The final episode of Hospital examines how the unique circumstances at Imperial College Healthcare NHS Trust enable some of the country’s leading experts to perform innovative and life-saving surgical procedures.
Camera crews follow patients at Charing Cross and Hammersmith hospitals as the Trust’s top surgeons carry out pioneering treatment, benefiting from the centralisation of resources in better-equipped hospital sites.
During the episode, 56-year-old Eddie is treated at Hammersmith Hospital’s Heart Attack Centre, 28-year-old Ben undergoes an operation on a brain tumour at the Charing Cross Neurosurgery Centre and 23-year-old Rosa benefits from surgery for an infected heart valve at Hammersmith’s Acute Cardiac Ward.
Imperial Health Charity is supporting research, innovation and technological development across the Trust and has helped to fund a series of other ground-breaking projects that are saving lives.
For patients with essential tremor, uncontrollable shaking makes it almost impossible to write, use a mobile phone or eat with a knife and fork. Many become withdrawn and isolated as a result.
But a £1.1 million charitable grant has funded a procedure at St Mary’s Hospital that is now turning lives around.
Clinicians have begun using new brain-scanning equipment that bypasses high-risk surgery and ineffective medication. Instead of cutting into the skull, high-intensity ultrasound waves are used to target specific parts of the brain with heat energy.
The results have been astounding. All the patients so far treated using the machine have experienced an immediate 95 per cent improvement in the severity of their tremor.
The treatment has enabled patients who were once unable to perform basic tasks to reclaim control of their lives, while elderly or unfit patients are able to access treatment for the first time.
Professor Wladyslaw Gedroyc, Consultant Radiologist at the Trust, is now working with NHS England and NICE with a view to extending the treatment across the country.
“This is life-changing,” he explained. “It brings these patients out of their homes and back into society.”
A grant from the charity is helping staff at St Mary’s better understand the effects of heart surgery on the brain.
One of the most common and least invasive methods of surgery for heart conditions, Thoracic Endovascular Aortic Repair, results in a short hospital stay and fewer complications than open surgery but can come with its own problems.
Between 3% and 6% of patients undergoing TEVAR suffer from stroke and 70% develop silent cerebral infarctions, also known as 'silent strokes', increasing risk of dementia, depression, stroke and premature death.
Charity funding is helping the vascular surgery team to look at ways to reduce this risk and improve the quality of life for patients after surgery.
“The grant enabled us to purchase equipment which we use to monitor brain signals during the stenting procedure”, said Gagandeep Grover, Clinical Research Fellow in Vascular Surgery.
“We’ve also had money from the grant to pay for the MRIs that we’re putting patients through before and after the procedure."
“We’ve had very positive results so far and hopefully it’ll turn into something bigger.”
Thanks to the grant, Gagandeep and her team can look at using an innovative device to reduce brain injury.
“We put it through the right arm and there’s two filters that sit at the blood supply to the brain on the right side and the left side and these filters capture any debris that would have gone up to the brain”.
“They’ve been used in hundreds of patients who are having cardiac valve replacements and they’ve been very effective in their trials so we thought why not use the filter in aortic stenting and just apply the same principle and see if we can reduce brain injury.”
The support from the charity has allowed the team to carry out research that’s led to further funding from the Stroke Association.
“This is kind of a feasibility study and it’s already taught us quite a few things”, said Richard Gibbs, Clinical Director and Consultant Vascular Surgeon at the Trust.
“The bottom is line that we want to prevent strokes in our patients but then the next level above that is that we’re going to try and prevent them from getting cognitive dysfunction and dementia over a longer period of time.”
Our Patient Activities Volunteers in the neurological rehabilitation unit at Charing Cross come in at weekends to keep the patients entertained through activities such as baking, painting, and reading.
Patients in the unit can suffer from a wide range of neurological conditions, including stroke, brain tumours and multiple sclerosis and often have lengthy stays throughout their rehabilitation process.
They undergo intensive therapy sessions during the week but on the weekend, boredom can set in, especially for patients with no family members close by.
By keeping the patients entertained and stimulating their brains, volunteers are playing a crucial part in their recovery.
For the last seven months, Rachel has spent part of her weekend in the neurological rehabilitation unit at Charing Cross Hospital.
“As a Patient Activities Volunteer, I visit the ward on weekends, prepared with an activity plan and a few other volunteers,” said Rachel. “We gather the patients together and provide them with entertaining activities to do such as baking, painting, reading.”
One of Rachel’s most memorable moments was taking a walk with a patient who had trouble expressing her thoughts.
“I spent the time making sure she never gave up on communicating what she was trying to say – she wanted to keep up to date on current affairs and she didn’t like the fruit she had so we got her some newspapers and fresh fruit. When we went back to the hospital afterwards, she held my hand and said thank you really carefully and it was one of the most fulfilling days I've ever had.”
Another of the volunteers, Richard Anderson, decided to get involved after spending 3 months in the same hospital with a brain injury. “I can empathise with them quite a lot because I was in a very similar situation,” he said.
“I can understand the frustration that some of the patients have on the ward when there isn’t the occupational therapy that would take place during the week or there perhaps aren’t visitations from friends or family.”
“When it came to weekends and evenings I felt that I should not be there basically, I felt completely fit and able. In retrospect, mentally I certainly wasn’t. I tried to escape from hospital on two occasions and got as far as the front door and security. I thought I was fully recovered and that was it, I was fine. I can say in retrospect that wasn’t that case”.
When Richard was discharged, he says he felt immense gratitude to the staff and when he later found out about volunteering opportunities on the same ward, he jumped at the chance.
“It’s very endearing when you go back and see patients that you saw two weeks ago and can sense a difference in their talkativeness or their willingness to interact within the group, that’s really satisfying.”
Every year the charity provides grants of up to £50,000 for medical and non-medical staff to undertake 12 months of out-of-programme research to develop their research skills for the benefit of patients at Imperial College Healthcare Trust.
Many of the fellowships result in tremendous improvements to healthcare and one led to a breakthrough that’s being used in 5,000 cardiology departments around the world.
Ricardo Petraco Da Cunha began his research fellowship looking at an easier way to detect problems in the heart and whether patients would benefit from having a stent inserted. The research he and his team were able to do led to a PHD funded by the British Heart Foundation, the discovery of a new technique to detect obstructions in the heart and two major publications in the New England Journal of Medicine.
“A lot of patients come to us for chest pains and the techniques we had to decide which patients would benefit from a stent are limited, expensive or time consuming,” said Ricardo.
“The benefit of this technique is that it allows us to detect in a matter of minutes whether the block is significant. It benefits patients because we’re accurate in determining who is going to receive stents but it also benefits healthcare systems because we save money from unnecessary tests.”
The technique involves inserting a fine wire into the coronary arteries during an angiogram and measuring whether there’s any significant pressure loss. If there’s a reduction in pressure caused by narrowing on the arteries, this means the patient would benefit from a stent.
Ricardo believes that this technique wouldn’t be around today without the charity’s support.
“It was essential because without it we wouldn’t have the capacity to get the early data, develop the technique and apply for more funding and work with my colleagues.”
“It’s one of the great successes of the Trust. It’s rare to have such a clinically relevant discovery like we had, translating the scientific findings very quickly and directly to improve patient care.”
To find out more about the charity’s research fellowships, visit www.imperialcharity.org.uk/research-fellowships
We’re proud to support better cardiology and neurology care at our hospitals and you can too. If you’d like to get involved and show your support, please visit our fundraising page to find out how you can take part in one of our regular fundraising events or organise your own.
You can also donate to help improve services around the Trust. 100% of the money raised by the charity goes back to improving patient care. Visit our website for more information.