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UCLH MAGAZINE ISSUE 16 2021 (SCROLL DOWN)

WELCOME

The pandemic has been a challenging time for all our staff. Their commitment, dedication and professionalism has really shone through as they have worked together to care for very sick patients throughout.

I have been so proud to lead the team across our hospitals since I joined UCLH last year. The work they do day in, day out is just phenomenal and I have enjoyed the opportunities to see it first-hand when COVID restrictions have allowed. From our porters and admin staff to our doctors and AHPs, everyone has pulled together to get us through this.

Of course, it hasn’t been easy for our staff and we have increased our wellbeing and psychological support to address this. It has been impressive how everyone has supported each other through this time and you can read about the experiences of three members of staff in a really touching interview below.

Despite the issues the pandemic has caused, we have still been able to introduce a number of fantastic innovations which are already making a difference to our patients’ lives. We work closely with a number of other organisations, including UCL, to ensure we are always driving forwards with research to enable us to be at the forefront of new technologies. This gives fantastic opportunities for our patients to receive cutting-edge care, and for our staff to be able to train to use these hi-tech options. “Improving” is one of our trust values and it is so important to everything we do at UCLH.

We were really excited to open our proton beam therapy centre in our new hospital, the University College Hospital Grafton Way Building. Proton beam therapy is a pioneering type of radiotherapy and UCLH is only one of two NHS hospitals in England to offer it. You can find out more about proton beam therapy, and read the inspiring story of one of our first patients, Prescilia, further down.

A new way of treating prostate cancer has been used for the first time in the NHS at UCLH. The minimally invasive technique, known as Nanoknife, causes fewer side effects and has so far seen great results. You can read more on page 14.

I would like to end by thanking all our patients for their patience and understanding if COVID has delayed their treatment. We appreciate that this is a stressful time for you but we are doing everything we can to see those patients who have been waiting as quickly as possible.

David Probert, chief executive, UCLH

HRH The Prince of Wales opens University College Hospital Grafton Way Building

His Royal Highness the Prince of Wales officially opened the University College Hospital Grafton Way Building on 2 March 2022.

The Prince of Wales was greeted by UCLH chair Baroness Julia Neuberger, chief executive David Probert, medical director Geoff Bellingan, deputy chief nurse Sarah Burton and Camden Mayor Sabrina Francis.

The new Grafton Way Building is a 13-storey structure which has one of only two NHS proton beam therapy centres in the UK, one of the largest centres for the treatment of blood disorders in Europe and a hyper-modern surgery service.

His Royal Highness was given a tour of the building, meeting patients, staff and supporters before unveiling a plaque. He said: “I was enormously touched to be invited to open this project, which I know has been a long time in the planning. But if I may say so, it is a remarkable achievement and for what it is worth, I offer my congratulations to those who played such an important part, including all those genius physicists who actually understand how proton beam therapy works. It is truly remarkable.

“I understand how much pressure you have been under for the last two years and quite how you have withstood it, I do not know. It is a great tribute to your professionalism and resilience to make this possible. And for all of us who relied upon you, depended on you and your skills, we cannot ever thank you enough. Many congratulations and thank you for all that you do.”

Baroness Neuberger said: “After many years in the planning, and more in the construction, it is a real honour to be able to host His Royal Highness.

Everything about this new hospital has been designed with patients in mind.

“From the light filled wards, art on every floor, and the garden, with medicinal plants and a quiet place to reflect and refresh, we hope the experience for patients is as stress free as possible.

“Alongside the environment, is the technology and equipment – some of the very best in the world, including one of only two NHS PBT centres in the UK.”

Chief executive David Probert thanked The Prince of Wales for visiting and said: “I am delighted that His Royal Highness could be here to personally thank our staff for their hard work in seeing through this project and managing to open it during the pandemic.

“I am extremely proud of everyone involved in this work and really pleased that patients are able to benefit from the myriad of care and research opportunities offered at our new treatment facility.”

Proton beam therapy centre starts treating patients

“I didn’t know what was wrong with me. All I could see was light, no people.” Prescilia was just nine when she suddenly lost all her vision. Tests revealed a rare type of benign brain tumour.

Despite not being cancerous, the location of the tumour meant that as well as impacting her sight, it could also affect the hormone-making process, and her growth.

Her mum Judith said: “After they gave her the MRI scan, the doctor said your daughter has to have emergency surgery today. She couldn’t see any more – she was completely blind.”

After two operations, which restored her sight, Prescilia needed further treatment to control the tumour and she was referred to our new proton beam therapy (PBT) centre in the Grafton Way Building which opened in December 2021. This specialised form of radiotherapy is extremely precise, making it the ideal treatment for Prescilia.

Before our PBT centre opened, patients who needed PBT had had to travel to Manchester, where the only other NHS PBT centre in the country is based, or travel overseas as part of the NHS treatment programme.

Lying on a robotically controlled couch, in a space-aged machine, Prescilia is ready for treatment. The proton particles are accelerated to two-thirds the speed of light and are targeted to release the destroying energy with millimetre precision.

Afterwards, Prescilia said: “The beam is shining on you, it doesn’t hit you, it’s technically invisible.

“You get onto the bed and as soon as you are in the right position, they place a mask over your face for the treatment to keep you very still. Then afterwards they start moving the machines around a couple of times, then they start.”

Prescilia has been to the PBT centre 28 times over 5 and a half weeks to have her treatment. Each time she has three, 25-second doses of proton beam therapy delivered by the rotating machine above her head.

Once it is fully up and running, the PBT centre at UCLH will be able to treat up to 650 NHS patients per year from across the south of the UK, with around a third of the patients being children and teenagers.

David Probert, chief executive, said: “I am extremely proud of everyone involved in the programme of work to open the PBT centre at UCLH. I would like to say massive congratulations to all the staff involved, whose leadership and determination has been outstanding. I am really pleased that patients are now able to benefit from this extremely precise form of radiotherapy closer to home.”

As one of the very first patients at the UCLH PBT centre, Prescilia shared her story first with BBC Morning Live, and Operation Ouch star, Xand Van Tullekan.

THANKS TO OUR PBT SUPPORTERS

With charitable support from Fight for Life, the children’s waiting areas are fun, with lots of toys and interactive games. Macmillan Cancer Support contributed a living room for patients. With Morgan Stanley, the Teenage Cancer Trust has fundraised to enhance the waiting space for teenagers and young people. Individual donations and fundraising activities via UCLH Charity have funded art works and installations in the corridors, anaesthetics rooms and gantries.

Proton beam therapy explained

Proton beam therapy (PBT) is a type of radiotherapy which can target tumours with millimetre accuracy, limiting the impact on the surrounding healthy tissue.

Patients treated with PBT range from very young children to adults who have hard-to-treat cancers. These may be tumours in the brain, on the spine, or near the reproductive organs, where it is particularly important to protect the surrounding tissue.

Proton beam therapy at UCLH

Explaining proton beam therapy

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New CAR T-cell therapy offers fresh hope for patients

A new CAR T-cell therapy developed by scientists at UCL has fewer ‘toxic’ side effects and may target and kill cancer cells for longer, a study at UCLH has found.

This offers new hope to adult patients with relapsed B-cell acute lymphoblastic leukaemia for which there is currently no approved curative therapy available. Patients typically have further chemotherapy and the prognosis is poor.

One patient who has benefited from the new treatment is Claire Evans.

Claire said: “I first heard about CAR T after watching the documentary ‘War in the Blood’.

“I’d previously been diagnosed with leukaemia in 2015 and was in remission but I suffered a relapse in 2019. The doctors initially treated me with chemotherapy before one of them mentioned CAR-T and I was referred to UCLH where I was assessed for participation in their clinical trial.

“As I was deemed suitable, I was able to start CAR-T treatment fairly quickly. I’d been made aware that the side effects could be very unpleasant but fortunately for me, I didn’t have any adverse effects.

“I’m so glad that I was able to take part in the trial, it has made all the difference and I’m still here. The initial results from my latest biopsy show no evidence of disease.”

A year on from her two infusions and Claire remains in remission.

How does the new therapy work?

CAR T-cell therapy programmes the body’s T-cells to make an artificial protein called a CD19 chimeric antigen receptor (CAR) on their surface, which means they can recognise cancerous cells.

The new form of the therapy developed at UCL has been designed so that CAR T-cells bind with the target leukemic cancer cells less tightly and for shorter periods than in the original form of CAR T-cell therapy. This shortens the time of interaction, limiting over-stimulation of the CAR T-cells, and they move on after killing one leukaemia cell, thereby reducing over-exhaustion. This new type of therapy design is known as a “fast off-rate CAR”.

The ALLCAR19 chief investigator Professor Karl Peggs, director of the Sir Naim Dangoor Centre for Cellular Immunotherapy at UCLH, explained: “While CAR T therapy is very effective for some patients, current CAR T-cell treatments have limitations. The immune system can become over-activated causing a toxic reaction called cytokine release syndrome.

“Another consequence of over-activation is that the engineered T-cells become immunologically exhausted and no longer persist in the patient’s body. This lack of persistence can allow the cancer to relapse.

“These two problems have proven to be particularly difficult in adults with relapsed B-ALL and consequently there is no licensed CAR T-cell therapy in this age group for this type of cancer.”

Cancer Clinical Trials Unit

The Cancer Clinical Trials Unit at UCLH is responsible for enrolling and supporting patients on clinical trials across haematology and oncology.

A team of more than 100 specialist cancer research nurses, clinical trial practitioners and data managers oversee more than 200 different complex trials. Such clinical trials are critical to the development of new and improved cancer treatments and have been fundamental in improving survival rates and quality of life for patients.

The study team has unique expertise in cellular therapies and has opened 22 CAR-T studies since 2016, recruiting and screening more than 100 patients to this ground-breaking treatment.

The team members are also the main point of contact for patients during their time on a clinical trial. The team care for the patient holistically, ensuring their physical, social and psychological needs are met during the demanding treatments.

The team continues to follow up patients closely after their treatment. Follow up can be complex, with patients often needing multiple procedures and blood sampling to ensure the safety and effectiveness of the test product. For patients who live outside London, the follow up can be logistically challenging, so the trials team has developed strong relationships with referring centres so patients can be seen locally where possible.

The pandemic through the eyes of our staff

COVID-19 has had a huge impact on our staff, professionally, personally and psychologically. We have offered them support throughout the pandemic, but it has still left an indelible impression on many. Here, three members of staff share their stories of working through the pandemic. A longer article featured in the Financial Times. Photo credit: Tom Pilston / Financial Times.

Segun Olusanya, intensive care doctor

We had to prepare ourselves that some of us may not survive this. We had no idea how COVID-19 would spread. We were all presuming droplets, based on what we knew from SARS, and we knew there was a significant chance some of us would get it. And so that was horrible. That whole time was just constantly horrible.

And then the patients started to arrive and we knew the increase was going to be exponential. We had one patient on a Wednesday, and by the next week we had 50. And they were all really sick and on ventilators.

Then I caught COVID myself so I had a week at home, wondering whether I was going to die or not. Thankfully I didn’t and I was fine.

I went back to work and we had created these amazing makeshift teams. Out of nowhere, we brought together people from other parts of UCLH who could do critical care. But it was just terrifying.

You are trying to do a job that you have trained to do for a very, very long time, but you’re trying to do it while wearing a space suit and barely hearing people while being surrounded by 10 times the number of patients you are used to. And you are trying to deliver the same degree of care. It was really, really difficult.

But on the flip side of it, there was this actual, incredible camaraderie because people came together. People literally downed tools and changed their jobs entirely to come to critical care to help. It was really bittersweet and it was really emotional.

Sarah Burton, deputy chief nurse and head of nursing cancer services, surgery and cancer board

I joined UCLH in November 2020, right at the beginning of the second wave, so that was an interesting and uncertain time to start a new job. I could see the wave coming but wasn’t quite sure when we would be in the eye of that storm.

I immediately observed how much UCLH genuinely look after their staff, providing easy access to psychological support and creating more respite spaces for staff – the support has been overwhelming. We had many practical things to help teams stay buoyant and feel valued such as little gifts of luxury skin care products and free yummy food being delivered to clinical areas. However, one of the things that impressed me most was how the culture from the top is really embedded in supporting each other. At 2am when the treats have gone and you just have each other, we’ve got much better at checking in with people, noticing if people seem a bit quiet, or mentioned they haven’t been sleeping well or struggling with their mental health. We tend to pick up on that much more and make sure support is in place.

On reflection one of the really poignant moments for me during the pandemic was when I got my first vaccine. I felt quite emotional that day. I didn’t anticipate feeling like that. I just remember receiving the vaccination and thinking how lucky I was to have it and I felt that I was protected and protecting others… then I felt a bit guilty that I’d got to that point of getting a jab when so many other people hadn’t.

There have been many positives and new, more collaborative ways of working have emerged. Cancer nurses as well as other staff groups were redeployed to intensive care to support the high volume of critically ill patients. It was tough for the depleted clinical nurse specialist teams left back at base holding the fort and carrying the burden of large numbers of naturally frightened cancer patients needing clinical reviews and additional support.

I am incredibly proud of all the teams and never felt more pride in saying “I am a nurse”.

Arup Sen, stroke consultant

The first surge was like a tidal wave due to the sheer volume of patients coming in sick. And then there were other issues too, like restricted visiting to help stop the spread of the virus. It wasn’t like the normal scenario we were used to dealing with where families could be at the bedside supporting their loved ones. We had to have some very hard conversations over the phone which was difficult for us and devastating for the families.

We had to make decisions which put a significant emotional burden on you as a clinician – we’re trained to emotionally detach ourselves, but when it’s on such an extreme level it’s not easy.

I think COVID has also shown us that it’s quite amazing how much you can achieve in such a short period of time when you’re under pressure, in the face of a crisis. For example, using technology to streamline the way we manage patients, such as stroke video triage. Patients might be at increased risk of contracting COVID when they travel to the hospital, so sometimes it is as simple as giving them a result of an investigation over the phone.

Working through the pandemic has been exhausting both physically and mentally, therefore it makes you realise the importance of looking after yourself. You can’t look after others if you aren’t looking after yourself. I think it also makes you appreciate the little moments more, like playing in the park with your kids, because you realise you might not have been able to do that anymore.

Jaydam Tierney - OCCUPATIONAL THERAPIST

Jaydam Tierney had wanted to be an occupational therapist since school, and is now enjoying the fast-paced environment of the emergency department.

What does an occupational therapist do?

I work as an occupational therapist in the emergency department, so I support our patients to do essential tasks – such as being able to get up, wash and dress (with or without support), go to the toilet and to eat and drink. We also help patients do the tasks that are meaningful to them, such as taking part in a particular activity. I signpost them to additional support depending on their needs so they can access the most appropriate help. Doctors and nurses make the patient medically fit, but we support them in their lives so they can stay well, mentally and physically.

What is a typical day for you?

Emergency medicine is very fast paced and you never know who you will be seeing that day. We start by prioritising the patients we have in that morning to make sure the most urgent are seen first. We assess them and work on a plan to address their essential and meaningful needs. Because everything changes so quickly, we prioritise patients again at lunchtime. As I am also a clinical leader, I make sure my team has the skills and resources they need to do their jobs. I also offer expertise for patients with complex needs.

What made you want to become an occupational therapist?

I grew up in a small town in Australia where there wasn’t an occupational therapist. My brother needed one and he had to travel to Sydney, and my dad had issues with his spinal chord and he had to travel to another town. When I started school, they asked us to write down what we wanted to be when we were older. When I was shown it after I left school, I saw I had put occupational therapist! I studied a bachelor’s degree in occupational therapy and qualified as an occupational therapist in Australia in 2014 before coming to the UK.

What is the best part of the job?

I work with a huge variety of people – you never know who you will be seeing next. I enjoy this variety as it means I am continually learning.

What is the worst part?

We offer support and signposting for patients when they come into the emergency department, but as they will move onto a different service when they are medically fit enough, we don’t always see the result of our initial work. However, I think the benefits of being able to offer patients initial support outweighs this and I enjoy being able to help them when they are first admitted to hospital.

Would you encourage people to apply to UCLH to be an occupational therapist?

UCLH is a great place to work. It is such a big organisation with some of the top clinicians in their areas, so there are fantastic opportunities for learning. Despite its size, UCLH doesn’t feel too big and the team is really supportive. You know everyone and they are always willing to help you learn and share their knowledge which is really important. As shown through COVID-19, everyone at UCLH is great at pulling together and supporting each other.

Watch our interview with Jaydam below:

UCLH first in the NHS to use Nanoknife for prostate cancer

Photo credit: Eddie Mulholland / Daily Telegraph

A minimally invasive technique for treating prostate cancer has been used for the first time in the NHS at UCLH.

Irreversible electroporation (also known as Nanoknife) can be used with precision to treat the area of the prostate affected by cancer, reducing the chance of side effects such as incontinence and loss of sexual function which are more likely when the whole prostate is treated.

UCLH consultant urologist Alistair Grey, who led the procedure on the first patients, said: “This technology has the potential to benefit cancer patients with rapid recovery and low side effects. It causes minimal discomfort, and we can use it for tumours that were previously difficult to treat.”

Nanoknife, as the technology is trademarked by its manufacturer AngioDynamics, works by administering quick electrical pulses around the tumour to kill the cancerous cells.

UCLH consultant urologist Mark Emberton said: “We are delighted to have been the first hospital in the NHS to use irreversible electroporation for patients with prostate cancer. And at times like this, when the NHS is under great pressure, day surgery avoids the need for overnight stays in hospital and means that we can use our operating theatres more efficiently.”

One of first patients treated at UCLH was Neil Gershon, 70, who had the procedure in November 2021.

Neil said: “It was all done in a day which was great. When the general anaesthetic wore off, I felt absolutely fine, no pain at all. It couldn’t have gone better. I would like to add my thanks to the superb team who looked after me during the procedure.”

Neil had the catheter removed at his local hospital one week later.

The team also includes urologists Caroline Moore and Clement Orczyk, anaesthetist Alan Fayaz, planning radiologist Shonit Punwani and nursing team Edfelyn Birung, Boyan Bonchin, and Sandra Paguyo.

UCLH one of the best trusts in London for patient care

Two surveys have put the care patients receive at UCLH as among the best in London.

In the National Inpatient Survey, patients rated their overall care as 8.7 out of 10 – the top score among our London peers.

It also puts UCLH as joint top of the Shelford Group (a collaboration between ten of the largest teaching and research NHS trusts in England), tied with Newcastle Hospitals NHS Foundation Trust.

UCLH chief executive David Probert said: “This is a fantastic achievement, especially considering the challenging time we have all had. A huge thank you and well done to all our staff – we couldn’t have done this without you.”

Questions focused on patients’ overall experience at UCLH, from waiting times to being able to sleep, from keeping in contact with family during the pandemic to the discharge process.

We have maintained good performance in a number of areas and seen particular improvements in giving written or printed information about what patients should or shouldn’t do after discharge, treating patients with dignity and respect, the trust and confidence patients felt in their doctor, and the information about the condition or treatment being given.

The only area that was flagged as needing improvement was in relation to hospital food. UCLH will continue work with our service partners to build on the improvements already made since the survey was carried out.

UCLH also performed well in the Care Quality Commission’s Urgent and Emergency Care Survey.

The survey involved 126 NHS acute trusts and asked people about their experiences of care from decision to attend, treatment and discharge.

UCLH scored 8.6 out of 10 for overall experience, an improvement from the previous survey in 2018, when it scored 8.2.

Melanie Watts, divisional manager for emergency services, said: “This is a major achievement in a time when emergency services are under more pressure than ever before. We are thrilled that the hard work of our staff has been recognised by our patients. Well done and thank you to everybody involved.”

WHAT'S ON?

MEET OUR NEW STAFF GOVERNOR

Our new staff governor, Professor John Duncan, is looking forward to getting involved in shaping future UCLH strategies.

John, a consultant neurologist and professor of neurology, has been at UCLH for a number of years, including as divisional clinical director of Queen Square from 2011 to 2018. During this time, he oversaw the £23m refurbishment of Queen Square and the initial planning of a new centre of excellence for neuroscience at UCL and UCLH in Grays Inn Road.

Since completing his time as clinical director, he continues to be closely involved in the Grays Inn Road project and is focused on clinical work at the National Hospital for Neurology and Neurosurgery, research at UCL, and advisory work for the Ministry of Transport.

John said: “I was appointed staff governor in September and it has been really interesting. I am used to dealing with strategic and operational matters in an executive role at Queen Square, and being a governor gives a very different perspective.

“Our main role as governors is to hold the non-executive directors to account and it is insightful being involved in these processes. This has taken some getting used to, and I am now delighted to support strategic developments at the Trust.

“There is a range of governors from all different backgrounds, which is a great asset as it provides a variety of opinions and expertise. The involvement of patient governors is very welcome as it gives us their perspective, which is so important when we are looking at improving the services we offer.”

If you would like further information regarding governors, UCLH foundation trust membership or are interested in standing as a governor in this year’s elections, please contact: uclh.governors@nhs.net or call 020 3447 9290.

2022 dates will be advertised on our website: www.uclh.nhs.uk/boardmeetings

WHAT’S ON AND DATES FOR YOUR DIARY

Council of Governors meetings 2022

25 April, 25 July and 24 October.

(Held virtually until further notice): www.uclh.nhs.uk/governors

Board of directors meetings

24 March, 26 May, 28 July, 22 September, 24 November

(Held virtually until further notice): www.uclh.nhs.uk/boardmeetings

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