Tag: NHS

Working with HIV/AIDS patients was the highlight of my clinical career


Originally published on the Imperial College Healthcare NHS Trust blog, Professor Jonathan Weber, Dean of our Faculty of Medicine, shares the story of his career working with people affected by HIV/AIDS.

In April 1982, I was a young doctor with an interest in infectious diseases when my mentor, Professor Philip Marsden, mentioned a new disease he’d seen in New York, which was affecting young gay men and had all the hallmarks of a sexually transmitted infection. He suggested it would be interesting to look for this new disease in London and he thought St Mary’s Hospital might be a good starting point. So in August 1982, I joined Dr Willie Harris’ Praed St Clinic, looking at the immune system of gay men who visited the clinic, guided by immunologist Professor Tony Pinching and virologist Professor Don Jeffries.

Early observations

I was fortunate to be able to work on my research full-time from early 1983, thanks to a fellowship  from the Wellcome Trust; I had gathered a cohort of 400 gay men at the clinic and examined their immune systems. What my colleagues and I discovered was that all the men in the cohort had abnormal immune systems; they all had a low number of CD4+ T-lymphocytes and low CD4:CD8 T-cell ratios. They also had enlarged lymph nodes in their necks, armpits and groin, which is usually a sign that the body is trying to fight an infection. These observations led us to believe that all the patients in this cohort had an early manifestation of AIDS; it was a chilling insight into the scale of the unfolding AIDS epidemic. (more…)

News worth celebrating for the cystic fibrosis community

Professor Jane Davies reflects on the positive news for those affected by cystic fibrosis on both sides of the Atlantic – access to Orkambi on the NHS and FDA Approval of ‘triple combination’ in the US.

Last week marked a milestone for people living with cystic fibrosis (CF) in the UK after NHS England announced that new drugs – Orkambi and Symkevi – will be made available on the NHS after securing a deal with the drug manufacturers, Vertex. After four years of community and patient organisation campaigns, I am delighted with this outcome which will be transformative for young people with CF.

There are over 10,000 people in the UK and over 100,000 worldwide estimated to be living with cystic fibrosis (CF). The condition is caused by a faulty gene encoding for a cell surface ion channel called Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). Ion channels are integral for regulating salt and water transport across mucosal surfaces, particularly in the lungs for defence against infections and in the digestive system. People with CF have a shorter life expectancy than healthy people and a hugely burdensome treatment regime just to keep as well as possible. (more…)

How we’re ensuring better care for older people with traumatic injuries

How we’re ensuring better care for older people with traumatic injuries
Originally published on the Imperial College Healthcare NHS Trust blog, consultant geriatrician Dr George Peck explains how the Trust is ensuring better care for older patients, and how trauma medicine is evolving to meet changing needs.

Bringing geriatric expertise to trauma care

As a registrar working with consultant geriatrician Dr Michael Fertleman, I was increasingly called to the trauma ward to offer geriatric assessments to patients who struggled with multiple issues. Best practice is to give a patient with suspected frailty a comprehensive geriatric assessment within 72 hours, but the volume of patients we receive who qualify has grown so much that this cannot be done without having a consultant geriatrician embedded in the service full time.

As a result, I became the first geriatrician in London to run a dedicated, embedded service in the trauma department. I will sit in the multidisciplinary team meeting with trauma surgeons, go on joint ward rounds with them throughout the week, and see major trauma patients whenever I am needed. I also help look after our surgical rehabilitation ward, which is for patients who are stable but require a longer period in hospital to recover. It is very rewarding to be able to offer continuity of care to our older trauma patients. (more…)

NHS England’s plans to cut prescribing for low-value items: well-intentioned but poorly implemented

Professor Azeem Majeed shares his take on the realities of NHS England’s proposed ‘do not prescribe list' for primary care.
Professor Azeem Majeed shares his take on the realities of NHS England’s proposed ‘do not prescribe’ list for primary care.

This week NHS England (the organisation responsible for managing the NHS in England) announced plans to curb the prescribing of ‘low-value’ items. This includes items such as silk garments, and bath and shower emollient for eczema and dermatitis. The plans follow on from earlier guidance issued by NHS England that aimed to limit the prescribing medications that are available over the counter, such as paracetamol and ibuprofen.

At a time when the NHS faces unprecedented workload and funding pressures, health professionals and the public all recognise the need to make the most efficient use of the resources available to the NHS; and prioritising key clinical areas such as cancer care. Prescribing costs in primary care, currently around £10bn annually, are a key component of the NHS budget in England. It is therefore entirely appropriate to look at this area to see where savings can be made without compromising patient care. (more…)

Grandfather of allergy: Dr William Frankland, the 106-year-old doctor

Dr William (Bill) Frankland, aged 106, has helped transform our understanding of allergies during his long career in medicine. A pioneer in the field, Dr Frankland popularised the pollen count to help clinicians and patients understand what triggers their seasonal allergies. Originally published on the Imperial College Healthcare NHS Trust blog and reproduced here with permission, he reflects on his career and working for the NHS for 70 years. 

People often ask me, how is it that I’ve lived until 106. All I can say is I’ve come close to death so many times but somehow I’ve always managed to miss it and that’s why I’m still here.

I was born in 1912, six weeks early. My identical twin brother and I weighed three pounds one ounce each but we both survived – he died in 1995, at age 83. As an early baby, that’s the first time I survived against the odds.

I first encountered hay fever when I was a child. I grew up in the Lake District where my brother and I spent our summers helping a local farmer with his hay. One day, I told my brother my eyes were itchy and I couldn’t go on. “You’re feeble,” he said. It took me 30 years before I realised I had a real problem with summer hay fever and about 90 years to grow out of that allergy.

(more…)

You don’t need to be a doctor to change healthcare

HELIX design studio

Healthcare and Design MSc student Peter White makes the case for why we need to think outside the box when it comes to innovation in healthcare.

Have you ever looked at something and thought, “how on earth did no-one invent that before?” You know the feeling. It’s the one you get while staring numbly at a copy of Harry Potter – all the while wondering how the idea of a boy who goes to school went unwritten for so long. It’s the one people probably had when the first guy rolled by with casters on the bottom of his chair. Even Facebook seems like such a simple idea in hindsight.

Forget happiness or sadness or the feeling of ‘it’s coming home’. It’s this constant ‘so close yet so far’ that’s the prevailing emotion in my life right now. A perpetual reminder that, yes, I’ll never be Mark Zuckerburg, or even a Google elf for that matter. All this is compounded by the fact that, according to my shiny laminated ID card, I’m supposed to be a healthcare design masters student at St Mary’s hospital in London, a building so old it seems to look down enviously at the geriatric ward within. (more…)

Universal Health Coverage in the United Kingdom: past, present and future

NHS staff with a patient at Charing Cross Hospital
NHS staff with a patient at Charing Cross Hospital

On World Health Day, Professor Azeem Majeed takes a look at the past, present and future of the NHS.

In 2018, the United Kingdom’s National Health Service (NHS) celebrates its 70th anniversary. With the creation of the NHS in 1948, universal health coverage was finally implemented in the United Kingdom, with the NHS replacing the previous patchy health coverage schemes that had left many people with limited access to health services. All residents of the United Kingdom were given the right to register with a general practitioner, who was responsible for both providing primary care services and organizing referrals for specialist care. (more…)