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UCLH MAGAZINE Issue 21 2023

Welcome to the latest edition of UCLH Magazine.

In this edition there’s a strong theme of research and innovation. Healthcare is always changing and developing to meet the new challenges we face. Whether global pandemics or changes in lifestyle, it’s vital we move with the times.

On average, people are now living longer, and this means diseases that are more likely to affect us the older we get – such as cancer and Alzheimer’s – have become more prevalent than they used to be.

At UCLH, we’re at the forefront of research that’s leading to better diagnostics and treatment, such as innovative ‘gene silencing’ for Alzheimer’s disease, which you can read about on page 4. We’re also pioneering new approaches to diagnosing and treating prostate cancer, such as using MRI scans in conjunction with the usual blood tests. This is being led by UCLH’s Professor Caroline Moore, who’s on the cover of this issue, and you can read about her work and that of her team on page 8.

The way we run our hospitals is also constantly adapting to meet new challenges, and we’re always looking for ways to innovate. Led by our director of innovation, Luke O’Shea, one such project is our Gloves Off campaign. Habitual glove wearing has been shown to give the wearer a deceptive feeling of security, creating a greater risk of moving between activities without washing hands in between. By removing gloves from specific activities and switching the focus to improved hand hygiene, we hope to see infections fall while also reducing waste, which is better for the environment. Read more on page 14.

Another example of innovation is the new UCLH and Whittington Health children’s dental service that’s helping to keep children out of hospital by providing specialist treatment in the community (page 6).

There’s lots more in this issue too, including a look at the new garden at the National Hospital for Neurology and Neurosurgery that came to us via the Chelsea Flower Show and a grateful patient, to a day in the life of one of our phlebotomists, who performs the vital job of skilfully taking blood samples from patients for examination in a laboratory (page12). You can also meet our new governors on page 15.

UCLH leading efforts to transform Alzheimer’s care

Researchers at UCLH are at the forefront of exciting new breakthroughs in how we treat people with Alzheimer’s.

It is thought the revolutionary treatments – and new ways of diagnosing neurological disease – could transform care. Professor Nick Fox, a consultant at UCLH’s National Hospital for Neurology and Neurosurgery (NHNN), said: “We are entering a new era in modification of Alzheimer’s disease – after a long period of hard work by many people, with many disappointments along the way.”

Gene silencing

In one study at the NHNN, led by Dr Cath Mummery, a new genetic therapy for Alzheimer’s disease successfully lowered levels of the harmful tau protein, known to cause the disease. The trial represented the first time a ‘gene silencing’ approach had been taken indementia. The drug was able to ‘silence’ the gene coding for the tau protein – reducing its production. In a separate study at UCLH, early results suggest a gene silencing approach can lower levels of amyloid – the other main protein thought to cause Alzheimer’s disease – in a way that could prevent early-onset disease.

Amyloid plaques

These gene silencing therapies are being trialled at a time when three other drugs – aducanumab, lecanemab and donanemab – have been shown to be effective in targeting the build-up in the brain of amyloid plaques (where pieces of the protein clump together). UCLH was part of research looking at aducanumab, and is carrying out research where lecanemab is used alongside other treatments.

Rapid diagnosis

To improve diagnosis and monitoring of Alzheimer’s disease, researchers at UCLH are also aiming to validate a rapid brain imaging (MRI) protocol, which would make it possible to acquire brain scans in just five minutes, instead of 20 to 30 minutes. Professor Fox and Dr Mummery are leading the work, with Professor Geoff Parker at UCL. Being able to complete a scan in five minutes would help more patients get a quick and precise diagnosis, and lead to better management of a patient’s condition. Importantly, rapid scans would support monitoring the safety of new treatments which require frequent MRIs.

Bringing the benefits to patients

As research continues, Professor Fox and Dr Mummery say that hospitals will need to be ready to be able to offer patients new therapies. Dr Mummery said: “We need to develop our dementia treatment pathways in the UK so that we are able to diagnose Alzheimer’s early and accurately enough for drugs to have a chance to work, and to deliver new treatments safely. If we can do this, it would be a revolution for our patients.”

Our award-winning children’s dental service is saving trips to hospital

A new UCLH and Whittington Health children’s dental service is helping to keep children out of hospital by providing specialist treatment in the community.

The joint service, known as the virtual Paediatric Dentistry Advice Clinic, is also giving new skills to community dentists, so they can treat more children with complex dental issues closer to home, often with shorter waiting times. Ms Alexandra Lyne, consultant dentist at UCLH’s Royal National ENT and Eastman Dental Hospitals, explains: “The Paediatric Dentistry Advice Clinic is good news for patients, dentists and the NHS as a whole.

“Not only has the service helped the 200 patients that used it last year, but it has also up-skilled local dentists and prevented referrals into hospital. We are now sharing the project regionally and nationally to inspire similar clinics across the country.”

During the virtual clinic, community dentists can discuss their own cases with a consultant dentist to help them decide on the best course of treatment for their patients.

Most of the 200 patients discussed by the virtual clinic last year went on to receive their treatment in a community dental clinic by their own dentist. Less than ten per cent of children needed to be referred to a hospital, with the rest treated or monitored locally, or referred to another service, such as for braces.

It's not only our patients and community dentist partners that are impressed by the virtual clinic. The clinic has won a number of prestigious awards that recognise the innovative way the service is improving children’s dental health and sharing expertise too.

Dr Tim Hodgson, medical director for specialist hospitals board and himself a consultant dentist, added: “This is a fantastic example of partnership working across UCLH, Whittington Health and community dentistry.

“What started as a small project has grown into a shining example of how hospital and community services can work together.”

Improving prostate cancer diagnosis with MRI scans

Magnetic Resonance Imaging (MRI) scans could be used to screen men for prostate cancer, according to new research.

The scans were found to be more accurate at diagnosing prostate cancer than blood tests, which look for high levels of a protein called PSA, alone. MRI, which uses strong magnetic fields and radio waves to produce detailed images of the inside of the body, picked up some serious cancers that would have been missed by PSA alone. The findings of the REIMAGINE study, led by researchers from UCLH, UCL and Kings College London, have been published in BMJ Oncology. Men aged 50 to 75 in London had MRI and PSA screening tests at University College Hospital for the study. UCLH consultant surgeon Professor Caroline Moore, who was chief investigator of the study, said:

“Our results give an early indication that MRI could offer a more reliable method of detecting potentially serious cancers early, with the added benefit that less than one per cent of participants were ‘over-diagnosed’ with low-risk disease. More studies in larger groups are needed to assess this further.”

Trial participant Paul Rothwell, 62 (pictured), was diagnosed with prostate cancer in 2020. His PSA score was normal but MRI revealed his cancer. “I felt unfortunate to be diagnosed with cancer, but very fortunate to have been offered the MRI as it meant I was diagnosed before I had any symptoms, when the cancer was at an early stage and still localised.

“If I had just had the regular blood test, I would have been completely unaware that I was walking around with a ticking time bomb. As a result of the MRI, my cancer was caught and I was able to start treatment early, which is a huge plus.”

The research was supported by the National Institute for Health and Care Research UCLH Biomedical Research Centre, the Medical Research Council (MRC) and Cancer Research UK (CRUK).

One in eight men will get prostate cancer. If you are over 50, or you are black, or your dad or brother had it, you are at even higher risk. Men over 50 and black men over 45 can talk to their GP about having a prostate cancer blood test.

Brain surgery patient’s labour of love to bring Chelsea garden to hospital

Simona was just 27 when she had a bleed on her brain while driving on the motorway.

The bleed meant the previously vivacious global head of PR lost her independence and was forced to move home because of balance problems, the need for a walking frame and severe pain.

Simona (pictured) was diagnosed with cavernoma, a lesion made up of abnormal blood vessels. In December 2015, Simona underwent a six-hour operation at UCLH’s National Hospital for Neurology and Neurosurgery (NHNN). After she recovered from the major surgery, Simona’s employer, financial technology company EXANTE, donated a Chelsea Flower Show garden to UCLH to thank staff for caring for her, as well as a number of its employees.

Designed by Finnish horticulturist Taina Suonio and built by Oxfordshire-based firm Nicholsons, the garden, called “Connected”, aims to improve the mental and physical wellbeing of people by connecting them to nature. The garden’s centrepiece is a three-metre oak tree stump, chosen by EXANTE, as it contributes to the surrounding biosphere as a home for fauna, food source and part of the water cycle.

Simona is delighted: “The NHNN saved my life. The hospital’s canteen, near where the garden now is, provided solace for my family as they waited for me to come out of surgery.” NHNN clinical director Dr Chris Turner said:

“We are so grateful for this beautiful gift from EXANTE. Having an uplifting space and fresh air are so important for our patients and staff.

“UCLH Charity is developing a garden volunteering project and fundraising to support the maintenance and upkeep of the garden so we can offer a sanctuary for patients and staff for years to come.”

UCLH head of charitable giving Carol Haraldsson said: “We would like to thank EXANTE for this extraordinary donation which is ‘above and beyond’ what the NHS could provide. All charitable donations we receive are used to enhance patient care and support the staff who care for them.

“EXANTE’s garden donation is a great example of how, together, we can really make a difference”.

The fundraising team is currently raising funds to replenish and maintain the garden spaces at sites across UCLH. To find out more and to donate visit our JustGiving page below.

Viviane tells us about her experience of working with the phlebotomy team at UCLH and her favourite aspects of the role.

What does a phlebotomist do?

As a phlebotomist, you carefully and skilfully take blood samples from patients for examination in a laboratory. The results are used to quickly diagnose diseases and other conditions. As a phlebotomist, you are a crucial part of a patient’s healthcare team.

What does your job involve day to day?

Phlebotomists can work in many different healthcare settings, such as hospital wards, clinics or GP surgeries. Besides collecting samples from patients, you spend time with them to explain the process and put them at ease, if needed. You are responsible for ensuring samples are delivered for testing on time and work with a multidisciplinary team of healthcare professionals. You may also deliver training to other healthcare staff so they can collect blood too.

Why did you become a phlebotomist?

I always knew I wanted to work in healthcare. My own experience of going to hospital, and the contact and care I had with the staff, inspired me to pursue a career where I could help people.

What skills do you need?

Besides the technical skills and training, you need empathy and patience. Having blood taken is not something patients are always comfortable with, so being able to remain calm, listen and reassure people is important. Having all these qualities will help when interacting with your patients.

What is the best part of your job?

The best part of my job is overcoming challenges and having the chance to develop a bond with patients.

Work with us!

We’re looking for people who will live our values and help us make a difference to the thousands of patients who come to us for treatment every year. We believe that every member of staff plays an important part in our vision, whatever their role.

Gloves off for better patient and staff safety

UCLH has changed the way patients and staff are protected from infection, by reducing glove use when treating non-infectious patients, and improving the focus on hand hygiene instead.

Habitual glove wearing has been shown to give the wearer a deceptive feeling of security, creating a greater risk of moving between activities without washing hands in between. By removing gloves from specific activities and switching the focus to increased hand hygiene, UCLH expects to see overall infection prevention and control improvements. As long as there is no risk from blood or bodily fluids, and the patient isn’t infectious, staff should no longer wear single use non-sterile plastic gloves when examining or moving patients, taking vitals (e.g. blood pressure), giving vaccinations or assisting patients with food and drink.

Director of infection prevention and control Dr Gee Yen Shin said: “We believe that reducing glove use and increasing the focus on hand cleanliness when dealing with non-infectious patients will lead to a better and safer experience for both patients and staff.

“Excessive use of gloves can also lead to an increase in skin issues in our staff, so this has the potential to improve staff wellbeing too.”

The Gloves Off initiative is additionally expected to reduce plastic waste and deliver cost savings, aligning with UCLH’s sustainability programme.

Meet our new governors

Following our Council of Governors elections earlier this year, five new Governors took up their seats on 1 September. They are:

  • Agnes Kory, patient governor
  • Bonnie Chu, public governor
  • Heather Macgregor, public governor
  • David Freedman, public governor
  • Jeanette Dye, carer governor (elected unopposed)

They join three governors who were re-elected:

  • Fiona McLean, patient governor (re-elected)
  • Emma Manuel Szelepet, patient governor (re-elected)
  • Anna Collinson, staff governor: nursing and midwifery (re-elected unopposed)

Public governor Bonnie Chu (pictured) said: “I'm an architect specialising in healthcare projects, and was lead architect designing and delivering the University College Hospital Macmillan Cancer Centre and the Grafton Way Building.

“I stood for governor because I want to continue to serve UCLH, its patients, staff and community. UCLH has fantastic values, it delivers ground-breaking services for patients, and the staff provide clinical care with such commitment and dedication.

“I am grateful and proud to be elected as public governor for the next three years.”

If you would like to contact the governors, or are interested in standing as a governor in next year’s elections, please email uclh.governors@nhs.net

Public meetings

Members of the public are welcome to attend UCLH’s Board of Directors and Council of Governors meetings. There is an opportunity towards the end of the meetings for members of the public to ask questions. Details of upcoming meetings are on our website or you can email uclh.directors@nhs.net or uclh.governors@nhs.net.

UCLH membership

Are you interested in becoming a member of UCLH? Would you like to receive information about upcoming events, news, and opportunities for involvement? You can sign up for free online at www.uclh.nhs.uk/members.