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Danny’sinsightWhy everyone withdiabetes should gettheir eyes tested
News from Guy’s and St Thomas’ Issue 17 | 2016
THIS ISSUE
2 the GiST
WelcomeAs I take up the role of Chief Executive ofGuy’s and St Thomas’, having been ActingChief Executive since Ron Kerr stepped down in October, I wanted to introducemyself to you.
I have worked at the Trust as ChiefOperating Officer since April 2012, so I amvery aware of the amazing work that staff doevery day to provide the best possible care toour patients locally, as well as to those whotravel to our hospitals from further afield forspecialist treatment.
The stories in this latest edition of the GiSTare a testament to their dedication, anddemonstrate how their work is literally lifechanging for many people.
Read about Alexandra on page 6, who wasborn with Pierre Robin syndrome. Thiscondition leaves babies with a smaller thannormal lower jaw, making it very difficult forthem to breathe or eat normally. Now aged 24,and after more than 60 surgeries, Alexandrahas fulfilled her goal to eat an apple.
Yaa and her son Rayhaan are featured onpage 7. Rayhaan was born with sickle celldisease and had a stroke when he was justeight months old. Yaa donated bone marrowto her son, and after three months in hospital,Rayhaan was cured of the disease.
I hope you enjoy this edition of the GiST. Ifyou have any comments please contact ourcommunications department by [email protected].
Chief ExecutiveGuy’s and St Thomas’ NHS Foundation Trust
7
10 18
Contents04 Dr Christian
backs HIV testing Raising awareness of theimportance of getting tested
07 Mum’s lifeline to sickle cell son Yaa donates her bone marrowto cure Rayhaan’s sickle celldisease
10 Helping handsJamie Williams on how hishand was saved at St Thomas’
14 e InterviewJames Lowell, General Manager, recalls his first job as a hospital porter
18 Role reversal Chaplains Imam Abdul Choudhuryand Reverend Nana Kyei-Baffourcompare notes
21 History CornerSt John’s Institute of Dermatologycelebrates 150 years
22 From the frontlinePhysician associate Sadia Quidwai
Meet the teamTELL US WHAT YOU THINK
If you have any comments about the magazineor suggestions for future articles, please contactthe communications department, St Thomas’Hospital, Westminster Bridge Road, London SE1 7EH, or email [email protected]
Visit us online at: www.guysandstthomas.nhs.uk
Produced by: The communications department
Design: AYA-Creative www.aya-creative.co.uk
Print: O’Sullivan Communications
Front cover: Diabetes patient Danny Ball and Dr SamanthaMann, consultant ophthalmologist, arefeatured on pages 8 and 9. the GiST is published by Guy’s and
St Thomas’ NHS Foundation Trust
Twitter @GSTTnhs
facebook.com/gsttnhs
youtube.com/gsttnhsPick up your copy: the GiST magazine is for ourpatients, local people, staff,members and other supportersof Guy’s and St Thomas’
ROUND-UP
www.guysandstthomas.nhs.uk 3
IN THE NEWSA round-up of media activity featuring Guy’s andSt Thomas’.
BBC News and Channel 4 News Dr Katherine Henderson,lead consultant in A&E, was interviewed by BBCNews and Channel 4 Newsabout the additionalpressures placed on A&E departments bypatients who have drunktoo much alcohol.
Her interviews werebroadcast on BBC News at Six, BBC News at Ten,and Channel 4 News.
A 98-year-old opera fan has become the oldest person ever tohave part of his lung successfully removed to treat lung cancer.
George Matthews was diagnosed with lung cancer in April2014. He says: “When I was first diagnosed, I was initially offeredradiotherapy, which didn’t sound pleasant, and wouldn’t haveremoved my cancer altogether.
“So when I met my doctor, and she offered me the surgery, Iwas amazed. I thought ‘at my age?’ but she was fully confidentthat it would be safe and successful.”
Lung cancer is the leading cause of cancer deaths in the UK,killing around 35,000 people a year.
George’s operation was carried out by Karen Harrison-Phipps,consultant thoracic surgeon, who says: “Older people die of lungcancer every day because they’re deemed too high risk forsurgery but I see no reason that fit people, no matter their age,should be denied this life-saving treatment.”
New year is a new dawn for cancer care
Karen Harrison-Phipps, consultantthoracic surgeon, with GeorgeMatthews after his operation
Opera fan becomes oldest personto have lung cancer operation
to Guy’s and St Thomas’ Charity’s £1.8 millionarts programme.
To find out how to support Guy’s CancerCentre Appeal, see www.supportgstt.org.uk.
We will be opening not one, but two, newcancer centres in 2016.
The centres – at Guy’s Hospital and atQueen Mary’s Hospital in Sidcup – have beendesigned by patients for patients, thanks to theinvolvement of cancer survivors.
In early summer our new centre at QueenMary’s Hospital in Sidcup will open its doors sothat people living in outer south east Londonwill no longer have to travel long distances forchemotherapy and radiotherapy treatment.
Thousands of cancer patients will avoid theprospect of ‘commuting’ to Guy’s or StThomas’ for their treatment.
Dimbleby Cancer Care and Macmillan CancerSupport will provide an information centre tosupport cancer patients and their families.
In the autumn our new centre at Guy’sHospital will open to offer most cancertreatment and research under one roof.
At present patients can be treated in up to13 locations in eight different buildings on ourtwo hospital sites, Guy’s and St Thomas’.
When the new centre opens at Guy’s,clinicians and researchers will be able todevelop better treatments together, which isgood news for patients.
The building will be full of light, space, and art – chairs, tables and lifts have all beendesigned with patients in mind thanks
Guy’s Cancer Centre will open this autumn
The GuardianAn article in The Guardianexplored the increase inchildhood allergies and theexperiences of familiesaffected by allergicconditions. EvelinaLondon’s allergy specialistsspoke about their researchand possible reasons forthe increase in allergies.
IndependentA four-page feature aboutthe history of St John’sInstitute of Dermatology at Guy’s and St Thomas’was published in theIndependent and inewspapers to launch a celebratory book aboutthe Institute’s 150thanniversary. See page 21 forour History Corner article.
4 the GiST
ROUND-UP
TV doctor Christian Jessen performed anHIV test on the Mayor of Lambeth at StThomas’ to raise awareness of theimportance of being tested.
Lambeth has one of the highest rates ofHIV in the UK. Approximately 10 out of every1,000 people living in the borough have thecondition, more than three times thenational average.
Dr Christian, who presents Channel 4programmes such as Embarrassing Bodies,and Councillor Donatus Anyanwu, theMayor of Lambeth, came to St Thomas’Emergency Department (A&E), where apioneering new approach to HIV screening
Hidden treasuresA previously unknown portrait ofEdward VI, son of Henry VIII andJane Seymour, is on display at theFlorence Nightingale Museum at St Thomas’ Hospital. It wasdiscovered in the art collection ofGuy’s and St Thomas’ Charity.
The painting is part of anexhibition titled Hidden Treasuresfrom the Hospital Vaults: TheRemarkable Art Collection of Guy’sand St Thomas’ Charity, whichshowcases precious and fragileitems of the Charity’s collectionwhich have never been displayed inpublic before.
The portrait of Edward VI, who re-established St Thomas’ Hospitalafter it had been closed during hisfather's Reformation, derives froman official full length portrait byWilliam Scrots. Expert testssuggest it was painted just afterEdward’s death at the age of 15.
Other pieces on display for thefirst time include a series ofcurious short films from the 1950scommissioned by the Ministry ofHealth to train physiotherapists,18th century silverware, artwork byrenowned 20th century artists,and a gold memorial ring made forthe funeral of Thomas Guy whowas the founder of Guy’s Hospital.
The exhibition runs until 27 March.
Staff, patients and visitors are remindedthat smoking is banned at Guy’s and St Thomas’ every time they walk past newsigns installed at our hospitals.
Smoking, including the use of e-cigarettes,is not permitted anywhere on the Trust’shospital and community premises, includingour grounds and gardens.
Karen Proctor, Director of Nursing, AdultServices, says: “We all have a part to play inmaking our hospital and community sites acleaner and healthier environment foreverybody. Please do not smoke when youvisit our hospitals or community buildings.Help us to stay smoke-free.
“We know thatquitting smokingcan be challengingfor many people.But with the support of our stop smokingadvisors people can see many healthbenefits almost immediately. You’ll also be inbetter shape for any treatment or surgerythat you may need.”
In the last 12 months our specialist StopSmoking Service has given advice andsupport to almost 1,500 smokers. For more information about the StopSmoking Service call 020 7188 0995 oremail [email protected].
Smoke-free and proud
is used. All patients having a blood test inthe department are also screened for HIV.
Dr Christian says: “Testing for HIV iscrucial for prevention. If you get tested andreceive a positive diagnosis, you can nowimmediately go on to receive treatment.
“This is why proactive approaches to HIVtesting like the one used in St Thomas’ A&Eare beneficial both for individual patientsand wider public health.”
Dr Laura Hunter, consultant inemergency medicine at Guy’s and St Thomas’, says: “Our new approach totesting is boosting HIV detection rates andsaving lives.”
Dr Christian backs HIV testing
Mayor of Lambeth Donatus Anyanwu with Dr Christian Jessen, Dr Laura Hunter and nurse Joel Paparello
www.guysandstthomas.nhs.uk 5
to improve the efficiency of thepumping action of the heart.This can alleviate symptoms ofheart failure such as severebreathlessness and extremefatigue.
Consultant cardiologists Dr Ronak Rajani (pictured) andProfessor Simon Redwood,who run the Parachute implantservice established at StThomas’ Hospital last year, say the early results have beenpositive.
Dr Rajani says: “TheParachute implant is anexciting new procedure to helppeople with severe heartfailure. These are patients whohave received all otherconventional treatments butare still significantly debilitatedby their symptoms. Theirconditions are so serious thatthey have a reduced quality oflife and indeed a lower life
expectancy. “The Parachute can improve
the efficiency of heart musclewhen alternatives such as amechanical heart pump or aheart transplant are unavailableor too risky. It’s bringing realbenefits to our patients and welook forward to offering it tomore people with severe heartfailure.”
ROUND-UP
Patients with life-threateningheart failure have been given alifeline thanks to an implantbeing offered by our pioneeringheart service.
Experts at Guy’s and StThomas’ are the only team inthe country using theParachute implant to helppatients with severe heartfailure when other medicaltreatments are not working.They now plan to expand theirservice so that more patientscan benefit.
The small device, whichmeasures 64-85mm indiameter and resembles anopen parachute, is implantedinto the main pumpingchamber of the heart whenthere is damaged musclepreventing blood pumpingaround the body properly.
By isolating the damagedmuscle, the Parachute is able
Parachuting in a new treatment
Art brightens up revamped East WingNew artwork in the refurbished East Wing ofSt Thomas’ Hospital has created a morepositive environment for some of our sickestpatients.
The installations were funded by Guy’sand St Thomas’ Charity and created byartists Hsiao-Chi Tsai and Kimiya Yoshikawa.They were chosen following a competitionwhich enabled patients, staff, and membersof the public to have their say.
The colourful sculptures, Aquatic Flora I & II, were designed to be large and cheerful,taking inspiration from the fish tanks oftenseen in doctors’ waiting rooms.
Two new patient lifts, installed as part ofthe refurbishment, make it easier andquicker to transfer critically ill patients fromthe Emergency Department (A&E) to thewards and intensive care units in East Wing.The building has also been weather-proofedand made more energy efficient.
TOP TWEETS@prodnoseExactly 5 years since
cancer diagnosis I have justbeen discharged from care ofGuys Hospital. The NHS. That'sthe true face of this country
@TomJFMonsoAmazing kids, amazing
parents, amazing staff. Justamazing @EvelinaLondon@GSTTnhs
@GSTTnhsWe're hugely grateful to
@DoctorChristian &@MayorLBLambeth for visitingour A&E today & supporting#HIVtestweek
@NHSGYWCCGCongratulations to
@GSTTnhs for winning theHealthcare Recruitment Awardat yesterday's #HBAwards15
@PeterABTaylor11 years ago today
surgeons @GSTTnhstransformed my life with a livingrelated kidney transplant.Forever grateful. Treasuring everymoment.
@MarkTJones500I am very grateful for
the care received over recentmonths. Keep doing what you do,cherish your staff and championinnovation.
@jimleedhamCelebrating
#WorldPrematurityDay with afew of the many incredible@EvelinaLondon #NHS staffwho we owe SO much to
@RuthRobboImpressed with my
Sunday afternoon MRIappointment at @GSTTnhs -delivered on time by friendlystaff who took time to explainthings to me
Ph
oto
cou
rtesy of Tsai & Yosh
ikawa, p
ho
tograp
h by T
iffany Lin
SPOTLIGHT
6 the GiST
Alexandra Robinson was born with Pierre Robin syndrome, a condition whichleaves babies with a smaller than normallower jaw, making it very difficult for themto breathe. Her lower jaw was almost two centimetres further back than herupper jaw.
She also had a severe cleft palate, whichleft her with no roof to her mouth andmeant she needed to be fed by a tube forher first few months of life. Pierre Robinsyndrome is a rare condition that affectsaround 1 in 10,000 babies.
Now at the age of 24, Alexandra hasundergone more than 60 surgeries andhas been visiting Evelina London Children’sHospital for nearly 10 years, often underthe care of Professor Piet Haers,consultant cleft and maxillofacial surgeonwith the South Thames Cleft Service.
Alexandra’s mum, Jules, reflects onwhen they first met Professor Haers in
2001. She says: “Alexandra struggled toeat anything that wasn't soft, her jaw didn'topen as it should and she was small for herage because she couldn't eat properly. Iremember Alexandra told Professor Haers,‘I just want to be able to eat an apple likeeveryone else’ and he said to her, ‘Trust me,we’ll get you to eat that apple.’”
Now working as a care worker in achildren’s hospice, Alexandra describesProfessor Haers as the man who changedher life. “He’s the best person ever,” shesays. “Visiting Evelina London is amazingcompared to other hospitals I’ve seen, it’sjust so colourful and it doesn’t feel like ahospital.”
Alexandra lives with a tracheostomy, asmall tube which is inserted into thewindpipe to form an artificial airway, but itdoesn’t stop her living a normal life. Sheexplains: “I work with children with life-limiting illnesses, some of whom also have
60 operationsbefore 24Alexandra’s childhood goal was to eat an apple, just like everyone else.
tracheostomies. They often ask mequestions about my tracheostomy, or‘trachy’ as we call it. I can help them byexplaining how I have dealt with situationsin life and how I got to be doing what I’mdoing now.”
Alexandra recently came back to EvelinaLondon to celebrate the 10th anniversary ofthe hospital with other tracheostomypatients past and present. She delightedeveryone by bringing her eight-week-oldbaby Penelope to the party.
Alexandra says: “We never knew if I wasgoing to be able to have a baby, I was placedin the 'high risk' category. There was noresearch around whether someone withPierre Robin syndrome has had a babybefore, so throughout the pregnancy wedidn't know whether or not Penelope wouldhave the condition. We are incredibly luckyto have a healthy, happy baby girl and I feelextremely blessed.
“I loved taking Penelope to the party as Ihadn't told any of the nurses who had lookedafter me during my time at Evelina Londonthat I was pregnant. Without the support ofthe people who cared for me, especially thenurses, I don’t know how I would have copedso I’ll always be grateful to them. Being ableto surprise them with Penelope was amazingand it also meant I could show other familiesthat having a trachy hasn’t held me backfrom living my life to the full.”
About the South ThamesCleft Service
The cleft team is made up ofspecialist clinicians includingsurgeons, nurses, psychologists,speech and language therapists,orthodontists, and dentists. Theywork together to provide care andtreatment from before birth and intoadulthood for people with cleft lipand palate problems.
Around 120 babies born with cleftlip and/or palate are referred everyyear. The team also treats childrenwho have speech problems that needsurgical treatment and adults whohave previously received treatment.www.evelinalondon.nhs.uk/cleft
SPOTLIGHT
www.guysandstthomas.nhs.uk 7
Rayhaan Kufuor-Gray, a five-year-oldfrom Streatham, started school lastSeptember after having a successfulbone marrow transplant from his mother,Yaa, in 2013. The transplant has helpedhim to overcome sickle cell disease, aninherited blood disorder.
Sickle cell disease affects people’shaemoglobin, the protein found in redblood cells that carries oxygen aroundthe body. Instead of having normal disc-shaped cells, their sickle-shapedcells block small blood vessels, whichputs them at greater risk of stroke, chestinfections, and severe pain.
Yaa says: “Rayhaan was diagnosedwith sickle cell disease and I was told howto care for him so he didn’t fall ill andhave a crisis. Then he had a stroke at justeight months old and couldn’t move hisleft side at all.
“I knew from the beginning that Iwanted a cure for Rayhaan so we wereput on the register for a bone marrow
transplant. There wasn’t a suitablematching donor so the doctors said theycould use my bone marrow instead.
“Rayhaan was in hospital for threemonths but it was worth it because he iscured of sickle cell disease. His bloodcount is now normal and he hasn’t lookedback. He started school last Septemberand is doing really well.”
Rayhaan had his bone marrowtransplant at St Mary’s Hospital, andreceived his follow-up care from EvelinaLondon Children’s Healthcare’s SickleCell and Thalassaemia Service.
Children with sickle cell disease face alifetime of challenges which can greatlyaffect their quality of life. They live inconstant pain and may need to take timeoff school because of regular hospitalvisits, which can lead to psychologicalproblems.
By transplanting healthy bone marrowfrom a matching donor, children withsickle cell disease can start to produce
Mum’s lifeline to sickle cell sonnormal haemoglobin.
A bone marrow transplant is anintensive medical treatment consideredfor very sick children with sickle celldisease. It involves chemotherapy andradiotherapy and a period in hospital tobuild up the immune system.
Dr Baba Inusa, a leading consultantfrom Evelina London’s Sickle Cell andThalassaemia Service, says: “Childrenwith sickle cell disease are 300 timesmore likely to have a stroke than otherchildren.
“To prevent a stroke from happeningwe usually give these children monthlyblood transfusions but this can lead toserious complications because of highlevels of iron in the blood.
“A bone marrow transplant can be alifeline for children with severe forms ofthe disease and may give them thepotential to lead healthier, fuller lives.”
8 the GiST
When Danny Ball found himselfstruggling to read a rail map at a trainstation, he put it down to his eyes beingtired.
Similar experiences made him thinkthat he should get his eyes checked soon,but he never got round to making anappointment for a check-up.
Danny, who is 35 and lives inBermondsey, says: “Like many youngmen, I felt invincible. I thought sight losswas something that happened to otherpeople.
“When I started finding it difficult toread, I put it down to my eyes being tired.I failed to get them checked.”
Danny has Type 1 diabetes. Everyonewith diabetes is vulnerable to diabetic eyedisease – one in four people withdiabetes will develop sight-threateningeye changes.
His vision continued to worsen. Thesituation eventually became so seriousfor Danny that he sought help at StThomas’ eye casualty unit. Unfortunately,it was too late – his condition hadbecome too advanced to treat.
Danny is now blind in one eye and haslost much of his sight in the other.
Eye health experts at Guy’s and StThomas’ warn that soaring diabetes ratesthreaten an upsurge in blindness unlesspatients like Danny receive regular eyechecks.
Diabetes is the main cause ofpreventable blindness for people ofworking age in the UK. It affects the smallblood vessels in the retina in acomplication called diabetic retinopathy,also known as diabetic eye disease.
Dr Samantha Mann, consultantophthalmologist, says: “With diabetesrates higher than ever before, there hasbeen a corresponding increase in thenumber of patients at serious risk ofblindness, especially if they don’t attendtheir eye appointments.
“The damage caused by diabetesneeds to be identified and treatedpromptly to avoid vision becomingimpaired. This is why we screen the eyesof people with diabetes to detect theearly stages of diabetic retinopathy usingspecial digital cameras.
“At Guy’s and St Thomas’ we screen1,000 people with diabetes each monthand we find that around 10 of thesepatients need urgent treatment toprevent them going blind.
“We’re worried that up to 20% ofdiabetes patients who need to bescreened aren’t attending check-ups. Ifpeople don’t undergo these checksthey’re vulnerable to developing sight-threatening complications in their eyes.”
Early detection and treatment canprevent blindness in 90% of diabetes-related cases. However, it is estimatedthat 590,000 people have diabetes buthave not been diagnosed with thecondition and not all patients arereceiving the specialist eye checksneeded to detect diabetic retinopathy.
Libby Dowling, senior clinical advisor
“I thought sight losshappened to other people”
IN FOCUS
Danny Ball didn’t get his eyeschecked until it was too late tosave his sight. He shares his storyto help other diabetes patientsunderstand why it is so importantto have regular eye tests.
Samantha Mann, consultant ophthalmologist,checks Danny’s eyes
“My sight couldhave been saved if I’d checked myeyes earlier.”
IN FOCUS
www.guysandstthomas.nhs.uk 9
at Diabetes UK, says: “Retinopathyfrequently has no symptoms until it iswell advanced, so people with diabetesmay not be aware of changes to theretina until their vision has already beenimpaired.
“That’s why it’s important to attendregular retinal screening, so that any caseof retinopathy can be detected early,therefore increasing the chances ofreceiving the most effective treatment.”
Danny is determined to share his storyso that others become more aware of thedangers of diabetic eye disease. He isalso interested in researching why youngmen fail to engage in healthcare, just ashe did when he first noticed his eye sightworsening.
His experience features in a new film –‘Danny’s Story’ – made by Guy’s and
St Thomas’ to promote eye screeningand highlight the risk of sight loss fordiabetes patients.
Danny says: “My sight could have been saved if I’d checked my eyes earlier. It’s crucial to make people aware of theimportance of having regular eye check-ups, particularly if they know they havediabetes.”
Diabetes is a rapidlygrowing problem:
3.9 million people in theUK have diabetescompared to 1.4 million in 1996.
An estimated 590,000people have diabetes but have not yet beendiagnosed.
Early detection andtreatment can preventblindness in around 90%of cases.
Find out more about the diabetic eyecomplication screening service andwatch ‘Danny’s Story’ atwww.guysandstthomas.nhs.uk/decs.
10 the GiST
”People rely so much on their hands, so itcan be particularly disruptive if somethinggoes wrong,” say Rachel Box and RachelLaddin, clinical specialists in hand therapyat St Thomas’ Hospital. “What if you can’twrite or drive? If you’re self-employed, howdo you support yourself?”
When Jamie Williams cut his arm with asaw, he thought his career as a tree surgeonwas over. He was rushed by ambulance tothe A&E department at his local hospitalwhere they stopped the bleeding andtransferred him to the hand and plasticemergency clinic at St Thomas’ Hospital forspecialist treatment.
Jamie says: “I was at home, building apond, and I had just a little bit left to dowhen I picked up the circular saw. At first, Ididn’t know how far the saw had made itinto my arm, but when I pulled it out, Icouldn’t move my hand at all.”
Matt James, consultant plastic surgeon,operated on Jamie twice. He reattached thetendons and nerves which had been cut bythe saw, and a week later Jamie went home.
After the surgeryAfter his operations, Jamie was seen by thehand therapy team at St Thomas’ Hospital.When they took the dressings off Jamie’shand, he saw the wound for the first timesince his operation.
Jamie’s hand was placed in a protectivesplint made by the hand therapists to stop
him from overstretching the tendons thatjoin muscle to bone.
Rachel Box explains: “The plastic surgeonstitches together the severed tendons, thenscar tissue grows over the stitch whichmakes the join stronger. Until the scar tissuehas grown, the tendon is really weak, so wehave to stop people from stretching thetendons by instinctively grabbing forsomething or moving their arm in theirsleep.”
After months of hand therapy, themovement and strength has mostly returnedto Jamie’s hand. Now the only limit to hismovement is caused by tightness around thescar on his arm.
Rachel Laddin says: “Scar tissue is apositive thing – it is your body healing itself –but it can also create a few problems.
“The scar tissue can become thickenedand sticks to the surrounding tissue. This canstop the tendons from moving properly.Techniques like massage, exercises andsilicone dressings can help to reduce scarthickening and prevent the tendons fromgetting stuck.”
Jamie will have a third operation toremove some of the scar tissue this winterwhile the tree surgery business is quiet.
Jamie concludes: “If I’d done this 10 yearsago, I might have lost my hand. Now I’m backat work and playing with my kids like normal.It’s amazing what the team has done.”
Helping handsAbout hand therapyHands contain a complicatedarrangement of 27 smallbones, tendons and musclesall very close together.
Occupational therapistsand physiotherapists in thehand therapy team have hadspecial training tounderstand the way the handis made up and how thedifferent elements react witheach other.
They work together tomanage patients’ woundsand scars, and restoremovement, strength andfunction in the hand.
Most of the people whoare treated by the handtherapy team have, likeJamie, injured their hand insome way, but the team alsosees people with trappednerves, arthritis or work-related upper limb disorder.
www.guysandstthomas.nhs.uk/handtherapy
Jamie Williams nearly lost his hand after an accident lastJuly. We find out how surgeons and the hand therapy teamhave worked together to save it.
Jamie leaves St Thomas’ Hospitalin July 2015 after two operationson his hand
IN FOCUS
www.guysandstthomas.nhs.uk 11
“Now I’m back at workand playing with mykids like normal. It’samazing what theteam has done.”
IN FOCUS
Jamie with Ellie Collen,a physiotherapist in thehand therapy team
12 the GiST
LIVING WELL
More than 60% of adults in the UK are overweight or obese. Three patients explain howthey've taken control of their weight with the help of our staff and patient support groups.
Paula’s storyWhen 47-year-old Paula Augustin felt outof breath after walking just a few yardsshe knew it was time to do somethingabout her weight.
A visit to the GP confirmed that Paula,who weighed 19 stone, had high bloodpressure and was at risk of developingserious conditions like diabetes or havinga stroke.
Paula, who now attends the ‘HealthyHeart, Healthy Weight’ programme inBrixton, says: “I’m a full-time carer formy mum. During the day I’m really activebut in the evenings I used to rewardmyself by snacking.
“I attend the classes and the walking
group in Brockwell Park. We learn abouteating healthily and things to watch outfor. There are about 13 teaspoons ofsugar in a can of fizzy drink, for example.
“Now I think about what I put in mymouth and how I prepare food. Thesedays the biggest portion on the plate isvegetables.
“Since joining the classes I’ve lost fourstone and I’m off the blood pressuretablets. Mum is also seeing the benefitbecause she’s eating more healthily.
“I love the group. Everyone goes attheir own pace. There’s a real team spirit.”
Mandy Keene, a health promotionspecialist who leads the programme, says:“Small changes really can make a big
Tackling a weighty problemdifference, for example replacing full fatmilk with skimmed milk, grilling instead offrying, reducing sugary foods and drinksand doing more exercise – even getting offthe bus a few stops earlier can help.”
Call Lambeth Early Intervention andPrevention Service on 020 3049 5242to find out about the programme.
Paula Augustin
www.guysandstthomas.nhs.uk 13
LIVING WELL
Ritchie’s storyWeight loss surgery (also known asbariatric surgery) is often presented in themedia as a 'miracle cure' for obesity – butit’s not that straightforward.
Dr Barbara McGowan, medical lead forthe Obesity and Bariatric Service at Guy’sand St Thomas’, says: “Patientsconsidering bariatric surgery need toundergo lifestyle changes and mustattend a local weight managementprogramme for up to 12 months.
“They also undertake medical andpsychological assessments and are madeaware of the long-term implications ofsurgery.
“It’s about improving patients' health,getting people back to work, and into anactive lifestyle.”
Guy’s and St Thomas’ prepares around150 patients a year for surgery whichtakes place at King’s College Hospital.Many more people are helped to controltheir weight in other ways.
Ritchie Hooper, 43, from Leybourne inKent, had bariatric surgery last January.
Richie says: “At my heaviest I weighed25 stone and had a 54-inch waist.Sometimes I wonder how I got in thatposition in the first place.
“The criteria for surgery are strict soit’s definitely not a temporary fix. Youneed to be in the right frame of mindbefore you go ahead with something soinvasive.
“I get lots of support from myspecialist bariatric dietitian CharlotteBirkett, and I attend the bariatric surgerysupport group which meets once amonth.
“Since the surgery I’ve lost nearly 10stone, I’m down to a 36-inch waist, and Idon’t need insulin any more.
“I used to always take the shortestroute or get the bus. Now I like to walkeverywhere.”
Ritchie Hooper (after)
Graham Dobson
Graham’s storyYou may associate cancer with weightloss but in fact obesity is a risk factor formany types of cancers.
Graham Dobson, 66, a retired solicitorfrom Orpington, was diagnosed withprostate cancer in October 2012 but,after surgery, he made a full recovery.
Last April he joined the 10-weekweight management programme forcancer survivors.
Graham says: “I’ve always loved foodbut because of the course I realise I’vebeen eating the wrong food in the wrongportions. I now weigh 14 stone but when Istarted I was 17 stone.
“It makes a big difference having thesupport of Rachel Bracegirdle, thecancer dietitian, and the other patients in
the group. “Each session starts with us being
weighed and we keep a diary of the foodwe’ve eaten. We talk about things likeeating habits and ways to increasephysical activity.
“I’m eating more fish and less meatand when I eat out I look at the menuonline beforehand so I can still eat adelicious plate of food.
“I have a belt that I add new holes towhen I lose weight. So far I’ve added fiveholes and lost eight inches from mywaist. I’m looking forward to the summerwhen I can wear clothes that I don’t feellike I’m bursting out of.”
For information about the WeightManagement after Cancer TreatmentProgramme call 020 7188 4128.
Ritchie Hooper (before)
14 the GiST
More than just a job
James Lowell was a teenager when he began his career at Guy’s and St Thomas’as a hospital porter. Now, 20 years later, he’s worked in almost every area of theTrust and is General Manager for pharmacy, therapies and clinical imaging. We find out more about his varied and inspiring career.
THE INTERVIEW
Q James, when you tell people you’ve worked at the Trust for 20 years they probably
assume you’ve always done thesame job. ey couldn’t be morewrong, could they?
A It’s certainly true to say that I’ve had a varied career at Guy’s and
St Thomas’. I left school with four GCSEsand began working at the Trust in 1995 asan agency porter earning £3.20 an hour.Thanks to the education and trainingavailable through the Trust, I’m now aqualified pathology technologist with amasters qualification in anatomicaltechnology, I’ve worked with thegovernment on national policies, and nowI’m managing some of the biggest areasof the organisation.
Q Can you remember your first day?
A I can remember it vividly. I arrived wearing a white shirt and black tie
and was just hoping that I’d be able tofind the portering offices. I did find them,and the manager had no idea I wascoming, but was thrilled to see me asthey were short-staffed that day. It wassuch hard work, there were no motorised
beds back then, and all oxygen had to becarried by hand. I didn’t think I’d be ableto walk after my first day. It felt great tohave a job, it meant that I could afford topay rent to my parents.
Q How and when did yourcareer begin to change?
A As a hospital porter you spend some time in the mortuary. I began
to be intrigued by the work and found outthat they offered a lot of training on thejob. This is where I started the secondwave of my career at the Trust as a traineeanatomical pathology technologist. I feltlike I’d found what I was good at. I went onto complete my masters in anatomicaltechnology. From the mortuary I movedup the ranks and got involved inmanagement roles that have brought meto where I am now.
Q What’s your proudestachievement?
A The thing I feel most proud of is the difference I was able to make in
the care given to bereaved families.Mortuaries are always seen as gloomyplaces but the team at St Thomas’ triedto make the experience as good as
possible for relatives. We cared for thewhole family.
Q What advice would you give to young people looking to begin careers
in the NHS today?
A Work hard, act with integrity, and never ask someone to do
something that you wouldn’t do yourself.Organisations like Guy’s and St Thomas’are full of opportunities. If you’re willingto invest yourself in the organisation thenthey will invest even more in you. I still sayhello to every person I’ve worked withthroughout my career when I see themaround. It’s the people that make thisplace special.
Q Where do you see yourself in 20 years?
A It’s hard to say. I don’t like to plan ahead so we’ll just have to see
what opportunities come next and wherethey take me.
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INTERVIEWTHE
“I still say hello toevery person I’veworked withthroughout mycareer when I seethem around.It’s the people thatmake this placespecial.”
16 the GiST
INSIDE OUT
Having a baby doesn’t have toinvolve a trip to a hospital’smaternity unit. Our teams ofmidwives also bring theirexpertise into people's homes.
Baby Maya is Chiara Paderni’s first baby,born on the day that she celebrated her46th birthday. “Everyone warned me myage might be an added risk, but I stillreally wanted a home birth,” says Chiara.
Home births have decreased inpopularity over recent decades. Betweenthe late 1940s and mid-1960s about twothirds of births in England and Wales tookplace in hospital and one third at home.Since 1975 home births have onlyaccounted for around 5% of all births.
Chiara’s mother was not impressedwith her decision. “My mother held thetypical Italian view that home birth wasnew-age madness. We avoided talkingabout it because she was so discouraging.She was mad at me. But my midwife,Laura, was always so positive and totallyunconcerned about my age so I feltsurprisingly relaxed about it,” she says.
On the day, it was the personal andhomely experience that Chiara hadwanted. “I don’t tell everyone they musthave a home birth,” says Chiara, “but forme it was just the best experience ever. Iused a birthing pool. It was not messy, itwas natural. In fact, because my partnerPaul had made enough food for everyone,both midwives stayed for dinner after
Maya was born.” The experience changed her mother’s
opinion. “My mother finally said I hadmade the right decision,” recalls Chiarafondly. “It is the only time she has eversaid this.”
It was a friend who had firstencouraged Chiara to consider having herbaby at home. When the option was raisedat her first registration meeting, Chiaratook the opportunity to find out more fromher midwife. Guy’s and St Thomas’ hasspecialised teams providing home birthmidwives across Lambeth and Southwark,like Lia Brigante and Laura Latina whohelped to deliver baby Maya.
“Being at home is a blessing for thefamily and the midwives,” says Lia. “It canbe a joyous event, not a medicalemergency.”
New mum Jamey Fisher Perkins wouldagree. She had baby Avery at home andhas lovely memories of lying on her own
bed with him just moments after he wasborn, while her midwife sat on the bedwriting up her notes. “When I am in theroom where Avery was born, I still findmyself thinking happy thoughts about hisbirth,” Jamey says.
“I did worry that midwives wouldinterfere or try to convince me to go tohospital if things weren’t progressing,”Jamey recalls. “But when my labourslowed the midwives let me and myhusband discuss the next steps privately.They gave us the information we neededand let us make our own choices. I felt likeI could really trust them.”
Midwife Laura Latina adds: “Noteveryone would want a home birth, but it’simportant that women are offeredchoices, that the risks and benefits areexplained, and their decisions arerespected and supported.”
Most mothers understandably want thereassurance that, in an emergency, the
ere’s no placelike home
Midwives Laura Latina and Lia Brigante with baby Maya, mum Chiara and dad Paul
“I don’t telleveryone theymust have a homebirth, but for me itwas just the bestexperience ever.”
www.guysandstthomas.nhs.uk 17
THE LEADING EDGE
required care will be available. Laura continues: “For women with healthy,
straightforward pregnancies, real emergenciesare unlikely. When it does happen, we have allthe equipment we need. We’re trained to identifypotential problems early and act while wetransfer the woman to hospital.”
As Jamey is keen to point out: “Fill yourselfwith positive birth stories. Most births arenormal, natural, boring miracles, not the dramaswe see on TV.”
For information about home births, and to findout if they’re suitable for you, visitwww.guysandstthomas.nhs.uk/home-birth
Inside the Cancer BiobankGuy’s and St Thomas’ is known around the world for its pioneeringclinical research. To understand why diseases start, how theyprogress, and how they respond to treatments, researchers oftenstudy human tissue samples.
The Trust has two main resources to help researchers do this –the National Institute for Health Research BioResource and theCancer Biobank.
Both store human tissue samples and corresponding patientinformation. This information is important because someone’sgenes or lifestyle may have an impact on why or how a diseasedevelops. All information is anonymised and kept completelyconfidential.
The Cancer Biobank at Guy’s Hospital is run by King’s CollegeLondon on behalf of the Trust. It has around 40,000 samples fromaround 17,000 patients.
Dr Cheryl Gillett,King’s College LondonHead of Biobanking,says: “The CancerBiobank is a resourcewhich helps researchersfind better diagnoses andtreatments for patients.We want to giveresearchers the bestpossible resource, sothat they can do goodscience which can betranslated into better patient care.”
The Cancer Biobank has samples and data for six cancer types– including for breast, head and neck and lung cancers. The breastcancer resource dates back to the 1970s, and is one of the largestin the country.
The life of a sampleCancer patients being treated at Guy’s and St Thomas’ may beasked to donate tissue and blood samples for clinical research.
If patients give their consent, samples including tumours andhealthy tissue are collected by the Cancer Biobank. Informationabout the individual such as their family history, lifestyle and genetic make-up is also gathered and stored by the Biobank.
The samples and data can then be used for research studiesaimed at improving the diagnosis and treatment of differentcancers. More than 300 studies using Biobank resources havebeen published in scientific journals, including studies into thebenefits of using genetic information to classify breast cancers.
Dr Cheryl Gillett, Head of Biobanking, looksthrough data records in the Cancer Biobank
TRUST LIFE
18 the GiST
Rolereversal
A How long have you beenworking here as a chaplain?
N In all, it’s been 12 and a half years. I started as a volunteer
and for the past 11 years, I’ve been apart-time member of staff.
A How do you occupy your time when you are not working here
at the hospital?
N I am a local church minister and I also like working in bible
colleges. So when I’m not here, I amoften teaching, marking papers, orproviding pastoral care in thecommunity.
A What do you enjoy most about your role as a hospital chaplain?
N I enjoy supporting those who are suffering from illness – being by a
patient’s bedside and praying for them.I also enjoy training new chaplains andvolunteers. Recently I have beenworking on a very rewarding projectaimed at making spiritual care moreaccessible for people with disabilitiesand learning difficulties. We have beentrying to understand and reduce thebarriers these patients face inaccessing spiritual care.
A What improvements have you introduced so far?
N We have provided information for staff on our wards and I hope
we’ve made it clearer for patientsexactly who the chaplains are, what wecan do, and where we can be found. Ihave produced a spiritual care passportfor patients with disabilities andlearning difficulties. Patients can fill itout to tell us about their religion, or ifthey have no religious beliefs, and alsoabout the people who are important tothem. It has been designed to capturethe things that give people hope andstrength. It should help patients feelmore at ease and cared for.
A I wish you every success and I’d like to support you as much as I
can. Tell me about the people you havemet in developing this work.
N It has been a collaborative journey. We have worked with
patients, staff and charities, such asKairos Forum and L’Arche Community.e project has led to some greatdiscussions, and the feedback has beenvery positive so far. I hope that otherhospitals might be inspired by how wehave improved communicationbetween patients and chaplains. Whatdo you like best about working here?
Imam Abdul Choudhuryand Reverend Nana Kyei-Baffour discuss theirroles as chaplains andtheir shared interest inmaking spiritual careaccessible to everyone.
Reverend Nana Kyei-Baffour and Imam Abdul Choudhury in the newly refurbished chapel at St Thomas’ Hospital
“We have chaplainsrepresenting theMuslim faith,different types ofChristianity,Buddhism, Judaism,Hinduism, Sikhismand Humanism.”
TRUST LIFE
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Find out how you can support our cancer research and care by [email protected] or call 020 7848 4701.
A I love meeting new people from all walks of life and
bringing a smile to someone’sface. Every day is different andslightly unpredictable. One day Imight have to rush to a patient’sside very urgently. On another day I might find myself having ameaningful conversation over acoffee or even in the lift. I think itis wonderful that our chaplaincyteam reflects the diversity of thecommunity we serve here in south London.
Why I fundraiseIn 2012 Gary Saunders was treated atGuy’s for testicular cancer. He says: “I am indebted to Dr Simon Chowdhury, my consultant oncologist, and hiscolleagues for their skill and excellence,which helped me to fight and survive thisterrible disease.”
In October 2015, Gary, Simon andsenior research fellow Deborah Entingtook part in the Royal Parks HalfMarathon. In fact, Deborah spent most of2015 in trainers. She set herself a targetto run 1,500 miles, the equivalent ofmore than a marathon every week, andhopes to raise £150,000, which wouldcover the costs of a year of her research.
Deborah is investigating ways inwhich the immune system can betaught to fight prostate cancer. She isalso running a clinical trial to assess thepotential effects of a common diabeticdrug on prostate cancer.
In May this year, Gary and Simon willbe cycling from Land’s End to Guy’sHospital to fund research into prostate,bladder, testicular and kidney cancer atGuy’s and St Thomas’.
“My family and I will be forevergrateful,” says Gary. “I wanted to find away to say thank you, so Simon and Iformulated a plan to do somethingrewarding and memorable to raisefunds so that more people can benefitfrom their life-saving research.”
N Yes, the patients we serve are very diverse in terms of
ethnicity, language and faith. Wehave chaplains representing theMuslim faith, different types ofChristianity, Buddhism, Judaism,Hinduism, Sikhism andHumanism, and between us wespeak a dozen differentlanguages. I’m very proud of thework we do.
“Between us we speak a dozendifferent languages.I’m very proud ofthe work we do.”
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20 the GiST
The Chapel at St Thomas’ Hospital hasrecently reopened after months ofpainstaking renovation work. A team ofexpert conservators brought the spaceback to the splendour of the 1870s, whenit first opened. They stripped off layers ofpaint from the walls and carefullyrestored the original reliefs andmemorials.
The painting Madonna and Child(pictured) by British artist Jason Brookshas been a focal point of the Chapel since2005. It was kept safely in storage whilethe works took place, and it can now beenjoyed in its restored surroundings.
GPs and other health professionals can refer to the districtnursing team by emailing [email protected] or calling 020 3049 4020.
Ask us: What is a district nurse?District nurses from Guy’s and St Thomas’go on more than 26,000 home visits acrossLambeth and Southwark every month. We speak to Ted Kargbo who manages ateam of district nurses at the Townley RoadClinic in East Dulwich.
Tucked away in a corner for quietreflection, Brooks’ painting is acontemporary take on the classicrepresentation of Mary and baby Jesus. It was modelled on an unknown womanand Brooks’ own daughter, who was bornat St Thomas’. Brooks spoke to manyusers of the chapel as he approached thetask and took several months tocomplete the ‘hyper-realistic’ portrait.
The painting was commissioned byGuy’s and St Thomas’ Charity and is partof its large fine arts collection which isused to enhance our hospitals andcommunity sites.
What do district nurses do?We see people at home who are housebound or not mobileenough to go to their GP or local health centre for treatment.Most have long-term conditions like diabetes or severe breathingproblems. We are also beginning to see more patients withmultiple and complex problems. One of our main priorities issupporting patients at the end of their life and their families intheir own homes.
Generally we work alone so, unlike a ward, there’s no one togive a second opinion. That’s why we do peer review, whichmeans that the next visit is always carried out by a differentdistrict nurse. That way everything is checked and we can makesure the best standards of care are always provided.
How is technology helping you to spend more time with patients?We have been given digipens to help record details of the visit thereand then. The pen reads what we have written on a special formand sends it back to a computer in the office so we don’t need torecord the information twice. The technology means we'respending less time record keeping and more time with our patients.
What’s it like providing nursing care in someone’s home? I always remember I’m a guest in our patients’ homes. Thereare some patients who I've worked with since I started districtnursing 12 years ago. It can be like going on a journey withthem as sometimes they develop other conditions over time.You become an important part of the patient's life and theirfamilies are often very grateful for the care provided. When Ileave a patient’s home I feel valued and fulfilled.
Art in St Thomas’ Hospital Chapel
Madonna and Child by Jason Brooks
TRUST LIFEHISTORY CORNER
www.guysandstthomas.nhs.uk 21
John Milton founded St John's Hospitalfor Diseases of the Skin in 1863. He wasa surgeon who suffered from handeczema so severe it ended his career.His personal experience of skin diseasetriggered his interest in dermatology.
The hospital was based in severaldifferent locations in Soho in the early20th century. After World War II itoccupied premises in Lisle Street,Leicester Square.
St John's Hospital for Diseases of theSkin moved to St Thomas' Hospital inthe mid-1980s. Soon after, St John's wasformally renamed St John's Institute ofDermatology.
St John's was based at St Thomas'until very recently when the newlyrefurbished Bermondsey Centre openedat Guy’s Hospital in November 2015. Thestate-of-the-art facilities allow multi-disciplinary teams from all of St John'sspecialities to be based in the same
St John’s Institute of Dermatology has come a long way inthe past 150 years. It evolved from humble beginnings in tworooms in Soho to today's newest facilities at Guy's Hospital,which have six specialist departments providing leadingedge treatments and research.
St Johns – 150 years as the world’sleading dermatology institute
premises, along with their King’s CollegeLondon research colleagues.
The Bermondsey Centre now sees theInstitute’s 36 consultants and 25 clinicalnurse specialists treating patients withthe most challenging skin conditionswho come from across the country andthe globe.
A book telling the story of the world-renowned St John’s Institute ofDermatology at Guy’s and St Thomas’has been published to mark its 150thanniversary.
SKIN, a history can be purchased online fromWiseman Press: www.wisepress.com/skin-a-history-150-years-of-st-johns-institute-of-dermatology.
The production of SKIN, a history was made possible through the support of Guy’s and St Thomas’ Charity.
John Milton Lisle Street The Bermondsey Centre
SKIN, a history was written byesteemed health journalist JeremyLaurance. It takes the reader on ajourney through the history of St John’s,and looks forward to even greatersuccesses over the next 150 years as StJohn’s leads the way with modern, multi-disciplinary medical care.
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22 the GiST
Physician associates are quite new inthe UK but you can find us across theNHS, working in everything fromintensive care to general practice.
The first physician associate at Guy’sand St Thomas’ started early last year.I was the first physician associate in theorthopaedics team but now there arefive of us.
We work closely with consultants andjunior doctors as part of the medicalteam. Like doctors, I take patients’histories, do physical examinations,provide diagnoses, run tests, and helppatients to understand what they’regoing through. I often act as a bridgebetween all the people who work with apatient – radiographers, occupationaltherapists, physiotherapists, nurses anddoctors. I help patients to get really well-rounded care.
In the orthopaedics team, we see a
From the frontline Physician associate Sadia Quidwai
lot of elderly patients who need kneereplacements, mainly due to severeosteoarthritis. Knee surgery is becomingmore and more common as thepopulation gets older and obesity ratescontinue to increase.
When we give someone a new knee,we’re giving them a new start. It’s hard tounderstand the pain that arthritis cancause, but it’s so common.
The most important thing to help apatient recover after a knee replacementis movement. Part of my job is to makesure patients understand how they cantake control of their own recovery. I thinkit really helps when patients have animportant role to play in their ownrecovery.
I love it when you see someone movingaround on their own for the first time aftersurgery – they get really excited and it’s aprivilege to share that moment with them.
Say what?
Q Growing up, what did you want to be?
A I’ve always wanted to be a seamstress. My sister is a
seamstress and ever since I was tinyI’ve loved making things.
Q What’s the best thing about your job?
A The people I help. Up to 50 members of staff visit me each
day for new uniforms and uniformadjustments. They appreciate theservice I provide.
Q If you could learn one thing?
A I’m about to start a business studies course at university. I
want to learn everything I can to allowme to start my own business.
Q What’s your dream?
A I want to have my own successful seamstress business
and employ a big team of people.
Q If you could change one thing?
A I’m originally from Poland. I love London but miss my family. I wish
we could see each other more often.
Q What’s your best advice?
A Enjoy what you do. My sewing room is down in the basement
of St Thomas’ Hospital and somepeople would find taking up pair afterpair of trousers repetitive, but I enjoymy job and know I’m helping makepeople more comfortable.
Aneta Anyszek, Sewing room operative
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We have two pairs of tickets to the London Eye up forgrabs. To be in with a chance of winning one pair, simplycomplete the wordsearch below.
Name
Address
Send your entry by Friday 11 March to the GiST competition,Communications Department, 4th floor, Staircase C, SouthWing, St Thomas’ Hospital, Westminster Bridge Road, SE1 7EH;or you can email [email protected].
The winners will be selected at random and notified withinseven days of the draw. The result will be final and we will notenter into any correspondence regarding the competitionwinners. The prize is non-transferable.
Competition
Every Monday: Free lunchtime concert 1- 2pm, Central Hall, St Thomas’
Every Wednesday: Free lunchtime concert 1- 2pm, Hospital Chapel, Guy’s
Raise money for your hospitalFor all the latest news about
our amazing fundraisers and how you can support Guy’s, St Thomas’ and Evelina London,
follow @SupportGSTT and @SupportEvelina
and like facebook.com/SupportGSTT and facebook.com/SupportEvelina
9 March No Smoking Day
10 March World Kidney Day
7 April World Health Day
18 – 24 April Orchid Male CancerAwareness Week Call 0808 802 0010 or visitwww.orchid-cancer.org.uk
21 April The Friends of St Thomas’Hospital Mini Market 11am - 3pm, Central Hall andBirdsong Corridor, St Thomas’
25 – 30 April Allergy Awareness Week Call 01322 619898 or visit www.allergyuk.org
27 April Joint Board of Directors and Council of GovernorsMeeting 3.45 - 7.30pm, Robens Suite, Guy’s
What’s OnNow until 27 March Exhibition: Hidden Treasuresfrom the Hospital Vaults: TheRemarkable Art Collection ofGuy’s and St Thomas’ CharityFlorence Nightingale Museum,10am - 5pmCall 020 7620 0374 or visitwww.florence-nightingale.co.uk
17 February The Friends of St Thomas’Hospital Book Sale 10am - 3pm, Birdsong Corridor, St Thomas’
1 – 31 March The Great Daffodil Appeal(Marie Curie Cancer Care) Call 0800 716 146 or visitwww.mariecurie.org.uk
2 March The Friends of St Thomas’Hospital Book Sale 10am - 3pm, Birdsong Corridor, St Thomas’
8 March Seminar for Foundation Trust Members –Prostate Cancer6 - 7.30pm, Robens Suite, Guy’s Hospital Call 0800 731 0319 or [email protected] tobook your place
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