The GiST, issue 40

Words and photos by Kelly Cook, Ciorsdan Glass, Azmina Gulamhusein, Maxine Hoeksma, Daisy Holden, Lucy Lisanti, Joe O'Hagan, Eloise Parfitt, Janine Rasiah and Lesley Walker.

Cover photo by David Tett.

Design: AYA-Creative

Print: O'Sullivan Communications

Front cover: Ginny Wanjiro, sister in the intensive care unit at St Thomas' Hospital

We are delighted that the GiST scooped the award for 'Best Corporate Publication – External' at the CorpComms Awards 2019, and a bronze award for 'Best Branded Content Publication' at the Corporate Content Awards 2020.

If you have any comments about the magazine or suggestions for future articles, please contact the communications department, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, or email [email protected]

Visit the Guy's and St Thomas' website.

Staff from Guy's and St Thomas' have been sharing their expertise in Vietnam to help improve healthcare for critically ill patients.

3 critical care consultants and a critical care matron travelled to the Southeast Asian country for a week-long visit.

They provided teaching sessions at the Hospital for Tropical Diseases in Ho Chi Minh City, and the National Institute of Infectious and Tropical Diseases in Hanoi.

They also joined ward rounds and provided advice on how to treat some of the sickest patients.

Dr Duncan Wyncoll, critical care consultant at Guy's and St Thomas', said: "Vietnam has received lots of new equipment and machines over the last few years and we have the expertise in how to use them.

"By holding teaching sessions we’re able to help upskill and educate staff at the hospitals so they can provide the best possible care to their critically ill patients."

The visit was part of the Intensive Care Development Programme – a 2-year partnership between Guy's and St Thomas' and the Oxford University Clinical Research Unit.

A new state-of-the-art research facility in Hillingdon, west London, was opened in November 2022 by Professor Sir Magdi Yacoub.

Professor Yacoub set up the heart transplantation centre at Harefield Hospital in 1980, performing transplants on patients who went on to be the longest living heart transplant recipients in Europe and the world.

The Clinical Research Facility provides a dedicated space for patients participating in vital research, many of whom require longer hospital appointments.

These patients are especially valuable to researchers because of the complex, and sometimes rare, conditions that they live with.

Currently there are more than 50 pioneering research projects at Harefield aiming to develop new treatments, improve patient care and help to inform decision-making and policy.

Royal Brompton & Harefield Hospitals Charity raised more than £161,000 to support the construction and opening of the Clinical Research Facility.

The new facility is part of a long-term plan to increase research capacity.

A round-up of media coverage featuring Guy's and St Thomas'.

Channel 4 News

Channel 4 News visited the post-Covid clinic set up by Evelina London Children's Hospital to examine how the disease can have lasting effects on children and young people and the support we provide to patients and their families. Staff and a patient who was undergoing treatment were interviewed. Similar coverage of the service was also later broadcast on ITV.

iNews

Terry Sewell, who has been a porter at Harefield Hospital for 42 years, explained to iNews why he loves his job and what he finds most difficult. This was for a feature highlighting careers in the NHS which don't always get the recognition they deserve.

Evening Standard

The Evening Standard covered the story of a father who spent Christmas with his daughter for the first time, having received life-saving intensive care treatment at St Thomas' Hospital. Metin Gakir was admitted on Christmas Day 2021 with COVID-19 and spent more than a month on ECMO, the highest level of life-support.

3 members of staff from Guy's and St Thomas' were recognised in the New Year Honours List.

Dr Joel Meyer, an intensive care consultant, and Samantha Salaver, head of dental nursing, were both made an MBE (Member of the Order of the British Empire).

Andrea Williams-McKenzie, Deputy Chief People Officer, was made a CBE (Commander of the Order of the British Empire) from her time at HM Courts and Tribunals Service.

Dr Joel Meyer was recognised for his services to the NHS during COVID-19. Together with Professor Louise Rose, a professor of critical care nursing at King's College London, Dr Meyer set up the Life Lines project. The secure virtual visiting platform kept families connected to their loved ones in intensive care.

Samantha Salaver was recognised for services to dental nursing. She helped set up the Dental Nursing Academy for apprentices at the Trust, and is currently developing a specialist dental nursing degree.

Andrea Williams-McKenzie has worked for Guy's and St Thomas' as Deputy Chief People Officer for a year. She was recognised for public service from her time at the Courts and Tribunals Service. Her mother was a cleaner at St Thomas' Hospital so she said it was ‘really significant’ to receive a CBE while working for Guy's and St Thomas'.

We love to hear from our patients, staff and supporters so join the conversation by following us on Facebook, Twitter, LinkedIn and YouTube.

@SarahKerruish (from Twitter) I’ve spent the weekend @GSTTnhs with a very unwell child. She’s going to be ok and I cannot speak highly enough of the extraordinary people here who are the beating heart of the NHS. Everyone has taken incredible care of her and me. I really do think they are angels. @ThankYouNHS

@Xenosmilus4 (from Twitter) Just got a patient survey form from @GSTTnhs for my mum's dental check up yesterday. Pleasure to fill it in, the dental team there are absolutely first class!

@SAfoodforlife (from Twitter) Congratulations @RBandH on achieving your Food for Life award – you're making a difference to our health and the climate

@ktbraybrook (from Twitter) Today marks my 6 year anniversary since I had scoliosis surgery @EvelinaLondon – Forever grateful to the spinal team & Savannah Ward (Lizard bay) for their outstanding care & bringing smiles and positivity to me throughout such a difficult time in my life. My special place

@vp581 (from Twitter) @GSTTnhs A massive thank you to Dr Bethan Thomas, Paul and Natalie who were absolutely amazing with my almost 80yr old, hearing impaired dad today in radiology! They listened, answered his questions, reassured and included him when making a treatment plan! #nhsheros

The CARE Awards celebrate those who have gone the extra mile to provide exceptional care for patients, or made a real difference to the way their colleagues work.

CARE stands for Courtesy, Attitude, Respect and Enthusiasm. The awards are given each month and winners are presented with their trophy at the quarterly Board meeting.

The awards are open to staff and volunteers from any of our hospitals and community sites, in clinical and non-clinical roles.

Nominations can be made by patients, visitors and staff.

Staff on Doulton ward high dependency unit at St Thomas' Hospital were nominated by a patient who had open heart surgery.

They were recognised for being "totally professional, knowledgeable, patient when under pressure from competing demands on their time, considerate, kind and sympathetic."

Bronagh James, Heather ward manager said: "The Doulton ward team were very grateful to be nominated by a patient for a CARE award. We felt honoured to be recognised for taking pride in our work and delivering excellent patient care, and it had a notable impact on improving staff morale."

Charles Alexander, Chairman of Guy's and St Thomas', said: "It is a great honour for me to present these awards throughout the year. We are so proud of our outstanding staff who go above and beyond to provide compassionate care for their patients and colleagues."

Please visit the Guy's and St Thomas' website to make a nomination.

Harefield Hospital has launched a pioneering new partnership with Thames Valley Air Ambulance.

Eligible patients who go into cardiac arrest and who don't respond to standard cardiopulmonary resuscitation (CPR) will be transported to the hospital by air ambulance.

They will then receive E-CPR which combines placing patients on ECMO, a machine which pumps blood through an artificial lung outside their body, and CPR.

This technique has been found to improve survival rates for these patients, and a 2020 study found survival rates reached 43% compared to 7% in patients who received standard interventions.

Dr Waqas Akhtar, registrar in cardiology and intensive care, said: "This new service has the potential to save more lives than we can with CPR alone."

The partnership is the first of its kind in the UK.

Patients aged 16 and over who receive routine blood tests when they attend the emergency department (A&E) at St Thomas' Hospital will be tested for HIV and hepatitis B and C, unless they choose to opt out.

The emergency department is one of the busiest in the country with more than 61,000 patients needing blood tests each year.

The combined blood borne virus testing will lead to earlier diagnosis and treatment for people who may be unaware that they have one of the viruses.

Since July 2015, all patients over the age of 16 having a blood test in the emergency department have been tested for HIV, unless they chose to opt out. This has resulted in more than 2,300 positive results.

Dr Laura Hunter, a consultant in emergency medicine and clinical toxicology at Guy's and St Thomas', said: "Testing in our emergency department has been hugely effective in allowing patients, who may not have been aware of their infection, to access successful and safe HIV treatments. This is allowing them to live long and healthy lives."

Kelly Cook meets a patient who has benefited from life-saving robotic surgery at St Thomas' Hospital.

Michael Smith was one of the first patients at St Thomas' Hospital to have a cancerous tumour removed from his oesophagus – known as the food pipe – using robotic surgery.

The 73-year-old, from Dartford in Kent, underwent chemotherapy treatment at his local hospital to shrink the tumour, before being transferred to St Thomas' for the pioneering oesophagectomy surgery.

The Trust is one of a few centres across the UK where surgeons are able to perform the complex surgery using a da Vinci robot.

Michael, who has 2 children and 3 grandchildren, said: "I tried to get as healthy as possible before the surgery and started a daily exercise regime so I was the fittest I could be.

"A month on from the surgery and I’m feeling pretty good. I've been speaking to the dietitians and learning what to eat again, small amounts but more often."

He added: "The staff at Guy's and St Thomas' have been the best I've ever known. They have been as helpful as can be and I've had complete faith in them."

Michael's 6-hour surgery was performed by consultant upper gastrointestinal and general surgeons, James Gossage and Cara Baker.

They used the da Vinci robot to remove the tumour and part of Michael's oesophagus.
His stomach was then made into a tube and reconnected to the remaining part of the oesophagus, allowing him to eat and drink relatively normally.

During a robotic procedure, the surgeons control the robot's 4 arms from a console in the same room.

They look down a small camera on the end of one arm to see inside the patient.

The machine gives them a 3-dimensional, high-definition view while they operate. It also eliminates tremor and provides an increased range of movement.

James said: "The robot provides us with better vision of the cancer and the tissue around it, so we have greater accuracy when we operate. We're able to access parts of the body which are normally difficult to reach. The instruments mimic a human hand allowing for better and cleaner removal of the cancer."

He added: "Patients have less blood loss, smaller scars and spend less time in hospital. They also have less pain afterwards and can potentially recover more quickly."

Fast facts

• 8 patients have had oesophagectomy surgery using the da Vinci robot at Guy's and St Thomas'
• The Trust has 5 da Vinci robots and one Versius robot making it the largest robotic programme in the UK
• Surgeons use the robots to operate across 6 specialities – urology, thoracic, head and neck, gynaecology, transplant and gastrointestinal medicine
• The Trust got its first da Vinci robot in 2004 thanks to a grant from Guy's & St Thomas' Charity

Lesley Walker finds out about a new joint MRI centre at St Thomas' Hospital.

A new medical imaging centre has opened at St Thomas' Hospital, using artificial intelligence to provide better care to patients and to enable ground-breaking research.

The Mary Seacole MRI Centre is a partnership between Guy's and St Thomas' and King's College London, with Siemens Healthineers.

Up to an extra 7,000 patients a year can be scanned, helping to reduce waiting times while also providing tailored imaging for each patient's needs.

The facility uses advanced imaging techniques and technologies for scanning babies in the womb, diagnosing cancer, and the treatment of cardiovascular and neurological conditions in adults and babies.

The new technology means patients can be seen more quickly, while there is better support for clinical decision making, such as when to operate on a patient.

At the heart of the centre's concept is the collaboration between clinical and research teams to ensure that the latest advances quickly translate into patient benefit.

Dr Asif Mazumder, Joint Clinical Director for Clinical Imaging at Guy's and St Thomas' said: "We have worked tirelessly with our King's College London imaging partners to deliver much needed imaging capacity at a time of high demand, and this will make a real difference to many patients in our local communities.

"Beyond this, we will continue to work together looking at applying artificial intelligence to improve patient experience, and how we support others in healthcare who wish to use this technology."

The name of the new centre was chosen by patients and the public in honour of the pioneering nurse and businesswoman Mary Seacole, who has a statue in the gardens of St Thomas' Hospital.

The centre echoes and celebrates Mary's values of good citizenship, entrepreneurship and achievement.

Across Guy's and St Thomas' and King's College London, there are now 28 MRI scanners.
This will allow more than 60,000 people to have an MRI scan in the coming year, and over 6,000 research scans to take place.

Professor Sebastien Ourselin, Head of the School of Biomedical Engineering and Imaging Sciences at King's College London, said: "This is a unique co-location model which is going to make a real difference to patients, not only at St Thomas' Hospital, but globally.

"Through our public-private partnerships, we have built research and clinical facilities to more quickly address patient needs and deliver innovation."

Nicola Jones, 37, from High Halden in Kent, visited the Mary Seacole MRI Centre. She said: "I had a really positive experience. Everyone was so helpful and really informative – even showing me my scans and explaining what I was looking at. The staff made me feel as comfortable as possible, and at ease – they made me feel important.

"The centre is pristine, clean and quiet and relaxing, and it all works to make the experience of having an MRI tolerable."

Fast facts

• The centre includes 2 advanced scanners from Siemens Healthineers – a 1.5 Tesla MAGNETOM Sola and a 3T MAGNETOM Vida
• The Vida scanner has artificial intelligence-powered image reconstruction technology which will mean shorter scanning times and more detailed reports
• The new centre is possible thanks to support from the AI Centre for Value Based Healthcare through a £16million grant by the Office for Life Sciences, and significant support from Siemens Healthineers

Maxine Hoeksma hears one patient's inspiring story of cancer treatment followed by support from the community head and neck rehabilitation team.

When Manuch Ghezelayagh got the devastating news that he had tongue cancer in March 2022, after already beating mouth cancer in 2019, he thought his career giving presentations would be over.

But thanks to life-saving surgery and cancer treatment at Guy's Hospital, followed by support from the community head and neck rehabilitation team, Manuch hopes to return to the job he loves.

In July 2019, Manuch found a wound in his mouth that didn’t seem to heal so his dentist referred him to King's College Hospital where a biopsy was taken.

Manuch said: "When I look back there is a life before cancer and a life after cancer. That's the point when everything changed."

Once mouth cancer was confirmed, Manuch was referred to Guy's Hospital where he had surgery followed by six weeks of radiotherapy.

The 65-year-old said: "It was a big operation. The surgery was 11 hours, it took a whole day of multiple teams to save my life. I’ll never forget that – they are amazing people."

During the surgery, the top of Manuch's mouth and the upper teeth on the right side were removed and bones from his left leg were used to reconstruct the area.

He said: "Every day I’m reminded of what has happened and how my life has changed. It's eating, speaking, opening my mouth, and about how I physically look."

Manuch, an IT system designer, was initially supported to readjust to his new life with the help of the community head and neck rehabilitation team, known as CHANT.
They were there for him again when a new cancer, this time of the tongue, was discovered in 2022.

The multi-disciplinary community team bring together physiotherapists, speech and language therapists, nurses, dietitians and a psychologist to provide joined up care for patients.

They support people with a range of conditions including those with a tracheostomy (a temporary opening created at the front of the neck so a tube can be inserted into the windpipe to help people breathe) and laryngectomy (a permanent opening in the neck where the larynx is removed).

Patients receive treatment at one of eight health centres across south east London, close to where they live, or at home.

Speech and language therapists support patients with communication and swallowing, while physiotherapists help with movement of the neck, shoulders and jaw as various muscles and nerves can be affected by surgery.

Dietitians provide a range of advice, including suggestions on food choices that will be nutritional. They also give advice, if needed, about feeding through tubes.

Manuch, from Bromley in south east London, said: "This whole thing is about learning to do everything again, like a child. To be able to swallow a sip of water uses so many muscles.

"They taught me how to swallow, how to eat food, and how to hold my head to make it easier so I don't start coughing.

"The fact that I can now speak and people can follow what I'm saying is all thanks to CHANT.

"The last appointment I had with the team was a virtual one because I wanted to simulate a scenario similar to my work where I am presenting something. They taught me all these tricks and it was successful.

"Thanks to these guys I’m in a position to start working again."

Yvonne Blake, a dietitian with CHANT, said: "We're all one team and the appropriate specialists are in the room with the patient. This means fewer appointments, but more importantly they don't have to repeat their story to different health professionals.

"If they are in pain or something is stopping them from eating, for example, we can address these problems quickly."

Fast facts

• In 2021/22, CHANT supported more than 360 patients
• According to Cancer Research UK, head and neck cancer is the 4th most common cancer in males in the UK, with around 8,600 new cases every year

Janine Rasiah meets the incredible staff who were recognised at a new awards ceremony.

Initiatives to improve equality, diversity and inclusion were celebrated at the first Kofoworola Abeni Pratt Fellowship Inclusion awards. Named after one of the first black nurses to work in the NHS, the awards were the brainchild of the fellowship honouring her legacy, and were open to allied health professionals, nursing and midwifery staff.

Avey Bhatia, Chief Nurse at Guy's and St Thomas', said: "Kofoworola Abeni Pratt was, and continues to be, an inspiring nurse leader. I am really proud of the tireless passion and enthusiasm that colleagues have for improving inclusion and making Guy's and St Thomas' the best possible place to work and be treated."

Up! Up! team

The Up! Up! team deliver a free 12 week weight management programme tailored to people of Black, African and Caribbean heritage.

The sessions are open to Lewisham residents, and alternate between focusing on nutrition and physical activity.

The classes cover everything from a 'cook and taste' week where participants learn to make jerk chicken in an air fryer, to Zumba.

Leona Williams, healthy living practitioner, said: "Research shows that people from African and Caribbean heritage weren't well served by the existing support, so we are proud of what we have achieved.

"It’s really wonderful how it makes people feel more empowered."

Lorna Collins, 87, who lost 14 per cent of her body weight during the programme, said: "The team are very encouraging and they make you feel good."

To sign up, email [email protected]

Health inclusion team

Set up last year in response to the increasing number of asylum seekers living in hotel rooms while their claims are processed, the health inclusion team visit clients in the hotels where they are housed.

The team of 13 offer clinical services, including health assessments and immunisations. But their work is often much broader, and can involve ensuring access to education and funds and helping clients to cope with being separated from family members.

They meet with the Home Office monthly to raise key cases. Recently their efforts helped reunite a mum-of-three with her husband after nearly a year apart, and to secure a home of their own.

Lara Gray, lead nurse for initial accommodation in contingency hotels, said: "A lot of our clients have had traumatic experiences and difficult journeys to the UK, sometimes involving trafficking and violence. Some cases are complex, but it can be very rewarding work too."

Acute surgical unit education team at Harefield hospital

Practice educator Julia Shears created a six week course to help support internationally educated nurses.

The induction includes shorter shifts on wards, workshops in the simulation centre and realistic case scenarios.

Julia previously worked as a nurse in Australia so can relate to the experiences of the new recruits.

She said: "Some nurses have not seen equipment that we use here in the UK as it is equipment that only doctors would use in their home countries.

"We are a very multicultural team and for some nurses they are going from being part of the majority to a minority, which can take some getting used to.

"Taking people away from the wards gives them a space to learn. It’s not rocket science but it has made a real difference."

Highly commended

Charmaine Turner

Physio Charmaine is committed to reducing inequality and led a project to assess the experiences of newly qualified physiotherapists from minority backgrounds. The feedback has helped create positive changes to support our diverse workforce immediately and also in the future.

Anti-racism implementation advisory (ARIA) midwives

This team is dedicated to ensuring that maternity services are anti-racist, and improving experiences for both staff and service users from Black, Asian and minority ethnic backgrounds. Their work has included training colleagues and a cultural day with a shared lunch to celebrate the diverse workforce.

Ginny Wanjiro

Intensive care nurse Ginny spearheaded a pilot project to look after the hair and skin of people from diverse backgrounds. Read more about her project.

Fast facts

• Kofoworola Abeni Pratt came to the UK in 1946 and was the first black student to attend the Nightingale Training School for Nurses at St Thomas' Hospital
• She returned to Nigeria in 1954 and set up a nursing school following the country's independence

An initiative to look after the hair and skin of people from diverse backgrounds began in the intensive care unit at St Thomas' Hospital. Lesley Walker talks to the nurse who started it.

Our cover star Ginny Wanjiro was inspired to launch a project to look after the hair and skin of the most poorly patients in hospital after working through the COVID-19 pandemic.

The intensive care unit sister at St Thomas' Hospital sourced a range of combs, hair and skincare products, which can be used for patients of all hair textures and skin tone.

She has also started training intensive care staff on techniques to look after the skin and hair of patients from Black and minority ethnic backgrounds.

During the 3 month pilot, more than 20 staff across four units at St Thomas' Hospital joined the programme to care for at least 250 patients.

The inspiration for the idea came from Ginny's experiences of nursing COVID-19 patients at the height of the pandemic.

Ginny, who has worked at Guy's and St Thomas' for 20 years and as an intensive care nurse for 14 years, said: "We had so many patients coming to intensive care from all over the country during COVID-19 and they were so ill.

"Our patients have diverse backgrounds and although we kept them alive, we didn’t have the tools to look after their hair properly.

"All we could get were little white combs which just didn't work, especially on Afro African hair. Some patients' hair got so matted we had to cut it off, which was heartbreaking for me.

"I thought – 'what can I do as a nurse to make sure this patient is ok, and to improve our standards of care?'"

Ginny added: "At Guy's and St Thomas' our care is world-class. I knew we could do better. I said to myself – 'we will not be defeated. We will make our intensive care unit inclusive.'"

Ginny's vision for how patients should look came from personal experience, after her father became ill, then died. He had been perfectly groomed, which was a comfort to her.

Ginny said: "That is the face that always stays with me and that's what I want to do for my patients' relatives too. It's those little things that really count.

"I want all our patients to be looked after as they deserve to be, especially when they are in intensive care.

"They should feel the best they can and that includes having their hair nicely brushed and their skin beautifully moisturised.

"I ordered a range of combs including afro combs, wide-toothed combs and detangling brushes, while colleagues in dermatology advised me on the best moisturiser for most skin types.

"We've had good feedback from patients' families, which is so satisfying. You feel like you are doing something good."

Toni, from Kent, was in intensive care at St Thomas' for nearly 2 months in late 2022 after an underlying health condition led to multiple organ failure.

"The nurses were expertly moisturising me, and brushed and plaited my hair too," the 22-year-old, who is studying French in Oxford, said. "They made me feel more human, doing things to me which I would do for myself but couldn't. It made me feel much better in myself. I was pampered – it felt like a spa day."

Toni's dad Olayinka, said: "Toni’s skin had become grey and dry after so long in ICU. When I came in one day and saw that Ginny had refreshed her and her skin glowed, it made such a difference."

Patricia McCready, critical care unit sister, was one of the nurses who took part in the project.

She said: "Psychologically, if a patient feels better they have a better chance of recovering. Caring for everyone’s hair and skin is a great skill to have and it's one every nurse should learn, so you can give your patient the right care."

Kemi Okelana, senior staff nurse in the intensive care unit, also worked with Ginny and colleagues on the initiative.

She said: "You spend so much time looking after the internal parts of the patient, but what happens to the external? This is a holistic programme, caring for the whole person, which is so important."

The aim now is to make this a permanent initiative, with it rolled out more widely across the Trust and ultimately through the NHS.

Fast fact

• Patients treated in intensive care get to keep the combs once they leave the unit

Lucy Lisanti meets the UK's first patient to receive a double lung transplant after contracting COVID-19.

Cesar Franco was working as a building services engineer for a five-star hotel when he contracted COVID-19 just before Christmas 2021.

Now, after many long months of intensive care treatment at St Thomas' Hospital and Harefield Hospital, he’s returned home with new, healthy lungs.

Cesar was previously fit and healthy, enjoyed exercising, cooking for his family and helping his teenage son with his schoolwork.

But within a few days of contracting COVID-19, Cesar was admitted to St Thomas' Hospital and placed on a ventilator and life support machine.

He went on to develop covid pneumonitis, an inflammation of the lungs, leading to lung fibrosis.

Fibrosis is a scarring of the lung tissue and meant that Cesar was unable to breathe independently.

He remained in the intensive care unit for five months before being transferred to Harefield Hospital, where he went on to receive a double lung transplant – the first of its kind in the UK.

Cesar said: "It was a very frightening experience and I didn’t know if I would ever leave the hospital.

"I was initially hesitant when the doctors spoke to me about transplantation. I wanted my body to heal on its own, but it quickly became clear that this wasn't an option for me, I was just so unwell."

Cesar's transplant surgery in August 2022 took 11 hours and was made possible by the expertise of his surgical team, and because of the donation of a healthy set of lungs by an organ donor.

The 50-year-old said: "My donor gave me the gift of life with their selfless decision to be an organ donor. I am now able to live my life again and I want to get everything out of life now I have been given this precious gift.

"Thank you to my donor, thank you to their family and thank you to the medical teams who have all got me to where I am now." 

He added: "The doctors, nurses and physiotherapists became my rock. They all treated me with the most respect,professionalism and compassion.

"They made sure to support me physically and emotionally during my lowest and most vulnerable times. I can’t thank them enough for taking care of me."

Professor John Dunning, director of heart and lung transplantation at Harefield Hospital, was Cesar's surgeon.

He said: "Cesar was fortunate because he was able to receive a transplant. We have seen a decrease in organ donors since the beginning of the pandemic, and as a result, many patients on transplant lists not living long enough to receive an organ.

"Without the transplant, he was unable to leave the intensive care unit, reliant on life support machines which were the difference between life and death."

He added: "Cesar's story exemplifies everything that is great about the NHS, receiving excellent care throughout his journey.

"He received his transplant and was rehabilitated to return home a couple of months after his operation. He is now flourishing and is able to spend time with his wife and son, less than a year on from a life-threatening illness."

Fast facts

• The transplant unit at Harefield Hospital is one of the UK's largest and most experienced centres for heart and lung transplantation
• Before the pandemic, Harefield Hospital carried out 40 to 50 lung transplants per year
• Lung transplant operations can last anywhere between 3 and 12 hours, depending on the patient's condition
• To register your decision about becoming an organ donor, visit the organ donation website.

Daisy Holden finds out how a ground-breaking procedure helped a baby who couldn't swallow.

Aged just 6 weeks old, Albie Foy Shoult became one of the first in the UK to have a new procedure to stretch his food pipe.

Born with 2 life-threatening conditions affecting his food pipe and airway, he was rushed to the neonatal intensive care unit at Evelina London.

The top part of Albie's food pipe didn't connect with the lower part, so food couldn't reach his stomach. It also allowed air to pass from his windpipe into his food pipe and stomach.

Known as trachea-oesophageal fistula and oesophageal atresia, these rare conditions meant that Albie couldn't swallow safely. He was put on a ventilator and had emergency surgery at 3 days old.

Albie was also born with a rare heart condition called coarctation of the aorta – where the main artery in the body is too narrow – and had major heart surgery just a few days later.

The emergency procedure to help him safely swallow was a success, but he needed follow-up operations to help stretch his food pipe, making it easier for him to swallow liquids and soft food.

He underwent a pioneering procedure to expand his food pipe using a small thin tube that inflated repeatedly like a balloon.

Albie's parents were able to continue this treatment themselves at home, and the new procedure meant he avoided having multiple operations.

His mum Hannah said: "The first year with Albie was really challenging, we visited the hospital 21 times for different procedures and appointments, and he had three major operations. All of the team that looked after Albie were amazing.

"Everyone was so caring and understanding. They made us experts in his condition, and now he's like a different baby.

"The whole team was great – in particular, Albie's surgeons Kirsty Brennan and Iain Yardley. They would not only check on Albie, but they looked after us as a whole family. Albie is now thriving, and is a happy, lively toddler.

"Over the past 6 months, we've been slowly weaning Albie and introducing solid foods," Hannah said. "It's been quite difficult at times, with lots of trial and error, and seeing what works best for him.

"The other day when I was eating breakfast, he stole a piece of toast off my plate. I was so amazed to see how well he ate it that I burst into tears. It was such a great moment, he's made excellent progress and I’m so proud of him."

To thank the teams who cared for Albie, his family and friends raised more than £1,700 for Evelina London Children’s Charity.

His mum Hannah added: "When Albie needed to be transferred to a specialist children's hospital, we asked if he could go to Evelina London Children’s Hospital.

"For one it has a phenomenal reputation, but also my dad was a specialist medical engineer for years and always spoke very highly of the hospital having worked in almost every hospital in the UK.

"Given their understanding of rare health conditions in children it was a no brainer."

Kirsty Brennan, consultant paediatric and neonatal surgeon, said: "Albie was the first baby at Evelina London that we have successfully treated with this new method. Without this operation, Albie would have needed up to 10 procedures to stretch his food pipe, all requiring a general anaesthetic.

"This was something we were keen to avoid, as he had a heart condition and had already had several major operations at such a young age."

Kirsty added: "Babies born with these rare birth defects are not able to swallow safely, if at all, without complex life-saving surgery.

"A huge team of specialists have been involved in Albie's treatment and we'll continue caring for him at regular appointments to check on his development. It's great to see how well he is doing."

Kelly Cook finds out how Guy's and St Thomas' is enabling its internationally educated staff to get back into nursing.

Guy's and St Thomas' has a diverse workforce, with staff from across the world choosing to work at the Trust.

Those who have trained outside the UK to become nurses and midwives must complete a set of tests before they can register with the Nursing and Midwifery Council, which allows them to continue in the same role in this country.

However, this can take time and be costly so many people choose to take on other roles in the NHS, such as support workers and care assistants.

In 2020, Guy's and St Thomas' launched its UK Overseas Trained Nurses Programme, which involves an English test (OET) and a clinical test (OSCE), to help those in assistant roles to become UK-qualified and take up nursing and midwifery positions at the Trust.

The programme is funded by Health Education England and is open to staff from south east London trusts including King's College Hospital, South London and Maudsley and Lewisham and Greenwich.

Leah Villa is a staff nurse in home dialysis therapy, based at the Borough Kidney Treatment Centre in Southwark, having graduated from the programme in 2021.
She came to the UK from the Philippines in 2014 and took on various healthcare assistant roles.

The 46-year-old said: "I completed 2 degrees in the Philippines and was a dialysis nurse for 2 years.

"I started working at Guy's and St Thomas' in 2019 and someone told me about the overseas programme so I jumped at the chance to return to nursing."

The mother-of-3 completed the programme and registered with the Nursing and Midwifery Council.

Leah said: "I really enjoy my job. I have more responsibility and I’m proud of myself and very thankful to all the people who supported and trusted me – my managers, the home dialysis team, the Trust and especially my family.

"My children are the ones who inspire me to do better. I hope my children and other people will be inspired not to give up on their dreams – I want to be a role model for them."

Saima Alwani is a senior nursing assistant on Dorcas ward at Guy's Hospital.
She moved to the UK from Pakistan in January last year and is currently enrolled onto the programme.

The 35-year-old was a critical care nurse in Pakistan and spent more than two years in Saudi Arabia as a nurse.

Saima said: "I applied for the assistant role because I wanted to learn about the culture of the NHS and familiarise myself with the UK's policies and procedures.

"When you are hunting for a job in the UK everything is so expensive so doing this course without any fees, and fitting it around my work, has been a massive help."

She added: "My colleagues have been very supportive and encouraging.

"I've learnt a lot about the English language and I feel more comfortable writing. I've also been taught a lot of communications skills that help me to be polite and empathetic when speaking to patients."

Sandra Mercadal is the project manager for the UK Overseas Trained Nurses Programme at the Trust.

She said: "Our internationally trained nurses and midwives have a wealth of knowledge and skills and are already working at the Trust. By investing in their training, we hope that they choose to work here for years to come."

Siân Noble-Davies, a practice development nurse for Internationally Educated Nurses, said: "It is my pleasure to teach our own international workforce that reflects our hugely diverse local community.

"By learning from each other it empowers us to improve and enables us to provide a more culturally enriched service."

Fast facts

• 28 internationally trained nurses from Guy's and St Thomas' have successfully completed the programme since 2020
• Nurses and midwives have come from all over the world, including Ethiopia, France, Greece, Ghana, Iran, Japan, Nepal, Nigeria and the Philippines

Alongside the Trust's work to support existing staff to become registered nurses, we also recruit internationally educated nurses from overseas. We have many initiatives to welcome and support these nurses as they join the different clinical teams across the organisation.

Guy's and St Thomas' welcomed 61 international nurses into the critical care team in 2022.
The critical care practice development team launched a communication simulation training session. This was designed to help boost their confidence and provide the tools to deal with challenging situations, including escalating concerns to colleagues.

Natalie Grey, lead nurse for workforce and education in critical care, said: "We wanted to acknowledge that it's normal to struggle with these situations and to create a safe space for staff to share their experiences.

"We surveyed the nurses before and after the session and were delighted to see an increase in their confidence. We're now planning to expand the opportunity to all our critical care nurses."

Mark Tsagli, patient experience specialist.

What is the role of your team?

At Guy's and St Thomas', thousands of patients come through our doors every day. The patient experience team supports staff to collect and act on feedback from patients. Every year, we collect about 100,000 surveys and comments on what we do well and what we could do better. We then help teams to make the best use of this feedback and improve patients' experience.

When has your work made a difference to patients?

Patients attending an outpatient appointment tell us they want to know when they will be seen after arriving. We have developed a toolkit to support staff in keeping patients informed about waiting times.

The toolkit has communication tips for staff and posters to display in waiting areas. If patients have an idea when they will be seen, this can ease their frustration and anxiety.

What do you enjoy about your job?

I am lucky to have dedicated colleagues, who are passionate about continuously improving patients' experience. On a day-to-day basis, I enjoy dealing with a variety of people, using my research skills and interpreting data or trends.

There is nothing more satisfying than hearing from patients about improvements that they have seen. It is important that we listen to patients' feedback and make sure that they have the best possible experience.

How do you collect feedback from patients?

Patients can respond to text messages or online surveys when leaving hospital. They can also complete paper surveys or surveys on mobile devices available in our wards and clinics. Sometimes, patients take part in focus groups or workshops to give us their feedback.

If patients want to pass on compliments or raise concerns, they can contact the Patient Advice and Liaison Service, known as PALS.

Archie Findley, general porter.

I have worked as a general porter at St Thomas' Hospital since 2019. This involves a lot of responsibility and is a very satisfying job.

I feel a special connection with St Thomas' because it is my local hospital and my family have been treated here.

My role is to transport patients, equipment and blood samples around the busy hospital.

I have to be careful and gentle when moving vulnerable patients, some with tubes inserted as part of their care, through the hospital corridors. I also help to direct visitors and give them information.

On average, I walk between 18,000 and 25,000 steps and make up to 20 journeys around the hospital every day.

I have received manual handling training and become a health and safety champion.

Once a month, I go to a meeting and discuss important safety issues.

The best part of my job is meeting a diverse range of patients from different backgrounds. I try to put patients at ease and make them smile or laugh.

When taking patients to the operating theatre, I help them to feel less nervous. We have a chat and I point out interesting pictures, photos and displays along the corridors.

Sometimes, patients ask to see me again when they come for their follow-up care.

A porter needs good communication skills, charisma and a polite manner when dealing with the public. I enjoy getting to know patients and making their hospital visit more pleasant.

Ciorsdan Glass explores Ludwig Wittgenstein's time working as a porter and ointment maker at Guy's Hospital during the Blitz.

Ludwig Wittgenstein is one of the 20th century's most important philosophers, but not everyone realises that during the Second World War he worked as a volunteer porter at Guy's and St Thomas'.

Born in Austria in 1889, Wittgenstein first studied aeronautical engineering.
In 1911, he changed direction to study philosophy under Bertrand Russell, who considered him a genius.

After fighting for Austria in the First World War, and spending months in a prison camp, Wittgenstein published his work Tractatus Logico-Philosophicus in 1921.

He then returned to Cambridge to receive his PhD and became a lecturer and fellow of Trinity College in 1930.

When the Second World War began, he contacted Professor John Ryle at Guy's Hospital – the brother of his friend and fellow philosopher Gilbert Ryle – and arranged to work as a porter.

He was first employed to deliver drugs to the wards and later worked as an assistant in a laboratory, mixing ointments for dermatology.

During his time at Guy's Hospital, Wittgenstein lived mostly in Nuffield House, returning to Cambridge at weekends to give Saturday lectures.

He was relatively discreet about who he was, but some of his colleagues knew his true identity.

SF Izzard, who ran the pharmacy at Guy's, noted: "After working here 3 weeks, he came and explained how we should be running the place. You see, he was a man who was used to thinking."

At Guy's, Wittgenstein met Drs Roland Grant and Basil Reeve, who were working in the clinical research unit on wound shock. There was no general agreement on the symptoms of shock, and he persuaded them not to use the word.

Wittgenstein helped Grant with his work on wounds and blood loss, for example by suggesting that wound sizes could be described in terms of the volume of tissue damaged – using a hand or fist as a measuring unit. He also helped to create new equipment.

When the Blitz ended and there were fewer casualties to study in London, Grant and Reeve moved to the Royal Victoria Infirmary in Newcastle-upon-Tyne. Wittgenstein left Guy's to take up a position with them as a lab assistant in March 1943.

In 1944, he returned to Cambridge, but increasingly disliked lecturing. He resigned in 1947 and died on 29 April 1951.

He left behind thousands of pages of work, which were edited and published over the next 40 years.

Working as a porter

Richard Bousoula has worked at Guy's and St Thomas' for 13 years – first as a porter and now the team lead for porters at Guy's Hospital.

Richard said: "I can understand why a famous philosopher like Wittgenstein might find it very fulfilling working as a porter during the Second World War – he must have felt he was making an important practical contribution at a very difficult time."

He added:"You need to be compassionate to be a porter. Sometimes you can really help to change a life.

"Often a patient will be waiting for you to collect them because they are unwell and need assistance to get to our hospital services. That extra smile that you give them and a little chat, to show that you care, changes everything for them.

"It might seem minor, but at the end of your shift, when you see that patient going home looking happy, you can really feel that you have done something great."

Serina Aboim reveals how becoming a governor is helping to give a voice to vulnerable people in the community.

The Council of Governors ensure that patients, local people and staff members have a say in the running of Guy's and St Thomas'.

Serina Aboim was elected as a community staff governor in July 2021, and has worked at the Trust in the Health Inclusion Team for 11 years.

She manages the homeless and high intensity user service in an interim role and is a nurse. The homeless service is a nurse-led specialist community team who work across Lambeth, Southwark and Lewisham.

They provide a range of services, including health assessments and advice on how to manage long term conditions, to around 500 people each month.

Serina said: "When you see someone rough sleeping their eyes are like a window. They might be smiling or asking for money but there are often many other challenges and life experiences going on.

"Our aim is to try and support health needs but we don’t work in isolation – it's a team approach that can involve lots of different services and staff from across the Trust."

Over the last 11 years, Serina has seen an increase in the number of people experiencing homelessness.

She said: "It's not just single people living on the streets, but also individuals and families who are the 'hidden homeless' and vulnerably housed, including those who are sofa surfing or staying in temporary accommodation like hotels."

As a governor, Serina hopes to raise awareness of the service and to create a collaborative network in the community with different staff groups.

She said: "I took on the governor role during the pandemic which was a challenging time so I feel like I’m still learning.

"I want to be able to hear the voices of non-clinical staff, nurses and our allied health professionals so we can work collaboratively. It's really important for me to hear the voices of staff and patients in the community and feed it back to the Board."

The governors are your elected representatives and are keen to hear your views. If you have a question, comment or idea please email [email protected] or call 020 7188 7346.

Duvie Dafinone explains why he decided to become a member having been a patient at Royal Brompton Hospital for 20 years.

As an NHS Foundation Trust, Guy's and St Thomas' has a membership made up of patients, carers, staff and local people.

The Trust counts on its members for feedback, support and local knowledge, with members able to make a real difference to the way services are developed.

Duvie Dafinone, from Chelsea in west London, has been a patient at Royal Brompton Hospital since 2003. Over the years he’s had various surgeries and a pacemaker fitted.

Duvie said: "I was interested in doing something for a long time so becoming a member was an ideal opportunity to get involved and see where it took me."

Duvie has helped create a leaflet for patients with arrhythmias who are looking to have a pacemaker fitted.

He also joined NHS England’s Peer Leadership Development Programme, which aims to support people with lived skills and confidence to become effective Peer Leaders for personalised care.

Duvie said: "By joining the programme I’ve been able to hear about things that they are planning to introduce and contribute to the discussion. Doctors see one perspective and I've been able to provide a patient's point of view."

Duvie is encouraging other people to consider becoming a member.

He said: "Membership allows you to contribute in so many ways, it's very rewarding and I look forward to the different meetings and discussions. I've even been invited into the hospital to taste the food when they were changing the menu and using new recipes."

To become a member call 020 7188 7346, email [email protected] or visit our membership webpage.

Help us shape your services

We involve patients, carers and Foundation Trust members in planning, designing, improving and monitoring the services and care that we provide.

How to sign up

You can sign up to our mailing list and tell us what interests you. We will get in touch when there are opportunities to get involved.

To sign up, visit the patient and public involvement page on the Guy's and St Thomas' website.

Current opportunities

Right now, we're looking for patients and carers to join our Youth Forum and our Parent and Carer Forum.

You can also help us to improve our:

• heart and lung services
• cancer and surgery services
• local community health services

Events and activities

We involve people in different ways, for example through workshops, interviews and advisory groups. Some events are held online and others face-to-face. We will adapt activities to help you take part wherever we can.

If you have any questions, email [email protected] or call 020 7188 6808.

For all the latest news about our amazing fundraisers and how you can support us, follow @GSTTCharity on Twitter and @RBHCharity on Twitter and like the GSTTCharity Facebook page, evelinalondonchildrenscharity Facebook page and RBHCharity Facebook page.