Recent progress and updates

TOHETI May’2018 Newsletter (

In this newsletter you will find an update on HIFU study which commenced in Dec’ 2017; Qualitative study on lung cancer which commenced in April’2018 ; an update on scaphoid study and headache study; Rapid Improvement Event in CLIMP; as well as an update on how lessons learnt from the TOHETI programme is informing key aspects of the Trusts new transformation programme called Care Redesign. There is also information on two scaphoid related papers published most recently in the hand trauma journal.

TOHETI September’2017 Newsletter

In this newsletter you will find an update on our lung study, which commenced in June, as well as an update on how lessons learnt from the TOHETI programme is informing key aspects of the Trusts new transformation programme called Care Redesign.

You will also see that our team have been out and about at various events during the last few months, including making an appearance at the BMA Patient Information Awards 2017!

TOHETI May’2017 Newsletter - HSJ Value in Healthcare Awards win for TOHETI

The TOHETI team was delighted to win an award in the Obstetrics and gynaecology category at the 2017 HSJ Value in Healthcare Awards.

Announced on 24 May at Grosvenor House, London, the awards recognise and celebrate outstanding improvement in quality of care and efficiency throughout the NHS. Over 400 entries were whittled down to 20 winners, with the judges in our category stating that they were impressed with the evidence of co design with patient groups, which resulted in materials which deliver informed content to women to empower them.

TOHETI January’2017 newsletter: Acute Chest Pain research study approved to commence patient recruitment in January 2017 and TOHETI shortlisted for two HSJ awards

The Acute Chest Pain research study which aims to improve the management of patients who attend A&E with an episode of Acute Chest Pain has now commenced, and recruited its first patient this month. As part of the study, a new clinic called the Rapid Access Chest Pain Clinic is being established to accept patients referred directly from A&E. You can read more about the study inside.

The scaphoid study is moving forward at a pace with eight patients recruited last week, and with the study enabling some patients to have further diagnostic testing through MRI in addition to their X-ray. The study has now recruited over 50 patients, and initial analysis of outcomes is underway.

In further exciting news, TOHETI has been shortlisted for the 2017 HSJ Value in Healthcare Awards under two categories: Improving the value of diagnostic services and Obstetrics and Gynaecology.

Clinical Imaging and Medical Physics Visiting Professor Programme

High quality research and teaching go hand-in-hand with clinical excellence.

A few years ago, a generous contribution by the family of Mrs Mabel Norris enabled us to develop an excellent Visiting Professor Programme. This has funded short visits to the Department of Radiology, by eminent academics from around the world, who have made an excellent contribution to the education of those working in Imaging at Guy’s and St. Thomas’ Hospital.

We are delighted that our Visiting Professor Programme has recently received strong support from Siemens Healthineers, Philips Healthcare, Boston Scientific and Medtronic. This will enable us to continue to invite eminent academics from around the world, who can teach our members of staff new techniques and broaden their horizons. We are very grateful to these industrial partners for supporting our teaching programme.

TOHETI October Newsletter

Across the TOHETI research studies, the scaphoid, headache and colon cancer studies have commenced recruiting patients, and close monitoring of weekly progress against recruitment targets is taking place across the studies. The team have worked closely to share learning across the research pathways, and a recruitment assistant is in role to support clinical staff in the recruitment and follow-up of participants across the studies.

Final clinical sign off and consensus is being reached in both the Acute Chest Pain and Lung Cancer pathways, and start dates for the studies are anticipated for year-end/early 2017. You can read more about the TOHETI lung feasibility study, which will evaluate the uptake of low-dose chest CT by high risk symptom-free individuals identified in Lambeth and Southwark in this month’s newsletter.

Guy’s and St Thomas’ NHS Foundation Trust becomes largest accredited Imaging service

Imaging staff across Guy’s and St Thomas’ NHS Foundation Trust (GSTFT) and King’s College London (KCL) are delighted to have been recognised by the United Kingdom Accreditation Service (UKAS), and have successfully been awarded ISAS (Imaging Services Accreditation Scheme) accreditation, making it one of the largest ISAS accredited services in the country.

ISAS is a patient-focused assessment and accreditation programme that provides an essential framework for Diagnostic Imaging services to engage with the NHS England Putting Patients First, Business Plan 2014-15 to 2016-17, to ensure that patients consistently receive high quality services, delivered by competent staff working in safe environments. ISAS has been acknowledged by the CQC as a robust accreditation scheme, and is now part of hospital inspection methodology.

On presenting the certificate of accreditation, Paul Stennett, CEO of UKAS said: “Congratulations to the Imaging Teams at Guy’s and St Thomas’ and King’s College London on achieving UKAS accreditation to the ISAS standard. Meeting the rigorous requirements of the ISAS standard enables the Trust and University to promote best practice in the four key areas of patient experience, clinical effectiveness, effective utilisation of resources and patient and staff safety, and demonstrates a commitment to providing patients with a high quality, effective and safe service.”

The two year collaborative project between GSTFT and KCL reinforces the shared commitment of embedding quality improvement into everyday practice. Part of the assessment for accreditation involved a 3 day on-site inspection by 10 imaging experts. The recurrent theme in the assessors feedback was how impressed they were with what they saw, and they consistently remarked on our staff being such a “friendly team”, “very patient focused”, “approachable” and “open and helpful”. Some aspects of what we do were described as “exemplary” and our service is “exceptionally safe”.

The imaging departments are currently going through an exciting period of expansion, innovation and transformation. This includes the work supported by the TOHETI programme which leads the way in transformation of imaging services, and aims to create models for future delivery of care across the clinical spectrum to ensure the right imaging test is performed at the right point in time for a patient.

Our ISAS accreditation will provide an underpinning quality framework and will inform a strategic direction of travel across Imaging within the King’s Health Partnership. Our continued commitment to ISAS will ensure that the quality of services we provide is both sustained and continually encouraged to grow.

TOHETI July Newsletter

We’re delighted that two new TOHETI-funded CT scanners are now live in the Lambeth Wing and A&E in St Thomas’ alongside a new MRI scanner in Guy’s Tower. Thanks and congratulations to all involved.

In line with the installation of the new CT and MRI scanners during May and June, three of TOHETI’s major research studies – chronic headache, scaphoid fractures and colon cancer have now commenced recruitment of patients. The involvement and linking up of staff across our Trust and two Hospital sites, from the Emergency Departments, to Radiology, to nursing staff, has made this a truly collaborative effort. We look forward to reporting back on progress over coming months.

We are also pleased to have developed a mobile phone app that allows participants in our research studies to quickly and conveniently keep a note of their daily symptoms. The app also allows us to send daily or weekly reminders, and there has been a positive response to its use so far from patients recruited to our studies. We hope it will mean a better experience for patients, and better data for us!

TOHETI April newsletter and infographic

So far in 2016, we have seen the launch of new information for patients on uterine fibroids through a new leaflet and video, with 10,000 copies of the leaflet printed to distribute to our local community. The project has been a great example of collaboration between health professionals and patients – with women affected by the condition providing the initial catalyst for the work.

The TOHETI research pathways continue to progress, with the recent recruitment of our first patient for the headache study, and recruitment anticipated to start in May for the colon and scaphoid studies. To support study participants, an app is being developed for the headache study, which will allow participants to fill out a daily headache diary quickly and easily. A GP event engaging 70 GPs was also held in April to raise awareness of the Headache study, and a patient focus group was held in the Breast Clinic to find out more about patients’ views of a new one-stop clinic model the Breast team hopes to implement.

Over two weeks in March and April, service improvements suggested by Clinical Imaging and Medical Physics (CLIMP) Directorate staff were also trialled within the CT and MRI services at St Thomas’ Hospital, supported by TOHETI.

International Forum on Quality and Safety in Healthcare 2016, Gothenburg

Now in its 21st year, the International Forum on Quality and Safety in Healthcare is one of the world’s largest gatherings of healthcare professionals committed to improving patient care and their safety.

Members of the TOHETI team presented a poster on the programme’s work under the Improvement works in progress section. In the poster sessions, we were given one and a half hour slots, and worked our way around different posters in groups. This was an interesting and interactive way to hear about other people’s work attending the conference, and to explain our work to a diverse range of people and organisations. See our poster here.

Medibord® launches a new Siemens Biograph mMR (PET-MRI) solution

In collaboration with King’s College London & Guy’s and St Thomas’ PET Centre, Medibord® has developed a PET-MRI overlay which has been especially designed for a head and neck cancer research project within their PET Centre.

This new product incorporates a newly developed coil holder and fixation mask which complements the existing Medibord radiotherapy planning solutions for the Siemens Biograph mMR (PET-MRI). This allows the body coils to envelop the patient’s head and neck, leaving space for a fixation mask and head rest. The patient’s arms are supported in position with new hand grips to minimise movement.

The purpose of the research project is to establish a good quality PET-MR protocol for patients with head and neck cancer to be scanned in the radiotherapy treatment position, with the immobilization devices in situ. Work has already been done on phantoms and healthy volunteers and a pilot study has just opened recruiting patients with head and neck cancer having radiotherapy to that area with curative intent. Ultimately, the aim is to develop an adaptive radiotherapy dose escalation trial with PET-MR image guidance.

For further information please contact Medibord, or follow the link to the King’s College London & Guy’s and St Thomas’ PET Centre

TOHETI Dec Newsletter - looking back over our first year and forwards to 2016!

The first year of the second phase of the TOHETI programme has flown, and we are delighted in this newsletter to share with you some of the successes of the past year and to look forward to what 2016 holds in store.

A huge thank you to all our colleagues across the CLIMP Directorate at Guy’s and St Thomas’, the clinical leads for our research pathways, the GPs we have worked with, the many patients we have met, our funders – Guy’s and St Thomas’ Charity, and all others who have touched upon our programme: we wouldn’t be here without you.

In a recent celebratory event held to mark Year 1 for TOHETI and the CLIMP Directorate, Dr Ian Abbs, Medical Director, Guy’s and St Thomas’ challenged staff to take the opportunity the TOHETI programme affords and the extra imaging capacity being delivered to Guy’s and St Thomas’ in 2016-17 to “think the unthinkable”. He asked staff assembled from CLIMP including radiologists and radiographers: “how radical can we be in changing patient pathways? In 5 years’ time, could we have a healthcare model led by you that looks completely different to what we have here today?”

As we look forward to year 2, we continue to welcome staff to come forward with ideas to shape the future priorities for both the Directorate and TOHETI. The programme is yours to own, and this is a unique opportunity to re-imagine the imaging services we provide as a Trust. We also of course welcome thoughts and ideas from external colleagues. You can get in touch with us:

TOHETI September newsletter

The first year of Phase 2 of the TOHETI programme has flown by, and we will be pulling together a roundup of the year to share, as well as looking forwards to the programme’s next steps. Ahead of that, we wanted to share with you some of the things that have been happening over the Summer.

In July, working together with Guy’s and St Thomas’, we hosted colleagues from the Virginia Mason Institute, Seattle, to share a different perspective on how to deliver healthcare in a continuously improving model. Many of you may have attended one or more of these sessions which included overview sessions as well as specialised sessions for Cancer Services, Primary Care, Evelina Children’s Hospital and Transformation services. The visit sparked many new conversations and ideas, and you can read more about the visit in our newsletter.

In this newsletter, we also feature progress around our research around clinical applications enabled by the new imaging technology of PET-MR, and report back on our work with Emergency Nurse Practitioners in preparation for the roll out of our pilot study on scaphoid (wrist) fractures. Read the newsletter here.

Learning from Virgina Mason

As part of Fit For the Future week, Guy’s and St Thomas’ welcomed colleagues from the Virginia Mason Institute, Seattle over Wednesday 1st and Thursday 2nd July. Virginia Mason are renowned leaders in healthcare, and have over the past twenty years introduced and developed a culture and way of working centred around the patient, combined with a compelling ethos of continuous improvement and elimination of waste. The visit built on our Hospitals’ existing relationship, following on from two visits made over June and October 2014 to Virginia Mason by senior staff across Guy’s and St Thomas’ the TOHETI team and colleagues from Primary Care and Public Health.

Those visits initiated new conversations across the Trust and more widely with local partners, and acted as a catalyst for discussion and enthusiasm around possible change and untapped potential in our work environments and relationships. Hosting Virginia Mason here as part of Fit For the Future week enabled sharing of Virginia Mason’s work and learning more widely with staff across the Trust, allowing staff to hear from Virginia Mason colleagues directly, and capitalising and building on the synergy of the week.

June Newsletter

The last three months have seen the TOHETI team visit Sunderland to find out about transformation work in NE England, out and about meeting staff and members of public through the Guy’s and St Thomas’ Fit For the Future Roadshow and International Clinical Trials Day, and progressing work around our research pathways – in this issue we showcase our work around the scaphoid pathway. In June we ran a series of patient focus groups across Southwark and Lambeth for women considering treatment options for fibroids – hugely inspiring for us all. Read more in the newsletter here

Treatment options for fibroids – helping patients to make an informed choice

We are looking at the information women receive when considering treatment options for management of fibroids at Guy’s and St Thomas’ Hospitals. A series of patient focus groups are being carried out in June and we would like to speak to women being treated at Guy’s and St Thomas’ who have recently been diagnosed with fibroids and are currently considering treatment options, or who have recently undergone a surgical procedure for fibroids – Uterine Artery Embolisation, Myomectomy or Hysterectomy.

We hope that patients will be able to share their experiences and insights with us, to help us improve and enhance experience and access to information for future patients. We will be running patient focus groups across several locations in South-East London over June, and we would need patients to attend one 1½ hour session, working with other patients. More information can be found in the flyer attached.

March Newsletter

It has been all-go to start the new year, and with our team more than doubling to reach its full size, we’ve been able to see the work across our pathways really start to move forwards. We’re pleased to welcome Bernadette Cronin as Associate Director, Charis Stacey as Programme Manager, Bharti Malhotra as Project Manager (scaphoid fracture, colon and prostate cancer pathways), Sophia Ho as Intelligence Analyst and Sarah Syanda as PA to the Director.

We hope you enjoy reading this second edition of the newsletter .

December Newsletter

With Phase 2 of TOHETI now well under way, we’re pleased to be able to share this first newsletter highlighting progress so far, the healthcare pathways the programme impacts, and how we hope to work together going forwards to introduce improvements and changes to the way we use imaging services.


An event was held on Wednesday 26th November for staff across the Clinical Imaging and Medical Physics Directorate (Climp) in Guy’s and St Thomas’, to hear more about progress on TOHETI and the programme ambitions going forwards, and to share questions, thoughts and ideas with the TOHETI team.

Underpinning TOHETI’s success will be how staff across the Hospitals are enabled to lead and own changes and improvements to ways of working, and this event helped demonstrate and embed this approach from the outset.

A short introduction to the programme was given by Professor Reza Razavi, Head of the Division for Imaging and Biomedical Engineering, KCL, John Scoble, Deputy Medical Director, Guys and St Thomas’ and Jo Turville, Associate Director, TOHETI.