Professor Neil Tolley, the first to perform robotic thyroid and parathyroid surgery. It is also unique in offering every type of adrenal surgery, including laparoscopic and retroperitoneoscopic adrenal surgery a minimally invasive surgery through the back, which means patients have less pain and a shorter hospital stay. Patients with fertility issues are jointly assessed by endocrinology, urology and gynaecology specialists. Consultant Dr Channa Jayasena sees men and women with any infertility or reproductive hormone condition. Many of his patients have severe problems and have not responded to treatment elsewhere or been told they cannot be helped. I diagnose conditions that many doctors aren t aware of because the hormonal levels resemble those of other conditions, says Dr Jayasena. Because our centre is run by reproductive clinicians, rather than scientists, we can spot particular clinical issues. Many of our experts here have been involved in endocrinology for decades, adds Dr Wernig. Alongside this rich experience, we have the latest facilities and knowledge to diagnose and treat every condition. Not many centres can say that. That s what makes us strong. The golden rule of endocrinology is to first establish a firm biochemical diagnosis. We go above and beyond to ensure subsequent diagnostic and treatment processes deliver the best possible outcomes. Dr Florian Wernig and Dr Harvinder Chahal INSIDE PRIVATE HEALTH ISSUE 10 9

10 FRIENDLY FACES OFFER DEDICATED SUPPORT TO THOSE LIVING WITH CANCER Patients with cancer meet many people during the course of their treatment so Imperial Private Healthcare is helping them access the right specialists and information when they need them. Imperial Private Healthcare has two dedicated cancer support navigators and two oncology clinical nurse specialists (CNS) working across Hammersmith and Charing Cross hospitals. Every patient diagnosed with, or suspected of having, cancer has a named CNS and navigator who have in-depth knowledge of their condition and treatment plan. While consultants will supervise all aspects of patient care, each patient s navigator and CNS are available for day-today practical support about everything from medication to appointments, meaning patients receive a comprehensive clinical service on all levels. Navigators and CNS aim to make life easier for patients, and also their families and carers. From the first conversation, they get to know the patient and hear their concerns and how cancer might affect their home life. They become a familiar face and a visible, comforting presence on the ward building a rapport, offering emotional support and reassurance, and communicating key information. When the patient is at home or their CNS is not on the ward, the patient, carer or relative can call or them directly if they have something on their mind no matter what it is. When a patient is living with cancer, their whole life is affected. That s why Imperial Private Healthcare s team of cancer specialist nurses and cancer support navigators are on hand to provide guidance and reassurance throughout their treatment. Expertise and understanding Clinical nurse specialists are trained and experienced in cancer nursing. Patients benefit from having easy access to an additional clinical expert, aside from their consultant, who can answer questions about their treatment. Patients can call navigators to manage their appointments and get whatever information they need from test results to details on local community services and home support. Navigators are also there if patients just want someone to chat to. If the patient has a clinical enquiry, the navigator will make sure the CNS or another healthcare specialist on the team returns their call as soon as possible. The team is always available including offering support and information related to a patient s secondary condition or injury they have while being treated for cancer. Together, the CNS and navigator build a trusted relationship with their patient, putting them at ease and delivering a seamless service that exceeds the expectations of everyone affected by cancer. If you have any ideas for service development at Imperial Private Healthcare, or would like to give feedback, contact Jane Boyle, head of business development, at jane.boyle@imperial.nhs.uk 10 INSIDE PRIVATE HEALTH ISSUE 10

11 HOW TO FIND US Queen Charlotte s & Chelsea Hospital Hammersmith Hospital EAST ACTON D U C A N E R O A D A40 W E S T W A Y A 4 0 St Mary s Hospital PADDINGTON A41 LEADING TO THE M1 EDGWARE ROAD MARYLEBONE A501 P R A E D S T R E E T S S E X G A R D E N S MARBLE ARCH A41 Western Eye Hospital BAKER STREET M A R Y L E B O N E R O A D A501 TOWARDS LONDON CITY AIRPORT S U A40 LEADING TO THE M40 H Y D E P A R K A219 A4 A4 LEADING TO THE M4 & HEATHROW AIRPORT HAMMERSMITH A4 A4 F U L H A M P A L A C E R O A D BARON S COURT Charing Cross Hospital R I V E R T H A M E S Tel: +44 (0) private.healthcare@imperial.nhs.uk The Lindo Wing of St Mary s Lindo Wing, St Mary s Hospital, Praed Street, London W2 1NY Charing Cross The Thames View, 15th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF Hammersmith Robert & Lisa Sainsbury Wing, Hammersmith Hospital, Du Cane Road, London W12 0HS Queen Charlotte s & Chelsea Sir Stanley Clayton Ward, Queen Charlotte s & Chelsea Hospital, Du Cane Road, London W12 0HS Western Eye Western Eye Hospital, Marylebone Road, London NW1 5QH INSIDE PRIVATE HEALTH ISSUE 10 11

12 EXPERIENCE WORLD CLASS CARE At Imperial Private Healthcare, our patients experience the best of both worlds: our world-class consultants provide care in modern private facilities within the reassuring setting of some of London s most trusted NHS hospitals. With over 350 consultants covering every medical, diagnostic and surgical specialty, we care for our patients whatever their healthcare needs. Our partnership with Imperial College London means that many of our consultants are involved in cutting-edge research, which in turn allows us to provide the most up-to-date treatment for patients. All funds generated by Imperial Private Healthcare are reinvested in Imperial College Healthcare NHS Trust, to support and enhance both NHS and private clinical services for the benefit of all our patients. For more information on our private healthcare services, please contact our customer relations manager on +44 (0) ( GMT) or private.healthcare@imperial.nhs.uk For more information about our consultants please visit