Inside Story - University College London Hospitals

Inside Story
Revolutionary cancer plans unveiled – page 3
AND
Spotlight on pharmacy – pages 4 & 5
PLUS
Research success – page 7
Inside Story is the UCLH staff magazine

news
Honouring staff long service
From researchers to registrars and
nurses to managers, a whole host of
UCLH staff have been honoured for
their long service to UCLH.
Some 35 members of staff who have
achieved at least 25 years’ service
were awarded with a crystal bowl
during the ceremony organised by
UCLH Charity and hosted by Peter
Dixon, Trust chairman.
Peter said: “You are the important
people and what you do is fantastic.
Yes, we have got the buildings and
the technology but without the staff
it’s nothing. It’s you people that make
this the great place it is.”
Pictured in the front row (l to r) are
Kay Eaton, consultant nurse, cancer
services who joined UCH as a
student nurse in 1984 and
Wihermina Rasay, deputy
phlebotomy manager, who
joined in 1972 as a
phlebotomy nurse. In the
back row (l to r) are Jim
Waite, biomedical scientist,
who has been with the
Trust since 1978; David
Starke, risk management
and business continuity
lead, who started at UCLH
in 1972; and Howard
Swanton, consultant
cardiologist, who began
work at the Middlesex
Hospital in 1979.
Louise wins top award
Chief nurse Louise Boden has won a
prestigious award in honour of her
outstanding contribution to healthcare
improvement and the nursing
profession.
She was presented with the Nursing
Times lifetime achievement award
after winning the public vote in an
online poll.
Louise was shortlisted by a
distinguished panel who said she had
won 'wide respect' for nurturing and
developing talent both in promoting
the careers of chief nurses at NHS
trusts and in believing that every
nurse, midwife and their support staff
has the potential to develop.
Louise said: "It is a great honour to be
recognised by my peers but my
achievement has only been possible
because of the support I myself have
received throughout my career and
the remarkable nurses and midwives
at UCLH."
In memory
Colleagues were
saddened to hear of
the unexpected
death of John
Golden (pictured
left), Unison branch
secretary and the
senior database
administrator in
pharmacy.
John had worked for the Trust for more
than 20 years and was much valued
for his long-standing trade union work.
He stepped down as chair of staffside
last year but continued to remain
active in union matters.
Colleagues remember John as
someone who always thought of
others rather than himself and would
always make the time to try to resolve
other people’s issues and problems.
Bev Wallace, a local representative for
another union, shared an office with
John.
She said: "If anyone had a problem he
would always take the time to listen. I
will really miss him and keep expecting
him to walk back into the office at any
moment. He wasn't just a colleague,he
was a friend."
Julia Whitehouse, interim workforce
director, said: “On behalf of the Trust, I
would like to take the opportunity to
formally recognise all of John's hard
work and achievements. Our thoughts
are with John's family, friends and
close colleagues at this difficult and
tragic time."
Pioneering
bacteriologist Dr
Joan Stokes
(pictured), who
died recently at
the age of 97,
was a trailblazing
female in a
predominantly
male world.
She was the first
consultant clinical
bacteriologist at UCH, developed
ground-breaking work and was an
inspiration to many. You can read
more about this remarkable woman on
the Insight news pages.
Contact Us
If you have any information you would like included in Inside Story, or on the Trust
intranet site Insight, contact: Communications Unit, 2nd Floor Central, 250 Euston Road,
London NW1 2PG. Email: communications@uclh.nhs.uk, Tel: ext 9897, Fax: ext 9401.
Front cover: Simon Keady with robotic
dispensing machines in UCH pharmacy which
use barcode technology to store and later ‘pick’
medicines with 100% accuracy. See pages 4 & 5.
2

news
(l-r) : Tahir Ahmed,
deputy director capital
investment; Ed Rose,
strategic development
manager: Daren Bubb,
finance lead;Julia
Solano, radiotherapy
services manager; Dr
Ivan Rosenberg,
technical lead; Dr Yen-
Ch’ing Chang, clinical
lead and Matthew
Metcalfe, deputy
director of finance. The
photo shows the PBT
team on the former
“Odeon” site near UCH
which is owned by the
Trust and is the
proposed location for
the new centre.
UCL Partners bids for world-leading cancer treatment
UCLH and five other London
Hospitals have announced plans to
provide Proton Beam Therapy (PBT),
one of the most advanced and
effective forms of radiotherapy in the
world. Proton Beam Therapy is far
more precise than conventional
radiotherapy, and is currently
available in only a handful of locations
worldwide – mostly in the US and
Japan.
More than a 1,000 patients a year –
particularly children and teenagers –
could benefit. It is also beneficial for
adults with brain tumours, head and
neck cancer, bone and soft tissue
sarcomas.
UCL Partners (UCLH, Great Ormond
Street Hospital for Children, Barts and
The London, The Royal Free
Hampstead and Moorfields Eye
Hospital) has now submitted a bid to
the Department of Health to provide
PBT. The service would be developed
on land owned by UCLH which is
large enough to house equipment
weighing several hundred tonnes
(see above).
Dr Yen-Ch’ing Chang, a paediatric
clinical oncologist working at UCLH
and Great Ormond Street Hospital for
Children, is leading the proposal. She
said: “For a specific range of cancers,
the advantages of PBT over
conventional radiotherapy are now
unquestionable. “For children in
particular, we will be able to
drastically reduce the chances of
severe long-term side effects.”
Ed Rose, who is project managing the
development, said: "Developing PBT
would allow UCLH to become one of
the world’s leading radiotherapy
centres – particularly for children, and
for adults with complex cancers.
Together with the opening of our new
Cancer Centre in 2012, it would
ensure UCLH continues to provide its
patients with the best possible care.”
If the Department of Health gives UCL
Partners the go-ahead, it is hoped the
new centre will be up and running
within four years.
New chairman to start work in the summer
UCLH non-executive director Richard
Murley (pictured) will take over as
chairman of the Trust when Sir Peter
Dixon steps down in June after nine
years at the helm.
Richard joined UCLH as a nonexecutive
director in November
2008. He is currently co-head of
the UK advisory business at
Rothschild in the City. He was
previously the director general of
the Takeover Panel, the City
regulator. He chairs the
UCLH Quality and Safety
Committee and the
Investment Committee.
Richard has a real
interest in the NHS,
coming from a family of doctors. He is
a Camden resident and his children
were born in the old Elizabeth Garrett
Anderson and Obstetric
Hospital, part of UCLH.
He said: “I am delighted
to have been named
chairman of UCLH. The
Trust has a very high
quality clinical and
management team and I
look forward to working with
them as we strive for
ever-higher
standards of
patient care.”
Sir Peter has
been chairman
at UCLH since 2001.
He said: “Richard is a splendid
appointment for the Trust and will
provide the leadership we need for
turbulent times ahead in the NHS. I
have been privileged to be part of an
exciting time for this great institution
and I am quite sure that Richard will
take it on to even greater heights”.
Sir Robert Naylor, UCLH chief
executive, said: “I am delighted that
one of our non-executive directors
has been appointed as chairman – it
gives continuity to the strategic
direction of the organisation. I look
forward to continuing to work closely
with Richard in the future.”
3

pharmacy special
Change is sometimes the best medicine
The Trust’s pharmacy team has cut
waiting times by 50% over the last
year: the majority of patients now
wait just 15 minutes to pick up their
medicines from the UCH outpatient
dispensary.
Not only that, complaints are
down, staff and patient satisfaction
is up.
So how did they do it?
Simon Keady, principal pharmacist,
explained: “Every member of the
team was empowered to make
suggestions. We examined every
step of the process to identify
inefficiencies and bottlenecks that
were acting as a barrier to
providing a good service.
Everyone rose to the challenge.
“Some of the changes were
relatively minor but together they
had a huge impact: extended
opening hours took the pressure
off the busiest times and has given
patients more choice; in-house
customer care training has
equipped our dispensary staff to
provide a better patient experience
and to deal more effectively with
patient’s concerns and anxieties,
especially those related around the
use of their medicines.“
Working with colleagues across
the Trust continues to be a priority.
For example, A&E and pharmacy
have redesigned the A&E
prescription to increase efficiency
and reduce potential for errors. “It
provides us with all the information
we need – so reduces the need for
phone calls.”
To limit discharge delays, the Trust
has agreed that 80% of discharge
prescriptions should be prescribed
on the day before a patient leaves
the hospital and pharmacy are
working with local clinical teams
and the discharge nursing team to
identify as early as possible those
patients who are ready to go
home.
“We know that when discharge
medicines are prescribed in
advance, patients are not delayed.
Unfortunately, many discharge
prescriptions are written on the day
and in some cases after patients
have been told they can go. This
inevitably causes delay and we are
keen to work with colleagues to
change this. Pharmacy is the last
port of call for most patients, it’s
important that their last memory of
the Trust is a good one.”
The lessons learnt at the UCH site
are being used across all
dispensaries at UCLH to improve
the patient experience wherever
they are being treated.
The pharmacy team undertook a
systematic review of their
department using the Lean
framework, looking closely at the
time it was taking to complete each
step of the process and targeting
troublesome areas.
Inge Edmondson, student pharmacy technician greets patients
Fact file
There are six dispensaries at UCLH
Two are at UCH: over-the-counter for outpatients, A&E and clinical trials;
another for inpatients and discharged patients
390,000 medicines dispensed each year. That’s around one a minute
Extended opening hours were introduced at UCH last year: now open until
7pm three days a week, and weekend mornings
Innovative IT tool designed by UCLH, gives visual “green amber red”
warning about patient waiting times. To be introduced across all sites
IT tool tracks medicine continuously: who has what, where?
Two robotic dispensing machines at UCH automatically store and retrieve
the correct medicines at lightning speed
Future developments:
A modern pharmacy is
due to open at the NHNN
next summer. It is
currently located in a
separate building
Robotic dispensing is to
be introduced at NHNN
and the new cancer
centre
4

pharmacy special
One of the five aspects of the UCLH approach to the recently
launched Quality Efficiency and Productivity (QEP) programme is
to ‘Make Life Simple’. This means getting all of our clinical
services in place so that waste is minimised, duplication
eliminated, flow is improved and unnecessary
tasks reduced so we can all concentrate on
our work for patients far more effectively.
This pharmacy project is a shining
example of how small changes can
make a big difference.
Read all about the five approaches to
QEP, great examples of good practice
and much more by visiting the newly
updated QEP pages on Insight.
UCLH has developed a
new IT system which
enables the pharmacy
team to see at a
glance how long a
patient has been
waiting and flags up
delays. Simon
Keady said: “It
provides a minuteby-minute
real time
overview. We aim
to expand it
across all the sites with access
for nursing staff – they could log on in their ward
and see whether a patient’s discharge prescription is ready.”
at the pharmacy counter
L-r: Rakhee Mandalia, pharmacy technician, Bhavini Patel, Bola Oduwole, Panayiotis Sphikas, senior technicians behind the scenes at the UCH pharmacy
5

interview
Facing up to the biggest taboo
Dr Chi-Chi Cheung talks to Elke Tullett
6
“Are you frightened of dying?”
A bit of a conversation-stopper
usually. But not for Dr Chi-Chi
Cheung (pictured).
“No, not frightened but I wouldn’t
want it to happen yet,” she answered.
“I don’t feel my time has come.”
It’s the kind of talk that is a cultural
taboo in England and one that Chi-
Chi aims to challenge in her role as a
palliative care consultant.
“Culturally people don’t want to talk
about it or even think about it, even
though it is not a failure of care but a
natural part of life. People who work
in the health service are not any
different. Many doctors are natural
optimists whose aim is to make
people well again. Death is not
something we are necessarily keen
to face.”
Chi-Chi and her colleague, senior
nurse Sue Hutton, co-chair the
Trust’s End of Life Strategy Group
which has developed a strategy to
reflect the Department of Health’s
mission to improve the quality of care
for patients in the last year of life.
The strategy advocates equipping
clinical and non-clinical staff with the
skills and confidence to support
patients in their last months, weeks
and days. All healthcare
professionals should be able to deal
with common end of life issues, be
able to have conversations with
patients and their families, and know
Fact file
70% of patients say they
want to die at home
60% die in hospital
29% discuss their wishes
about dying
Only 4% have written
advance care plans
Over 50% of complaints
to the former Health Care
Commission related to
end of life care
when to seek specialist advice.
The most difficult part is actually at
the beginning – identifying when
someone is reaching the end of their
life. Once that has been
acknowledged, the next part involves
discussing with them their wants and
need are (Where would they like to
be cared for? Where would they
prefer to die? Who would they like to
be involved with decision making?
What are their priorities?) and
helping to co-ordinate care through
the various stages. It also
includes encouraging them to
prepare for the inevitable so that
family and friends are not left to
'pick up the pieces', the wills left
unmade, the things left unsaid,
the loose ends of a life left
untied.
And whose role is it to have
these conversations with
patients?
“It would be whoever the
patient feels most
comfortable with be they a
GP, district nurse, specialist
nurse, consultant or even a
junior doctor or ward nurse.
It is a sensitive process –
trying to discover when
someone is ready to talk
about dying. Naturally, a
person’s culture, religion or
ethnicity is a major influence.
Some people, of course, deny it
to the end.”
Chi-Chi splits her week between
the UCLH and Islington
community palliative care
teams. It means that she has
the opportunity to see people in
their own home following
discharge from hospital.
“As a ward doctor I was firefighting
and managing crises,
always rushing from one patient
to the next. I didn’t find that
particularly fulfilling. Helping
someone face the end of their life
and allow them to die comfortably
were aspects of medicine where I
actually felt I was making a
difference – we only get one
chance to get it right, and when
we do I find that very rewarding.”
Dying Matters, a national coalition of
more than 700 organisations, was set
up by the National Council for Palliative
Care to promote awareness and
change attitudes and behaviour
towards death and bereavement. The
UCLH palliative care team held
displays in the UCH atrium to mark an
awareness week in March. Visit
www.dyingmatters.org
If staff need any advice they can
contact the palliative care team on ext
3672.

esearch
Consultant wins £1 million funding to help stroke patients
A stroke specialist has been awarded
major research funding to prevent
patients suffering life-threatening side
effects following treatment.
Dr David Werring, a consultant
neurologist at the NHNN and leading
member of the stroke research group
at the UCL Institute of Neurology, aims
to develop techniques to predict – and
therefore protect – those patients at
risk of suffering brain haemorrhage
after being treated with blood thinning
drugs.
Anti-coagulants are often prescribed
for long term use if blood clotting and
stroke is due to an abnormal heart
rhythm. This might follow the initial
‘hyper acute’ treatment with clotbusting
drugs given within the first few
hours of stroke.
The British Heart Foundation and The
Stroke Association awarded his team
nearly £1 million to help fund a fiveyear
research programme into new
types of MRI brain scans and genetic
testing which could predetermine those
most at risk.
David said: “Blood thinning drugs are
very effective for most patients who
have suffered a stroke as a result of
atrial
fibrillation, an
abnormal
heart rhythm.
However, in a
small minority
of patients it
can put them
at greater risk
of devastating
brain
haemorrhage.
“In some
cases it is very
hard to know
the best thing
to do. On the
one hand
there is a high risk of recurrent blood
clots to the brain, on the other, a
danger of bleeding in the brain. We
want to identify those at highest risk of
bleeding.”
Sophisticated MRI scans can detect
previous tiny bleeds (‘microbleeds’)
that have occurred around fragile,
leaky blood vessels.
He added: “In patients with a lot of
microbleeds, especially near the brain
surface, anticoagulant drugs might
L-r: Dr Rustam Al-Shahi Salman, MRC clinician scientist (University of
Edinburgh), Dr David Werring clinical senior lecturer (stroke) and consultant
neurologist UCLH, Dr Henry Houlden clinical senior lecturer (neurogenetics)
and consultant neurologist UCLH.
cause a life-threatening large
haemorrhage. If this theory is correct,
screening for microbleeds could help
target the right anticoagulant treatment
to the right patients, making them
much safer to use."
“This is a very exciting time for stroke
research because the new hyper acute
stroke unit at UCH will give many
more patients the chance to take
part in this and other important
projects.”
Pass me the painkillers – I’ve got an award to win
Clinical research fellow Dr Andrew
Flett used his initiative when
emergency back surgery threatened to
thwart his hopes of winning an
international award.
Undeterred, he recorded his
presentation on webcam from his
bedside and submitted it along with
PowerPoint slides via a webcast to the
panel of judges in Phoenix, Arizona.
The next day The Society of
Cardiovascular Magnetic Resonance
declared him the winner of the Young
Investigator Award at its annual
scientific conference.
Andrew, who underwent spinal surgery
at the NHNN, said: “I knew I couldn’t
travel to America as planned and
thought ‘that’s the end of that award’.
Then having recorded webcasts at
conferences before, I realised this
could be an option. I never really
believed I could win it from the other
side of the world though! “
He was awarded the young
investigator award for his work in
developing a new technique to
measure the amount of diffuse scar
tissue in the heart using a cardiac MRI
scanner. He found a strong correlation
between the amount of scar tissue
measured on the scan and that found
on biopsy in two heart diseases, aortic
stenosis and hypertrophic
cardiomyopathy.
He said:” Usually a biopsy is
needed to measure scar tissue
and is only undertaken as a last
resort because it is very invasive
and carries risk. Scanning is safe
and will enable us to screen many
more patients. This could play an
important role in diagnosing
patients, monitoring the rate of the
disease and the effectiveness of
treatments.”
The research is being funded by
The British Heart Foundation.
7

the back page
Secret lives
If a silken voiced Italian promises you
the moon and the stars you may feel
a little taken aback. But in the case of
Dr Giovanni Quarta (pictured left), a
clinical researcher – and enthusiast
astronomer – they may not be empty
words. As his wife discovered.
“On our honeymoon a couple of
years ago we travelled to the Gobi
desert to see the total eclipse of the
Sun. It was amazing. As the moon
passed over the sun, it got colder,
darker, the wind dropped and shafts
of light flared out. It is no wonder that
ancient people were afraid. When
you study the universe you start to
appreciate how amazing it all is – to
look at the very same sky that was
present centuries ago, while almost
everything else around us has
changed.”
Giovanni who works at The Heart
Hospital alongside Professor William
McKenna, Dr Perry Elliott
(cardiomyopathy) and Dr James
Moon (cardiovascular MRI) says he
is fascinated in scientific subjects
including mathematics and physics.
He is currently attending an
astronomy evening class at UCL and
with fellow students makes regular
trips to the Mill Hill Observatory to
peer into infinity and beyond. Their
lessons are filled with talk of
galaxies, solar systems, dark matter:
the stuff of unsettling dreams.
“It’s true it makes most people feel
very small and a little lonely. We think
of distance as going from A to B but
the scale of the universe is
impossible to imagine and prompts
so many philosophical questions.
What are the chances of the right
conditions all coming together at the
same time, in the same place to
support intelligent life? It certainly
makes me appreciate being on
Earth!”
Our shooting stars
Nurses,
physiologists,
administrative
staff: it takes
all sorts to
make a
winning team.
They’ve
formed the
Trust’s first
netball team
‘All Blues’ and
are ready to
storm up the league tables!
Tahlita Mabuza, a specialist in neurophysiology at UCH, said:
“I posted a message on the intranet staff room last summer
and we got an amazing response. We have a lot of fun – and
yes, we are very competitive! The time invested in this team
is worth every second and I hope I started something good
that will last for many years to come. ”
In the coming months, they’ll pitch their skills against rival
teams such as MTV Skaters, Mediacoms Meertkats and
Great Ormond Street Hospital.
Logica has generously agreed to sponsor the team and
funded their specially designed kit, equipment and hire
charges.
If you would like to join the team email Tahlita on
Tahlita.Mabuza@uclh.nhs.uk
Archives
The dispensary in the outpatients department
in the East Wing of the former Middlesex
Hospital in 1924 before it was demolished and
rebuilt. The pharmacist was Mr Sydney White
and one of the dispensers seen here was Mr T
C Willey. In 1924 there were nearly 190,000
outpatient attendances.
8