The GiST, issue 41

Words and photos by Shammi Anand, Matt Barker, Ciorsdan Glass, Azmina Gulamhusein, Maxine Hoeksma, Daisy Holden, Rebecca Leddy, Emma Ong, Janine Rasiah, Andrea Martina Terracciano and Lesley Walker. 

Cover photo by David Tett.

Design: AYA-Creative.

Print: O'Sullivan Communications.

Front cover: Jack Pepper pictured one year on from his heart transplant.

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.

A new state-of-the-art NHS eye clinic has opened in Clapham. 

Specialists from St Thomas' Hospital eye clinic now also work at Minnie Kidd House Community Eye Clinic to assess and monitor people with glaucoma and retinal conditions. These problems can lead to irreversible vision loss if not diagnosed early. 

The new clinic is staffed by consultant ophthalmologists and ophthalmic technicians. High quality equipment is used to assess visual function and the structure of the eye in detail. This allows fast and accurate assessment to make diagnoses for new patients and to monitor conditions already diagnosed. 

There is increasing demand for eye services across the whole country, made worse by a backlog of patients waiting caused by the COVID-19 pandemic. 

It is estimated that around 57,000 extra appointments are needed each year to meet the current demand for assessment and monitoring of glaucoma and medical retina conditions across south east London. 

Professor Ian Abbs, Chief Executive for Guy's and St Thomas', said: "It’s fantastic that Minnie Kidd House Community Eye Clinic is now open. This means we can care for more patients currently waiting for diagnosis or monitoring, and treat even more patients, with the potential to save the sight of many people across south east London." 

Porters at Guy's Hospital have brightened up their most popular routes with a new art display. 

They teamed up with Breathe Arts Health Research and Guy's & St Thomas' Charity to select their favourite artworks from the Charity's art and heritage collection. The new trail is designed to bring colour and creativity to corridors and lift lobbies, helping patients, visitors and staff feel more at home.

Breathe poet Simon Mole worked with the porters to select the display, and develop talking points for them when escorting patients to and from their appointments. Each piece of artwork is accompanied by an interpretation panel about why they picked it. 

Hannah Dye, head of programmes at Breathe Arts Health Research, said: "I love seeing how the artworks provide patients with a welcome distraction whilst being taken to and from appointments." 

The Art of Portering was first introduced at St Thomas' Hospital in 2019. The new display at Guy's starts on the ground floor of the hospital.

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

BBC News

BBC Sport journalist Chris Slegg interviewed his cardiologist Dr Hannah Douglas about his rare heart condition, Ebstein's anomaly. The story also included an interview with his clinical psychologist from the Trust, Mina Arvanitopoulou, who spoke about the mental impact of heart disease.

Sunday Mirror

The Sunday Mirror wrote about Guy's and St Thomas' becoming the first Trust in the UK to complete a fibre optic guided heart operation. Grandad Kevin Dowd was discharged just 10 days after having an abdominal aortic aneurysm repaired.

Evening Standard

A new service at Evelina London for children with rare genetic conditions was covered by the Evening Standard. It reported that patients with inherited White Matter Disorders can be fast-tracked for earlier diagnosis and specialist care.

Sunday Express

The Secretary of State for Science, Innovation and Technology, Chloe Smith, mentioned her recent visit to the Trust to see Oxford Nanopore work in action in a comment piece.

The Trust's CARE awards are presented to staff who have exemplified the highest standards in courtesy, attitude, respect and enthusiasm.

A huge congratulations to the 2023 winners so far:

Olivia Beaumont, hospital birth midwife:
Nominated by a patient for her support in the labour of their first baby boy. 

Evelina London Children’s Hospital – Beach ward:
Nominated by a patient’s mother for all of their support in looking after their son during his stay.

Rebecca Devine, nurse from Evelina London's Mountain ward:
Nominated by a patient's mother for her compassion and attention to her son's needs.

Dimbleby Cancer Care Centre:
Nominated by a colleague for their work to go above and beyond to support their patients in non-clinical ways. 

Glenda Baillie, head of nursing for Transplant, Renal & Urology:
Nominated by a colleague for her support of other teams and strong communication skills. 

Rebecca Myatt, acute oncology unit nurse:
Nominated by a colleague for going above and beyond to help her teammates and colleagues.

Harefield’s intensive therapy unit:
Nominated by a patient for their kindness, understanding and compassion during a difficult time. 

To make a nomination, please visit the care awards page.

Their Royal Highnesses The Prince and Princess of Wales were the surprise guests at a very special NHS Big Tea party to celebrate the NHS's 75th birthday. Patients and staff from across the country were invited to the NHS Charities Together event, which was held in the charity-funded Florence Nightingale wellbeing garden at St Thomas' Hospital.

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

@ElianaChr (from Twitter) Thank you all in the maternity team at @GSTTnhs for their exceptional care! Special thanks to our midwives Niamh & Jose for helping deliver our baby girl naturally. We will never forget you #IDM2023

@IainDale (from Twitter) Some news. This afternoon I tripped at the top of an escalator at Charing X Tube. I was taken by ambulance to St Thomas'. I have a badly broken hip. Replacement op scheduled for Monday. Superb care from all here. In the immortal words of Britney Spears: Oops I Did It Again!

@Walk4ECMO (from Twitter) Really enjoyed my four-day hike along @HWpath this week. Amazing views along the wall and many friendly walkers sharing journey tales. My first summer challenge complete! Supporting @GSTTCharity to support the exceptional staff @GSTTnhs #ECMO @GSTT_ICUe

@mitraudita3 (from Twitter) shout out to the #Urgentcarecentre. Received a quick response from MJ while I was waiting. She made me feel comfortable and looked after me, explained what the department can offer. Being a nurse myself I feel so proud how these wonderful colleagues are making a difference.

A new non-clinical team has been introduced to support patients and staff across the Trust.

The patient and staff enhancers, known as PASE, are on hand to do everything from making beds to cups of tea. The team work in a variety of clinical areas including inpatient wards and outpatient clinics.

Emily Clatworthy works across four wards, and was previously a carer for her nan. Every day is different but it could include speaking to patients who are on dialysis.

Emily said: "I’ve always wanted to work in the NHS. My nan always said my calling was caring for people and it’s everything I wanted it to be."

The PASE team was initially launched in 2021 during the pandemic to help staff to support patients, answer phones and undertake non-clinical duties. This released time for the clinical team to provide direct patient care. It was relaunched this year as a Trust wide pilot, with positions funded by Guy's & St Thomas' Charity.

Jennifer Yeboah, PASE programme manager, said: "The clinical staff benefit as they are able to focus more on their clinical role, and the patients benefit from the additional support. We have had some great feedback." 

A scheme allowing the Trust's patient transport vehicles to use bus lanes is being rolled out across the capital. 

The one year pilot with Transport for London (TfL) saw a 20 per cent drop in missed appointments, with no impact on bus journey times. 

The patient transport service is a lifeline to some of the Trust’s most vulnerable patients, many of whom have cancer or are dialysis patients and have to attend hospital appointments multiple times a week. 

Following the success of the trial, TfL announced that other non-emergency NHS ambulances, police cars and fire brigade vehicles can use its bus lanes on main roads. 

Ian Abbs, Chief Executive of Guy's and St Thomas', said: "Missing appointments is hugely frustrating for our patients and staff, so we are really pleased that this trial with TfL has reduced journey times by up to 16 per cent.

"It is brilliant that this initiative is being rolled out more widely, and we are grateful to our governors for campaigning for this change." 

The Evelina London Children's Day Treatment Centre opens to patients in July. The new building, situated next to Evelina London Children's Hospital, houses a day surgery unit designed with families in mind. Featuring two new operating theatres, it will help treat an additional 2,300 children each year.

Children from across London and the south east have helped develop the interior theme of 'outer space', submitting creative designs which have influenced the intergalactic interiors. They were invited to a pre-opening event with special guests from the UK Space Agency to see the space-themed artwork and engage in educational activities.

Helen Harker, consultant anaesthetist and clinical lead for the unit, said: "We’re delighted to be launching this fantastic facility, with many features designed to help families with their care in a fun and engaging way. It also frees up space in our hospital theatres for more complex surgeries requiring overnight stays, helping us cater to the growing numbers of children and young people needing our specialist care."

For more information, visit the Children's day surgery unit page.

Matt Barker reports on the latest milestone for the Trust's trailblazing robotic surgery team.

Rob George has achieved plenty of firsts in his medical career - and has now chalked up one as a patient.

He was one of the first to benefit from Guy's and St Thomas' becoming the first Trust in the UK to adopt the newest surgical robot, the Hugo robotic-assisted surgery (RAS) system, from healthcare technology company Medtronic.

The 70-year-old, who is a professor of palliative care, was diagnosed with prostate cancer. He had surgery to remove his prostate, called a prostatectomy, at Guy's Hospital.

Rob, who lives in Honor Oak Park in south east London, said: "I've done a lot of firsts in my own career so I know things from the other side of the fence. I've had conversations with patients about doing something new or novel so I thought it was fitting that it was me this time.

"I came to this massively informed about what cancer means and what its potential consequences are but I am an optimist. I thought 'I've got cancer, here are the options, so let's get it out'.

"I arrived early on Friday morning and was home by tea time the next day. From start to finish the whole process was amazing."

Ben Challacombe, who was Rob’s surgeon and is clinical lead for robotic surgery at Guy's and St Thomas', said: "We carry out the most robotic operations in the NHS with more than 1,500 cases a year. Expanding our robotics programme with Hugo allows us to offer the benefits of this technology, including fewer complications and smaller scars, to even more patients.

Rob, a father of four with eight grandchildren, added: "Because I was monitoring my Prostate-Specific Antigen (PSA) levels it meant the issue was picked up as early as it could be and managed appropriately. So, my message to other men is to check your risk with Prostate Cancer UK's online risk checker."

During a robotic procedure with Hugo, the surgeon sits at an open console, which displays a high definition 3D view and allows them to precisely control the robotic arms and instruments. The high-tech surgical instruments and a state-of-the-art camera are inserted through tiny incisions in the body.

George Murgatroyd, vice president and general manager, digital technologies, surgical operating unit, Medtronic said: "It's always inspiring to hear about the impact Medtronic technology is making on a patient’s life. We're honoured to partner with Ben Challacombe and the team at Guy's and St Thomas' to lead a forward-thinking approach to working with robotics and digital solutions in the operating theatre, in support of our mission to expand access to care to more patients around the world."

Fast facts

• The Trust has the largest robotic surgery programme in the country
• The adoption of Hugo means it now has seven robots operating across six specialities: urology, gynaecology, transplant, head and neck, gastrointestinal and thoracic surgery.

Andrew Kiln was the first person in the country to have a new type of mitral valve replacement to fix his leaky heart valve. He and Professor Simon Redwood, consultant cardiologist, explain more to Lesley Walker.

The doctor Simon Redwood

"Andrew had mitral regurgitation. This is a type of heart valve disease where the valve doesn’t close properly and so blood leaks back across. One in 10 people aged over 75 in the UK have this, and over time it can make the heart dilate, which can cause increasing shortness of breath and ultimately shorten a person’s life expectancy.

"It came to a point where we needed to treat Andrew, but because of previous surgery after a heart attack, he wasn't suitable for open heart surgery.

"With the new SAPIEN M3 mitral valve replacement, we could implant it in a minimally invasive way, by making a small cut in Andrew's groin, inserting a catheter into a vein and up through his body. It then passes through the right side of his heart into the left side. Special tubing is inserted through the catheter and this tubing wraps itself around the faulty mitral valve flaps to create a circular docking point. The new heart valve is installed inside the docking point and expanded with a balloon mechanism to create the new mitral valve.

"This procedure on Andrew took just over an hour. Andrew was up and about the next day and home the day after. This compares to conventional open-heart surgery where the recovery usually involves a couple of nights in intensive care, a week in hospital and several months before the patient is feeling back to normal.

"In time we hope to treat many more patients with this valve, which could have huge benefits particularly to those patients who wouldn’t be suitable for open heart surgery."

The patient Andrew Kiln

"I’ve been a patient at Guy's and St Thomas' since 2000. I first found out I had mitral regurgitation after my open heart surgery in 2010. It was mild then and they kept an eye on me, but at the time doctors told me they couldn’t do anything because of my previous surgery.

"I didn’t have strong symptoms of the mitral regurgitation – I was refereeing football matches up until the weekend before my latest surgery. But the doctors said it would get worse and that this new implant could sort me out.

"I knew I was in good hands so I just took it stage by stage. I've always been really well treated at St Thomas', so I trusted them. Now I've had it done, it's tremendous. It’s like I'm a millionaire. I don’t need money when I have my health like this. It's given me a new lease of life.

"I can't fault anything at all. I’ve been in the best hands and I hope they can do this on more people like me. Now I'm getting back to the gym and enjoying seeing all my friends there."

Daisy Holden finds out how exercise can help people with Parkinson's as staff work with Joe Wicks to create a new workout video.

Celebrity fitness coach Joe Wicks has joined forces with Guy's and St Thomas' to release a dedicated exercise video for people with Parkinson's.

Parkinson's is a condition where parts of the brain get more damaged over time, affecting about 145,000 people in the UK. People with Parkinson's can have slow movement, stiffness and tremor, and it can also affect their walking, sleep and memory.

Research has shown that taking part in regular physical activity can leave a positive impact on patients' symptoms, both physical and mental.

Milly Khan, highly specialist neuro-physiotherapist at Guy's and St Thomas', worked with Joe to develop a bespoke video that can help people with Parkinson's in the comfort of their own home.

Milly said:"I was delighted to create an exercise video with Joe Wicks designed especially for people with Parkinson's. Physical activity is a really important component of treatment for Parkinson's, and the condition shouldn’t be a barrier to being physically active."

The online workout comprises of ten different exercises including a 'sit to stand' challenge, where people stand up from seated as many times as possible in a minute. All of the exercises are suitable for people with a range of severity of symptoms.

Milly continued: "It's important that physical activity sessions contain components of aerobic fitness, strength training, balance and core control, and stretching. You don't have to challenge these systems all in one go, spread them out throughout the week!

"We have tried to incorporate all these components in this video and recommend patients complete them at their own pace. Physical activity doesn’t necessarily mean attending exercise classes several times a week, it also includes gardening and dancing. It's important that you challenge your symptoms and you enjoy it."

The specialist neuro-physiotherapy team host exercise classes for patients' with Parkinson's in six-weekly blocks at St Thomas' Hospital. While filming the workout video, Joe took part in one of the classes.

Joe Wicks said: "I'm so passionate about making exercise accessible for all people, no matter their ability. Taking part in regular exercise has many benefits not just for your physical health, but also your mental health. It was great to come to St Thomas' Hospital to hear more about how exercise can help people with Parkinson's manage their symptoms and to create this workout video tailored specifically for them."

Carol Webb, from Eltham in south east London, was diagnosed with Parkinson's in 2019 and has taken part in the exercise classes at St Thomas'. Joe invited Carol to join him in filming the workout video.

Carol said: "Since being diagnosed with Parkinson's, I've found taking part in regular exercise like yoga really helps to keep my joints flexible. If I sit still for too long, my joints can feel stiff so it's good to keep moving. I found the exercise classes with Milly really helpful and, although tiring, it has given me the confidence to start a circuit training class locally – something I would not have thought possible previously.

"During lockdown, my youngest daughter and I took part in Joe's online PE lessons in our garden, so it's been exciting to take part in this video alongside him!"

Milly Khan continued: "Having this specially-created resource that people can do in the comfort of their own home will make a huge difference to not only the patients I see at St Thomas', but patients across the country."

The exercise video for people with Parkinson’s is available free online on The Body Coach YouTube channel. 

Top five exercises for staying active at home

Repeat these exercises 10 times:

• From standing, raise your heels
• Star jumps
• Bridge
• Boxing punches
• Squats

Daisy Holden finds out more about the incredible team who transfer critically ill children to hospitals providing specialist care.

The South Thames Retrieval Service (STRS) has been transporting seriously ill children and young people from local hospitals to paediatric intensive care and critical care units across the south Thames region for a quarter of a decade.

The team is made up of clinicians from Evelina London Children's Hospital's paediatric intensive care unit, who are trained in stabilising and transferring children.

Dr Shelley Riphagen is a consultant in paediatric intensive care and service lead for STRS. She joined the specialist retrieval service in 2000, shortly after it launched in 1998.

Shelley said: "When we get a phone call referral for a child to be moved, our team will share expert advice with the child's local hospital.

"The child is assessed and if we feel that they need intensive or critical care, one of our specially equipped ambulances is dispatched. A retrieval nurse, retrieval nurse practitioner or doctor and an ambulance technician will collect the child and their family so they can be admitted to a specialist unit.

"The service has developed so much over the last 25 years, especially as technology and medical advances have changed. When we first started transferring patients, we didn't have mobile phones so small things like being able to communicate with the receiving hospital en route has made a huge difference!"

The STRS team is one of two retrieval teams in the UK to be fully integrated with a paediatric intensive care team. Shelley said: "This is hugely beneficial for families as it ensures our retrieval team has highly specialist skills, making sure the sickest patients receive expert care as soon as possible."

Isla, 14, had to be urgently transferred from Kingston Hospital to Evelina London Children's Hospital paediatric intensive care unit (PICU) after she was diagnosed with severe pneumonia last December. She deteriorated so quickly that her mum, Lisa, and dad Charlie were in shock.

"I felt helpless seeing Isla fighting for breath and not being able to do anything to help her," Charlie said: "In between these feelings, I remember seeing how calm STRS were, listening to each other, agreeing every next step together, knowing exactly who was doing what and when. "I’ve watched great sporting teams in action, but this was as good as any of them."

When Isla arrived at Evelina London, she was immediately taken to PICU where she spent two weeks on a ventilator.

Charlie continued: "In between all the activity, the ambulance, the sirens, beeping machines, the sound of the ventilator; every nurse, doctor, physio and member of staff found a human connection with Isla. She was not just another patient to them. Isla’s hair was plaited each day, the radio was tuned to the stations she liked, they talked to her, and kept Lisa and I going."

Isla spent 10 days on PICU and then three days on a ward before she was discharged back home to Twickenham.

Charlie added: "She has made a great recovery, both physically and mentally. We know that Isla owes her life to the STRS team and that, more than anything else, sums up the amazing job they do."

Leading the way

STRS has the biggest team of retrieval nurses in England, and they were the first to develop the retrieval advanced nurse practitioner role.

Kirsteen McCulloch, as part of STRS, became the first paediatric critical care advanced nurse practitioner in Europe to undertake a nurse-led retrieval of a critically unwell child in July 2006.

Kirsteen, who is now Head of Patient Safety, Quality and Assurance for Evelina London Children's Hospital, recalled: "Ahead of the journey, I was slightly nervous but I was also confident of the comprehensive training that we had completed, and excited about what this would mean for both the development of nursing and the development of the service.

"It's incredibly humbling to see the direct impact the service has on families, and when they recognise, sometimes years later, that you were part of the journey transferring their child into intensive care."

Fast facts

• STRS cares and provides for more than 2,000 critically ill children in the south Thames region annually
• Two teams are available to transport children 24 hours, 7 days a week
• Evelina London Children's Hospital is the largest centre for paediatric intensive care in the south Thames region, with 30 intensive care beds.

Shammi Anand speaks to a teenager who recently celebrated a year since his heart transplant.

Hanging out with friends and going to the gym are activities that most teenagers take for granted. But not 19-year-old Jack Pepper, who recently celebrated a year since his heart transplant at Harefield Hospital.

The milestone moment was marked with a family break at Go Ape doing activities Jack wouldn’t have been able to do previously. He’s determined to make the most of living a more active life, and recently passed his Level 2 plumbing exams. He plans to do an apprenticeship next year.

"I feel so much more free as before I was limited in what I could do," Jack, who lives in Leicester, explained. "Now I can do anything and I don’t have to worry about collapsing randomly. I have peace of mind, whereas before my heart condition was always in my head."

Jack was diagnosed with hypertrophic cardiomyopathy when he was 12 years old. This causes the walls of the heart chamber to thicken and can make it harder for the heart to pump blood, meaning he couldn’t do strenuous activity.

Early last year, aged just 18 years old, he began a scary decline from sepsis to heart failure. A sore throat was followed by vomiting a couple of days later. He then developed purple spots on his elbows – a well-known sign of sepsis – and was rushed to his local A&E.

"The sepsis went straight to my heart," Jack recalled. "It usually attacks the weakest point in your body, and because my heart was weak already, it was just game over for my heart."

After several unsuccessful attempts to stabilise his heart, Jack was transferred by emergency ambulance from Leicester's Glenfield Hospital to Harefield Hospital, where he spent the next two months attached to a machine to support the function of his heart. He was also placed on the UK's super-urgent heart transplant waiting list. Jack’s mum, Sarah, dad, Lee, and sister Louisa, now 17 years old, regularly travelled to be by his side.

Jack received his new heart in an 11-hour operation in May 2022. His surgeon, Mr Espeed Khoshbin, described it as one of the most challenging transplants he had ever done.

Sarah said: "We’ve been back to thank the nurses and the doctors a couple of times, and I've just said, 'you’re miracle workers, you’ve given us our son back'. The transplant hasn't just fixed him, it's made him better than he was."

Throughout this period, Sarah was battling with her own health, having been diagnosed with lung cancer a week before Jack got sepsis, and breast cancer when he was in intensive care. She had a lung operation while Jack was in hospital, and a mastectomy three days after his heart transplant.

"It was full on the whole time but I genuinely didn't care,” Sarah said. "My focus was on Jack – it was all about getting him through."

Jack was discharged two weeks after the transplant. Later in the summer, he was well enough to take a trip to Southwold with his girlfriend, Francisca, thanks to funding from Royal Brompton & Harefield Hospitals Charity.

"I was very determined to get back to how I was," Jack said. "I was always looking at pictures and videos of myself from before."

He's so grateful to his donor, and the doctors and nurses who cared for him at Harefield.

"I owe my whole life to them," Jack said. "They’ve given me a second chance at living my life."

Katie Stallwood, senior sister, critical care at Harefield Hospital

"When Jack was transferred to us, he was incredibly poorly. There were some very scary moments when we were worried he might not survive.

"We witnessed Jack and his family's incredible strength and resilience, and his engagement with his rehabilitation while waiting for a new heart was an inspiration to us all.

"Seeing Jack now makes us feel very proud and full of admiration for this young man and his family. Knowing we played a part in making it happen is amazing and inspires us every day."

Allergy expert Adam Fox tells Janine Rasiah how to best combat symptoms, including a treatment which retrains the immune system.

With the second peak of the grass season now upon us, sneezing and itchy eyes will be all too familiar for many.

Hay fever is extremely common, with around 20 to 25 per cent of adults experiencing symptoms, and approximately 10 to 15 per cent of children.

But while most people have quite mild symptoms, for a small number it interferes with their quality of life, despite them doing all the right things.

It is this group of people that Professor Adam Fox, professor of paediatric allergy at Guy's and St Thomas', is encouraging to think ahead to next year.

He explains: "Around 15 to 20 per cent of people still have symptoms despite doing all the right things, and now's the time to prepare ahead of next year's hay fever season if you have a pollen allergy."

Sublingual or 'under the tongue' immunotherapy, also known as desensitisation, involves taking a daily pollen tablet to retrain the immune system.

Through research trials partly carried out at St Thomas', home to the largest allergy centre for children in Europe, this treatment has been clinically proven to reduce hay fever symptoms.

Hundreds of people in the UK receive this treatment through specialist services like those at Guy's and St Thomas' which are recognised by the World Allergy Organisation as a Global Centre of Excellence.

"The tablets are taken at home under medical supervision every day for three years," Prof Fox explained. "The real magic of it is that once you have finished the course there is a reasonable expectation that you will be protected for a number of years as the treatment changes the body's underlying response and has a long term effect.

"It's also been found to reduce the likelihood of children aged 11 to 16 years old going on to develop asthma which can be quite common among those who have hay fever."

So how do you know whether immunotherapy is the right course of action for you?

Professor Fox said: "The first thing is to be honest with yourself, "Are you optimising your medication properly and actually taking your antihistamines every day?

"The other key thing is to consider the effects of hay fever on your life – so is it stopping you sleeping, affecting your concentration or making you unable to drive?"

If you fall into these categories, it's worth speaking to your GP about whether immunotherapy could help to alleviate your hay fever symptoms.

Prof Fox added: "By starting treatment before the end of January, you will feel the benefits when spring arrives."

Prof Fox’s top tips for dealing with hay fever

• The first line of defence is long-acting antihistamines, pollen balm and salt water nasal spray
• For more severe symptoms, nasal sprays can be bought over-the-counter for adults, and are available on prescription for children
• On high pollen days don’t dry laundry outside, wear wraparound sunglasses, buy a pollen filter for your car and wash your hair when you get home so you don’t rub pollen into your pillow
• Find more help and advice on Adam’s Instagram page @dradamfox

Fast facts

• Immunotherapy has evolved from regular pollen injections which were a popular treat-ment for hay fever sufferers from the 1950s to 1970s 
• By the 1980s, the decision was made to limit pollen injections to just a small number of specialist centres – including at Guy's Hospital and Royal Brompton – as they cause severe allergic reactions for a small number of people, especially those who also have asthma 
•  The Trust continues to offer injections to patients who find them more convenient than daily tablets.

Evelina London has launched training to support children taking medication. Daisy Holden finds out more.

Children and young people are being offered training to take tablets safely, thanks to a new initiative launched by the pharmacy team at Evelina London’s Children's Hospital.

The 'pill school' supports children across the inpatient wards and outpatient departments. One of the first in London, the scheme encourages families to swap liquid medication for tablets, which has many benefits. Tablets are easier to transport and store, and reduce the risk of dosage error. They are also cheaper to buy in pharmacies.

The pill school offers patients different methods to successfully swallow tablets in a safe, controlled environment.

Children are given a range of small sweets to swallow with either water, juice or soft food, like yogurt. A range of cups and bottles can also be used.

James Nichols took part in a pilot study for the pill school at Evelina London when he was recovering following a kidney transplant.

James’s mum, Samantha Nichols, said: "James was five years old when he completed the training, and successfully swapped from liquid medicine to taking tablets. It's made a huge difference. James had a kidney transplant when he was five, so will be on medication for his whole life – including taking many tablets daily. Every morning, James needs to take a number of different drugs to protect his kidney, and being able to take them in the tablet form has made things so much easier. The medication he needed meant that he was having to drink quite a lot of liquid medicine, which was not pleasant.

"It also means at the start of every week, I can organise his tablets into blister packs so they're ready for the week ahead. This makes it much safer."

James, now eight years old, said: "I find it easier taking tablets now. It was horrible before because I had lots of liquid medicine to take and it didn't taste nice!"

Dr Asia Rashed, pharmacy project manager at Evelina London Children's Hospital, said: "We start children off using a small hard sweet approximately 3mm wide, and slowly increase the size to be approximately the same as the tablet, normally about 1cm to 1.5cm. Children will swallow food bigger than these sizes, so the training provides tips on how to angle their head and to provide reassurance."

Asia led a feasibility study in 2019 with 30 children aged between three and 14 years old and 26 of them successfully completed a single-short session at the pill school, having learnt how to take tablets. 24 of these patients went on to be discharged from hospital with tablets instead of liquid medicines, with the youngest being just three years old.

Asia continued: "It was great to see that the majority of children who took part in the study were able to swap to taking tablets, as it has lots of benefits for the patient and their family. For example, liquid medicines often don’t taste nice which reduces the chance of children taking the medicine accurately. Tablets can also reduce medication error as the dose is pre-measured, unlike pouring out a liquid.

"There is also a cost implication for families and the hospital. Tablets are a lot cheaper than liquid medicine so it can help save families money. Many of our patients will need to be on medication for long periods of time, so being able to take tablets will help prepare them for the move from children's to adult services as they can take charge of their own medication."

The feasibility study found that if the 24 patients discharged from care with tablet medication were to continue being prescribed tablets for a year, it would save £30,000.

Nanna Christiansen, associate chief pharmacist at Evelina London, said:

"Although liquid medications are seen as the obvious 'go-to' for children, they have drawbacks. These include an unpleasant taste and a higher risk of accidently giving the wrong dose. They are also harder to transport and store and contain additional substances which may have harmful effects.

"I find adults often underestimate a child's ability. I have had children as young as three years old swallow large capsules. Pill school is a fantastic opportunity to support children taking their medication in tablet or capsule form, which is often much safer and more practical."

This summer marks the 75th anniversary of Windrush and the NHS. To mark this milestone, Lesley Walker, Janine Rasiah and Emma Ong speak to some of the Trust's inspiring staff.

Cherese Reid

Cherese Reid's grandmother travelled from Jamaica to build a new life for herself in south London in 1955. She began a bond with Guy's and St Thomas' that would span four generations of her family, including many babies and multiple careers.

Now a midwife and clinical practice facilitator for student midwives at St Thomas', Cherese pays tribute to her grandmother Mabel, aged 88 and still living in Lambeth. Mabel's "fighting spirit" is a trait Cherese says she has inherited and which has shaped her own life and career.

Mabel began her family's connection to the Trust when she had all her six children at the hospital, including her daughter Angela, Cherese's mother. Mabel also got a job in catering at St Thomas' Hospital in 1972. Angela gave birth to Cherese at the same hospital and so did Cherese with her own daughter Seryiah. Five years later, Cherese started her midwifery training and career at the hospital, where she has worked since 2014.

Cherese said: "I'm deeply rooted in the hospital. I've always thought of it as the best-of-the-best. Guy's and St Thomas' has never let me down, personally or professionally.

"I wasn't very academic at school and I didn't think I’d go to university. But my first job working as a receptionist in the maternity unit at St Thomas' sowed the seed of an idea of becoming a midwife. I was really supported by one of the midwives here, who said I would be amazing at it. I later thought this is a job I could really do. I signed up for evening classes to show I had recent study experience, and to help with my university application. I was a single mum with a small child, and it was really hard work. But I got my GCSE maths, and I was accepted on the midwifery course at King's College London – it was a really big achievement for me.

"Now I'm training the next generation of midwives. I'm proud to be part of Guy's and St Thomas'."

Bill Addison

Affectionately known to many as 'Bill the bed', Bill Addison worked at the Trust for 47 years before his recent retirement.

He was one of the first male midwives, and a charge nurse in the intensive care unit. But he will be best remembered for his decades as bed manager for St Thomas', ensuring every patient was in the right bed and the right environment.

One of his biggest challenges came when he was forced to close 140 beds in the late 1980s."I had to look carefully at the flow of patients," Bill recalls. "It used to be the case that patients were admitted two days prior to elective surgery. That had to change and there was also more emphasis on outpatients."

Bill introduced 12 hour critical care shifts, helping reduce multiple handovers, and then later become standard practice across many Trusts.

Despite his long career, Bill originally joined the NHS in Aberdeen as a stopgap to "fill the time" for about a year until he was old enough to join the police force.

"But I enjoyed it so much that I stayed and my original plans went out of the window," Bill said. "It wasn’t planned this way. It's just happened that I've gone from one thing to another and I have really enjoyed every minute of it."

Professor Michael Gleeson

The Professor of Otolaryngology (ear, nose and throat) and Skull Base Surgery at Guy's and St Thomas' NHS Trust recently retired, and continues to serve as Chairman of the Friends of Guy's and St Thomas' Charity. He will be celebrating his 75th birthday this year.

What was your role at GSTT?

I have been very privileged to work at world famous institutions throughout my training and professional life. I started my career as a dental student at Guy's in 1967 before receiving a scholarship to study medicine also at Guy's. After qualifying I became an Ear, Nose and Throat Surgeon (ENT) and was appointed senior lecturer and eventually Professor of ENT and Skull Base Surgery at Guy's and St Thomas' in the early 1990s. I established the British Skull Base Society and was elected World President of the Federation of Skull Base Societies and editor of their organ journal.

You celebrate your 75th birthday in the same year as the NHS – how have things changed in your field of medicine?

During my career there have been huge changes. Surgery on head and neck tumours was once carried out by general surgeons who had no specialist training. Skull Base Surgeons now undertake long training before joining a multidisciplinary team of clinicians that include neurosurgeons, maxillo-facial surgeons, oncologists, neuroradiologists and speech therapists. The development of multidisciplinary teams with each member contributing their individual skills has had a profound effect by improving patient outcomes.

Anna Scott, dietitian, and Nicole Harris, dietetic assistant, talk about the edible garden project they run at St Thomas’ Hospital.

What does the staff edible garden project involve?

We decided to set up a staff edible garden project in the grounds of St Thomas' Hospital. Guy's & St Thomas' Charity funds this project.

Since June 2022, we have been offering 6-week gardening programmes to groups of staff. They take a break from their desk every week and help with the general upkeep of the garden. Activities include watering, weeding, litter picking, seed sowing, planting and harvesting.

The gardening programmes are well attended and we thoroughly enjoy meeting staff from across the organisation.

What do you grow in the edible garden?

We grow a variety of fruit, vegetables, herbs and flowers. This includes strawberries, rhubarb, sweetcorn, purple sprouting broccoli, lettuce, beans, rosemary and garlic.

Staff can take home the produce that they grow. They learn how to use different fresh ingredients and often share recipe ideas. This helps to promote healthy eating.

How does the project help to improve staff health and wellbeing?

Evidence shows that there are 5 main ways to improve wellbeing. Our project helps with all of them.

Firstly, staff can connect with others by meeting new colleagues. Secondly, they get active by growing crops outdoors and this can reduce stress. Thirdly, staff learn new food growing skills. Fourthly, they give to and help others by looking after a communal garden that everyone can enjoy. Fifthly, staff notice and appreciate their surroundings by spending time in nature.

Does the project have any other aims?

We aim to have an environmentally-friendly garden. We take care of the soil, use chemical-free plant feed and save seeds. There are now lots of worms and insects in the garden. We plant flowers that attract bees, butterflies and other species that carry pollen.

Staff work together to create a pleasant environment for patients, visitors and colleagues.

Andrea Martina Terracciano, Cancer Biobank quality manager.

I am responsible for developing, leading and managing quality practices in the Cancer Biobank in Guy's Cancer Centre.

We have around 370,000 samples from almost 40,000 patients, including samples of blood, saliva, urine, bone marrow and tumour tissue, so we require a lot of storage space. At the moment we have eight freezers (plus back up) and we also have an archive room where we keep paraffin blocks and microscope slides.

I run monthly internal audits against Human Tissue Authority (HTA) standards. I'm also working on getting the Biobank accredited for ISO 20387. Being ISO accredited is like having a medal of honour, as ISO standards are notoriously very strict and specific and you have to go through quite a few external audits by an authorised accreditation body. I am confident we’ll get there.

For us, both HTA and ISO accreditations are proof of our hard work, extensive knowledge and quality being recognised at a national and international level.

I also run a traceability audit on a different Biobank each month, and this is the only time I directly interact with samples.

I grew up in Italy and have dreamt about living in the UK and working in a hospital ever since I was young. Having my blue NHS lanyard means the world to me. Sometimes I wonder how "young me" would react to finding out we actually made it!

Ciorsdan Glass explores Florence Nightingale's love of animals.

Florence Nightingale is widely considered to be the founder of modern nursing. Following her return to England after the Crimean war, she established a nursing school at St Thomas' Hospital. She is still an inspiration to nurses around the world, and there is a museum dedicated to her at St Thomas'. While many people are aware of her dedication to the sick, it is less well known that she had a great love of animals and that this may have influenced her career choices.

Cap the sheepdog

Cap was owned by a shepherd named Roger who lived close to Florence's family home. One day in 1837, Florence learned that some local boys had attacked Cap with stones, damaging his leg so badly that he couldn’t put it down on the ground. Despite his love for the dog, Roger couldn't afford to keep a dog that couldn't work, and had apparently made the decision that he would have to put the dog down.

Florence was extremely distressed. However, after visiting the dog with her friend, they realised the injury was not a break, but just a severe bruise. Under her friend's instruction, Florence tended to the dog's injuries with hot compresses.

Florence and her friend convinced Roger not to kill his dog and promised to return the next day to care for Cap. The dog recovered and shortly afterwards Florence had her famous visionary dream in which she heard God tell her to dedicate her life to healing others. It is likely that this dream was at least partly triggered by her experience saving Cap.

Athena the owl

Florence had over 60 cats in her lifetime, but her most famous pet was Athena the owl, which she rescued while visiting Greece.

Florence found Athena (now preserved at the Florence Nightingale museum) when she visited the Acropolis in Athens. Athena was reportedly being tormented by a group of boys when she intervened.

Athena became Florence's constant companion and apparently liked to sit on her shoulder or in her pocket. Florence was very upset when Athena died in 1854, writing "poor little beastie, it was odd how much I loved you".

Jimmy the tortoise

Florence also seems to have understood the calming effect animals could have on patients.

While working at Scutari hospital, she introduced Jimmy the tortoise as a 'ward pet' for the wounded soldiers and would later write in her book Notes on Nursing (1860) that "a small pet is often an excellent companion for the sick".

For some, Jimmy represents the very beginning of the 'animal therapy' movement. His shell can be viewed at The Florence Nightingale Museum.

Pets as therapy

Our hospitals often receive visits from animals that are part of registered charity Pets As Therapy. Volunteers and their specially trained pets bring delight to many of our patients and visitors.

Volunteer Ruth Todd has been visiting Evelina London with her labrador Rosie for six years. She said: "It often makes the children smile to see a dog unexpectedly on the ward, and it can provide a distraction from their illnesses. They enjoy stroking Rosie, and seeing the odd trick too! Rosie also gets a boost from all the affection and attention she receives."

David AL-Basha reveals how he helps to give a voice to carers in his role as a governor.

Governors play a crucial role in representing the views of Guy's and St Thomas' patient, public and staff members, ensuring the Trust's service meets the needs of its communities.

David AL-Basha joined the Council of Governors as a patient governor in August 2022. He is a carer for his disabled grandmother who has been a cardiac patient at Royal Brompton Hospital for several years.

David, who lives with his grandmother in Harrow, said: "I wanted to become more active in the community and represent carers, and also give a voice to people like my grandmother who are disabled and who might feel they are not heard."

He is most proud of his work with the Trust's quality and performance committee and being part of the nomination committee that oversees the appointment of non-executive directors.

David is committed to making the Trust more diverse, and believes that his half Irish, half Lebanese background gives him a unique perspective.

"I always aim to champion diversity and help ensure that the people we hire are representative of the local communities we serve, and that they add something of value," David said.

As well as being a governor and carer, David juggles working part-time in public relations for a global luxury fashion house, with volunteering as a magistrate and supporting local community initiatives, as well as fundraising.

David says being a governor is really rewarding, and he enjoys hearing more about the Trust's world-leading work. He recommends anyone who is interested in becoming a governor to reach out to him.

"Governors play an important role, and I would really encourage anyone who wants to get involved," David said. "The Trust belongs to the people that it serves and there’s such an incredible team behind it.

"Wherever you go in the world, people know this Trust and its world class care. I’m proud to be a part of it and this incredible community."

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.

Margaret Doyle explains why she recently became a member to say thank you for the care she has received at Royal Brompton Hospital.

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

The Trust counts on its members for feedback, support and local knowledge.

Margaret Doyle has been a patient at Royal Brompton Hospital since 2021 after being diagnosed with cardiac problems.

She recently became a member after being encouraged to sign up by her grandson, David AL-Basha (see above), and she is very enthusiastic about the care she has received at the Trust.

Margaret, who also has Chronic obstructive pulmonary disease (COPD), a lung disease which affects respiratory functions said: "It's so good. Everybody knows their jobs inside out and they are so efficient."

She has regular appointments to manage and stabilise her heart condition, the majority of which are virtual.

"This means that appointments are in the comfort of my own home, without needing to spend time travelling or in a waiting room," Margaret said. "And there hasn’t been a glitch yet!"

Margaret moved from Dublin to England in the 1960s and spent most of her career at Scotland Yard where she worked in admin.

She is looking forward to getting involved in everything that being a member entails.

Margaret said: "I am very grateful for the care I have received, and this is my way of giving back."

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. To find out more and to get involved, please email [email protected]

Other opportunities

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, such as 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.