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Another year of expansion in patient services at The Lister Hospital Issue 19 Spring 2014 With a wide range of new patient services and the latest phase of the renewal and reconfiguration programme completed, The Lister Hospital has another year of growth ahead. With the completion of a £2 million plus redevelopment creating four new theatres, the first phase of the new outpatient facilities and the enhancement of the diagnostic and imaging facilities, The Lister Hospital now ranks as one of the most up-to-date and best equipped private hospitals in the UK. Overall more than £25 million has been invested in new facilities at The Lister Hospital in recent years. Following the opening of the £3 million Critical Care Unit in 2011, the hospital has gained a reputation as one of the most modern and capable facilities for complex surgical cases as well as the more routine procedures traditionally performed there. In recent months the new Acute Care Unit has become increasingly busy with the 100th patient being treated as we go to press. Chief Operating Officer, Suzy Jones, said one of the most pleasing aspects was the positive feedback from patients and their doctors. “Everything we do is designed to expand and develop the range of world-class treatments that we can offer patients and their doctors. When we have high levels of patient satisfaction as we’ve had in recent months, it spurs us all on to strive to create even better service and care. “Developing facilities including the cardiac CT and MRI and the ability to offer interventional radiology are just a couple of examples of the latest diagnostic and treatment facilities we’ve now got up and running. “New services in ENT, gastro and allergy medicine are just a few of a long list of new developments in recent months and there’s more to come. “I am also delighted to welcome our new Chief Nursing Officer, Andy Willcocks. Andy brings a wealth of experience from the NHS and the private sector and his enthusiasm, teamwork and dedication to providing world class care is very much appreciated. “But the success we are having is very much down to our patients and the tremendous support we have from GPs and consultants and I would like to thank all our colleagues and partners for their patience during our redevelopment phases, as well as for their continuing support.” In this issue: • New ski clinic for winter sports injuries • Practice Development Forum is established • The Lister Hospital’s ‘cough detectives’ • New clinic for investigating abnormal heart rhythms THE LISTER HOSPITAL - NEWS - Suzy Jones Andy Willcocks joins as new Chief Nursing Officer Andy Willcocks has joined The Lister Hospital as Chief Nursing Officer following a spell as Clinical Services Director at Holly House. Prior to that he worked at The Harley Street Clinic as Theatre Manager, and was previously at The Portland as a pain management specialist. Andy originally trained at Essex University in Colchester, moved to The Royal Free and then on to The Homerton. Andy said he was delighted to be back in the HCA group and especially pleased to be at The (new) Lister Hospital! “In HCA we have the resources to provide truly world class care and to do that you have to have investment. You have to invest in your people and your services just as we’ve done here at The Lister Hospital.” “Healthcare is about people and care delivered face to face. HCA invests in people and believes in a care ethic as much as a work ethic. Care for patients and care for each other.” “I always like to keep three things front of mind as a nurse: be kind, be safe, be well. And if we get these three things right, great care will happen!” LIS GP Spring News A4 8pp June14 aw3:Layout 1 19/06/2014 18:00 Page 1

Transcript of A!&˙˘$ +˘ $ ˇ ˘*# !%˝! ˝! # &˝˘!& %˘$(˝ ˘% & ˙˘ ˝%&˘$ %#˝& ˜ of The Lister...

Another year of expansion

in patient services at The Lister Hospital

Issue 19 Spring 2014

With a wide range of new patient services and the latest phase of therenewal and reconfiguration programme completed, The Lister Hospitalhas another year of growth ahead.

With the completion of a £2 million plus redevelopment creating four newtheatres, the first phase of the new outpatient facilities and the enhancement ofthe diagnostic and imaging facilities, The Lister Hospital now ranks as one of themost up-to-date and best equipped private hospitals in the UK.

Overall more than £25 million has been invested in new facilities at The ListerHospital in recent years.

Following the opening of the £3 million Critical Care Unit in 2011, the hospital hasgained a reputation as one of the most modern and capable facilities for complexsurgical cases as well as the more routine procedures traditionally performed there.

In recent months the new Acute Care Unit has become increasingly busy with the100th patient being treated as we go to press.

Chief Operating Officer, Suzy Jones, said one of the mostpleasing aspects was the positive feedback from patients andtheir doctors. “Everything we do is designed to expand anddevelop the range of world-class treatments that we can offerpatients and their doctors. When we have high levels ofpatient satisfaction as we’ve had in recent months, it spurs usall on to strive to create even better service and care.

“Developing facilities including the cardiac CT and MRI andthe ability to offer interventional radiology are just a couple of

examples of the latest diagnostic and treatment facilities we’ve now got up andrunning.

“New services in ENT, gastro and allergy medicine are just a few of a long list ofnew developments in recent months and there’s more to come.

“I am also delighted to welcome our new Chief Nursing Officer, Andy Willcocks.Andy brings a wealth of experience from the NHS and the private sector and hisenthusiasm, teamwork and dedication to providing world class care is very muchappreciated.

“But the success we are having is very much down to our patients and thetremendous support we have from GPs and consultants and I would like to thankall our colleagues and partners for their patience during our redevelopmentphases, as well as for their continuing support.”

In this issue: • New ski clinic for winter sports injuries • Practice Development Forum is established • The Lister Hospital’s ‘cough detectives’ • New clinic for investigating abnormal heart rhythms

THE LISTER HOSPITAL

- NEWS -

Suzy Jones

Andy Willcocks

joins as new

Chief Nursing

Officer

Andy Willcocks has joined The Lister Hospitalas Chief Nursing Officer following a spell asClinical Services Director at Holly House. Priorto that he worked at The Harley Street Clinicas Theatre Manager, and was previously atThe Portland as a pain managementspecialist.

Andy originally trained at Essex University inColchester, moved to The Royal Free and thenon to The Homerton.

Andy said he was delighted to be back in theHCA group and especially pleased to be atThe (new) Lister Hospital!

“In HCA we have the resources to providetruly world class care and to do that you haveto have investment. You have to invest inyour people and your services just as we’vedone here at The Lister Hospital.”

“Healthcare is about people and caredelivered face to face. HCA invests in peopleand believes in a care ethic as much as awork ethic. Care for patients and care foreach other.”

“I always like to keep three things front ofmind as a nurse: be kind, be safe, be well.And if we get these three things right, greatcare will happen!”

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New ski clinic opens

One of The Lister Hospital’s orthopaedic surgeons is overseeing a new ski clinic.

This one-stop shop for patients injured duringwinter sports is the brain child of seniorConsultant Orthopaedic Surgeon Mr RhidianThomas and aims to provide quick access tophysiotherapists, radiologists and upper andlower limb specialists.

“On the NHS you may have to wait weeks foran MRI scan and physiotherapy,” says Mr

Thomas. “Here we have access to physiotherapy and all the verylatest imaging equipment within 24 hours. Patients can also seeeveryone they need to under one roof.”

As an experienced skier himself, Mr Thomas says winter sportsinjuries often fall into two camps. “Generally speaking you findthat skiers tend to have leg injuries and snowboarders will haveupper body injuries. We have specialists who are expert indealing with both.”

The clinic, which runs from both The Lister Hospital and ChelseaOutpatient Centre, has had a busy first season since it launchedearly this year.

“People who come to us seem to like the fact that many of usare keen skiers ourselves,” says Mr Thomas. “We see it from theskier’s point of view and want to get them back enjoying theirsport as soon as possible.”

Mr Thomas, a specialist in lower limb sports injury, has workedwith a wide variety of professional sportsmen and women and is the Match Day Orthopaedic Surgeon for English RFU atTwickenham.

He has also been a senior Consultant Orthopaedic Surgeon atImperial College Healthcare NHS Trust for the past 15 years andis one of only a handful of British members of the AnteriorCruciate Ligament Study Group, a worldwide group that sharesthe latest research into specialist knee surgery.

This experience can help the team make specialised decisionsabout the most appropriate type of reconstructive knee surgeryfor each patient. “Much can depend on the activity level of apatient as to what is most appropriate and we can help tailor therepair to the patient,” he says.

Mr Thomas also likes to pass on to patients his own

‘Thomas rule of threes’ to help prevent future injuries:

1 People are more likely to injure themselves after 3pm

on the third day of their winter sports holiday.

“People are tired on that day so I always advise

people to rest that afternoon,” he says.

2 Beware the third party on the ski lift. “I commonly

see injuries where people have become tangled up

with another person.”

3 Watch out for the third party skiing above you.

“Injuries are often caused by collisions!”

Mr Rhidian Thomas

New and improved daily vascular service

The Lister Hospital is pleased to offer a new and improved daily vascular service.

Vascular appointments are now made directly with our Imaging team. The service is available daily and we aim to see patients on the same day.

The Imaging department can accommodate a range of requests including DVT and varicose vein scans as well as treadmill tests and aortic or carotid duplex scans.

How to refer your patients

To make an appointment, please call 020 7730 3759. Or download the new Vascular booking form from www.thelisterhospital.com > Health professionals and fax the completed form to 020 7259 0138.

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A breath of fresh air

In many areas of medical treatment the trend overrecent years has been to go smaller. That’s certainlythe case in the field of rhinology, where the limitedworking space in the nose, sinuses and related areas,calls for a scaled-down approach to treatment.

“One of the newer treatments over the last two tothree years is balloon sinuplasty. It’s a minimallyinvasive way of opening up sinuses and the drainagechannel for sinuses”, explains Ms Romana Kuchai,Consultant ENT specialist at The Lister Hospital andImperial College. “In fact I carried out the first oneat The Lister Hospital very recently. It’s good for acertain group of patients who don’t necessarilyrequire full endoscopic sinus surgery, but are havingheadaches and some sinu-nasal symptoms. ”

This procedure involves inserting a small balloon, on the end of a tube, into the narrowed sinuspassage and gently inflating it. “It’s quite a goodway of opening narrow sinuses without actuallyoperating on them,” explains Ben Hunter, also aConsultant ENT surgeon at The Lister Hospital.“You can also rinse the sinuses out, while you’recarrying out this procedure, and with some people,we can carry this out under local anaesthetic.”

Romana Kuchai and Ben Hunter are relatively newadditions to The Lister Hospital's growing team ofhighly experienced team of medical experts.Romana has a particular interest in allergies, andhas helped to set up a new allergy service, opento patients of any age. Her clinic takes patientsfrom skin-prick tests to any further investigations,followed by the most appropriate treatments, upto advice for immunotherapy. Snoring diagnosticsand surgery, and sleep disordered breathing areamong her other interests.

As well as specialising in rhinology, Ben Hunter isalso a facial plastic surgeon. “From the nose pointof view, I do a lot of reconstructive surgery. Thisincludes post-traumatic or revision surgery, andclosing septal perforations. This is when there is ahole through the septum from one nostril to theother.” He also has an interest in sinus surgeryand working with immunologists and rheumatologiststreating vasculitic and autoimmune conditions.

Romana Kuchai and Ben Hunter are workingtogether to provide a cohesive rhinology serviceat The Lister Hospital. By combining their sharedand individual areas of expertise and embracingthe latest research and treatments they aim togive their patients the best service possible.

To refer your patient to our ENT specialists, call020 7881 4000

New Practice Development Forum is established

The Lister Hospital’s Practice Development Forum aims to facilitate the trainingand development of practice managers and medical secretaries, within the privatehealthcare sector. The Forum will offer members a network of support, givingpractice managers and medical secretaries a platform in which to shareinformation, ideas and views on the smooth running of practice life.

The Forum will provide educational opportunities on topics requested by practicemanagers and medical secretaries, and successfully launched on 15 January, withan event on employment law and CQC compliance, which received plenty ofpositive feedback from attendees.

On Wednesday 25 June, the Forum hosts an evening event at The Lister Hospitalwhich will cover:

• A short guide to what’s changed with Disclosures (formerly CRB checks): what you need to know when taking on staff in the future

• Ten ways how not to bankrupt your boss: small points that create big returns.

If your practice manager or medical secretaries would like to attend future eventsemail to [email protected]

About the Forum members

Anza Clarke SRN RSCN is the Forum Chairperson. She qualified as a StateRegistered Nurse and a Registered Sick Children’s Nurse from The Royal LondonHospital and The Hospital for Sick Children Great Ormond Street.

Anza is currently the Practice Manager for All About Spines and ChelseaOrthopaedics. Previously she ran the Government of Qatar Medical Office for fouryears and subsequently worked for a Harley Street Practice. In 2001 she wasappointed Practice Manager at the Wilbraham Place Practice, a multidisciplinarymedical practice located at Sloane Square. During her time there she played anintegral part in both establishing and developing the practice in addition tooverseeing staff recruitment, training and appraisal.

Anza is well known in the Central London medical world and continues to play avery active role in many aspects of it. She is a mentor for the Harley Street PracticeManagers Forum which provides both career and professional advice to both newand established practice managers.

Martha Walker is Education Lead for the Forum. She has over 20 years experienceof running independent medical practices and has been successfully registeringand overseeing continued compliance of clinics in the independent sector since2003.

She now divides her time between advising and assisting GPs, consultants, dentistsand a wide range of other health and social care providers in the independentsector and the NHS who are embarking on Care Quality Commission registration.Martha regularly holds workshops and presentations on CQC compliance for awide range of providers. She also mentors managers and their teams in practicesand has lectured to undergraduates on practice management.

Martha has a Diploma in Management and is a member of the Institute ofLeadership and Management and the Royal Society of Medicine. She is the CQC advisor to the Independent Doctors Federation, the CQC commentator for Independent Practitioner Today and also contributes to the dental publication VITAL.

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The treatment of male infertility

For a man wanting to start a family, to be told hecannot produce sperm can be devastating, buttechniques have been refined, so now, in manycases it is possible for men given such news to

father a child.

The Lister Hospital’s Mr SuksMinhas, one of the few fulltime andrologists in the UK,specialises in surgical spermretrieval in men who, throughinjury or illness, find out theirtesticles are not working as wellas they should be.

“It can be extremely distressing for a man to be toldthat he is not producing sperm but I have publisheda paper which has found that in 50% of cases,where the problem arises from non-obstructivereasons, you can find sperm,” he says.

The technique that Mr Minhas uses is‘micro-dissection sperm retrieval’ and he performsover one hundred of these operations each yeareither in his private practice or as part of NHS work.Few surgeons do more.

“I do it by opening up the testicles and looking forthe tubules that are dilated or pink as these tend tobe the ones that contain sperm,” he says. “I thengive these to an embryologist and the sperm caneither be frozen for later use or, sometimes, Iperform the operation and the sperm is injected intotheir partner’s eggs on the same day.

“There is no standardised operation for spermretrieval in this country and often people come tome who have had unsuccessful outcomes fromother forms of the surgery.”

Mr Minhas also performs surgery in cases where thelack of sperm is due to an obstruction - such as ablockage in the testicles.

However his work is not restricted to fertility issues -in many ways his clinic is an andrology ‘one stopshop’. He is also experienced in treating penile andtesticular cancers, erectile dysfunction, andreconstruction work.

“I do quite a lot of work with reconstruction of thegenitals, also treating Peyronie’s Disease, insertingimplants to help with erectile dysfunction andoncology of the genitals, including penile cancer.

“I really enjoy the work - I got into Andrology partlybecause it is challenging and also because, althougha lot of people were dabbling in it, few specialise inthis area as I do.”

To refer your patient to Mr Minhas, please call 020 7881 4000

Mr Suks Minhas

The Lister Hospital’s ‘coughdetectives’

Whether they are hacking coughs, chesty ones, or tickly attacks that strike inthe middle of a night at the theatre, coughs are annoying and debilitating.They can also be the bane of a GP’s life.

Around one in 10 people see their GP for help with their cough and up to20% of referrals to respiratory medicine specialists are for cough-related issues.

“For most of us coughs are just minor irritations and ashort term problem,” acknowledges Dr Lieske Kuitert, aConsultant in Respiratory Medicine at The Lister Hospital.

“But the effects of persistent coughs shouldn’t beunderestimated. They can disturb your sleep and leave youfeeling exhausted, cause embarrassment in socialsituations, make you feel socially isolated and triggerdepression.”

The Lister Hospital has been running dedicated Cough Clinics since December2013. These clinics are staffed by a multi disciplinary team of consultants –including respiratory medicine, ENT and gastroenterology specialists, as well aspsychologists and physiotherapists and speech and language therapists.Members of the team will thoroughly investigate and then treat patients whohave had persistent coughs for more than eight weeks.

“We can test patients for asthma, perform skin-prick tests for allergies, orderinvestigations for acid reflux problems and check out nasal and sinus problems- all within the same clinic,” explains Dr Kuitert.

“The good news is that 90% of coughs can be cured and for the minority thatcan’t, we have therapies which can lessen their impact.”

Dr Kuitert says physiotherapists can help patients by teaching them how tobreathe to interrupt the coughing cycle and suppress a cough as well asdistraction techniques. Psychologists may be able to help those patients forwhom coughing has become a habit.

The impact of coughs on careers canbe huge. Dr Kuitert saw one patientwho was told by their employer thatthey would no longer be allowed todeal with clients and would beassigned to backroom paperwork astheir coughing fits were causingembarrassment.

“Another patient had battled with apersistent cough for nine years andtried numerous treatments,” says Dr Kuitert.

“His health insurers refused to cover him for any more treatments as it seemeddoctors had exhausted every avenue. But we managed to cure him within twoclinic visits as we discovered his cough had two causes and he had only everbeen treated for one at a time.

“My message to patients and their GPs, is there is always something we can doabout coughs,” says Dr Kuitert. “We run a service which can really helppatients and take some of the burden of coughs off GPs.”

Dr Lieske Kuitert

The good news is that 90% of coughs can be cured ”

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The weekly clinic is the first to offer directaccess to an electrophysiologist and reflectsthe growing demand for speedy access toinvestigations for abnormal heart rhythms.

“Probably up to 2% of the populationsuffers from atrial fibrillation (AF),” explainsProfessor O’Neill, who is also a ConsultantCardiologist and Professor of CardiacElectrophysiology at Guy’s and St Thomas’s

Hospital and King’s College London.

“Numbers are increasing as people live longer – AF prevalenceincreases with age from less than 0.5% at the age of 40 to over10% in 80 year olds. We each have approximately a 25% risk ofdeveloping AF at some stage during our lives.

“Now there is also much greater awareness of the symptoms ofAF and more recognition of the stroke risk it poses.”

One in four strokes is estimated to be caused by AF. The two keyaims of treatment are to prevent a stroke and to manage thepatient’s symptoms appropriately. Anticoagulants are highlyeffective in reducing the risk of stroke associated with AF whileother drug treatments or cardiac ablation are used formanagement of symptoms. Aspirin is largely ineffective in strokeprevention for AF yet continues to be be widely prescribed forthis purpose.

Heart arrhythmias can be difficult to diagnose because they areoften intermittent, but Professor O’Neill’s clinic will offerspecialist investigations includingboth 24 hour and eight dayambulatory recorders, ECGs,echocardiography and advancedcardiac imaging.

“If a patient has the symptoms of AF or another heart rhythmdisorder it makes sense for a GP to consider referring directly to a heart rhythm specialist – an electrophysiologist,” saysProfessor O’Neill.

“The sooner we see patients the better, so that we can establishthe cause of the problem and treat it. I think in the past therehas been a lack of awareness about the levels of specialisationthat exist in cardiology.”

Professor O’Neill says investigations for palpitations will aim tocapture a recording of the heart rhythm during a patient’ssymptoms. It is important also to establish if the heart isstructurally normal, which can be achieved by echocardiography,CT or magnetic resonance imaging. Many heart rhythmdisturbances can be explained by the presence of electrical shortcircuits within the heart chambers. These can be thoroughlyassessed during an electrophysiological study where fine tubesare inserted into the leg vein at the top of the thigh and softspecialised catheters passed into the right side of heart to recordthe heart’s electrical signals.

“As well as measuring the heart’s electrical function during anormal rhythm, using specialised equipment we can safelycreate extra beats to initiate a short circuit and then work out

where the problem is coming from,” explains Professor O’Neill.“For the common tachycardias seen in patients with structurallynormal hearts, approximately two thirds will be on the right sideof the heart and in the remaining third it will be on the left.Although patients may have lived for years with ineffectivemedication before referral to the appropriate specialist, their livescan be transformed by a relatively simple procedure.”

Professor O’Neill has specialist expertise in the management ofpatients with complex heart rhythm disturbances of atrial andventricular origin, in particular atrial fibrillation and tachycardiain the context of inherited and acquired structural heart disease.He carries out catheter ablation procedures for atrial fibrillationand treats arrhythmias in adult congenital heart disease.

“Catheter ablation is not appropriate for all patients who haveAF. In general, the longer a patient has had continuous AF, the

lower the likelihood of being ableto eliminate the problem. Patientswith intermittent (paroxysmal) AFhave the highest likelihood ofbeing cured by a catheter ablationprocedure. As with any heart

procedure, catheter ablation for AF carries a risk, between 1 and2% risk of a serious complication including stroke (1/200) andthere remains uncertainty about whether elimination of AF bycatheter ablation can reverse the long term consequences of adiagnosis of AF,” says Professor O’Neill.

“On the first ablation procedure, up to 70% of patients withparoxysmal AF will have their AF eliminated – of those whoneed a second procedure, up to 80% may achieve a cure.

“The key message is that AF is common and carries a stroke riskwhich can be very effectively treated with warfarin or one of thenovel oral anticoagulants that are now in use in the UK. Drugtreatments for AF are variably effective, depending on thepatient and AF type and are without doubt the appropriatetreatment for many patients with AF. Appropriately selectedpatients will benefit from an AF ablation procedure formanagement of their symptoms. In the future, from ongoingstudies, we will learn if catheter ablation treatments have effectsbeyond simply reducing symptoms and improving quality of life;i.e. if in fact ablation can reduce stroke risk or even death.”

To refer your patient to Professor Mark O'Neill, call 020 7881 4000

New clinic for investigating abnormal heart rhythms

Professor Mark O’Neill, one of the country’s leading specialist heart rhythm cardiologists, is offering a new dedicatedservice for patients with heart arrhythmias at The Lister Hospital.

Professor Mark O’Neill

The sooner we see the patients the better, so that we can establish the cause of

the problem and treat it.”

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Why radiology can be the answer to renal problems

Hard-to-treat high blood pressure can benefit from the small screen

When a patient has hypertension, a vital part of treatment isto look at their lifestyle, says Dr Peter Hill, ConsultantNephrologist at The Lister Hospital. “Salt reduction, exercise,weight and alcohol reduction are all part of the first linemanagement of hypertension in patients.

“A National Institute forHealth and Clinical Excellence(NICE) study shows that saltand weight reduction, whencarried out together, canreduce blood pressure quitesuccessfully. ”

However, for patients with hard-to-treat hypertension, thenephrology team at The Lister Hospital turns to developmentsin radiology.

“Contrast-free Magnetic Resonance Imaging (MRI) is a goodchoice for patients who have renal disease, because the dyeyou use for a CT or MRI scan can be poisonous for thesepatients,” explains Dr David Game, also a ConsultantNephrologist at The Lister Hospital.

Interventional Radiologist, Dr Steve Moser, the third memberof the team, is an expert in renal vascular disease and doesvery intricate work with patients with kidney disease. Dr Moser and radiologist Dr Narayan Karunanithy are expertsat interpreting contrast-free scans, and finding the cause ofuncontrolled high blood pressure.

“If the patient has a renal artery stenosis (narrowing of therenal artery, a cause of high blood pressure), which is causingproblems, we can treat it usingangioplasty,” explains Dr Game.

The radiologist will put acatheter through the femoralartery in the leg and up intothe renal artery. Then they will inflate the balloon, reducing

the narrowing in the artery. The patient can be conscious forthis treatment, and can even watch it on the screen.”

While the patient won’t feel any different, their blood pressurewould fall quite quickly, and can reduce the amount ofmedication they need to take.

“We are hoping that we willbe able to introduce aprocedure called ‘renaldenervation’ to The ListerHospital,” says Dr Hill. “Some patients who have

high blood pressure may have abnormal nerve impulsescoming out of their kidneys. These may cause the bloodvessels to the kidney to become rather constricted, whichcauses high blood pressure throughout the body.”

Renal denervation is carriedout by performing anangiogram, and passing asmall wire into the kidney.“This denervates the nervessupplying the kidney by

using a small electric current. It brings the patient’s bloodpressure down.

“Renal denervation has been suspended around the world forthe moment, while we wait for the results of a study,”explains Dr Hill. “It’s a question of watching this space, untilthe results come through.”

To refer your patient to Dr Hill, or Dr Game, call 020 7881 4000. For Imaging referrals, call 020 7730 3759.

…salt and weight reduction, when carriedout together, can reduce blood pressure

quite successfully.”

The patient can be conscious for thistreatment, and can even watch it on

the screen.”

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Is your patient taking too many pills?

Dr Iñaki Bovill says prescriptions for older people need regular reviews.

Reviewing an elderly person’s medications can not only make their lifesimpler, in some circumstances it can improve quality of life and reducesymptoms too.

So says Dr Iñaki Bovill, a Consultant Geriatrician and General Physician atThe Lister Hospital. He specialises in polypharmacy and examining theoften lengthy prescriptions elderly people have - to ensure nothinginteracts, or indeed, is being taken unnecessarily.

Dr Iñaki Bovill

“Elderly patients often have a number of co-existing conditionsand as a result end up on a number of different medicines,”explains Dr Bovill.

“The difficulty is that these patients may be seeing a number ofdifferent doctors and specialists and while the GP should keep anoverview of all the different medications each is prescribing, theydon’t always receive this information.”

Up to 20% of hospital admissions among older people result froma problem with prescription drugs – often side effects.

“The more medicines you are on, the greater the risk ofinteractions, adverse events or side effects such as nausea,vomiting and an increased risk of falls,” says Dr Bovill.

“I once came across an elderly patient who was taking 18 differentpills a day - three of which were from duplicate classes of drugs.

“This is the other issue: the more medicines someone is on thehigher the chance that they are taking some of these unnecessarilyas they are taking drugs that, by and large, do the same job.”

His approach is to query which drugs a patient really needs andwhich may be causing more problems than they relieve.

“A good example is proton pump inhibitors which for someindications need to be taken and are helpful. But they do raise therisk of developing clostridium difficile so if a patient does not reallyneed them it is good to take them off them.”

Dr Bovill, who also has a degree in pharmacology, says reducingthe amount of pills and medicines someone has to take each daymakes it more likely that there will be better compliance with theirdrug regimen.

“The more medicines someone is taking, the harder it is to makesure they are taking them correctly,” he says.

“So sometimes, for example, I suggest changing medication to tryand make it easier for the patient – so maybe switching from adrug that needs to be taken three times a day to one that needs tobe taken once a day.”

Dr Bovill says “attention to detail” is crucial.

“I don’t look at repeat prescriptions to find out what someone ison - I ask to see their medication as there may be meds on the listthey are not taking that they should be. “

Physiotherapy services expand

Our Physiotherapy services continue to expand at Chelsea Medical Centre, 272 Kings Road, and at the hospital.

We now offer a specialist Temporomandibular Joint (TMJ) Physiotherapy outpatient service. Working closely with Temporomandibular Joint consultants, our physiotherapist,Helen Cowgill will be able to assess and treat any patients with TMJ problems.

A Domiciliary Physiotherapy service is offered by specialist Physiotherapist, Brigid Duffy who is also able to see neurological outpatients at Chelsea Medical Centre.

Our specialist Women’s Health Physiotherapist, Maire Oakley treats all conditions relating to women’s health, including bladder control problems, stress incontinence and weak pelvic floor muscles. She also provides treatment to support recovery post-hysterectomy and other gynaecological surgery and offers therapy to ease menopausal symptoms.

In addition to the new services above, we also now offer shockwave therapy for patients, as a treatment for accelerating the body’s healing process.

If you would like more information on any of our Physiotherapyservices, or to refer a patient please call 020 7824 8041.

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Chelsea Bridge RoadLondon SW1W 8RH

t: 020 7730 7733f: 020 7881 4074

e: [email protected]: www.thelisterhospital.com

For any enquiries please contact GP liaison on 020 7881 4000.

Date Consultant Topic

26 June Marcus Reddy General surgery

2 July Vivek Datta Colorectal

8 July Ben Hunter Ear, nose and throat

16 July John Janssen Neurology: memory loss

16 Sept Warwick Radford & Richard Field Orthopaedic: hip

24 Sept Andrew Forester & Sarah Davies Orthopaedic: shoulder and

Sports Medicine

30 Sept Richard Staughton Dermatology

9 Oct Andrew Davies Orthopaedic: knee

14 Oct Daniel Morganstein Endocrinology

22 Oct Guri Sandhu Voice and swallow clinic

11 Nov Rhidian Thomas Orthopaedic: foot and ankle

19 Nov Julian Collinson Cardiology

25 Nov Tony Kochhar Orthopaedic: elbow

The Lister Hospital’s GP Liaison teamlooks forward to welcoming you to theirregular breakfast seminars, which takeplace from 7.30 - 8.20am in thehospital’s newly refurbished diningroom, unless otherwise stated.

If you’d like to attend any or all of thesedates, please call the GP Liaison team on 020 7881 4000 or [email protected]

Our annual golf tournament will take place, once again, at New Zealand GolfClub in Surrey, which is rated as one of the top 100 courses in the world.

This year’s competitions include 10-hole Texas Scramble and 18-holeStableford, with prizes available for nearest to pin, longest drive and bestoverall performance throughout the tournament. Any competition fees anddonations will go directly to Womb Transplant UK, one of The Lister Hospital’snominated charities.

Mulligans will be available to purchase on the day. A traditional carvery lunchwill be served during the prize-winning ceremony and this fabulous event willculminate with drinks on the 19th hole!

To register your interest, email [email protected] or callthe Marketing team on 020 7881 4086

T H E L I S T E R H O S P I T A LG O L F S O C I E T Y

Lister Golf Day - Tee off on Thursday 25 September!

Dates for your diary

Please note: seminars are subject to change - check www.thelisterhospital.com for the most up to date details on our educational programme.

GP breakfast seminars

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