LEADING THE WAY WITH LIVE KIDNEY TRANSPLANTS NEW MIDWIFERY-LED MATERNITY SERVICE INTERNATIONAL PATIENT TEAM ISSUE 7 WINTER 15/16

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1 ISSUE 7 WINTER 15/16 LEADING THE WAY WITH LIVE KIDNEY TRANSPLANTS NEW MIDWIFERY-LED MATERNITY SERVICE INTERNATIONAL PATIENT TEAM Professor Vassilios Papalois, Professor of transplantation surgery

2 WELCOME TIM LEAK Modern matron, Hammersmith Hospital Every day, I am struck by the individualised care that nurses at Imperial Private Healthcare offer to our patients. We are constantly pushing boundaries to find new therapeutic approaches and, at the same time, caring for our patients as individuals. 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 editor: Julia Elmer +44 (0) For information on any of the services or projects featured in this issue, contact our customer relations manager on +44 (0) We are completely focused on providing a good experience for patients clinically and in terms of patients personal preferences in order to make their stay as comfortable as possible. By enabling and encouraging our nursing staff to personalise care, Imperial Private Healthcare continues to achieve the best outcomes for our patients in every aspect of their wellbeing. The new midwife-led maternity package (see pages 5-6) is one way in which we are doing this. Parents-to-be can now opt for their care to be led by midwives, rather than consultants, throughout their entire pregnancy. Our experienced midwives have a one-to-one relationship with expectant parents through the journey up to and including the birth. We also have a new International Patients Office (see page 10). The service started in May to support people travelling from overseas for treatment. An expanded team provides a single point of contact to patients and embassies, and manages personal and administrative requests from patients coming from outside the UK. Also in this issue, we look at some of the ways in which our experts are using innovative techniques to improve outcomes or speed up recovery. Our feature on the renal transplantation team (pages 6-7) shows how our consultants are breaking ground in their approach to live donor transplants, while our interview with Mr Ranan Dasgupta (page 4) highlights his expertise in the only non-invasive method for removing kidney stones. Finally, our feature on nonmalignant haematology is a great example of the strength of our academic capabilities. We have specialist laboratory facilities that allow our haematology team to research, identify and, ultimately, treat rare blood diseases, meaning we can care for people who might otherwise wait years for a diagnosis. I am proud to be part of Imperial Private Healthcare s highly skilled team that is constantly pushing boundaries to find new therapeutic approaches, and, at the same time, caring for our patients as individuals. Tim Leak 2 INSIDE PRIVATE HEALTH ISSUE 7

3 NEWS IN BRIEF New breath test identifies early-stage gullet and stomach cancers A breath test could help doctors diagnose early oesophageal and gastric cancer in minutes. In a trial of Imperial College Healthcare NHS Trust patients, researchers analysed more than 200 breath samples and were able to distinguish between malignant and benign oesophageal tumours. The current method, an invasive endoscopy, takes up to six hours to process and diagnoses are usually made at a late stage. Early diagnosis could give patients more treatment options. Following this success, a larger trial of the breath test is planned. Eye surgery technique radically improves recovery times Imperial College Healthcare NHS Trust surgeons at The Western Eye Hospital have transformed surgery for patients with Fuchs endothelial dystrophy; a cornea condition that causes eyesight to gradually deteriorate. Previously, surgeons replaced damaged layers with 0.15mm donor tissue, which improved vision to driving standard in three to six months. The new transplant technique takes 30 minutes and requires only the damaged membrane (0.01mm thickness) to be replaced, giving some patients 20/20 vision within a week of surgery. Top consultant is keynote speaker at inaugural haematology conference Dr Josu de la Fuente, paediatric haematology consultant for Imperial Private Healthcare, will be the keynote speaker at the first Pan Arab Thalassaemia & Haemoglobinopathies Conference (PATH 2015) in Abu Dhabi in November. Organised by the Emirates Society of Haematology, PATH 2015 includes in-depth scientific sessions and an awards ceremony to honour individual and group achievements in the fields of thalassaemia and haemoglobinopathies. Dr de la Fuente will speak about haematopoietic stem cell transplantation, where stem cells collected from bone marrow, peripheral blood, or umbilical cord blood are transplanted into patients. Milestone for Europe as lasers identify cancerous brain tissue Charing Cross Hospital surgeons have registered the first use in Europe of nearinfrared lasers to diagnose abnormal brain tissue during surgery. The non-invasive process measures the vibrations of light reflected off tissue to determine within seconds whether it is cancerous or healthy. The technique is more accurate and faster than standard methods, where biopsies are sent for analysis during operations, taking up to 40 minutes. Following extensive research, the trial took place during surgery to successfully remove a tumour from 22-year-old patient Reuben Hill (pictured). CONTENTS: 3 News in brief 4 In the spotlight: Ranan Dasgupta 5 Midwifery-led service offers holistic parenting support 6 Leading the way with live kidney transplants 8 Blood disease specialists bring research findings direct to patients 10 New team creates smooth care path for overseas patients 11 How to find us INSIDE PRIVATE HEALTH ISSUE 7 3

4 IN THE SPOTLIGHT RANAN DASGUPTA Endo-urology clinical lead Ranan Dasgupta, a specialist in urology, offers patients with kidney stones a comprehensive management approach in terms of treatment and prevention. Endo-urology clinical lead, Mr Ranan Dasgupta, offers the most minimally invasive techniques to treat patients with kidney stones. Mr Dasgupta offers the full range of clinical treatments for kidney stones. This includes non-invasive extracorporeal shock wave lithotripsy (ESWL) and laser fragmentation using a uretroscope (a long thin instrument inserted into the ureter, which connects the kidney to the bladder). He also offers percutaneous (through the skin) surgery. Charing Cross Hospital was one of the first UK institutions to use ESWL more than two decades ago. ESWL uses ultrasound waves applied from outside the body to break the stone into small fragments that can pass naturally by the urine. The attraction of this technique is that it is non-invasive, says Mr Dasgupta. It lasts less than 60 minutes and does not require a general anaesthetic. A broad offering Mr Dasgupta is proud that Imperial Private Healthcare offers comprehensive urology management in order to individualise care. Some cases are better suited to laser treatment or a percutaneous procedure, and not suitable for ESWL, he says. All options should be available and presented to the patient for comprehensive care. We can respond to patients unique situation, whether they have challenging anatomy, complicated stone disease or many other health problems at the same time. We have a fantastic multidisciplinary team, including interventional radiologists and medical colleagues, which ensures the Trust can offer unparalleled safety, whether patients arrive as an emergency or after referral from their healthcare practitioner. Groundbreaking approaches Mr Dasgupta s knowledge and involvement in national and international clinical trials are critical to progressing the team s understanding of effective treatments for kidney stones and prostate disease, among other diseases. For instance, in 2003, he carried out the UK s first botulinum toxin injection for overactive bladder symptoms, for patients with multiple sclerosis* and has since introduced this local anaesthetic procedure to the Trust. In addition, along with endocrinologist Dr Jeremy Cox, he offers a monthly metabolic clinic to reduce stone recurrence rates in patients who experience them regularly, and to monitor patients with rare types of stone. I m keen to maintain high-quality clinical outcomes in urology through the use of minimally invasive techniques, says Mr Dasgupta. We have seen this in stone disease and extending to prostate disease, certain kidney tumours and patients with neurological disease. We can respond to a person s unique situation. We have a fantastic multidisciplinary team that ensures we can offer unparalleled safety. 4 INSIDE PRIVATE HEALTH ISSUE 7 *further information on this study can be found in the BJUI journal 2003, Harper M et al

5 MIDWIFERY-LED SERVICE OFFERS HOLISTIC PARENTING SUPPORT A dedicated team of midwives is now providing one-to-one care and emotional guidance to parents-to-be during their pregnancies at Queen Charlotte s & Chelsea Hospital. Parents-to-be choosing Imperial Private Healthcare can now build even closer relationships with the midwife who will be at the birth of their baby. The new service at Queen Charlotte s & Chelsea Hospital is led by lead midwife Jenny Smith, who has 30 years experience in the field, and midwife Anneke Brown, who joined the Trust in 2011 and has a particular interest in mother and baby bonding. The service is led entirely by midwives, rather than consultants, from the start of the pregnancy journey although Jenny and Anneke work closely with their obstetric colleagues if necessary. This approach allows parents to have a deep rapport with their midwives, explains Jenny. It s reassuring for patients to have the same small team of trusted people throughout their pregnancy, all the way through to delivery. We aim to ensure the pregnancy and birth is a positive experience. Jenny and Anneke also help parents who already have children to introduce the new arrival. We advise parents on maintaining relationships with their newborns and other children, and getting older siblings involved in planning for the baby. It s reassuring for patients to have the same small team of trusted people throughout their pregnancy and delivery. Not just a rehearsal Patients have monthly appointments with Jenny or Anneke up to 28 weeks of pregnancy and then fortnightly to 36 weeks, with all scans and tests included. At 36 weeks, parents have a birth rehearsal. We talk about their wishes for the birth, and how and why those plans may change on the day, says Jenny. It s reassuring for parents to build a relationship and have early discussions with the people who are going to be at the birth. The service is not just for mums-to-be, adds Jenny. We encourage fathers to come to the rehearsal and scans, and they are welcome to attend every appointment. Both parents can stay over after birth and the ward even has a double bedroom. Midwives Jenny and Anneke aim to give patients as much normality as possible, regardless of the type of birth. They work closely with obstetric consultants and backup NHS services when necessary, and are supported by the wider midwifery and maternity team. Patients can call or text Jenny or Anneke with concerns 24 hours a day. Our aim is to put parents completely at ease and prepare them for parenthood in a nurturing and supportive way, focusing on health and emotional aspects. We get new parents into the mindset of being a family. INSIDE PRIVATE HEALTH ISSUE 7 5

6 LEADING THE WAY WITH LIVE KIDNEY TRANSPLANTS Renal transplant experts at Hammersmith Hospital have advanced the UK s use of live kidney transplants and are one of the most experienced teams in the country to offer this service. Until the late 1990s, most patients needing a kidney transplant in the UK had to wait on dialysis until a deceased donor match was found. Over the past 15 years, the Renal and Transplant Centre of Imperial College Healthcare NHS Trust has adopted an alternative approach that is saving lives and improving outcomes. In 2000 the centre s team at Hammersmith Hospital began offering live donor transplants, where an organ comes from a living donor - usually a family member or friend. Most advanced healthcare systems in the world had been using live donor transplants for years, recalls professor of transplantation surgery Vassilios Papalois. UK hospitals were lagging behind, so we decided to change that but push the method even further. The team meets with patients and their families to explain what is involved and what they should expect in the short and long term. We have an ambitious plan to make this approach effective for as many people as possible and to change lives for the better. One key distinction of the service is that, when possible, the transplant is performed before the patients reach the point that they need dialysis. This offers a better long-term outcome, as a patient s overall health gradually gets worse if dialysis is required. 6 INSIDE PRIVATE HEALTH ISSUE 7

7 Also, the centre s consultants have the skills to take on high-risk surgery. For example, older donors or those with a weight higher than the usual acceptable level have been treated. The centre also cares for donors and recipients with complex vascular anatomies. If a living donor and recipient are incompatible or mismatched by blood type or tissue, it is also possible at Imperial for them to be matched with another donor/recipient pair and the kidneys exchanged. A better match Hypertension and diabetes are the biggest causes of kidney failure, but the team also treats kidney failure in patients who suffer from complex conditions, such as autoimmune diseases. Live donor transplants resolve these problems in the best possible way and with excellent long-term outcomes. Relying on a deceased donor is a lottery, says Professor Papalois. You could be on a waiting list, and on dialysis, for years. Live donors are usually a better match and higher quality, as they come from a healthy individual. The team uses mini-open surgery on the donor, which means they can usually go home after just two or three days. This technique is safe and minimally invasive, enabling a kidney to be removed through a small side incision and leaves a scar that is hardly visible a few weeks later. Revolutionising transplant philosophy The team performs around 80 live donor transplants each year. We are able to carry out these advanced techniques because of our combined expertise, says Professor Papalois. Live donor transplants on this scale can only be done by highly experienced people, including transplant surgeons and physicians, interventional radiologists, pathologists and, of course, our superb live donor coordinators. We have those people and we are really proud of our team. Many other centres wouldn t attempt what we can do. We had an ambitious plan to make this approach effective for as many people as possible and change the lives of patients and their families for the better. It has revolutionised the renal transplant philosophy and helped people who have come for treatment from the UK and across the globe. Professor Vassilios Papalois, with a patient and her donor INSIDE PRIVATE HEALTH ISSUE 7 7

8 BLOOD DISEASE SPECIALISTS BRING RESEARCH FINDINGS DIRECT TO PATIENTS Imperial College Healthcare NHS Trust s haematology consultants include internationally renowned experts in blood cancer, haemopoietic stem cell transplantation and blood clotting disorders. The non-malignant haematology team cares for patients with a wide range of illnesses, including anaemia, sickle cell disease and immune blood disorders. The haematology department at Imperial College Healthcare NHS Trust and Imperial College London has a global reputation for the care of patients with both malignant and non-malignant blood diseases, with world-class consultants in both. As an academic department working within a clinical service, the team is among the first to offer new therapies to improve the treatment of non-malignant blood diseases. It also has an active clinical trial programme supported by a dedicated research team. Currently, several novel therapies for sickle cell disease, haemolytic anaemia and immune thrombocytopenia are undergoing evaluation. Consultant haematologist Dr Mark Layton, a specialist in non-malignant haematology, explains that the team s work takes them from the lab to the wards. We run our own tests investigating blood or bone marrow and interpret the results. We then translate our findings into clinical practice. The Trust also has a paediatric haematology service where the adult and paediatric team work closely together, seeing patients jointly from around the age of 14. Adolescence is a critical time, says Dr Mark Layton, a specialist in non-malignant haematology. We have an effective model, which includes specialist clinics, to help young patients transition into adulthood. We ensure they develop a therapeutic relationship with our team. 8 INSIDE PRIVATE HEALTH ISSUE 7

9 The Trust led the way in stem cell transplantation (SCT) for children with sickle cell disease and thalassaemia. Building on this success, the adult haematology team plans to offer this potentially curative treatment to older patients with inherited blood disorders such as sickle cell anaemia through its internationally recognised SCT programme. Groundbreaking research and investigation The Trust Hammersmith Hospital particularly has a long history of diagnosing and treating rare red cell diseases. That legacy has endured, says Dr Layton, who has more than 30 years experience in treating rare blood diseases. We have state-of-the-art investigative facilities that enable us to make accurate diagnoses of rare disorders. Working with the pathology team, the Trust s haematologists develop innovative diagnostic techniques and apply the latest DNA sequencing technology to identify the gene mutations that cause blood disorders. For example, consultant Dr Nichola Cooper, a specialist in immune blood diseases, is a leading researcher on immune thrombocytopenia (ITP), a disorder that destroys circulating platelets, causing excessive bruising and bleeding. Dr Cooper s team is identifying the immune abnormalities that cause this condition and conducting clinical studies to improve its treatment. Haematology is a broad clinical area, reflects Dr Layton. The Trust s academic strength and wide-ranging expertise in this field underpins our clinical excellence. THE 100,000 GENOMES PROJECT As a leader in this field, the Trust is one of NHS England s 11 Genomic Medicine Centres. These are central to the 100,000 Genomes Project, which aims to bring genome sequencing into routine clinical practice in the NHS across England. The Trust will recruit patients with blood cancers, rare diseases and inherited disorders, explains Dr Layton. We see patients with rare blood diseases that are likely to have a genetic basis that has not been identified by conventional diagnostic tests. Where we have discovered the gene responsible, this has in some cases led to new treatment approaches. The 100,000 Genomes Project is geared towards such cases. We have state-of-the-art investigative facilities that enable us to make accurate diagnoses of rare disorders. Dr Mark Layton Members of the haematology team at Hammersmith Hospital, including Dr Mark Layton (centre) INSIDE PRIVATE HEALTH ISSUE 7 9

10 TEAM CREATES SMOOTH CARE PATH FOR OVERSEAS PATIENTS Making sure that international patients have the best experience possible is the job of a new team at Imperial Private Healthcare. Patients from overseas are benefiting from a new service that provides a wider range of support before and throughout their treatment in London. Imperial Private Healthcare has set up an International Patients Office to enhance the care to patients referred from outside the UK. The team s medical expertise and cultural knowledge allows them to advise clinical and non-clinical colleagues of the best way to care for, and tailor support to, overseas patients. The office acts as a single point of contact for patients, embassies and insurers, which means enquiries are dealt with quickly and efficiently. A patient s relationship with the office usually starts while they are in their home country, says Dr Talha Elyas, head of the International Patients Office. It s reassuring for patients to have one coordinated team managing all initial referral and administrative processes. We previously had a referrals office and translation service, but not a single point of contact, which is what patients told us they wanted. Staff manage the referral, admission process and appointments and handle visa administration enquiries. They provide information about each hospital s facilities and relevant consultants specialties. The team responds to the patient s personal needs during their hospital stay, from room requirements and support for family members, to cultural and language requests, as well as embassy liaison. The International Patients Office team (Dr Elyas, 2nd left) Because we have increased our resources, the patient experience has improved... and our relationships with embassies have strengthened. Dr Elyas Support to Arabic-speaking patients With many referrals from the Gulf states, an Arabic advocacy service has been introduced across all hospitals and specialties. It provides Arabic-speaking patients and their families with tailored customer service and interpretation support from the first point of contact. Dr Elyas was specially recruited to lead the team. He is a qualified doctor and has lived, practised and managed teams in the Middle East and Arabic-speaking countries. I have an insight into international patients needs and I understand the cultural differences in medical practice, he says. Consolidating and expanding elements of the previous offering allows Imperial Private Healthcare to provide an even more professional service, says Dr Elyas. Because we have increased our resources, the patient experience has improved, the timescale in which we deal with enquiries is shorter and our relationships with embassies have strengthened. If you would like to get in contact with the International Patients Office, please call +44 (0) or ipo@imperial.nhs.uk 10 INSIDE PRIVATE HEALTH ISSUE 7

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 Western Eye Western Eye Hospital, Marylebone Road, London NW1 5QH 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 INSIDE PRIVATE HEALTH ISSUE 7 11

12 EXPERIENCE WORLD CLASS CARE At Imperial Private Healthcare, our patients experience the best of both worlds: our worldclass 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