The Operating Theatre Journal September 2021

otjonline

The Operating Theatre Journal September 2021

THE THE

THE

SEPTEMBER 2020 2020 2021 ISSUE ISSUE NO. NO. 360 NO. 360372 ISSN ISSN ISSN 0000-000X

1747-728X

SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

The The Operating Theatre Theatre Journal

Journal

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THE THE

THE

SEPTEMBER 2020 2020 2021 ISSUE ISSUE NO. NO. 360 NO. 360372 ISSN ISSN ISSN 0000-000X

1747-728X

SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

The The Operating Theatre Theatre Journal

Journal

OTJONLINE.COM £2.00

OTJONLINE.COM

£2.00

The The Leading Leading Independent Print Print & Digital & Digital Journal Journal For For ALL ALL Operating Theatre Theatre Staff

Staff

The Leading Independent Print & Digital Journal For ALL Operating Theatre Staff

Specialist equipment to help address the

waiting list for Total Hip Replacement Surgery

While the pandemic is still not fully behind us,

healthcare leads are already focusing on one of the

key challenges of its legacy: the 5.1 million people

now waiting to begin some kind of treatment.

Over half a million patients in the UK are waiting for

trauma and orthopaedic procedures - including hip

replacements – so it is clear than any approach that

facilitates the surgical patient journey and maximises

theatre time must be helpful.

One possibility is the concept of ‘same day, same

device’ – i.e. the use of a surgery trolley for patient

transport, treatment and recovery rather than

utilising transport stretchers and static operating

tables.

The Anetic Aid QA4 Powered Mobile Surgery System

has been popular since it was first developed in 2004,

and there are now more than 2,500 in use in some

110 same-day surgery departments across the UK.

Like any single device system, its use means cutting

down on unnecessary time involved in transfers – as

well as minimising the associated lifting and handling

risks for patient and practitioner alike. And there are

other, perhaps less obvious, potential benefits:

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requirements of a wide range of procedures

in a same-day surgery basket reduces

the time it takes to appraise and specify

requirements and simplifies procurement

• Less clutter – having one multi-purpose device

means less need for equipment for specific

surgical specialties or procedures, so freeing up

storage space

Hip replacement is a procedure that particularly

benefits from this approach, using the QA4 together

with the HIP FIX positioning system from Danish

expert Opitek. Designed to facilitate this exacting

surgical technique, the HIP FIX enables the

orthopaedic surgeon to accurately orientate the

implant components, offering the best possible

surgical outcomes.

There are also infection control elements built in

- the Hip Fix’s stabilising arms are fitted with singleuse

pads for each new procedure, reducing the risk

of cross-contamination – vital for such an invasive

surgical procedure.

In combination, the QA4 and HIP FIX can offer a

practical solution to help reduce waiting lists in this

important specialism.

www.aneticaid.com

On 14th October 2021, the 14 Allied Health Professions (AHPs) will be celebrating AHPs Day.

The day is an annual opportunity for AHPs to come together and celebrate being part of the AHP family.

It also gives an opportunity to showcase to others, the impact AHPs make to the delivery of high-quality

care.

Key messaging for AHPs Day this year includes:

• Celebrating those professions who are AHPs

• Appreciating AHP skills and impact on care

• Inspiring the future workforce

• Connecting so that AHPs are included in workforce transformation and pathway redesign in systems.

On AHPs Day, Suzanne Rastrick, the Chief Allied Health Professions Officer (CAHPO) for England, will be

delivering a live address to the AHP workforce at 9:30am and live streaming the CAHPO Awards Ceremony

at 6:15pm. Please email england.cahpo@nhs.net for joining details for both live streams.

We will keep you informed of further plans for both the CAHPO celebrations and local and regional events

as we receive details of these from NHS England & NHS Improvement.

Inside this issue

IDC Develops Realistic

Human Arm Model

to Train Doctors in

Fracture Reduction

P5

NIHR-funded study

shows patients who isolate

before surgery are 20%

more likely to develop

postoperative lung

complications

P8

‘Long-awaited’ research

into effects of long-term

health conditions on

expectant mums and their

babies underway

P9

RCS England and RCS

Edinburgh to partner in

programme of work to

support Surgical Care

Practitioners

P10

Calling all colleagues,

are invited to join

BAOMS conference

P13

Green Surgery Challenge

Judging and Awards

Ceremony

Medica & Compamed

2021

HCPC Consultation on

Remote Hearings

Scientists grow

muscle cells

Workforce shortages

will limit NHS Recovery

Kent Trust chosen to pilot

improving wound care

Lucida Medical and

Hampshire Hospitals

announce major study on

AI for prostate cancer

Healthcare safety

investigation branch

makes over 1,500

recommendations

New body to tackle

health disparities

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 3

P13

P16

P18

P18

P21

P21

P24

P26

P33


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The next issue copy deadline, Monday 27th September 2021

All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YY

Tel: 02921 680068 Email: admin@lawrand.com Website: www.lawrand.com

The Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.com

and in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.

Neither the Editor or Directors of Lawrand Ltd are in any way responsible for the statements made or views expressed by the contributors.

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at the PO Box address above. No part of this journal may be reproduced without prior permission from Lawrand Ltd. © 2021

Operating Theatre Journal is printed on paper sourced from Forest Stewardship Council (FSC) approved paper mills and is printed with vegetable based inks. All paper and ink waste is recycled.

Journal Printers: The Warwick Printing Co Ltd, Caswell Road, Leamington Spa, Warwickshire. CV31 1QD

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IDC Develops Realistic Human Arm Model to Train Doctors

in Fracture Reduction

International product design company, IDC (Industrial Design

Consultancy), has just completed a project to develop a high quality

human arm model to represent a fractured radius bone close to

the wrist. The model was developed for Limbs & Things, which

manufactures models of human anatomy for use in medical training

and simulation. The arm model was developed to help student doctors

practice a complicated technique called Colles’ fracture reduction.

Colles’ fractures are breaks in the radius bone, close to where the

bone joins the wrist. The Colles’ fracture reduction technique is a

non-invasive procedure to re-set the bone. To do this the clinician

has to extend the fracture and manipulate the hand into the correct

position. The Limbs & Things model aims to provide a realistic training

experience for doctors to practice this technique, as well as plastering

the newly set arm. The design allows for common mistakes to occur

such as a partially reduced fracture. If the arm is not held correctly

when plastered it will pop back to the original state.

Limbs & Things came to IDC as an extension to their own in-house

design team. A first 3D printed prototype had already been created

and IDC was tasked with improving the performance, simplifying

the assembly, and adapting the design to be manufacturable. IDC’s

engineers were briefed to develop an anatomically accurate model that

included the lower and upper arm. The model included an internal

mechanical structure to represent the fractured radius bone. This

could be adjusted to different tensions to change the retraction force.

The break itself needed to feel the same as a human wrist would,

with realistic anatomical detail for the muscle, skin and bone. As

well as this, the team needed to consider the design for manufacture;

minimising the number of components and simplifying the assembly

process. With the skin being constantly touched during training, the

client also wanted an option for a replaceable hand and skin.

The first challenge for IDC’s engineers was developing a design

which mechanically simulated human wrist movement. The design

was simplified from a number of strap components to a simple dual

directional hinge with limiting features which made assembly easier.

Silicone was selected as the best material for a realistic skin, however

the silicone’s low friction properties caused issues with the skin rotating

around the inner structure of the arm and the skeletal structure of the

hand. IDC worked with its network of materials suppliers to find a

bonding material which was perfect for the job of bonding the two

hand parts together. There were also a number of mechanical features

to stop the skin sliding over the arm assembly, and the team developed

an all-in-one silicone skin piece which could be easily peeled off and

replaced by the user if needed.

A key feature of the product was the ability to adjust the tension of the

fracture retraction, which would enable progressive levels of difficulty

in training to replicate the differences in muscle tension across the

human population. The tension could be changed by adjusting a hidden

screw located in the elbow. The team also developed a clamping

attachment on the upper arm, so the model could be fixed on a stand

if needed. The skin was designed to hide the internal mechanism and

fixing features.

Design for manufacture was an important element of this project.

Limbs & Things wanted to produce a design that could be 3D printed

initially, and then injection moulded once volumes reached a suitable

level. The team was able to improve the performance at the same time

as simplifying the assembly, successfully delivering a production ready

design. The Colles’ Fracture Reduction Trainer is now in production

and has received excellent feedback from clinicians.

View the video here: https://bit.ly/IDCLTOTJ

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Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 5


E-water’ – a better solution for healthcare disinfection

The Healthcare Facilities

Management conference and

exhibition will take place at

the NCC in Birmingham on 12th

October 2021, and one of the

event’s recurring themes will

be disinfection strategy. In the

following article, Adrian Gee-

Turner from L’Eau Ltd and Gary

Driscoll from Portsmouth AQUA

Ltd; both exhibitors at the

event, will explain why E-water

(electrolysed water/hypochlorous

acid) has advantages over

traditional disinfectants in a wide

range of healthcare applications.

Disinfection strategy will also

be addressed by one of the

Conference speakers, Professor

Stephanie Dancer, who will deliver

a presentation entitled: ‘Smart

cleaning: the best defence against

hospital-acquired infection’.

Professor Dancer advocates the

physical removal of soil and

pathogens rather than obliteration

for routine cleaning, but accepts

that there are circumstances

where disinfectants are necessary

in the healthcare environment4.

She says: “The challenge is to

find a product that is effective,

quick-acting, non-toxic to people

and the environment; and, for

the NHS in particular, it must

be cheap. Electrolysed water

(hypochlorous acid) is a potential

choice for hospitals and other

healthcare organisations.”

A wide variety of disinfectants

are commercially available; the

majority of which are toxic to both

microorganisms and humans. This

toxicity represents a safety hazard

during use and storage, as well as,

in some cases, an environmental

threat. Interest is therefore

growing rapidly in products

that are able to deliver superior

(verified) levels of efficacy, but

without toxicity to users and

the potential for environmental

harm. Electrolysed water meets

these requirements, but has not

been universally adopted because

past products quickly reverted to

the original ingredients – salt and

water. However, a small number

of manufacturers have recently

developed processes that have

resolved this issue and it is now

possible to purchase E-water with

a 12 month shelf-life or longer.

E-water – what is it?

For the purposes of disinfection,

the active ingredient of E-water

is hypochlorous acid (HOCl) in

an aqueous solution which is

approximately pH neutral. It

does not contain any substances

that are hazardous to human

health, so there are no COSHH

requirements and no personal

protective equipment (PPE) is

necessary when handling the

ready-to-use liquid.

The end products from the

practical deployment of HOCl are

salt and water.

The effectiveness of the market’s

leading e-Water products has been

tested according to international

standards such as EN 1276, EN

14476 and EN 13704 against the

most common pathogens, with

most demonstrating impressive

Log-6 effectivity against bacteria,

Log-4 against viruses and Log-3

against spore-forming bacteria.

Application for Inclusion in the

2021 WHO Essential Medicines

List

Towards the end of 2020, Dr.

Eric Rasmussen, Briotech’s

Chief Medical Officer, made an

application to the World Health

Organization proposing the

inclusion of Hypochlorous Acid

(HOCl) for disinfection, antisepsis,

and wound care. In response,

the WHO recommended further,

larger clinical trials, but the

submission contains information

that is pertinent to this article:

HOCl has emerged in the current

pandemic as the most potent and

environmentally safe disinfectant

available and with a wide range

of efficacy against many human

pathogens, including the SARS-

CoV-2 coronavirus.1,6,7 In recent

years compelling evidence of

the potency of pure, stable

preparations of HOCl in the

inactivation of even the most

resistant infectious agents,

such as BSE Prions6 and HPV16

viruses10,11 (both of which

are completely unaffected by

disinfectants currently on the EML

list) has made it clear that HOCl

deserves a place in every public

health program as a fundamental

instrument of infectious disease

control.12

HOCl solutions are already

included in the WHO list of

coronavirus-effective biocides,

and in the US EPA ‘N’ list of

disinfecting agents able to control

emerging pathogens like SARS-

CoV-2.7,14 More than ten branded

aqueous HOCl formulations

have been cleared by the US

FDA for topical Adrian Gee-

Turner Adrian Gee-Turner use

in wound management over the

last decade. A Class III medical

product approval for HOCl has

been granted in the EU, and the

Japanese Ministry of Health has

approved use of HOCl for topical

medical applications. The US FDA

has approved HOCl for high level

disinfection and sterilization of

medical instruments, including

those for use at critical (i.e.,

sterile) sites.

Block and Rowan in 2020

reviewed surgeons’ needs for

disinfection in the face of the

coronavirus pandemic and

concluded that HOCl comprises

many of the desired effects of

the ideal disinfectant: it is easy

to use, is inexpensive, has a good

safety profile, and can be used to

disinfect large areas quickly and

with a broad range of bactericidal

and virucidal effects.1

In conclusion, Adrian Gee-Turner

says: “The COVID-19 pandemic

has dramatically increased the

use of HOCl in a wide variety

of applications, and helped to

raise the profile of this promising

disinfectant. Infection control

measures should maximise

effectivity whilst minimising

risks to cleaning staff and to the

environment, therefore evidence

is increasingly indicating that

HOCl formulations with proven

performance and a long shelf-life

represent an excellent choice for

cost-effective disinfection.”

References:

1. Block MS, Rowan BG. Hypochlorous Acid: A Review. Journal of oral and maxillofacial

surgery: official journal of the American Association of Oral and Maxillofacial Surgeons.

2020:S0278-2391(20)30672-8.

2. Dancer S.J., Mallon J., Murphy R., Murch C., (2015). In-use effect of electrolysed water

on transcutaneous oxygen sensors. Healthcare infection,Volume 20, Issues 3–4. (www.

sciencedirect.com/science/article/pii/S1835561716300126)

3. Dancer SJ. Covid-19 exposes the gaps in infection prevention and control. Infect Dis Health.

2020 Nov;25(4):223-226. https://pubmed.ncbi.nlm.nih.gov/32863200/

4. Dancer SJ, Kramer A. Four steps to clean hospitals: LOOK, PLAN, CLEAN and DRY. J Hosp

Infect. 2019 Sep;103(1):e1-e8. doi: 10.1016/j.jhin.2018.12.015. Epub 2018 Dec 27. PMID:

30594612.

5. Dotson GS, Lotter JT, Zisook RE, Gaffney SH, Maier A, Colvin J. Setting occupational

exposure limits for antimicrobial agents: A case study based on a quaternary ammonium

compound-based disinfectant. Toxicology and industrial health. 2020;36(9):619-33.

6. EPA. Briotech’s Aquavert Entered on List N for activity against SARS-CoV-2 (COVID-19). In:

Agency EP, editor. Washington, DC: EPA; 2020.

7. EPA. List N Disinfectants for use against SARS-CoV-2.: US Environmental Protection Agency;

2020 www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

8. Hughson AG, Race B, Kraus A, Sangare LR, Robins L, Groveman BR, et al. Inactivation of

Prions and Amyloid Seeds with Hypochlorous Acid. PLoS Pathog. 2016;12(9):e1005914.

9. Meakin NS, Bowman C, Lewis MR, Dancer SJ. Comparison of cleaning efficacy between inuse

disinfectant and electrolysed water in an English residential care home. J Hosp Infect.

2012 Feb;80(2):122-7. doi: 10.1016/j.jhin.2011.10.015. Epub 2011 Dec 21. PMID: 22196853.

10. Meyers C, Milici J, Robins L, Contreras L, Williams J, Robison R. Efficacy Testing of HOCl as

a Disinfectant for High-Risk HPV. ICPIC 2019.

11. Meyers J, Ryndock E, Conway MJ, Meyers C, Robison R. Susceptibility of high-risk human

papillomavirus type 16 to clinical disinfectants. J Antimicrob Chemother. 2014;69(6):1546-

50.

12. Stewart M, Bogusz A, Hunter J, Devanny I, Yip B, Reid D, Robertson C, Dancer SJ. Evaluating

use of neutral electrolyzed water for cleaning near-patient surfaces. Infect Control

Hosp Epidemiol. 2014 Dec;35(12):1505-10. doi: 10.1086/678595. Epub 2014 Oct 24. PMID:

25419773.

13. Thorn RM, Lee SW, Robinson GM, Greenman J, Reynolds DM. Electrochemically activated

solutions: evidence for antimicrobial efficacy and applications in healthcare environments.

Eur J Clin Microbiol Infect Dis. 2012;31(5):641-53.

14. WHO. Cleaning and disinfection of environmental surfaces in the context of COVID-19.

World Health Organization; 2020.

6 THE OPERATING THEATRE JOURNAL www.otjonline.com

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NIHR-funded study shows patients

who isolate before surgery are

20% more likely to develop

postoperative lung complications

Patients isolating before surgery - mainly to avoid COVID-19 and its

complications – are actually at a 20% increased risk of developing

post-operative lung complications compared with patients who do

not isolate, unexpected findings from a National Institute for Health

Research-funded study show.

Central Medical Supplies Makes Business

Branding Investment

Specialist medical equipment provider Central Medical Supplies (CMS)

has re-energised its brand and redeveloped its website, to make it more

user friendly and informative for users. The updates mark the start

of a new era at CMS. While the company remains a privately owned

business, firmly rooted at its Staffordshire headquarters, the new brand

reflects the modern, forward thinking company CMS has become.

Amy Sellers, Marketing Manager at Central Medical Supplies, says: “As

we look to the future, it’s important our logo epitomises our company

values and our ongoing commitment to customers. This is the first

major refresh of our brand since the company’s inception over thirty

years ago so we were keen our new logo design reflects who we are

now. We pride ourselves on the personable, reliable service we offer so

the softer shapes, and colour pallet, of the new logo have been chosen

to convey this approachability and trustworthiness.”

As part of the rebranding, CMS has updated its website, making it easier

to navigate for busy healthcare professionals. The new website – www.

centralmedical.co.uk – features lots of product information, along

with details about the technical and ongoing support CMS is renowned

for providing. CMS is also strengthening its on the ground support

to healthcare teams, with the appointment of two new Critical Care

Regional Account Managers. Mary Morgan and Toby Wallis have recently

joined CMS, covering the M1 corridor and Central region respectively.

CMS specialises in providing hospitals with an innovative range of medical

devices, for both critical care and neonatal procedures. The company

also supplies baby and maternity products to major UK retailers, as well

as direct to the public via its online shop. Over the past thirty years,

CMS has built up strong relationships with its customers and suppliers,

becoming a trusted and reliable partner.

For more information on the products and services offered by CMS,

contact Tracey Pavier-Grant, Medical Sales Director at Central Medical

Supplies, on 01538 392 596, email tracey@centralmedical.co.uk or visit

www.centralmedical.co.uk

When responding please quote ‘OTJ’

The research was carried out by the University of Birmingham led

GlobalSurg-COVIDSurg Collaborative - a global collaboration of over

15,000 surgeons working together to collect a range of data on the

COVID-19 pandemic – and published in Anaesthesia (a journal of the

Association of Anaesthetists).

A total of 96,454 patients from over 1,600 hospitals across 114 countries

were included in this new analysis, and, overall, 26,948 (28%) patients

isolated before surgery. Post-operative pulmonary complications were

recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated

with SARS-CoV-2 infection.

The research team said the study results go against the current guidance

in common use which mandates isolation before surgery.

Patients who isolated pre-operatively were older, had more respiratory

comorbidities and were more commonly from areas of high SARS-CoV-2

incidence and high-income countries.

Although the overall rates of post-operative pulmonary complications

were similar in patients who isolated and those that did not (2.1%

vs. 2.0%, respectively), pre-operative isolation was associated with

a 20% increased risk of post-operative pulmonary complications after

adjustment for age, comorbidities, and type of surgery performed.

The rate of post-operative pulmonary complications also increased with

periods of isolation longer than 3 days, with isolation of 4 to 7 days

associated with 25% increased risk of post-operative lung complications

and isolation of 8 days or longer associated with a 31% increased risk.

These findings were consistent across various environments whether

or not other protective strategies were in place (pre-operative testing

and COVID-free pathways), showing that regardless of those other

strategies, pre-operative isolation does not seem to protect surgical

patients from post-operative pulmonary complications or death.

Looking at the possible reasons for these unexpected findings, one of

the study’s lead authors, Senior Lecturer and Surgeon Dr Aneel Bhangu,

from the University of Birmingham-led NIHR Global Health Research

Unit on Global Surgery, says: “Isolation may mean that patients reduce

their physical activity, have worse nutritional habits and suffer higher

levels of anxiety and depression.

“These effects in already vulnerable patients may have contributed to an

increased risk of pulmonary complications. Further, there is increasing

evidence demonstrating that prehabilitation (preconditioning) before

surgery improves patient recovery and outcomes.

“It is possible that isolation may have, therefore, conversely led to

patient deconditioning and functional decline, adversely influencing

their outcomes.”

The authors do however warn that the study does not take into account

the risk of transmission of SARS-CoV-2 from patients to other patients

and staff in hospitals. They say: “The benefits of pre-operative isolation

are not only for the individual patient but also to other patients and

staff in hospitals who are at risk from asymptomatic carriers of SARS-

CoV-2.”

The authors say: “Healthcare providers may wish to take these findings

into consideration when reviewing local and national guidance.

Relaxation of pre-operative isolation policies appears to be safe for

individual patients, especially in the presence of pre-operative testing,

which this and previous studies showed to be beneficial. Selected

isolation practices may remain in place in certain conditions (such as

high-risk patients and periods of high community prevalence).”

They add: “Further research is needed to explore the most effective

method for maintaining patient fitness and conditioning in patients that

are isolating, which may include home or remote prehabilitation using

telephone or online methods.”

8 THE OPERATING THEATRE JOURNAL www.otjonline.com


INTS2022

BERLIN

GERMANY

© Marco2811 - Fotolia.com

15 th International

Neurotrauma Symposium

Improving lives after neurotrauma through research

17–20 July 2022

Pre-symposium-courses scheduled for 17 July

www.neurotrauma2022.com

‘Long-awaited’ research into effects of long-term health

conditions on expectant mums and their babies underway

The impact of having more than one long-term health condition on

pregnant mothers and their babies is to be investigated by researchers

at the University of Aberdeen.

UK Research and Innovation (UKRI) have awarded the Aberdeen team

more than £185,000 to investigate the long-term health outcomes for

mothers and their babies with a view to improving maternity and postnatal

care.

Living with two or more health conditions is becoming increasingly

common in pregnant women with one in five pregnant women having

two or more active long-term physical or mental health conditions such

as diabetes or depression.

Managing these health needs can often mean women are taking several

medications and the impact of this is unknown. This is the first large

study to investigate these issues.

Using routinely collected datasets from across the UK, this study

will investigate how pregnancy and long-term health outcomes vary

according to combinations of medications taken during pregnancy,

specific combinations of health conditions and also by specific

pregnancy complications and their impact on health in later life.

Due to start early September, the large collaboration led by the University

of Birmingham, will see key sub-projects co-led by researchers at the

University of Aberdeen, seven further universities, and NHS Trusts

across the UK. The research is being funded via the £20m Strategic

Priorities Fund (SPF) Tackling Multimorbidity at Scale programme. The

programme is delivered by UKRI’s Medical Research Council, with the

Economic and Social Research Council and the Engineering and Physical

Sciences Research Council, also part of UKRI. It is jointly funded by

the government’s Department of Health and Social Care through the

National Institute of Health Research.

Dr Mairead Black Senior Lecturer in Obstetrics at the University of

Aberdeen and Consultant Obstetrician at NHS Grampian who is coleading

the Aberdeen side of the project alongside Professor Louise

Locock, explains: “We know that pregnant people with more than one

long-term health condition are disproportionately affected by severe

illness and even death during or shortly after pregnancy.

“We also know that maternity care systems can be difficult to navigate

for these people.

“Without deeper understanding of the problem, women with several

long-term health conditions may not have the best and safest experience

of care before, during and after pregnancy because services have not

been designed with their health needs in mind.

“The UK national body that reports on maternal deaths (MBRRACE) has

been calling for research of this nature for many years so with this

large-scale collaboration we look forward to addressing the challenges

that are increasingly affecting new and expectant mothers.”

Prior to this study, research into the impact of long-term health

conditions in pregnancy has focused on those people with single health

conditions. This is the first large study to assess these issues in those

affected by more than one long-term health condition.

Professor Krish Nirantharakumar, of the University of Birmingham and

Principal Investigator of the study said: “Having two or more health

conditions is becoming more common in pregnant women as women are

increasingly older when they start having a family and as obesity and

mental health conditions are on the rise in general.

“However, we don’t really understand what the consequences are of

multiple health conditions or medications for mothers and babies.

“This can make pregnancy, healthcare and managing medications more

complicated. Without deeper understanding of the problem, women

with several long-term health conditions may not have the best and

safest experience of care before, during and after pregnancy because

services have not been designed with their health needs in mind.”

Dr Black continues: “Our novel multidisciplinary approach will allow

future care to be tailored to women’s needs, from the early pregnancy

stage through the maternity journey to their long-term healthcare.

“This long-awaited project will also identify important time points

to target with future care improvements to prevent pregnancy

complications and long-term health conditions in women after

pregnancy. We will produce recommendations on how to plan and

design services that meet the needs of women and their families

before, during and after pregnancy.”

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 9


RCS England and RCS Edinburgh

to partner in programme of work to

support Surgical Care Practitioners

The Royal College of Surgeons of England (RCS England) and the Royal

College of Surgeons of Edinburgh (RCSEd), as the surgical bodies

currently championing and supporting the work of Surgical Care

Practitioners (SCPs), wish to announce that they are working jointly

on a new bi-collegiate project intended to better support and assist

SCPs in being recognised and granted formal regulation by the General

Medical Council (GMC).

Entitled ‘Supporting the extended surgical team’, the project signals an

ongoing commitment by both Colleges to collaborate more effectively

and, specifically, to continue to promote and support the extended

surgical team and the vital work they do in delivering safe surgical care

to patients.

SCPs are one of the four roles named as Medical Associate Professions

(MAPs). The UK government has agreed to support statutory regulation

by the GMC for two of these roles, namely Physician Associates (PA)

and Anaesthesia Associates (AA). This decision was made primarily

on the basis that the majority of practitioners in these categories are

currently from a non-healthcare background and therefore are not

subject to regulation.

In contrast, SCPs are registered healthcare professionals, typically from

a nursing or operating department practitioner background, and are

regulated by either the Nursing and Midwifery Council or the Health

and Care Professions Council. Both regulators are highly experienced

and competent in their approach to regulation.

However, given the diverse role of an SCP who is likely to be now working

towards a medical model of care often with a consultant surgeon as

their clinical and educational supervisor, the Colleges are supportive of

their regulation being the same as other professional roles within the

Medical Associate Professional group.

In response, RCS England and RCSEd are working together to produce

the following:

• A revision of the MSc in Surgical Care Practice curriculum intended

to align with a new career framework for SCPs. This is currently

under development via Health Education England (HEE) and Medical

Associate Oversight Board;

• The development of a Managed Voluntary Register for SCPs, which has

been an important step towards statutory regulation for other MAPs

groups but will also ensure that consistent standards of postgraduate

education and training for SCPs are developed across the UK.

The project will be run on a bi-collegiate basis with RCS England and

RCSEd as equal partners in all aspects of this development, and in

collaboration with a range of partner organisations such as HEE, the

higher education institutions who will deliver the curriculum, and SCP

representatives, who have been invited to participate in shaping the

project outcomes and who are all welcome contributors to the project.

It is intended that the project will not only support SCPs but also the

wider surgical team. In particular, junior doctors and surgical trainees

will benefit from their expertise, and as SCPs provide further service

resource for patient care, it will enable surgical trainees to attend

teaching or theatres and assist employers in managing the service

needs within their organisations. It will also offer support and clarity

to existing regulators in providing a consistent approach to supporting

SCPs.

We would welcome engagement from other stakeholders to ensure

that the project brings value to all, please do contact us with your

comments and feedback ~ PressOffice@rcseng.ac.uk

TRAGIC INCIDENTS HIGHLIGHT

SAFETY DILEMMA FOR HOSPITALS

Recent tragic events in India and Iraq have focused minds on the safety

measures in place at hospitals for the storage of oxygen supplies. Now

gas processing systems specialist Oxair is urging medical and healthcare

facilities across the world to avoid shortcuts and consider safety above

all when ordering in their oxygen supplies.

At least 22 people died in a hospital in India when the flow of oxygen

through ventilators was fatally interrupted. Meanwhile in Iraq 174

were killed in two separate catastrophic fires within three months at

hospitals in the capital Baghdad and Nassiriya, reportedly caused by

oxygen tanks exploding.

International health agencies had sounded warnings about a growing

crisis of severe oxygen shortages, which is leading to hospitals

outsourcing as many oxygen cylinders as possible. However, there are

potential pitfalls such as a lack of suitable and safe storage space.

Oxair has developed a simpler, safer solution – and it has already been

deployed and proven.

A significant number of hospitals across India and other regions of the

Middle East and Australasia are now self-sufficient and saving lives with

an off-the-shelf Oxygen Pressure Swing Adsorption (PSA) system. These

are high quality, robust medical devices designed to last and deliver

consistent, high purity oxygen on tap to hospitals and healthcare

facilities - even in the remotest locations around the world.

As it extracts its supplies directly from the atmosphere, PSA Oxygen

offers better patient care with a permanent flow of high-quality oxygen.

This system saves room space, offers output pressure and a flow rate to

suit the needs of the hospital and is capable of piping oxygen to every

department where it is needed.

Oxair’s system delivers constant oxygen of 94-95 per cent purity through

PSA filtration, a unique process that separates oxygen from compressed

air. The gas is then conditioned and filtered before being stored in a

buffer tank to be used directly by the end user on demand. Orders for

ready-to-use, standalone Oxygen PSA units can be turned around in just

a few weeks, depending on local lockdown conditions.

David Cheeseman of Oxair said: “We’ve seen terrible consequences

recently from a lack of life-saving medical oxygen, especially when

treating Covid-19 patients. But there’s a lot more to it than simply

pulling in extra cylinder supplies. If exposed to certain conditions the

storage, handling and removal of these cylinders can also be hugely

dangerous. It’s precisely the type of far-lying medical facility that might

run out of oxygen, that is least equipped to store more of it safely and

securely.

“We believe our PSA systems are the safest and ultimately cheapest

solution for hospitals anywhere. The design of these PSA systems as

‘plug-and-play’ means that they are literally ready to start working as

soon as they are delivered and plugged in, with voltage adapted to the

country of delivery. So, hospitals can rely on technology that is tried

and tested over many years, coupled with almost instant access to vital

oxygen supplies under significantly safer conditions.”

For further information on Oxair’s products and services visit:

www.oxair.com.au

When responding to articles please quote ‘OTJ’

10 THE OPERATING THEATRE JOURNAL www.otjonline.com


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Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 11


www.OperatinggTheatreJobs.com

A one-stop resource for ALL your theatre related Career opportunities

View the latest vacancies online !

Theatre Practitioners Recovery Nurses Anaesthetic Nurses ODPs

Scrub Practitioners Nurse Practitioners Medical Representatives

and Clinical Advisers

83 AUDIT REPORT Waitematā District Health Board Annual Report 2018/19

12 THE OPERATING THEATRE JOURNAL www.otjonline.com


Calling all OMFS nurses – ward, clinic and theatre nurse

colleagues are invited to join BAOMS conference for a

study day on latest OMFS clinical practice

British Association of Oral and Maxillofacial Surgeons (BAOMS)

President Austen Smith has put out a call to OMFS nurses to join the

surgeons at their 2021 Sheffield Annual Scientific Conference (ASM) for

the first ever study day for nursing colleagues. There is also a day of

separate sessions for maxillofacial prosthetists and technologists (IMPT

– Institute of Maxillofacial Prosthetists and Technologists).

Austen Smith said: “I’ve asked BAOMS members to talk to our OMFS

nursing colleagues who work with us in theatres, clinics and wards to

let them know there’s a dedicated programme for them at the BAOMS

ASM – and we’d love to see them here in Sheffield.”

The OMFS nurses study day programme is fully integrated with the

BAOMS ASM at the University of Sheffield Diamond Centre 9 Saturday

October 2021 with sessions on the latest OMFS nursing care and

development in wards, theatres and clinics. The programme includes

current practice on the late effects of cancer treatment in specialist

cancer services led by Nurse Consultant Diana Greenfield, Leeds

Teaching Hospitals. Head and neck (H&N) Clinical Nurse Specialist

Joanna Spellman presents a session on allied health professions/nurseled

H&N clinics together with H&N Consultant Anastasios Kanatas, also

from Leeds Teaching Hospitals.

BAOMS President Austen Smith’s conference theme is OMFS How to

do it: A workshop manual It’s made up of two days of sessions with

a focus on the basics and a series of how to guides from oncology

and reconstruction, deformity and TMJ and aesthetics to cleft and

craniofacial.

Everyone attending this year’s BAOMS ASM must pre-register. So, to

pre-register for the OMFS Nurses’ Day at the BAOMS 2021 Sheffield ASM

9 October, Sheffield University Diamond Centre email: office@baoms.

org.uk

The BAOMS ASM programme is available here https://baoms21.

talkingslideshd.com/home and you can read the full details of the OMFS

Nurses’ Day study day on page 7.

“I’m really looking forward to welcoming you to Sheffield. I think we’ve

put together an exciting programme that you’ll enjoy and learn from.

See you there!” Austen Smith concluded.

JOBS IN New Zealand, Minimum 12 months. Assistance with Accommodation,

Isolation, and Relocation to New Zealand from the UK.

Our client is a leading private healthcare provider with a team of 900 and growing.

Their group includes premium private surgical hospitals and day specialist hospitals

based in Wellington, Hawke’s Bay, Auckland, and Tauranga. They are looking for

Anaesthetic Technicians from the UK.

For further information and to APPLY visit

www.operatingtheatrejobs.com

Green Surgery Challenge

Judging and Awards Ceremony

Join us and our partners November 4th 12:00-14:30 for the Green

Surgery Challenge Judging and Awards Ceremony.

Five teams that are catalyzing cultural change within the surgical

community will showcase their Green Surgery Challenge projects,

highlighting the environmental, social, and economic impact made. A

panel of distinguished judges will provide feedback on the project’s

innovation, impact and transferability. At the event, delegates will

have the opportunity to network and take part in a session with one

of the teams.

Register for the event here: https://bit.ly/OTJGSC21

We anticipate Find that out more the programme 02921 680068 will • be e-mail granted admin@lawrand.com CPD points by the Royal College Issue 372 of Pathologists. September 2021 13


ns

Michael Goosey Joins

Bender UK’s Clinical

Sales Team

Bender UK has appointed Michael Goosey as

Clinical Sales Manager for the Midlands and the

South East of England.

An experienced healthcare professional

with 25 years-experience, Michael began his

career as healthcare service engineer with

Siemens Medical, before working for numerous

healthcare businesses.

Operating from his home in Leicestershire,

Michael will support sales and clinical trials

of Bender and Merivaara equipment across

the UK. He will provide expert advice and

guidance on the specification and purchase

of turnkey theatre solutions and clinical

equipment including LED operating lights,

pendants, and surgical tables.

Michael explains: “Bender UK was well known

to me as a leading healthcare supplier and I

have followed their impressive growth and

strong partnership with Merivaara and the

introduction of leading clinical products which

has made a big impact on the UK market.

As a former service engineer I was also familiar

with their Medical IT power systems and the

work Bender UK has done to raise the bar in

the field of critical power provision, so I am

delighted to now be part of the organisation.

With the huge challenges faced by the NHS

in clearing surgical backlogs and undertaking

new build and upgrade theatre projects that

have been delayed by the pandemic, I am

looking forward to being part of the team that

is providing such outstanding support to many

leading acute hospitals”.

Bender UK Managing Director Gareth Brunton

adds: “As our company continues to grow it is

vital that we have the right people to provide

the high level of support our customers

expect. I have known Michael for a number

of years, and with his technical background,

experience and knowledge of the market he is

a natural fit for the clinical sales team.”

For more information on Bender UK’s turnkey

operating theatre capabilities, visit

https://www.bender-uk.com/solutions/

healthcare

When responding to articles please quote ‘OTJ’

North Manchester General Hospital

selects Alphenix Sky to future-proof its

interventional imaging services

Dose and workflow optimisation benefits will help hospital to see more patients

An Alphenix Sky ceiling-mounted C-Arm interventional imaging system from Canon Medical

Systems UK has been selected by North Manchester General Hospital to replace an incumbent

system and steer non-vascular services into the future.

The versatility of the Alphenix Sky will give the interventional team more flexibility of movement

and positioning during examinations with 270° unrestricted access around the patient and 201cm

full patient coverage without needing to move the individual or table. The system’s innovative

Dose Tracking System will also provide enhanced dose awareness, estimating skin dose in real

time and displayed as a 3D colour map on a patient graphic. This helps imaging teams exclude

regions of previous high exposure.

“We’re delighted with the Alphenix Sky – it has broadened the procedures we can do, helped

speed up patient throughput and provides much better image quality than we had been used

to,” states Helena Hill, Interventional Radiology and Fluoroscopy Manager at North Manchester

General Hospital. “We have a long-standing, hugely positive experience with Canon Medical UK

so we know that we’ve got a great product and many years of outstanding service support ahead

of us to meet our patient service needs.”

“Looking to the future of interventional imaging equipment replacement isn’t only about

selecting a system that meets the needs of today, but it is also about thinking ahead to ensure

you can evolve with the changing needs of a department and patient cohort,” states Daniel

Parr, Interventional X-ray & HIT Modality Manager. “The Alphenix Sky provides versatility and

flexibility that will future-proof patient services at North Manchester General Hospital and also

has the assurance of Canon Medical’s Apps for Life and Service support teams in the background

to keep it running smoothly.”

An Alphenix Sky ceiling-mounted C-Arm interventional imaging system from Canon Medical

Systems UK has been selected by North Manchester General Hospital.

L to R: Jordan Niblock, Senior Radiographer; Bashir Siddiqi, Staff Nurse; Andy Mayes,

Clinical Product & Applications Specialist VL/XR, Canon Medical Systems UK; Helena

Hill, Interventional Radiology and Fluoroscopy Manager; Epiphania Muranda at North

Manchester General Hospital.

At Canon Medical, we work hand in hand with our partners - our medical, academic and research

community. We build relationships based on transparency, trust and respect. Together as one,

we strive to create industry-leading solutions that deliver an enriched quality of life.

For more information, visit:

Canon Medical Corporation: https://global.medical.canon

Canon Medical Europe: https://eu.medical.canon

Canon Medical United Kingdom: https://uk.medical.canon

For further information, please contact: Amy Rosoman

Canon Medical Systems UK T: +44 (0)1293 653762

E: Amy.Rosoman@eu.medical.canon

When responding to articles please quote ‘OTJ’

14 THE OPERATING THEATRE JOURNAL www.otjonline.com


Theatre Practitioner

opportunities

nationwide

A career at Spire Healthcare offers excellent education

and career development, with protected training and

investment in our staff.

Our nationwide hospitals cover a variety of specialties

including Orthopaedics, ENT, Gynae, Cardiac, General

Surgery and Ophthalmics, amongst many others.

You will have the opportunity to work in state of the art

surroundings utilising some of the latest technology and

working with leading Consultants from across the UK.

We are keen to promote from within the Spire Healthcare

network, so if you are looking for a long-term career with

advancement opportunities you will find them at Spire.

There has never been a better time to join us. Get in

touch today and find out how Spire can support

your career choices.

For us, it’s more than just treating patients;

it’s about looking after people.

For more information contact our

recruitment team at:

recruitment@spirehealthcare.com

www.spirehealthcare.com/recruitment/


MEDICA 2021 + COMPAMED 2021: For the restart as an

in-person event, participations reflect the optimism

of the medical technology industry

The exhibitor database, interactive hall plan and the ticket shop are already up and running

The medical technology industry and its suppliers are looking forward

to heading to the world’s leading industry platforms, MEDICA 2021 and

COMPAMED 2021, with optimism. The booking figures for both events

confirm this. Almost all of the halls (excepting halls 13 and 14) at the

Düsseldorf Trade Fair Centre will be occupied from 15 to 18 November,

when the trade fairs will be held on-site once more. “Despite the

planning time frame for companies becoming far shorter due to the

pandemic, a total of over 2,500 exhibitors from 68 nations was attained

three months before the trade fair started. In particular, bookings from

co-exhibitors on the big joint stands are still being snapped up like

hotcakes”, reports Christian Grosser, the Director for Health & Medical

Technology at Messe Düsseldorf. He believes that this is proof of MEDICA

and COMPAMED’s internationally prestigious position, despite the tough

conditions in which they are taking place.

Due to their high level of global attraction, both events are also on

the list of the selected trade fairs that the German Federal Ministry

for Economic Affairs and Energy (BMWi) in conjunction with AUMA

(The Association of the German Trade Fair Industry) are supporting.

These bodies have recently jointly set up an assistance programme to

support innovative small and medium-sized companies (headquartered

in Germany) in participating in trade fairs. This assistance comprises

a grant of up to 12,500 Euro to cover costs for stand rental and stand

construction. Objective: To reinforce export marketing in order to

gain new customers and tap into new markets. Apply now or lose your

chance! To receive a grant to participate in MEDICA 2021 or COMPAMED

2021, the grant application must be submitted to the German Federal

Office for Economic Affairs and Export Control (find more information

at: https://www.bafa.de; to contact the MEDICA and COMPAMED team:

exhibitor@medica.de) by the relevant exhibitor (following registration)

“The by 15 measures September. Sir Bruce Keogh outlined during his speech last night

will be instrumental in supporting healthcare professionals to identify

the early signs and enable them to act, Health Education England’s new

Innovations, trends and topics dedicated to the pandemic

education and training materials will be particularly relevant as will a

clinical network approach to care where professionals and organisations

work The corona together pandemic across a has dened pushed geographical the healthcare area sector – this firmly helps to into bring the

a spotlight safe, standardised has shown and up equitable weak points approach in our to care care. system. Hospitals,

outpatient service providers and care institutions have an increased

need for medical and laboratory technology, a wide variety of medical

“As products a college, and we personal have updated protective the equipment, national template and in for particular the Personal new

Child digital Health healthcare Record solutions to include or point-of-care information for telemedical parents on applications,

how to tell

if due your to child the pandemic. is ill, for The health exhibitors professionals, will present have recently many innovations launched

Paediatric focused on Care these Online themes, (PCO-UK) and the specialist – an online forums decision and accompanying

support tool,

providing conferences specialist on these diagnostic will amplify advice the to expert help dialogue ensure children and transfer get the of

right knowledge, treatment the at content the earliest of both opportunity. of which will be perfectly tailored to

the needs of the important target groups in the healthcare industry.

“To support this, I now urge paediatricians and all healthcare

professionals Once again, to CompuGroup utilise the resources Medical (CGM) Sir Bruce will has be outlined. one of Collectively

the biggest

we exhibitors can slow at down MEDICA. the grip They of this are deadly an international disease and provider reduce the of medical number

software children solutions who come that face is to addressing face with trending it.” topics. Michael Franz,

Head of Brand Communication at CGM SE & Co. KGaA, is excited about

the upcoming trade fair: “CGM is delighted to be able to take part in

Louise Silverton, Director for Midwifery at the Royal College of

MEDICA once again, at long last. From our point of view, this new hybrid

Midwives, said: “Severe sepsis can and does kill. Though it is rare, it

concept helps to fulfil our high expectations for trade fairs, even during

can be catastrophic for pregnant and postnatal women.

a pandemic. Trade fairs should stimulate interactive exchange between

all participants, across all sectors. We will be able to demonstrate this

“Sepsis to our customers remains a leading and interested cause of parties maternal with death. aplomb That at is the why biggest it is so

important healthcare that trade we fair do in all the we world. can to identify All of the it current as soon as digital possible themes so that are

it shown can be using treated. hands-on It is also use cases, important covering not to the forget patient’s newborn entire babies journey.” who

can succumb to infection very quickly.

The theme segments of MEDICA are oriented towards the complete

“Midwives

needs of outpatient

should certainly

and inpatient

“think

care.

sepsis”

An

where

overview

there

of

is

their

deterioration

allocation

in

to

the

the trade

health

fair

of either

halls is

mother

available

or

online

baby.

(link:

This means

https://www.medica.de/

we need the right

number

sitemap2021).

of midwives

The MEDICA

so that

segments

they can

are:

deliver

Lab technology

the best possible

& diagnostics,

care,

including

electrotherapy

in the

and

postnatal

medical

period.

technology, disposables and consumables,

information and communication technology (digital health) and

physiotherapy and orthopaedic technology. Fittingly, the exhibitors at

“Having COMPAMED the (approx. right numbers 400 exhibitors) of staff will will also showcase help to the ensure entire continuity range of

of products care and and carer services for women. that the Midwives supplier who market know provides the woman for medical will be

better technology: equipped from to spot individual changes components in the woman’s and condition parts to and high-tech identify

problems solutions, such innovative as sepsis materials developing.” and packaging to complete contract

manufacturing.

The digital services launch was a success!

The profiles of all exhibitors admitted to date can be looked up online

on the “Companies & Products” database, and can be filtered using a

variety of criteria, on the industry portals MEDICA.de and COMPAMED.

de. The interactive hall plans provide information on the exact stand

locations of the exhibitors in the individual halls (link: https://www.

medica.de/de/interaktiver_hallenplan). The ticket shop has also

been launched. In line with the hybrid event concept of MEDICA and

COMPAMED, tickets can now be purchased either as a hybrid ticket for

a one-day visit on site and parallel use of the extensive digital services

(45 euros) or as a pure digital ticket (without a visit on site/ 30 euros).

Professor All the Helen specialist Stokes-Lampard, forums which Chair are of integrated the Royal College into the GPs, themed said:

“Sepsis segments is a of huge the worry trade for fair, GPs such as initial as the symptoms MEDICA can CONNECTED be similar

to HEALTHCARE other common FORUM illnesses, (including and the the MEDICA College Start-up is putting COMPETITION a lot of effort and

into the Healthcare helping family Innovation doctors World recognise Cup), potential the MEDICA sepsis HEALTH and ensure IT FORUM that

patients and the rapidly MEDICA receive LABMED appropriate FORUM, are assessment some of and the treatment. programme items

that are offered both on-site and online, which can be accessed with

“We the appropriate have produced ticket. a toolkit, The COMPAMED in partnership HIGH-TECH with NHS FORUM England, by IVAM which (the

brings International together Microtechnology existing guidance, Business training Network) materials and the and COMPAMED patient

information SUPPLIERS’ FORUM to encourage by DeviceMed us all to are ‘think special sepsis, COMPAMED talk sepsis highlights. and treat

sepsis’.

In addition to these highlights, there will also be a programme of onstage

are events pleased at the to epicentre be working of with the trade NHS England fair. In to parallel, raise awareness speeches,

“We

and discussions improve and outcomes even the for patients. award ceremonies It really could can save be viewed lives.” via live

stream on the industry portals MEDICA.de and COMPAMED.de with the

Anna Crossley, Professional Lead for Acute, Emergency & Critical

right ticket (link to overview of all forums and their themes for 2021:

Care at the RCN, said: “Sepsis is a life-threatening condition and early

https://www.medica-tradefair.com/forums).

identication is the key to survival, but it can be difcult to diagnose

and Further often highlights symptoms of can MEDICA be mistaken 2021’s for programme a u-like illness. include This the is 44th why

raising German awareness Hospital Conference among carers, (as a live health stream) care and professionals the English language and the

public conferences is so vital. DiMiMED Even and though MEDICA there MEDICINE has been good + SPORTS progress CONFERENCE. to improve

diagnosis, They bring a together cohesive the national best of plan the is best needed from to the ensure fields that of international healthcare

professionals military and disaster are supported medicine, and and equipped sports medicine to identify and and sports treat science, sepsis

early. in Düsseldorf and can be followed with one of two tickets: either live

in-person, or as a live stream.

“If sepsis is not recognised quickly, it can lead to shock, multiple organ

failure The trade and fair death, halls which are open is why from early 10 a.m. detection to 6 p.m. is on critical all days to of start the

treatment trade fair. All within visitors the and hour. exhibitors Nurses and must health comply care with support the the workers, 3G rule

who (they see must their be vaccinated, patients on recovered a regular or tested: basis, and this is are what often the the three rst Gs

healthcare stand for in worker German) to in see order them, to are enter well the placed trade to fair recognise premises. the Tickets signs

of can sepsis be purchased early and exclusively raise the alarm. online. If a person has signs or symptoms

that indicate possible infection, think ‘could this be sepsis?’ and act

fast All information, to raise the for alarm, example wherever current you news are. on the hygiene and infection

protection concept at MEDICA 2021 and COMPAMED 2021, can be

https://www.england.nhs.uk/wp-content/uploads/2015/08/Sepsis-

viewed online at: https://www.medica-tradefair.com / Action-Plan-23.12.15-v1.pdf

compamed-tradefair.com.

twitter.com/OTJOnline

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16

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THE OPERATING THEATRE JOURNAL www.otjonline.com


Congratulations, you are now reading, the extended OTJ

The Operating Theatre Journal

Discovering the many more pages available online @ www.otjonline.com

Clinical software applications expand Barco’s Nexxis OR-over-IP system

Global visualization and

collaboration leader Barco has

expanded its solution portfolio

for the digital operating room

significantly. We look back on our

track record, as we start nearing

our OR-over-IP system Nexxis’s

tenth birthday, anticipating a

future with even more flexibility.

Excellent connectivity for

surgical teams around the globe

Nexxis makes it possible to share

uncompressed, 4K video and

audio in and between operating

rooms, in both 2D and 3D. It’s a

unique technology platform that

has been specifically designed for

integration with the digital OR.

Some facts and figures:

• First introduced in 2012,

Nexxis has steadily grown into

a mature system that provides

teams worldwide with a secure,

solid environment to operate

in.

• Nexxis obtained 510(k)

clearance from the FDA and is

registered as a medical device

in the European Union.

• More than 12,000 patients

every day undergo surgery

enabled by Nexxis. This equals

4.2 million people per year!

• Around 4,500 operating rooms

worldwide are equipped with

Nexxis video-over-IP. This

number will rise to 20,000 by

2025, thanks to a substantial

growth in customer base since

the pandemic.

• We partner with leading

companies all over the world,

that specialize in many

different kinds of surgical

technology and solutions, from

neurosurgery and to minimally

invasive orthopedic surgery.

Quality matters most, and Nexxis

has become the de facto standard

platform for digital operating

rooms, thanks to our innovative,

reliable, and value-add

technology, reinforced with user

focus and commitment. In the

words of Kuan-Cheng Chang, M.D.,

Ph.D, Vice President and Director

of Cardiovascular Medicine at

China Medical University Hospital:

“Barco’s Nexxis helped us improve

work efficiency in operations &

made overall cardiovascular suite

management a lot easier.”

Surgical displays integrated into

the system

Barco has accumulated

unparalleled experience in

visualization technology. Our

surgical displays portfolio

comprises displays for use in

any environment where surgical

procedures are carried out. They

are available in high definition or

4K ultra-high definition, and in 2D

or 3D. Almost all of them have

embedded Nexxis connectivity,

which makes it possible to

integrate them with the videoover-IP

system on a ‘plug & play’

basis.

Next step: a flexible solution

for every hospital

In a hospital, every team

works differently, and every

enterprise has its own needs and

challenges. With solutions such

as NexxisCare and NexxisLive,

we have now started building

up a third pillar: a portfolio of

SaaS building blocks that makes

it easier to manage ORs and to

involve the necessary people.

These dedicated applications are

all about increasing value for

the hospitals, without the need

to have a customized product.

An added value here is that it is

possible to extend the solutions

to non-Barco equipment as well,

which gives their capabilities a

much wider scope.

Cybersecurity and patient

safety first, always

Providing hospitals with a safe

environment to work in is always

at the top of our priority list.

When patient data are at stake,

hospitals simply need the best in

online security.

Davide Nocentini, VP of Surgical

Imaging at Barco, explains:

“‘Innovate for impact’ is one of

the key elements of Barco’s DNA.

We’re continuously researching in

what ways technology can help

us make our solutions even more

clinically valuable for hospitals

and clinical staff. For Nexxis, our

main pillars are offering flexibility

for surgical departments, best-inclass

performance for operating

teams, and cybersecurity and

data protection for patients. Our

offering is more than ever an

integrated solution, with which

we want to help hospitals lower

risks and increase flexibility and

productivity. We are proud of

where we stand today with the

Nexxis portfolio and are looking

with confidence to the future.”

For more information, visit us

on www.barco.com, follow us

on Twitter (@Barco), LinkedIn

(Barco), YouTube (BarcoTV), or

like us on Facebook (Barco).

© Copyright 2021 by Barco

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 17


HCPC launches consultation on

permanent changes to our Rules

to hold remote hearings

On the 31.08.2021, we launched a consultation on permanently

amending our Rules to give us the express power to hold hearings

remotely.

In March 2020 we were granted powers by the Department of Health and

Social Care to hold remote hearings during the pandemic. Currently, the

Coronavirus emergency provisions are due to expire on 30 September

2021. However, we would like the ability to continue holding remote

hearings in circumstances where it is fair and practical to do so even

after the expiry of the emergency period.

We are therefore seeking the views of our stakeholders on our proposal

to permanently amend our Rules to give us the express power to hold

hearings remotely.

We encourage all our registrants as well as professional bodies, employers

and trade unions to help and provide input on this consultation.

We are seeking your views on reasons why we should or should not hold

remote hearings once the emergency period ends. We also want to

know if you consider there to be any equality and diversity implications

for groups or individuals because of the proposed change to our Rules.

The consultation questions, more detail on our reasoning for the

proposal, and information about our experience of holding remote

hearings can be found in the consultation documents on our consultation

page.

Our experience of holding remote hearings

The introduction of remote hearings last year was a major part of

our pandemic response. We wanted to ensure fitness to practise, and

registrations appeals cases could be heard expeditiously. The measures

introduced in March 2020 meant that we had to adapt aspects of our

fitness to practise and registrations appeals processes. Our aim in

making these changes was to ensure that we could continue to fulfil

our statutory duty to protect the public, progress fitness to practise

investigations without unnecessary delay and conclude hearings as

efficiently and safely as possible.

We have seen benefits to holding our hearings remotely. In line with our

corporate strategy to continuously improve and innovate, we want to

embrace new ways of working where it can bring advantages to us and

those involved in the process.

Over the last year or so, we have also found that holding remote

hearings offers greater flexibility and efficiency when scheduling and

listing hearings. There have been advantages for all those involved in

a hearing in not having to incur the time and financial costs associated

with travelling to hearings and staying away from home. Our Tribunal

Services team have also reported increased engagement from

registrants who have been supported to participate in the process by

the remote nature of the event.

We do recognise that other people may not share our views on remote

hearings and that for some the technology involved may act as a barrier

to participation. We are keen to hear all opinions and experiences so

that we can take a range of views into account in planning for how we

might proceed with remote hearings, should we receive our permanent

Rule change.

The consultation opens today and you can download the consultation

documents by visiting our consultation page:

https://bit.ly/OTJHCPC

Getting involved

Submit your feedback through our easy to use online survey, by emailing

our policy team or by posting your responses.

For more information, visit the consultation page or email

consultation@hcpc-uk.org.

The consultation will run until 23 November 2021.

www.facebook.com/TheOTJ

Scientists grow contracting muscle

cells from human blood (BHF)

Researchers we fund have successfully grown smooth muscle cells in a

dish from a small sample of blood and have shown that these behave

in similar ways to those found in blood vessels, according to research

published 23rd August 2021 in the Frontiers Cell and Developmental

Biology journal.

Growing cells from blood vessels in the lab usually requires taking

arteries or veins from someone during surgery or after death. Now,

researchers from Imperial College London have shown that smooth

muscle cells, grown from blood samples from healthy volunteers,

contract in the same way as cells grown from blood vessels.

Researchers hope that this discovery could, one day, make it possible to

grow complete blood vessels in the lab. Eventually, these blood vessels

could be used as replacement blood vessels for people with heart and

circulatory conditions.

Moving blood around the body

Smooth muscle cells, found in the walls of blood vessels, support the

movement of blood around the body by contracting and relaxing in

response to chemical signals. This vital function helps to direct blood

to the areas of the body where it is needed most. Problems with

how smooth muscle cells contract have a role in a range of heart and

circulatory conditions, including high blood pressure and diabetes.

The Imperial team have previously shown that it’s possible to grow

endothelial cells (which line the inside of blood vessels) and smooth

muscle cells in a dish from blood samples from healthy volunteers and

look at inflammation. In this study they compared the contraction of

these smooth muscle cells with those grown from an existing blood

vessel.

To do this the researchers exposed the smooth muscle cells to

thromboxane, a hormone which is known cause these cells in the body

to contract. Shortly after exposure they saw increased levels of calcium

in the cells – a signal that the cells need in order to contract.

Lab-grown blood vessels are one step closer

Now, the team are focusing on growing smooth muscle cells from blood

samples from people with heart and circulatory conditions. They have

already started in patients with type 1 diabetes, who are at increased

risk of heart and circulatory complications, and have successfully shown

that these cells are also able to contract in response to thromboxane.

Dr Blerina Ahmetaj-Shala, Research Fellow at the BHF Centre of

Research Excellence, Imperial College London, led the study. She said:

“So far we’ve been able to grow the individual cells that make up a

blood vessel from blood samples. Next, we want to create 3D models of

blood vessel systems using blood samples from both healthy volunteers

and people with heart and circulatory conditions. This will allow us to

compare how blood vessels function in health and disease, which will

reveal more about the development of different conditions.”

Source: British Heart Foundation - Alana Cullen - Category: Research

18 THE OPERATING THEATRE JOURNAL www.otjonline.com


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New PPE Mask range begins killing SARS-CoV-2 on contact:

saving lives and reducing costs

• Antiviral and antimicrobial masks begin killing SARS-CoV-2 and other

viruses and pathogens on contact

• Ergonomic mask design, moulded fit and with adjustable nose bridge

to ensure an optimal seal to filter out infectious coronavirus aerosols

• Masks can be safely used for a full working day

• Validated by Lancaster University and to be produced to international

standards in the UK

Lancaster based ViraCoat Limited has announced the global launch of

ViraCoat 3 Ply Type 2R Surgical Face Mask, ViraCoat FFP2 Respirator

Mask and ViraCoat FFP3 Respirator mask, a new range of antiviral

and antimicrobial personal protective equipment (PPE) masks that

begin to kill SARS-CoV-2 and other viruses on contact. This is a major

breakthrough in reducing risks, to staff and patients, of COVID-19, as

there is a significant reduction in contamination risk during handling of

masks while in use. They will also reduce costs, because there is no need

to change masks multiple times per working shift. The product has gone

through rigorous validation with Lancaster University and is now going

into production in the UK.

The ViraCoat masks are impregnated with a novel and patented antiviral and antimicrobial coating that completely kills SARS-CoV-2 virus within

minutes. The entire surface of the mask is covered in the antimicrobial coating, including the straps; this significantly reduces the risk of

contamination during handling of the masks and therefore transfer of the virus to the wearer or patient, even if the mask is removed and replaced

several times during a shift. Many hospitals report health workers changing masks between 3 and 8 times throughout the course of the day as they

move between patients or tasks. ViraCoat’s COVID-19-eliminating masks could save millions of tons of masks ending up in landfill and our oceans

every year. Less-frequent replacement means a significant potential financial saving for public and private health buyers, and other high-volume

users.

The masks are ergonomically shaped for comfort and have an adjustable nose bridge for an optimal seal to prevent contamination by infectious

aerosols - tiny virus particles that linger in the air and are now widely accepted as a source of coronavirus infections not screened by surgical

style masks. They are a distinctive green colour to easily differentiate from standard PPE. At this stage the ViraCoat antimicrobial coating is being

applied to masks conforming to the filter-barrier requirements of EU Standard EN149:2001 + A1: 2009 type filtering efficiency standard to meet

current regulations. However, the coating obviates the need for these types of barriers and new standards are being sought that will allow ViraCoat

antimicrobial masks to be a lighter, more comfortable single layer, which can be repeatedly washed or sterilised.

The new masks, over a year in development, have undergone rigorous testing in the world-class biomedical facilities at Lancaster University.

Dr Muhammad Munir, Chief Scientific Officer at ViraCoat’s parent company ViraCorp and Lecturer in Molecular Virology at Lancaster University,

who will be familiar to many as a regular contributor to discussions of COVID-19 in the media, says, “The antimicrobial coating of ViraCoat can

significantly reduce the risks of contamination of wearers associated with handling masks, which may have SARS-CoV-2 and other viruses on their

surface, for example while putting them on, removing them or disposing of the masks. The ViraCoat anti-microbial coating kills not only SARS-

CoV-2 but also influenza and potentially other viruses. It has already been tested as effective against SARS-CoV-2 variants first identified in UK

(alpha), South Africa (beta), Brazil (gamma) and India (delta). The moulded design also ensures an effective seal against ingress or egress of virus

particles around the mask.”

ViraCoat is a subsidiary of ViraCorp, a group of biomedical research and development companies focused on developing viral defence products

against the viral outbreaks, pandemics, and endemics that threaten world health; the ViraCoat range of masks is the first product to go into

production. The masks will be in UK production at scale in October with the highest standards of quality control. (https://viracorp.global/)

The Royal Marsden Adult

Palliative Care Virtual

Update

Explore new trends and ideas

surrounding palliative care issues

Wednesday 3 and Thursday 4 November 2021

Register: www.royalmarsden.nhs.uk/studydays

20 THE OPERATING THEATRE JOURNAL www.otjonline.com


Kent health trust chosen as a pilot

site for improving wound care

Kent Community Health NHS Foundation Trust (KCHFT) is to be one of

just five pilot sites in the country to run a new wound care programme.

The National Wound Care Strategy Programme (NWCSP) strives to make

improvements in wound care. The aims are to:

• develop recommendations which support excellence in the standards

of care relating to preventing, assessing and treating people with

complex wounds

• achieve the best healing rates

• minimise the burden of wounds for patients and carers.

KCHFT has five wound centres in Deal, Ashford, Herne Bay, Folkestone

and Broadstairs. The centres are staffed by advanced wound nurses,

supported by tissue viability specialist nurses. Specialist care is offered

to patients with hard to heal complex wounds.

Nationally and at the trust, around 60 per cent of a community nurse’s

time is spent on wound care.

A new strategy is being designed by working with key partners to see

what improvements could be made, what needs to change and how to

make this change happen.

The two-year programme has been commissioned by NHS England and

NHS Improvement and runs until 31 March 2023.

At KCHFT, a Care Quality Commission (CQC) outstanding trust, the aims

are to:

• improve patient outcomes in lower limb management

• improve standards of wound care

• have consistent use of a digital wound assessment tool

• demonstrate clinicians and patients are working in partnership

• promote patient-led support groups.

The work will involve a review of hard to heal patients and sharing

patient stories so lessons can be learned.

KCHFT’s Medical Director Sarah Phillips said: “We’re really proud

and pleased to have been selected as a pilot site, having had stiff

competition from all over the country. Becoming a national pilot allows

us to focus on the progress we’ve already made through our wound care

centres and to understand what more we can do to improve the lives of

patients with lower limb wounds.

“The team is passionate about improving the lives of people with hard

to heal wounds and providing best possible care to all our patients with

lower limb wounds. Being part of this pilot enables KCHFT to lead the

way in finding a solution.”

The team will be using quality improvement (QI) methodology and tools

on the project. QI is an evidence-based approach to change in complex

health and social care environments and is used by healthcare trusts

worldwide.

Up to 14% of patients regret having undergone surgery, and previous

Cochrane reviews suggests implementing shared decision making

reduces the number of patients who choose major surgical interventions.

Ensuring patients make informed choices has recently been the focus of

new GMC and NICE guidance, and there are now a vast number of

resources to help patients and clinicians arrive at decisions in

partnership. At CPOC, we have collated this into one hub.

This hub contains a range of resources such as short podcasts,

education and training packages, suggested quality improvement

projects and national guidance. We hope we ignite your interest in

implementing or furthering shared decision making in your context. This is

simply a start and we welcome your suggestions to help us improve this

hub. For now, we hope you enjoy it and let us know how you get on – if

you have any shared decision making case studies, please do not forget

to submit them here.: https://bit.ly/OTJCPOC921

Visit the New SDM Hub here: https://bit.ly/3zNJR6w

Despite additional funding, workforce

shortages will limit the recovery of the NHS

The current shortage of 1,400 anaesthetists across the UK could

mean that more than one million surgical procedures will need to

be delayed every year

Urgent investment is required in higher anaesthetic training places

to fill workforce gaps

Responding to the government’s announcements of additional funding

to support the elective backlog recovery and the reforming of health

and social care, Professor Ravi Mahajan, President of the Royal College

of Anaesthetists said: “While this financial investment and reform is a

very welcome start, the greatest shortage faced by our national health

and social care services is that of trained staff. Even before COVID, data

showed that one million surgical procedures would need to be delayed

every year unless anaesthetic workforce numbers are increased to

meet patient demand1.

“While the government’s plans2 set an ambitious course for the NHS

and social care over the next three years, investment in facilities and

reforms alone will not reduce the backlog. With 90% of NHS hospitals

across the UK having consultant vacancies3, we have been warning

about the downward trend in anaesthetic workforce capacity for some

time. Without a well-staffed and healthy anaesthetic workforce, the

NHS will struggle to address the COVID surgical backlog and meet the

long-term expected increase in patient demand.

“This is why we are calling on the government to deliver an immediate

increase in funded higher anaesthetic training posts to expand the

anaesthetic workforce.

Getinge UKI appoints Amy Rothwell as General Manager Healthcare

Sales

Amy Rothwell has been appointed General Manager Healthcare Sales

for Getinge UKI starting August 31, 2021.

Getinge UK and Ireland are excited to announce that Amy Rothwell has

decided to join the organisation as General Manager Healthcare Sales.

Amy has extensive senior sales management experience and has spent

the past 11 years with Bausch + Lomb as Business Unit Director for UKI

and Nordics.

“Amy’s result orientation, analytical and strategic skills as well as the

ability to hire and develop talent will be invaluable to our organisation

moving forward securing business sustainability and driving sales force

effectiveness” shared Avril Forde, President North Europe.

Amy will be a member of the UKI Senior Leadership Team and report to

Avril Forde, President North Europe.

“This year, hundreds of anaesthetists in training were left without a

funded higher anaesthetic training post. This is at a time when the

NHS needs as many anaesthetists as possible to be in post and working

across hospitals delivering the care to which they have dedicated their

careers.

“We are pleased to see the government’s funding proposals for

health and social care services, but the success of this plan lies in

the government’s ability to staff these critical and much-loved public

services adequately.

“Investment in the anaesthetic workforce will also support the ambitions

of the NHS Long Term Plan and the devolved nation equivalents for a

health and social care service fit for the 21st century.”

References:

1. Medical Workforce Census Report 2020

2. Record £36 billion investment to reform NHS and Social Care

3. Medical Workforce Census Report 2020

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 21


New private hospital leading the way with robotic joint

replacement surgery

The hospital is the first in Bath to provide total hip and knee replacements using robotic technology

Sulis Hospital Bath is firmly sighted on becoming the most advanced

joint replacement centre within Bath, and the surrounding areas.

Having completed more than 200 robotic-assisted procedures, the Bathbased

hospital is fast becoming a leading joint replacement centre

within the Somerset and Wiltshire regions.

The highly experienced surgeons at Sulis Hospital Bath — which has

recently undergone a name change — specialise in hip and knee joint

replacements and the multidisciplinary team of nurses, radiographers,

and physiotherapists, pride themselves on providing the most advanced

robotic surgical techniques to improve patient outcomes and recovery

times.

Robotic-arm assisted surgery enables surgeons to have a more

predictable surgical experience and offers them a leadership advantage

in our evolving healthcare environment.

Recently, consultant surgeons Mr Latimer, Mr Heaton, and Mr Berstock

joined their colleague Mr Burwell in providing total hip replacements

utilising the innovative robotic arm technology.

Talking about his experience, Mr Heaton explains the benefits of this

technology: “I’m familiar with the robotic technology having already

completed robotic total knee replacements at Sulis Hospital Bath. I’m

delighted to be able to offer this technology to private patients for hip

surgery too.”

A CT scan prior to the operation is combined with the Mako SmartRobotics

systems to create a 3D model of the joint and bone anatomy.

Mr Heaton continued: “Mako’s 3D CT software allows me to create

a personalised surgical plan and identify the desired implant size,

orientation and alignment based on each patient’s unique anatomy.

This is all done before entering the operating room.

“During surgery, I can validate that plan and make any necessary

adjustments while guiding the robotic arm to execute that plan. It’s

exciting to be able to offer this transformative technology across the

joint replacement service total knee and total hip replacements.”

Traditional surgery involves the surgeon using a burr saw to remove

bone. The surgeon uses their experience to examine and judge the

accuracy of surgery by eye.

The Mako SmartRobotics system means surgeons can create

personalised surgical plans for each patient (Image: Sulis Hospital)

Mako systems enable the surgeon to look at the anatomy of the bone

and track healthy and diseased bone. This assistance prevents the

removal of healthy bone tissue and improves accuracy.

Within the operating theatre, the surgeon will use the Mako robotic

arm, which supports guiding the consultant within a pre-defined

surgical area. The robotic arm uses real-time feedback, preventing the

surgeon from moving outside the planned surgical areas.

The guidance of the robotic-arm ensures a high degree of precision

and accuracy in placing implants. Read more about the benefits of this

surgery here.

The hospital has also recently expanded its ability to support partial

knee joint replacement surgery. Consultant orthopaedic knee

specialist, Mr Bradbury, is ranked third in the United Kingdom for his

experience of utilising the Mako Robotic Knee total and partial knee

replacements. He spoke to us previously hailing the robotic surgery as

‘the gold standard of joint replacement surgery.’

Visit the Sulis Hospital website for more information:

https://www.sulishospital.com/mako-robotic-surgery

Source: SomersetLive – Jessie Parker

The 14 th Royal Marsden

Opioid, Cannabinoid &

Gabapentinoids Conference

What’s new in the science of opioids?

Wednesday 25 and Thursday 26 November 2021

Register: www.royalmarsden.nhs.uk/studydays

22 THE OPERATING THEATRE JOURNAL www.otjonline.com


Capacity by Getinge

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theatre capacity at short notice, transfer one or several operating

theatres during renovations or renovate your existing decontamination

facility. Ensure unimpeded operation during this time with our flexible

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Lucida Medical and Hampshire Hospitals NHS Foundation

Trust announce major study on AI for prostate cancer

Lucida Medical Ltd, the Cambridge-based start-up, and Hampshire

Hospitals NHS Foundation Trust (HHFT), have initiated a groundbreaking,

collaborative multi-centre research project. This is the first

retrospective study in the UK to validate the use of AI to help identify

prostate cancer using real-world data from a range of hospitals and

scanner types. It will demonstrate the potential of this technology to

improve the accuracy of diagnosis and could help over 100,000 patients/

year in the UK alone.

Prostate cancer is the most common cancer in men in Europe, Africa

and the Americas, with 1.4 million diagnosed worldwide each year and

375,000 deaths. In the UK, prostate cancer now kills more each year

than breast cancer, and 56% of cases in England are detected late,

when the disease is high-risk or advanced. Improved ways of screening

for and diagnosing the disease are needed to help detect the disease

earlier and offer patients better treatment and outcomes.

Lucida Medical’s Pi (Prostate Intelligence) technology uses

radiogenomics, machine learning and image processing to analyse

magnetic resonance imaging (MRI) scans. Results presented at the

European Congress of Radiology (ECR) in March 2021 indicate that it can

help automate labour-intensive tasks such as marking out lesions, and

avoid unnecessary invasive biopsies, with unprecedented accuracy and

consistency. The technology recently received the CE mark, allowing it

to be used in hospitals.

For the NHS to adopt this technology, its accuracy needs to be proven

in a range of settings. Most studies on AI for radiology to date have used

data from single centres, but it is known that performance can vary

between hospitals and with equipment from different scanner types.

This collaborative research led by HHFT is specifically setting out to

test how the software would work at a range of different NHS hospitals

and with all major MRI scanner manufacturers.

The PAIR-1 (Prostate AI Research – 1) study will collect data on 2100

patients who were diagnosed at 7 different centres. All data will be

de-identified so that the researchers will not be able to link it to

individuals, following a strict protocol approved by the UK Health

Research Authority. This work is especially valuable because it will

allow the software to be tested with the same types of patients,

scanners and hospitals that would be encountered in practical clinical

use, but without impacting on patients’ care.

Prof Richard Hindley, consultant urologist and lead for innovation at

HHFT, said: “We are delighted that HHFT is able to work with Lucida

Medical on this collaborative study. It will gather real-world information

on the prostate cancer diagnostic pathway across a range of NHS

Hospitals, and is a natural evolution for our trust having been leading

participants in the PROMIS trial (2015-2017) which provided the evidence

to support the incorporation of prostate MRI into the assessment of

any man with suspected prostate cancer. We are passionate about

improving the quality of care that we offer our patients, and welcome

initiatives like this that could help hospitals deliver more efficient and

effective care and better patient outcomes.”

Dr Aarti Shah, consultant radiologist at HHFT and Chief Investigator for

the PAIR-1 study, added: “Reviewing prostate MRI requires experience

and expertise to ensure that the right patients have a biopsy as well as

to help target biopsies to maximise the chances of finding significant

cancers. AI has exciting potential to enhance the processes of screening

and treating patients, and this study will provide strong evidence on its

performance.”

Lucida Medical Co-founder and Chief Medical Officer Prof Evis Sala,

Professor of Oncological Imaging at the University of Cambridge, said:

“Now Pi has CE marking, clinical studies such as this are crucial to

demonstrate the performance of the system in real-world clinical use.

HHFT has brought together a group of Trusts representative of the

wide range of settings across the NHS, from major teaching centres to

district general hospitals.”

Hampshire Hospitals NHS Foundation Trust

Interventional Approaches for

Cancer Related Pain & Acute

Pain and Persistent Post-

Surgical Pain Conference

Defining the role of interventional

approaches in the treatment of cancer pain

Thursday 16 and Friday 17 December 2021

Register: www.royalmarsden.nhs.uk/studydays

24 THE OPERATING THEATRE JOURNAL www.otjonline.com


The Operating Theatre Journal

Discovering the many more pages available online @ www.otjonline.com

State-of-the-art mobile operating theatre opens at

Alexandra Hospital

Patients across Worcestershire awaiting surgery will have their

procedure more quickly thanks to the opening of a new operating

theatre at the Alexandra Hospital in Redditch.

The addition of the new mobile operating theatre, which opened on

Wednesday, September 1, means an additional 200 patients a month

will be able to have a range of planned procedures including breast

surgery, minor vascular, upper and lower GI surgery, urology, and

gynaecology operations and minor orthopaedic work.

The theatre provides an anaesthetic room, operating theatre, twobed

first-stage recovery area, staff changing room, and utility areas.

A specially-constructed corridor and ramps join the main body of the

hospital to the unit and ensure a seamless journey for patients.

Countywide Theatre Matron for Worcestershire Acute Hospitals NHS

Trust, Mathew Trotman, said: “We are delighted that we have been able

to introduce the new theatre at the Alexandra Hospital. This enables

our teams to utilise our theatres and facilities more efficiently, and

more importantly see those patients who may have been waiting for

their elective procedure following delays caused by the Covid pandemic

more quickly than we might otherwise have been able to do.

“Our priority is to ensure we are delivering safe and effective care, with

patients having a positive experience when in our care. This purposebuilt

theatre enables us to see a high number of low complexity cases,

allowing us to perform more procedures, as we increase our capacity,

allowing us to see approximately 150-200 more patients a month.”

Robin Snead, the Trust’s Deputy Chief Operating Officer added: “The

additional theatre forms an important part of our wider reset and

recovery programme that is in place to help hospital and wider health

services continue to keep putting patients first despite the continuing

impact of the Covid pandemic. Having this extra facility at the

Alexandra is also entirely consistent with our vision for the future of

the Alexandra as a centre of excellence for planned surgery, and our

objective of providing the best care for local people.

“We would like to thank our colleagues at Herefordshire and

Worcestershire Clinical Commissioning Group for supporting this

important initiative, as well as all the staff who have gone above and

beyond to ensure this project has run smoothly. It’s a great example of

the work being done across our local health and care system to improve

access to services for our patients.”

Mari Gay, Managing Director and Lead Executive for Quality and

Performance for NHS Herefordshire and Worcestershire CCG said: “We

know that - despite the best efforts of hardworking NHS staff - the

impact of Covid has disrupted non-urgent care and meant that many

people have had to wait longer for procedures than they usually would.

This new theatre will allow us to treat patients quicker and forms a

critical part of our wider system plan to address some of the Covid

backlog.”

The new theatre is designed and built by a specialist company, who

also provide theatre staff to work alongside the Trust’s surgeons and

anaesthetists. It will operate at the Alexandra site until April 2022.

Watch our YouTube video here: https://youtu.be/WmlHdKPDZEw

We are pleased to accept

clinical articles for publication

within the pages of

The Operating Theatre Journal

Please send for the attention of the

Editor at:

admin@lawrand.com

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 25


HEALTHCARE SAFETY INVESTIGATION BRANCH MAKES

OVER 1,500 RECOMMENDATIONS TO NHS TRUSTS AFTER

HUNDREDS OF SERIOUS MATERNITY INCIDENTS

The Government’s healthcare safety adviser, the Healthcare Safety

Investigation Branch (HSIB), has made a wide range of recommendations

over the last year following investigations into hundreds of incidents

that have uncovered repeated errors involving NHS trusts. HSIB, which

is part of NHS England, has focused on NHS maternity units following

scandals relating to poor-quality care, such as the one at Shrewsbury

and Telford Hospital concerning a series of particularly serious failures.

The quality of care in maternity units has been the subject of

significant scrutiny in recent years, including by the Health and

Social Care Committee, which made recommendations that included

ensuring women have a personalised care and support plan. These

recommendations are examined in more detail in the panel below.

Donna Ockenden’s independent review focused on midwifery services

at Shrewsbury and Telford but also nationwide maternity units. The full

report is unpublished, but an interim report was published in December

2020, in recognition of an urgent need for change. Conclusions included

a need to coordinate neighbouring trusts working together so that

local investigations have external oversight, and ensuring women and

families are listened to by those responsible for their care.

An update in May 2021 stated that some advances were being made

under the direction of NHS Improvement, and noted that as a result of

the interim report, £95 million had been invested in maternity services

in England with the aim of increasing the number of midwives and

obstetricians. In addition to creating more jobs, this investment should

ensure that existing staff are better supported and improve the culture

by reducing workplace stresses among obstetric and midwifery staff.

The General Medical Council (GMC) and the Nursing and Midwifery

Council (NMC) have announced that where doctors’ or midwives’ actions

or attitudes pose a continuing risk to patients, they will investigate and

take any regulatory action necessary to protect the public.

It may be questioned whether these actions are enough. The Health

and Social Care Committee recommended increasing the budget for

maternity services by £200 – 350 million per annum, some of which

should be ring-fenced for training. The GMC has stated that its own

regulatory powers are insufficient. Charles Massey, the GMC chief

executive, wrote in June 2021:

“The world in which doctors practise today is fundamentally different

but the legal framework governing how they’re regulated has remained

largely unchanged. Until now, regulators have tried to work around this,

pushing at the boundaries of legislation to make our interventions more

responsive. But we’ve reached the limits of what we alone can do.”[1]

The Care Quality Commission (CQC), an executive body of the

Department of Health, has also taken a role in overseeing the quality

of care, and has downgraded multiple hospitals in recent months due

to concerns about women’s safety, highlighting poor communication

between staff.

HSIB’s role is to investigate serious incidents referred to it by NHS

trusts within hours. It is responsible for the investigation of maternity

cases involving stillbirth, neonatal death, or severe brain injury. Some

760 referrals were made to HSIB between April 2020 and March 2021,

involving 125 NHS trusts. Half of these referrals related to babies who

had suffered brain damage, 147 involved stillbirths, and 66 concerned

the death of the mother during childbirth.[2]

The recommendations published by HSIB as a result of these

investigations include an early warning system to spot women who

are starting to experience problems, which should be available in any

setting including A&E departments; better quality clinical records that

are easier to access; and a named consultant being responsible for

oversight of the care of mothers with complex needs. Overall, the HSIB

has made more than 1,500 safety recommendations to NHS trusts.[3]

Although the serious incidents are shocking and make headlines, it is

not just these incidents that need addressing. It is hoped that a culture

that offers women choice can be encouraged, for example by ensuring

they are fully informed of the safest options for them, so they can

take decisions on their care themselves with the support and advice of

their doctors. Instances in which this objective is not being met include

the underuse of Caesarean sections in a small minority of NHS trusts,

where natural births are preferred in order to improve statistics and

ratios, and women not being informed of the danger of Group B Strep

(GBS) and the possibility of being tested for GBS cheaply (further detail

on GBS screening is also provided in the panel below).

[1] General Medical Council, Monday 21 June 2021, GMC publishes

response to the Department of Health and Social Care’s consultation on

regulatory reform, available at: https://www.gmc-uk.org/news/newsarchive/gmc-publishes-response-to-consultation-on-regulatory-reform

[2] Independent, Monday 16 August 2021, Hundreds of maternity

incidents in one year prompt 1,500 safety instructions to hospitals,

available at: https://www.independent.co.uk/news/health/maternitysafety-hsib-nhs-babies-b1903308.html

[3] Ibid.

Source: Penningtons Manches Cooper – Alison Johnson.

This article has been co-written with Dominik Young, a trainee solicitor in the clinical negligence team.

When responding to articles please quote ‘OTJ’

26 THE OPERATING THEATRE JOURNAL www.otjonline.com


Vanguard helps Trust address patient waiting times

in the aftermath of COVID-19

MOBILE healthcare solutions are helping a UK healthcare trust address patient waiting times in the aftermath of the COVID-19 pandemic.

In April 2020, three trusts merged to become Mid and South Essex NHS

Foundation Trust, an organisation whose group of hospitals provides

a huge range of clinical services and care for a population of over 1.2

million people in central and south Essex. Prior to March 2020, these

trusts had, through a number of effective measures, managed to reduce

the number of people waiting over a year for an elective procedure

down to fewer than 200.

Following the merger, and as a result of COVID-19 and the cancellation

of elective procedures across all hospital trusts during the first period

of lockdown, the newly formed Trust has seen waiting times increase

again and as of March 2021, had more than 8,500 people who had been

waiting for their procedure for over a year.

While the easing of restrictions, that number has begun to reduce, but

the Trust wanted to do all it could to increase capacity. Part of that

work is being undertaken alongside Vanguard Healthcare Solutions.

Vanguard is the UK’s leading medical technology company and provides

a wide range of mobile and modular solutions for healthcare providers

to help them increase capacity to provide essential patient care.

For an initial period of six months, Vanguard will be providing three

different mobile solutions at three of the Trust’s hospitals, supporting

different disciplines. At Broomfield Hospital a Vanguard visiting hospital

will provide additional capacity for ophthalmology procedures, at

Basildon University Hospital a mobile laminar flow theatre will support

orthopaedics and at Southend Hospital a mobile theatre will be used

for general surgery. As well as standard ophthalmology procedures,

the unit at Broomfield will also host more complex ophthalmology

operations.

Vanguard will also be supporting through the provision of a team of 16

staff across the three solutions. All three units will run at least five days

a week, with Basildon expected to run seven days a week.

The Vanguard solutions being used by the Trust provide high quality

clinical environments which are ground-breaking and innovative. They

can be deployed completely separately from the hospital, or linked

seamlessly as required.

Visiting hospitals include an operating theatre and ward, allowing for a

complete patient pathway independent of the hospital’s estate. They

include anaesthetic, operating theatre and first stage recovery room,

reception/nurse station areas, HEPA-filtered environmental air and

utility areas. All Vanguard mobile theatres also include anaesthesia

and recovery areas, scrub area, changing rooms and HEPA-filtered

environmental air.

Maxine Lawson, Account Manager South for Vanguard, said: “From our

first site surveys in March, this has been a hugely exciting project to

work on with the Trust, with logistical complexity both in delivery and

staffing. We’re delighted that our mobile solutions will play a key role

in helping the trust drive down waiting times, increase patient capacity

and deliver essential patient care.”

vanguardhealthcare.co.uk

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A one-stop resource for ALL your theatre related Career opportunities

www.Operating peratingTheatre heatreJobs.com

New Study Evaluates the Use of Masimo

Bridge® As an Alternative to Opioids

Masimo announced recently the findings of a study published in the Journal of Pain & Relief in which Dr.

Jacques Chelly and colleagues at the University of Pittsburgh investigated the utility of Masimo Bridge®,

an auricular field nerve stimulator, in reducing postoperative opioid requirements in patients undergoing

kidney donor surgery.1 The researchers found that use of Bridge was associated with significant reductions

in opioid use at 24 hours and pain at 24 and 48 hours after surgery, concluding that Bridge “may represent a

complementary approach to minimize the postoperative requirement for opioid[s].”

Masimo Bridge®

Noting that opioids are still considered to be required after kidney donor surgery, in spite of their “established

serious side effects including respiratory depression, postoperative nausea and vomiting” and that they

“expose the donors to an unnecessary risk of opioid use disorder,” the researchers sought to evaluate whether

the technique of percutaneous nerve field stimulation might provide benefit during the postoperative period.

To evaluate this, they enrolled 20 patients undergoing kidney donor surgery, divided into two groups of 10.

Both groups underwent the same enhanced recovery after surgery (ERAS) protocol based on a multimodal

analgesic approach. The primary endpoint was opioid requirement, measured as oral morphine equivalent

(OME), 24 hours after surgery. They also evaluated pain (on a 0 to 10 scale) 24 and 48 hours after surgery. In

the experimental group (n=10), Masimo Bridge was fitted on patients in the post-anesthesia care unit.

The researchers found that, compared to the control group (n=10), the patients in the Bridge group had a

75.4% reduction in OME (8.3 ± 9.6 mg vs. 33.5 ± 37.3 mg, p = 0.03) and a 58.3% reduction in pain (2.5 ± 2.0

vs. 6 ± 1.4, p < 0.001) at 24 hours. At 48 hours, they had a 16.1% reduction in OME (22.4 ± 19.5 mg vs. 26.7 ±

21.9 mg, p = 0.33) and a 73.3% reduction in pain (1.6 ± 1.6 vs. 6.0 ± 2.8, p = 0.0004). There was no difference

in non-opioid analgesic use between the two groups. “Tolerability” of the Bridge device was reported as

“excellent” by 78% of participants.

The researchers concluded, “This study suggests that the NSS-2 [Masimo] Bridge device may be of significant

value in controlling postoperative opioid consumption and pain. This is especially interesting in the context

of the current opioid epidemic and associated risk of opioid use disorder (OUD) in surgical patients. However,

a prospective randomized placebo control design is required to confirm our findings.”

Masimo Bridge, the first evidence-based, drug-free, non-surgical device of its kind, has been cleared by the

FDA for use in the treatment of clinical symptoms associated with opioid withdrawal, but is not currently

FDA-cleared for postoperative pain management. The solution consists of a wearable, single-patient-use,

percutaneous neurostimulator, fitted behind the ear, which applies gentle electrical impulses to branches of

the cranial nerves around the ear. By using neuromodulation to aid in the reduction of withdrawal symptoms,

Bridge may help patients with OUD successfully transition into a treatment program. In clinical testing, Bridge

was found to reduce opioid withdrawal symptoms within 15-30 minutes and provide continuous relief for as

long as it was applied, which can be up to 120 hours per device, allowing opioids to leave the body. In a study

of 73 adults with OUD, it was shown that opioid withdrawal symptoms (such as increases in resting pulse

rate, sweating, restlessness, bone or joint aches, tremors, and anxiety) were reduced by 85% after the first

hour of using the device and 97% after 5 days of use (measured using the clinical opiate withdrawal scale).2

Study author Dr. Chelly commented, “Auriculotherapy is an ancient technique that has been used for centuries

to treat pain. However, it requires long and specialized training and experience to be used effectively on

patients. The Bridge device, by contrast, provides similar therapy but requires only limited training. Bridge

offers the possibility of allowing many more patients to benefit from auriculotherapy, especially at a time

when the use of opioids is so controversial.”

Joe Kiani, Founder and CEO of Masimo, said, “With FDA clearance, we have been marketing Bridge for opioid

withdrawal for over a year and have seen amazing success stories. With this new promising study from UPMC,

we will now work towards getting Bridge cleared for postoperative pain treatment worldwide. Last year,

over 83,000 people died in the US alone from drug overdoses, with almost 63,000 of them killed by opioids,

many of them from prescription opioids used post surgery.3 While we hope that with our FDA-pending,

breakthrough-designated Masimo SafetyNet opioid solution, we will catch opioid overdoses early enough to

save lives, it would be best if we can avoid the unnecessary use of opioids altogether. We hope additional

studies will confirm that Bridge can help reduce the use of opioids.”

@Masimo

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High fat diets break the body clock in rats, and this might

be the underlying cause of obesity

When rats are fed a high fat diet, this disturbs the body clock in their

brain that normally controls satiety, leading to over-eating and obesity.

That’s according to new research published in The Journal of Physiology.

The number of people with obesity has nearly tripled worldwide since

1975 (1). In England alone, 28% of adults are obese and another 36% are

overweight (2). Obesity can lead to several other diseases such as Type

2 diabetes, heart disease, stroke, and some types of cancer (3).

This new research may be a cornerstone for future clinical studies that

could restore the proper functioning of the body clock in the brain, to

avoid overeating.

Historically, it was believed that the master body clock was only located

in a part of the brain called the hypothalamus. However, further

research over the years has clarified that some control of our body’s

daily rhythms (hormone levels, appetite etc.) lies in several other parts

of the brain and body, including a group of neurons in the evolutionary

ancient brainstem, called the dorsal vagal complex (DVC).

Specifically, the DVC has been shown to control food intake by inducing

satiety.

Research has also shown that in obesity, daily rhythms in food intake and

the release of hormones related to eating, are blunted or eliminated.

However, it has not been clear if the malfunctioning of brain centres

controlling appetite is a cause or the result of obesity.

This new research conducted at the Jagiellonian University in Krakow in

collaboration with the University of Bristol found that high-fat diet fed

rats, before they started to gain weight, showed changes in the DVC’s

daily neuronal rhythms and the response of these neurons to appetite

hormones.

Thus, the researchers propose that disturbance in the DVC’s timekeeping

leads to obesity, rather than being the result of excessive body weight.

The research was performed on two groups of rats: those fed a wellbalanced

control diet (10% kcal from fat) and a high-fat diet (70% kcal

from fat).

To mimic the impact of unhealthy diet on humans, the researchers

introduced the new diet to adolescent rats (4-week-old) and monitored

their food intake across 24 hours for four consecutive weeks.

Electrophysiological recordings were performed to measure how DVC

neuronal activity changes across 24h. The use of multi-electrode arrays

allowed for simultaneous monitoring of around a hundred DVC neurons

from each brainstem slice. This enabled the researchers to assess

circadian changes of neuronal activity as well as neuronal responses to

metabolically-relevant hormones in each of the diet groups.

While the human and mouse brainstem share common features, the

major limitation of the study for its immediate translation to humans

is that it was performed on nocturnal animals (rats). The peak of the

DVC activity was observed at the end of day, which is the rest phase

for rodents, but an active phase for people. Thus, it remains to be

established if the phase of the brainstem clock is set to day and night,

or whether it depends on patterns of rest and activity.

This study opens new research opportunities for trying to establish the

strategy how to restore body clock function of the DVC, and therefore

help tackle obesity.

Dr Lukasz Chrobok, first author of the study said:

“I’m really excited about this research because of the possibilities it

opens up to tackle the growing health issue of obesity. We still do not

know what are the time cues which are able to reset or synchronise

the brainstem clock. Hopefully, the restoration of daily rhythms in this

satiety centre before or after the onset of obesity may provide new

therapeutic opportunities.”

1. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

2. https://commonslibrary.parliament.uk/research-briefings/sn03336/

3. https://www.nhs.uk/conditions/obesity/

Full paper title: Rhythmic neuronal activities of the rat nucleus of the

solitary tract are impaired by high-fat diet - implications for daily control of

satiety Link to paper:

https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/JP281838

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 29


Birmingham 2022 appoints Canon

as Official Imaging Supporter to

the Commonwealth Games

Canon, a global provider of imaging technologies and services, has been

appointed as the Official Imaging Supporter for the Birmingham 2022

Commonwealth Games. The company will use its imaging expertise to

showcase the event and inspire people across the world, while also

nurturing a new generation of sports fans.

Through the sponsorship, Canon will demonstrate its full breadth of

imaging technology by supporting athletes and organisers with on-site

medical imaging services, dedicated Canon professional service (CPS)

support and printing solutions which will help to bring the Games to life

to more than a billion spectators and viewers.

The Birmingham 2022 Commonwealth Games will see around 6,000

athletes from 72 nations and territories compete in 19 sports and eight

para-sports across 14 competition venues from 28 July until 8 August

2022. As the biggest event ever to be held in the West Midlands, it is

expected to attract more than one million spectators to the city and

have a global TV audience of 1.5 billion.

Yuichi Ishizuka, President and CEO of Canon Europe, Middle East and

Africa, said: “At Canon we have a proud heritage of supporting worldclass

sporting events, so we are incredibly pleased to be the Official

Imaging Supporter to the Birmingham 2022 Commonwealth Games. We

believe that imaging can transform our world, and we look forward to

using our full-range of innovative technologies to support the welfare

of athletes, ensure the smooth running of the Games and inspire sports

fans across the globe.”

Through this sponsorship, Canon will help the Commonwealth Games

to be seen like they’ve never been seen before. Canon Professional

Services will give photographers and broadcasters behind-the-scenes

support in capturing every moment of the action, while dedicated

on-site printing services will help the event organisers and venues to

deliver an exciting fan and spectator experience.

Cutting-edge medical imaging services will also support athletes’

performance during the Games. MRI, ultrasound and X-ray imaging

services will be available throughout the athletes’ village and in

diagnostic vehicles to provide unparalleled support for some of the

biggest sports stars.

Mark Hitchman, UK Managing Director, Canon Medical Systems, said:

“We’re excited to use our industry-leading medical imaging technologies

to help make the Birmingham 2022 next summer’s biggest sporting

event. High-level performance demands high-quality medical support,

and our experience in using our technology to support some of Europe’s

biggest sporting teams and events will be instrumental in keeping the

athletes at the Games fit, healthy and at the top of their game.”

Canon and Birmingham 2022 are united in their aim to act as a

catalyst for change by bringing people together and inspiring younger

generations to improve their health and wellbeing. As part of this,

Canon will connect with schools and communities in and around the

Midlands through its Young People Programme, using the power of sport

to inspire a new generation of creatives.

Ian Reid, CEO at Birmingham 2022, said: “We are delighted to have

Canon on board as they join us as our Official Imaging Supporter for

Birmingham 2022. Canon is a clear leader in imaging technologies and

has an enviable pedigree when it comes to sports and leisure events

and it is this that makes them the perfect partner to help us deliver a

truly memorable edition of the Games.

“As well as inspiring fans and athletes across the world, Canon are using

their expertise to work with us on our engagement programme across

schools and communities. We are looking forward to working together

to embrace and champion the youth, diversity, humanity and pride of

the region and the Commonwealth.”

Martin Reynolds, Executive Director at the Commonwealth Games

Federation, said: “The Commonwealth Sport Movement is delighted to

welcome Canon as the Official Imaging Supporter for Birmingham 2022.

Their imaging expertise will help capture and showcase the very best

of Commonwealth Sport and bring to life the inspiring stories across our

72 nations and territories.”

Birmingham 2022 recently announced the ticket ballot will run from 8

to 30 September. To be part of the largest sporting and cultural event

to take place in the UK in a decade, visit birmingham2022.com and

register for a ticket account to receive all the latest information about

the ballot.

MitraClip implant at Apollo Hospitals saves

41-year-old farmer who waited 91 days

for heart transplant

“1 out of 5 patients may get off the heart transplant list if they have

access to this therapy” - says Dr. Sai Satish

Apollo Hospitals, Asia’s foremost and most trusted healthcare group,

today announced a successful MitraClip implant on a 41-year-old male

farmer who had waited for over three months in different hospitals for

a heart transplant.

The patient was back on his feet within a few days after the procedure,

and might not even need a heart transplant.

Photo caption: MitraClip implant at Apollo Hospitals saves

41-year-old farmer who waited 91 days for heart transplant

Ms. Preetha Reddy, Executive Vice Chairperson, Apollo Hospitals Group

said, “As one of the few hospitals in India accredited to perform the

MitraClip procedure, being able to save the life of a patient waiting for

a heart transplant gives us the ability to offer hope to many others.

Research has shown that using MitraClip as a bridge to heart

transplantation is safe and may lead to functional improvements that

permit patients to be removed from the transplant list.

We are proud to have demonstrated this at Apollo Hospitals through

the case of a 41-year-old male patient who was waiting for a heart

transplant for over three months. The success of this case has renewed

our commitment to taking this cutting edge and revolutionary medical

innovation to the people who need it the most.”

Dr. Sai Satish, Senior Interventional Cardiologist, Apollo Hospitals said,

“The MitraClip is a globally accepted procedure for patients with heart

failure. For three years now we have been performing this procedure on

patients and we have seen incredible results in the quality of life they

are able to return to.

Our experience in this domain has enabled us to achieve many

milestones including back-to-back MitraClip implants in four very sick

patients in just one day. Today, we are at pole position; 70% of all

MitraClips in India to date have been performed at Apollo Hospitals and

we are only looking at bigger milestones in the journey ahead.”

India’s first two scientific papers on MitraClip have both been published

from Apollo Hopsitals. Dr. Sai Satish is involved in the authorship of

the APAC guidelines for MitraClip implants. Asia’s first MitraClip training

programme that included theory and four cases over two days was

conducted at Apollo Hospitals, cementing its position as a Centre of

Excellence in Interventional Cardiology.

SOURCE Apollo Hospitals

30 THE OPERATING THEATRE JOURNAL www.otjonline.com


Middlesbrough Hospital opens two new Laparoscopic Theatres

The theatres will be used by a

range of specialities including

cancer, upper GI, bariatric,

gynaecology and urology.

Two new state-of-the-art

laparoscopic theatres are new

in operation at The James

Cook University Hospital, in

Middlesbrough, Teesside.

The operating theatres feature

advanced imaging technologies

with multiple flat-screen monitors

and leading edge laparoscopic

equipment.

They are also the first in the

region to boast ICG technology

which uses a special dye to pinpoint

the exact location of a

tumour in relation to adjacent

vital organs.

Laparoscopic surgery has been

performed at James Cook for

many years, but for the first time

surgeons at the Middlesbrough

hospital can now carry out their

life-saving work in a dedicated

facility.

The new theatres are safer, more

efficient and less cluttered as

screens and equipment are built

into the specially designed room.

This means there are fewer wires

for staff to work around and the

high tech equipment is always

available on demand.

They will also reduce the

number of tasks theatre nurses

have to perform, enhance team

performance and improve patient

safety.

Photo (left to right): Alison Waines, Sarah Baker, Rob Harrison, Venkat Kanakala and Michael Stewart in one of the

new laparoscopic theatres at The James Cook University Hospital

High definition screens enable

surgeons to see clearly inside the

patient’s abdomen while a video

link makes it possible for trainee

doctors to watch live surgery from

the hospital’s STRIVE academic

centre.

The theatres will be used by a

range of specialities including

cancer, upper GI, bariatric,

gynaecology and urology.

Mr Venkat Kanakala, upper GI

and bariatric surgeon and clinical

director for general surgery

at South Tees Hospitals NHS

Foundation Trust, said:

“It’s very exciting to be a part

of this project which helps us to

simplify complex procedures by

having the right technology in

place.

“Technology is evolving all the

time, so our working environment

needs to change too, and we are

delighted to offer this state-ofthe-art

facility to our patients

who are the focus of our service.”

Source In YourArea – Marie Levy

Mum and son work together in same department at West Cumberland Hospital

Maree O’Neill and her son, Mark, are keeping it in the family working as Operating

Department Practitioners (ODPs) at the West Cumberland Hospital.

Maree moved to Cumbria from Scotland in 1989 with a young family, she said: “I did not have

a support network so concentrated in settling my family in to our new life in Cumbria, a few

years later I trained as a pharmacy technician and worked in a family run pharmacy, I had a

discussion with one of my regular clients who was a recovery nurse in Theatres at WCH and

she informed me that the department were currently looking to recruit ODPs”

Maree now works as a senior ODP in Theatres at West Cumberland Hospital.

She said: “My main discipline is anaesthetics but I am fully trained in recovery and

surgical. I am also the Education Facilitator for the department and I have a close working

relationship with UCLan and UoC. I am in a privileged position which enables me to assist

in the development of the next generation of healthcare professionals. The apprenticeships

available for staff are developing our future workforce.”

“Mark is extremely proficient and professional in his role, our working relationship has caused

some problems at home as we do emergency out of hours cover and my poor husband and

Mark’s father was often woken by one of us being called out through the night!

“The benefits are that we can always help one another out with shift swaps. He is now married with a home of his own and has given us a

beautiful grandson.

After sixth form Mark graduated and applied for an ODP course at UCLAN. He studied for three years and qualified and has worked in the

Anaesthetic department within the operating theatres for the past 13 years.

Mark said: “I am lucky/unlucky enough to work in the same department as my mum who is also an ODP, it has its perks as I rarely struggle to get

a shift swapped and I know I can count on her in difficult situations.”

Mark said the best part of his role is collaborating with his team: “I wouldn’t be able to do what I do without everyone else working to such a

high standard of care and professionalism, this was most recently highlighted during the Covid pandemic and subsequent Covid surges where me

and my theatre colleagues joined forces with other departments to provide the best competent care for all our patients.”

Source: News & Star with The Cumberland News – Ollie Rawlinson

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 372 September 2021 31


The effect of metabolic syndrome traits on atherosclerosis can be

reduced by increasing cardiorespiratory fitness already in childhood

The deleterious effects of

metabolic and cardiovascular

risk factors on arterial health

can be reduced by increasing

cardiorespiratory fitness already

in childhood, a new study

suggests. The study also found

that the traditional way of

investigating whether excess

body fat relates to poor arterial

health may be insufficient in

understanding the biology of

disease, because better arterial

health was associated with higher

fat mass in children.

Researchers from the University

of Eastern Finland, the University

of Exeter, and the University of

Bristol carried out the study using

data from one of the world’s most

extensive ongoing prospective

birth cohort studies – The Avon

Longitudinal Study of Parents and

Children (ALSPAC).

Metabolic disease and

atherosclerotic cardiovascular

disease are among the world’s

main causes of death. The paucity

of evidence on the mediating role

of cardiorespiratory fitness on the

associations of cardiometabolic

risks with atherosclerotic

cardiovascular disease risks in the

young population warranted this

novel study, which was conducted

among more than 5500 British

children and adolescents, aged

9 to 11 years. Cardiometabolic

risk comprised of elevated blood

pressure, abnormal blood lipids

and high body fat. The study found

that increased cardiorespiratory

fitness was associated with a

reduction in the adverse effect

of cardiometabolic risk factors

on arterial elasticity and stiffness

by 4 – 12% after controlling for

other risk factors. Theoretically,

this implies that for every 100

children who could develop

atherosclerosis from metabolic

syndrome, about 4 – 12 children

may avoid atherosclerosis due to

high cardiorespiratory fitness.

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Increased risk of metabolic syndrome in childhood could increase arterial stiffness and reduce arterial elasticity, which are precursors of

atherosclerosis. However, increased cardiorespiratory fitness in childhood could delay this progression by 4-12%. Image: Andrew Agbaje.

“This result may have clinical

and public health significance

since the studied population was

apparently healthy but it needs

to be replicated in a population

with a high prevalence of obesity

and metabolic diseases, and in

prospective studies. If the findings

from such studies are consistent,

it would suggest that enhanced

cardiorespiratory fitness from

childhood could prevent an

altered cardiovascular effect of

metabolic syndrome in later life,”

says Andrew Agbaje, a physician

and clinical epidemiologist at the

University of Eastern Finland.

“These data add to a growing

body of evidence highlighting

the importance of providing

children with opportunities to

develop their physical fitness.

This can be achieved by meeting

physical activity guidelines

for health, which encourages

children to reach 60 minutes of

physical activity at a moderate to

vigorous intensity on a daily basis.

Children should be provided with

opportunities to accumulate

activity across the day” says Alan

Barker, an Associate Professor of

Pediatric Exercise and Health at

the University of Exeter.

Researchers found a two-way

connection between arterial

health and fat mass

Another key finding from this

study is that the usual approach

for studying the adverse effect

of fat mass on arterial health

in a single direction might have

led to insufficient knowledge

on the biology of arterial

physiology and disease since

the reverse association has

been largely overlooked. The

researchers found that increased

arterial stiffness in children

was associated with reduced

general or central adiposity and

better endothelial function was

associated with higher adiposity.

These results remained consistent

after accounting for factors such

as age, sex, puberty, systolic blood

pressure, socio-economic status,

total fat mass, cardiorespiratory

fitness, low-density lipoprotein,

and the diameter of the brachial

artery.

This finding can be described as

an ‘arterial paradox’ in which

healthy arteries in children and

adolescents seem to promote

higher fat mass, albeit healthy

fat since less than five percent

of the study participants were

obese. “Hence, it is important to

prospectively investigate whether

this ‘arterial paradox’ continues

into early adulthood, especially

in the same population,” says Dr

Agbaje.

The collaboration allowed a

new approach to the ALSPAC

data, which was analysed at the

University of Eastern Finland. “To

me, this is a very nice example

of the benefits of international

collaboration and efficient use

of accessible datasets,” says

Tomi-Pekka Tuomainen, Professor

of Epidemiology, University of

Eastern Finland.

The findings were published in

Medicine and Science in Sports

and Exercise and abstracts were

presented in several international

congresses. This research was

supported in part by research

grants from the Jenny and Antti

Wihuri Foundation, the Finnish

Cultural Foundation Central Fund,

the Finnish Cultural Foundation

North Savo Regional Fund, and

the Doctoral Programme of

Clinical Research, Faculty of

Health Sciences University of

Eastern Finland. The UK Medical

Research Council, the Wellcome

Trust, and the University of

Bristol provided core support for

the ALSPAC study. The figure was

created with Biorender.com

For further information, please

contact:

Andrew Agbaje, MD, MPH, Cert.

Clinical Research (Harvard),

Institute of Public Health and

Clinical Nutrition, University of

Eastern Finland, Finland. andrew.

agbaje@uef.fi , +358 46 896 5633

Research article:

Agbaje AO, Barker AR, Tuomainen

TP. Cardiorespiratory Fitness,

Fat Mass, and Cardiometabolic

Health with Endothelial

Function, Arterial Elasticity,

and Stiffness. Med Sci Sports

Exerc. 2021 Aug 12. doi: 10.1249/

MSS.0000000000002757. Epub

ahead of print. PMID: 34334718.

ALSPAC webpages:

http://www.bristol.ac.uk/alspac/

When responding to articles please quote ‘OTJ’

32 THE OPERATING THEATRE JOURNAL www.otjonline.com


New body to tackle health disparities

will launch 1 October, co-headed by

new Deputy Chief Medical Officer

New Office for Health Improvement and Disparities to officially launch on 1 October.

• Dr Jeanelle de Gruchy has been appointed as the new Deputy Chief Medical Officer for England and

will co-lead the new body alongside Director General, Jonathan Marron

• Health disparities across nation to be reduced by tackling top risk factors for poor health

The Office for Health Improvement and Disparities (OHID) will officially launch on 1 October with the aim

of tackling health inequalities across the country. It will be co-led by newly appointed Deputy Chief Medical

Officer (DCMO), Dr Jeanelle de Gruchy.

The OHID will be a vital part of the Department of Health and Social Care and will drive the prevention

agenda across government to reduce health disparities, many of which have been exacerbated by the

COVID-19 pandemic, and improve the public’s health.

Health disparities across the UK are stark – for example, a woman living in Blackpool will on average live 16

fewer years in good health than a woman born in Brent, London and we know someone’s ethnicity can have

a significant bearing on their health and health outcomes.

Health disparities can undermine people’s ability to work and live long, healthy, independent lives while

creating pressure on the NHS, social care and other public services.

Ill health among working-age people alone costs the economy around £100 billion a year and it’s estimated

that 40% of healthcare provision in the UK is being used to manage potentially preventable conditions.

The new body will tackle the top preventable risk factors for poor health, including obesity caused by

unhealthy diets and lack of physical activity, smoking and alcohol consumption. It will work across the

health system to drive forward action on health disparities, including improving access to health services

across the country, and coordinate with government departments to address the wider drivers of good

health, from employment to housing, education and the environment.

As the new DCMO for Health Improvement, Dr Jeanelle de Gruchy will advise government on clinical and

public health matters as the co-lead for OHID, alongside the DHSC Director General for the OHID, Jonathan

Marron. They will be under the professional leadership of the Chief Medical Officer, Professor Chris Whitty.

Health and Social Care Secretary Sajid Javid said:

The COVID-19 pandemic has exposed the disparities that exist within our country. We know the virus has

had a greater impact on those with poorer health and we must ensure we give people the tools they need

to maintain a healthy lifestyle, whilst relieving pressures on our NHS.

By focussing on preventing and not just treating poor health, the Office for Health Improvement and

Disparities will tackle health disparities to break the link between people’s background and their prospects

for a healthy life.

I look forward to Dr Jeanelle de Gruchy coming on board to co-lead the OHID, bringing her extensive

knowledge to deliver a meaningful reduction in health disparities for people up and down the country.

Dr Jeanelle de Gruchy, incoming Deputy Chief Medical Officer said:

The Office for Health Improvement and Disparities will play a critical role in reducing health inequalities

across the country and build on the important work undertaken over recent years.

COVID has exposed and exacerbated the health inequalities across the UK. It is critical we address these

head-on and support people to live healthier lives. I look forward to getting started.

Professor Chris Whitty, Chief Medical Officer said:

Dr Jeanelle de Gruchy brings extensive local, regional and national experience to the role.

The Office for Health Improvement and Disparities has a lot of important and challenging work to do and Dr

de Gruchy is well placed to ensure it delivers meaningful health improvements for people nationwide.

The Office will help inform a new cross-government agenda which will look to track the wider determinants

of health and reduce disparities. The OHID will bring expert advice, data and evidence together with policy

development and implementation to ensure action on improving health is better informed, more effective

and more joined-up. It will bring together a range of skills to lead a new era of public health polices,

leveraging modern digital tools, data and actuarial science and delivery experts.

Dr Jeanelle de Gruchy is currently President of the Association of Directors of Public Health (ADPH),

the Director of Population Health at Tameside Metropolitan Borough Council and Chair of the Greater

Manchester Association of Directors of Public Health. She will be stepping down from these roles to

become DCMO.

Her previous roles include being Director of Public Health at the London Borough of Haringey (2010 to 2018)

and Chair of the London Association of Directors of Public Health. Prior to that, she was Deputy Director of

Public Health at Nottingham City NHS Primary Care Trust.

SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

THE

The Operating

SEPTEMBER 2020 ISSUE NO.

Theatre

360 ISSN 0000-000XJournal

SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

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