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									      ESSENTIAL HEALTHCARE NEWS AND INFORMATION SPRING 2008 ISSUE NO. 8

                                                                                                                      We hope you enjoy this copy of




          eyes
                                                                                                                      ‘HEALTH MATTERS’. If you would
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                                                                                                                           EVER
           NEW TREATMENT HELPS AMD                                                                                         ENHANCING
           SUFFERERS TO SEE AGAIN                                                                                          OUR
                                                                                                                            CULTURE
                       Age related Macular                   the capsule at the front of the eye, as in standard            OF HYGIENE:
                       Degeneration (AMD) is the             cataract surgery – while the second, a convex
                       leading cause of impaired sight       lens, sits behind it in front of the iris. The effect is to       WORLD FIRST
                       in people over age 65. A              create a ‘telescope’ which provides a magnification
                       progressive disorder, AMD results     of 1.3 – but more importantly, by rotating the                  IN POWER
Will
Ayliffe,
                       in the loss of central vision, fine   lenses relative to each other, images can be                    CLEANING
Consultant             detail and colour –                   focused on to a functioning part of the retina.
Opthalmic              in the part of the eye which is
Surgeon
                       essential for reading, driving,
                                                             Simulated results before operatin                                  LOOK NO
         watching television, recognising people and         Patients are assessed on a simulator using software              HANDS!
         performing fine tasks.                              to map the preferred areas of the retina. This
                                                             allows the patient to experience the potential
      A revolutionary new treatment to improve vision
                                                             improvement in vision before the operation.                      Turn to page 2
      in people with macular disease is to be offered at
      St.Anthony’s by Consultant Ophthalmic Surgeon          The surgery is usually done under local
      Mr. Will Ayliffe. The pioneering treatment             anaesthetic as a daycase procedure – and post-
      developed by a team in                                                         operative care is the same
      Milan is primarily suitable                                                    as for cataract surgery.
      for patients with the dry                                                      Risks are broadly similar
      version of AMD – which                                                         to those of cataract
      affects cells in the retina at                                                 surgery. The IOL-VIP
      the back of the eye causing                                                    procedure is not suitable               ‘HEALTH MATTERS’ is
                                                                                                                            created, edited and produced by
      loss of central vision.                                                        for everyone; patients                 the Marketing Department of
                                                                                     with glaucoma are                      St. Anthony’s Hospital.
      The new procedure,
                                                                                     excluded and certain
      known as IOL-VIP                                                                                                       If you have any suggestions,
                                                                                     other groups. Patients
      (Intraocular Lens for Visually                                                                                        requests, or follow-up details
                                                                                     with moderate visual                   relating to published articles
      Impaired People) places
                                                                                     loss are most likely                  then please e-mail:
      two lenses in the eye. One
                                                                                     to benefit.                           Philip.Cook@stanthonys.org.uk
      lens is concave, placed in
          REPORTING

world first in look no
cleaning power hands!
                                                        Niagara from Medisafe. It delivers the                       TOUCH-FREE TAPS FIGHT INFECTION
                        ST. ANTHONY’S                   cleaning power of sonic irrigation for
                                                                                                                     A new design of
                                                        intricate instruments, with standard
                         £1.2 MILLION                   deluge washing principles. The dual
                                                                                                                     touch-free tap
                       INVESTMENT IN                    function of the machine was critical to
                                                                                                                     is helping
                                                                                                                     St. Anthony’s in
                    STERILE SERVICES                    the project, as it enabled the unit to be
                                                                                                                     the constant
                                                        upgraded within the footprint of the
                                                                                                                     fight against
                                                        original department.
                                                                                                                     infection. First
                                                                                                                     seen by
                                                                                                                     Infection
                                                                                                                     Control Nurse,
                                                                                                                                          Touch-free ‘Rada Sense’ taps
                                                                                                                     Debbie Calver
                                                                                                                     at an exhibition in 2006, the digitally-
                                                                                                                     controlled Rada Sense taps are now gradually
                                                                                                                     being installed throughout the hospital.
                                                                                                                     The taps are operated with just a wave of
                                                                                                                     the hand – not only to turn them on and off,
                                                                                                                     but also to control the temperature.
                                                                                                                     A digital mixing valve allows water to be
                                                                                                                     stored at high enough temperatures to kill
                                                                                                                     legionella and other infections – while still
                                                                                                                     delivering safe maximum and minimum water
                                                                                                                     temperatures to users. The taps are also
                                                                                                                     programmed to flush if not used for
                                                        John Stevens, Sterile Services Manager (left)
          After a visit to St.Anthony’s in 2006,        with Martin Johnson, Medisafe Corporate Projects Director.   24 hours; thus preventing stagnant water
          the Healthcare Commission’s report                                                                         collecting, which can harbour deadly bacteria.
          made particular note of our infection         The envy of European experts
          control – which it said “is managed           Together with a variety of other machines
          enthusiastically and effectively” and
          also of our “ethos of continuous quality
          improvement”. Evidence of the
                                                        including a gas plasma sterilizer, a high
                                                        temperature drying cabinet for
                                                        instruments that have to be hand washed
                                                                                                                      BUPA:
          hospital’s commitment to this strategy
          can be seen in the recent significant
                                                        and two autoclaves, the department                            MRI
          investment in the Sterile Services
Hand-held wireless system                department.
                                                        comprises a high quality decontamination
                                                        facility that is already the envy of visiting
                                                        experts from across Europe.
                                                                                                                      scans
tracks instruments                  The very latest
through the
hospital                             decontamination    Department Manager, John Stevens,
                                       technology has   explains that service was maintained
                                       been             while work was in progress by hiring a
                                      incorporated      mobile unit originally built for the Swiss
                                    into a completely   army. “The department has 16 staff
                                  refurbished Sterile   across all shifts, working from 7am to
                               Services department      10pm six days a week. With the faster
                                                        cycle times of the new equipment we                          We are pleased to advise that St. Anthony’s
                             – in a major
                                                        will also be able to offer an express                        has recently signed a contract with BUPA
                            development costing
                                                        sterilization service to local GP                            for the provision of MRI scans. This ensures
                             over £1m. At its
                                                        surgeries – and could even go to a 24                        that from 20th April 2008, BUPA-insured
                            centre, the world’s first
                                                        hour operation”.                                             patients will once again be able to have
                            combined washer /
                                                                                                                     their MRI scans here.
                           disinfector, the SI
PROCEDURES & RESOURCES

bone conserving
mini-hip replacement
Today’s patients undergoing total hip replacement have     allowing for a conventional total hip replacement to be
greater expectations than ever before. Almost all regain   carried out later if needed.
an active lifestyle and a growing proportion expect to
                                                           Computer simulation studies, including mechanical
resume recreational sports. Combined with a trend
                                                           loading tests at the world famous Rizzoli Institute in
towards earlier intervention before long term stiffening
                                                           Bologna, have provided strong evidence that the design
and muscle damage occurs, there is a growing awareness
                                                           will protect the bone from the early problems seen in
that these patients may require a second or even a third
                                                           conventional hip resurfacing. Mr. Field and Professor
surgical procedure in their lifetime.
                                                           Rushton are currently training other surgeons in the
                    With this in mind, internationally     technique – and the operation is now being adopted in
                    renowned orthopaedic surgeon,          other UK and international centres. Mr. Field says “It
                    Mr. Richard Field has devoted over     will be several years before we prove that our design does
                    20 years to finding a solution to      resolve the limitations of hip resurfacing and extend the
                    the problem. Mr Field dates his        age range to individuals in their seventies. However, all the
                    interest in bone conserving            indications so far are very positive.”
                    surgery from 1982, when he was a
                    newly qualified doctor working at
                    the Royal National Orthopaedic
                    Hospital in Stanmore. From there
                    he moved to Cambridge where he
worked with the Professor of Orthopaedics, Neil
Rushton – and the two have worked together since, to
develop a bone conserving hip replacement which can
be used for the majority of patients.
Overcoming limitations of hip resurfacing
and implants
It was Mr.Derek McMinn from Birmingham who
revolutionized total hip replacement, by successfully
creating a hip resurfacing implant with a metal on metal
bearing in the mid 1990s. This innovation has given tens
of thousands of patients a dramatically improved quality
of life, whilst preserving as much of their own bone as
possible. Unfortunately, the benefits of hip resurfacing
are currently restricted to younger, more active
individuals. Individuals who have, or may develop poor
bone quality are not suitable for resurfacing.
The work carried out by Mr. Field and Professor
Rushton has resulted in the development of the MITCH
PER Mini-Hip implant, designed to overcome the                                          Richard Field is a Consultant
limitations of both hip resurfacing and standard hip                                    Orthopaedic Surgeon practising
implants. The implant replaces the top half of the                                      at St.Anthony’s and is Clinical
natural femoral head and has a mini stem which                                          Director at the South West
strengthens the femoral neck. Much of the head and all                                  London Elective Orthopaedic
of the neck of the femur (thigh bone) are preserved,                                    Centre (SWLEOC).
                                                                                                   MEET THE
                                                                                                   CONSULTANT
ugandan outreach                                                                                       .
                                                                                                  Mr. P Ramesh
                                                                                                 MCh (Orth), FRCS, FRCS (Orth)
                                                                                                 Consultant Orthopaedic Surgeon
 Mr Clement Akomea-Agyin, one
 of our Resident Cardiac




                                                                                            “
 Surgeons, has started a cardiac                                                                            I am a Consultant
                                                                                                            Orthopaedic Surgeon, with
 surgery programme in Uganda.
                                                                                                 a special interest and training in foot
 The programme really became                                                                     and ankle surgery. I qualified in 1989
 possible when St. Anthony’s                                                                     and trained extensively in the South
 donated its old cardio-pulmonary                                                                East and North West of England.
 bypass machines, when the                                                                       I also completed a Fellowship in
 cardiac theatre was re-equipped.                                                                America and had further training
                                                                                                 in India.
 In April 2007, two children with                                                                I am a member of the British
 atrial septal defect were operated                                                              Orthopaedic Association, Association
 on in International Hospital                                                                     of American Orthopaedic Surgeons
 Kampala, Uganda by Clement,                                                                      and American Orthopaedic Foot &
 assisted by John Nelson, a                                                                       Ankle Society. My NHS practice is
                                                                                                   based at Kingston Hospital, where I
 perfusionist from St.Anthony’s.                                                                   have been one of a team of
 This was a landmark event, as it                                                                  consultant orthopaedic surgeons
 was the first open heart surgery                                                                   since August 2005.
 to be carried out in the country.
 In October 2007, five more
 patients were operated on – with
 the next trip by Clement and his
 team scheduled for March 2008.
 All the operations have been carried out at no cost to the patients whatsoever. Local Ugandan
 companies, banks and individuals have been generous with donations – which have gone to
 pay for consumables used. This local surgical programme amounts to a fraction of the money
 needed to sponsor patients going abroad for surgery – which the majority of Ugandan patients
 cannot afford anyway.


  NEW CLINICS AT ST. ANTHONY’S
  The following consultants have recently started clinics at St. Anthony’s                             There are 28 bones and more
  and are able to offer appointments at short notice. Unless otherwise                                 than 30 joints in the foot and
  indicated, please book your appointment through the Outpatient                                       in recent years foot and ankle
  Department on 020 8335 4678 / 4679.                                                                  surgery has developed as an
                                                                                                       important sub-speciality of
  Dr. Richard Bogle Coronary heart disease including angioplasty and stenting,                         orthopaedics. Whether for
  Hypertension, Cardiovascular risk assessment. Thursday pm                                            sports injuries in the younger
                                                                                                      adult or arthritis in the older,
  Dr Asif Mahmood Inflammatory Bowel Disease, Endoscopy, Acid related disorders,                      consulting a specialist foot and
  Irritable Bowel Syndrome, Liver disease, gut motility and nutrition. Wednesday am                   ankle surgeon will provide an
                                                                                                      additional level of expertise and
                                                                                                      training.
  Mr D Banerjee Breast cancer management, oncoplastic breast surgery, sentinel
  node biopsy, benign breast diseases including breast pain, breast augmentation and                  My clinics at St. Anthony’s
  reduction, male breast problems. Thursday pm                                                        are on Tuesday afternoons and
                                                                                                     can be booked by telephoning
  Dr S Paramothayan All general respiratory problems, asthma, chronic obstructive                    the Outpatient Department
                                                                                                     on 020 8335 4678.




                                                                                                                         ”
  pulmonary disease, sarcoidosis and sleep disorders. Friday evening

  You can find full details of all the consultants and clinic specialities at
  St Anthony’s, by going to our website www.stanthonys.org.uk – or you
  may enquire on the above telephone numbers.
REPORTING




scores on
the doors
Bon Appetit! The Five Star St. Anthony’s Catering Team



ST. ANTHONY’S GAINS 5-STAR
RATING FOR FOOD HYGIENE
Following an unannounced visit by Sutton
Environmental Health inspectors at the end of
last year, St.Anthony’s Catering Department has
secured a top award for food hygiene. Under a
national scheme known as “Scores on the Doors”,
St. Anthony’s is one of only three
establishments in Sutton to be awarded five
stars, signifying “Very high standards of food
safety management and fully compliant with food
safety legislation”.
While many of the organizations inspected are
small restaurants, St.Anthony’s Catering
Department serves not only the hospital
restaurant where it provides up to 500 meals
a day – but also, patients in their bedrooms,
the Hospice, the Convent and St.Bede’s
conference centre where there may be up
to 100 delegates for a meeting.
“Scores on the Doors” is a pilot scheme
being run by London Boroughs and supported by the
Food Standards Agency. Results will be listed on the       In the meantime, if you can’t enjoy a
website www.food.gov.uk/scores but we are advised it       meal at St. Anthony’s you can at least check the ratings
may be some time until the Sutton results are published.   of other eateries in nearby Kingston and Merton.
 PEOPLE & SERVICES

                                                                                                                      ‘DAUGHTERS OF
it wasn’t                                                                                                             THE CROSS’
in vein!          We were delighted to find an
                                                              Maggie was
                                                              assured that
                                                              lost veins
                                                              would have no
                                                                                                                      ANNUAL REVIEW

                  appreciative testimonial for                effect upon
                                                                                Patient and author, Maggie Day                                The 2007
                  our laser treatments for                    blood circ-
                                                                                                                                             Annual Review
                  varicose veins, in the March                ulation. “Blood
                                                                                                                                             of the
                  issue of Time & Leisure                     simply re-routes through other healthy                                         Congregation
                   magazine. Author Maggie Day                veins, for improved circulation – because                                      of the
                   had attended a Public Medical              blood is no longer held back in poorly                                         Daughters
                   Lecture by Consultant, Ian                 functioning veins” explains Maggie. Walking                                   of the Cross,
                   Loftus at our St. Bede’s                   is encouraged as soon as possible after                                       who own
                   Conference Centre. She                     treatment and it helps to sit with feet up as                                 St.Anthony’s,
                    then decided to book a                    often as possible. “Whilst my legs felt tender           has recently been published – and
                    consultation and diagnostic               for about two weeks, they were less achy                 copies are available from the
                    ultrasound scanning.                      from the very next day”, says Maggie. “I have            hospital Reception. The Review
                                                              lost that leg heaviness and can look forward              describes the ethos of the
Many varicose veins can now be treated with                                                                             organisation and gives details of
                                                              to Summer skirts with no veins to hide”.
laser therapy – where no surgery is required                                                                             recent developments at the
and no need for general anaesthetic. The                      Other areas of vein conditions laser-treated               various centres within the
whole procedure can be undertaken in under                    by Mr. Loftus include vein inflammation                     English Province.
an hour. “My leg was anaesthetised and a fine                 which, untreated, can lead to deep vein
laser optical fibre inserted into the vein,”
explains Maggie. “Laser energy delivered
                                                              thrombosis – and the venous ulcers in older
                                                              people, not previously treated surgically.                  ARE YOU
through the fibre causes the vein to close,
shrink and then disappear.”
                                                              Book an appointment with Mr. Loftus by                      NEEDLED BY
                                                              calling Outpatients on 020 8335 4678.
                                                                                                                          DEPRESSION?
                                                                                                                            You might well be – because
                                                                                                                            Acupuncture has a long history
 free public                                                                                                                of effective use in the
                                                                                                                            treatment of psychiatric
 medical                                                                                                                    disorders. It is now being used
                                                                                                                            increasingly in the UK for
 lectures                                                                                                                   depression. This will come as
                                                                                                                            great reassurance following the
 Hundreds of people flocked to our St. Bede's                                                                               recent announcement that
 Conference Centre for last Autumn's series of                                                                              Prozac and similar medications
 Orthopaedic lectures – by leading consultants
                                                                                                                            may not be as effective for
 practising here at St. Anthonys. Whilst the lectures
                                                                                                                            depression as previously thought.
 were entirely comprehensive presentations, informality          Thursday, 22nd May
 was very much the order of the day – with plenty of                                                                        Indeed, the research concluded
                                                                 Cataracts and Age Related                                  that some patients might do as
 time for floor questions and excellent cheese and wine          Macular Degeneration
 refreshments beforehand.                                                                                                   well to take a placebo!
                                                                 Monday, 9th June                                          You can find out more about
 We are, therefore, delighted to announce our Summer             Hand Surgery
 series of lectures. Places are completely free, on a first                                                                Acupuncture and book an
 booked basis – and the lectures will again take place           Tuesday, 15th July                                        appraisal consultation now at
 at St. Bedes, in the hospital grounds. Lectures start at        Liver Disease                                            St. Anthony’s, by calling
 7pm, with doors opening for refreshments at 6.30pm.                                                                      therapist, Camilla McQuade
 The programme is as follows:                                    Book your places now, by calling Philip Cook
                                                                 on 020 8335 4557                                         on 0208 335 4678.




                                                                                       St. Anthony’s Hospital, North Cheam, Surrey SM3 9DW. Tel: 020 8337 6691

								
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