4 July 2018
Heart surgery will become obsolete and Star Trek-like handheld scanners are likely to become a reality, according to experts at the UK’s leading specialist heart and lung centre.
In a series of first-person blogs to mark the 70th anniversary of the NHS experts look back at the past 70 years and give their views on medical advances on the horizon.
The blogs have been published to mark 70 years of highly-specialised NHS care at Royal Brompton and Harefield hospitals, which were founded in 1841 and 1915 respectively, and come as patients, relatives, staff and volunteers come together to celebrate 70 years of the National Health Service on Thursday (5 July).
The celebrations also include the unveiling of an exhibition that uses stories and images from the archives, and interviews with former patients, to represent the care that Royal Brompton & Harefield NHS Foundation Trust has provided across the ages.
Excerpts from the blogs include:
Mr Babulal Sethia, consultant cardiac surgeon
“In time, I predict that cardiac surgery, as we know it today, will become largely obsolete. Consider the evolution of the treatment for a simple stomach ulcer – it is treated with antibiotics now, whereas previously, people would undergo surgery. That type of surgery has become obsolete, within a single generation.
“Advances in technology will continue to result in further dramatic changes for patients as well as for the practice of surgery, including cardiac surgery, and much of today’s technology will potentially end up as exhibits in the Science Museum.”
Dr Mark Mason, consultant cardiologist and director of the heart division at Harefield Hospital
“Being able to monitor patients with chronic disease remotely, without them needing to come into hospital for an appointment, is going to be a massive opportunity for us.
“Home monitoring for patients with implantable cardioverter defibrillators (these are devices implantable inside the body, able to perform controlled shocks and pacing for the heart), is now the standard of care for our patients. We check the device every three months, but instead of having to travel here, they have a box which they take home and plug into the mains. On any given day there are cardiac-physiologists watching and monitoring the devices. We can remotely check if there’s a problem with their heart.”
Professor Anita Simonds, consultant in respiratory and sleep medicine
“It used to be very top down before: consultants, junior doctors, nurses. Now we have a consultant physiotherapist, hospital practitioner (this is a doctor with a similar skillset to a GP, but who works in a hospital setting), and a consultant nurse who runs the outreach work. We have clinical physiologists who analyse the detailed sleep studies and set these up. It’s become a much more dynamic, multidisciplinary specialty in recent years – and without doubt an improvement on times gone by.”
Professor Stuart Elborn, consultant in respiratory medicine and centre director for specialist adult cystic fibrosis
“Triple therapy trials have now started, using a combination of drugs to tackle the underlying cause of cystic fibrosis. If the triple therapy combination works, and early trials are very encouraging, it’ll work for 90 per cent of people with CF and could possibly extend their survival in the region of 15 to 20 years. We’re very excited because there’s been nothing like this in our lifetimes as clinicians.”
Carol Gadd, cardiothoracic clinical service manager at Harefield Hospital
“Now of course we have specialist nurses and nurse practitioners – a new and highly-skilled breed of nurse with an incredible amount of specialist clinical knowledge – I think the patients love them.
“With the amount of technology involved these days, it can be hard to flip from clinical process mode to caring mode. Every so often, we have to pull back and say: ‘Are we caring? Are we doing enough?’ That is not a bad thing in my opinion. It’s important not be complacent.”
Professor Pallav Shah, consultant physician in respiratory medicine at Royal Brompton and Chelsea & Westminster hospitals
“Working at Royal Brompton Hospital is a privilege. We are like a family – we all have the same ethos, which is to strive for excellence and compassionate care of our patients. There’s an almost invisible quality which make it a pleasure to work for; this special quality makes me really want the hospital to do well.”
Dr Nitha Naqvi, consultant paediatric cardiologist at Royal Brompton Hospital
“If you add up all of the years of service my family have given to the NHS, it works out at 140 years!
“My son is 17, but I don’t think he’s going to go into medicine … but maybe my daughter! All of my family love the NHS. We’ve worked hard for it, but it’s been so wonderful for us too and we really feel privileged to work in it.”
Dr Shelley Rahman Haley, consultant cardiologist and the first clinical lead for echocardiography at Harefield Hospital
“People sometimes ask ‘What did we do before we had all this technology?’ Well, the answer is simple – we got it wrong more often! When echocardiography came into routine use for the diagnosis of heart murmurs, lots of patients who had been told what was wrong with them many years earlier discovered that they had something entirely different! Fortunately, the echo we have today means that our patients can be confident that we will we get it right first time.”
Professor Michael Polkey, specialist in respiratory medicine
“This country’s rigorous research and collegiate approach allows better communication and the sharing of knowledge. NICE (The National Institute for Health and Care Excellence), for example, has a global influence. Other countries look to us to see what we’re doing. It gives the UK an importance on the worldwide scientific and medical stage that is disproportionate to our size or population.
“Ultimately the fact people can get word-class health care regardless of their wealth or social standing, free of charge, is a matter of national pride.”
Professor Dudley Pennell, professor of cardiology and director of the cardiovascular magnetic resonance unit at Royal Brompton
I think we can say for definite that in 70 years’ time, scanners will be much smaller, much more capable, much more versatile, measuring new and different things that we can’t measure today, and potentially all handheld.
When we look at Star Trek, with Bones McCoy and Captain Kirk, they always had this thing called a tricorder, and they’d waft it over someone and say, “Oh dear, you’ve got a blood leak” or something, I think that is probably going to come true.
Liz Biggart, senior nurse, children’s services, Royal Brompton Hospital
“The medical advances I’ve seen are amazing. Twenty years ago diagnosis was in its infancy – now over half of children with cardiac anomalies are diagnosed in the womb before the baby is born, which is fantastic as it means we can ensure their birth is safe, that they are near the specialist heart centre they need to get to, and that both mother and baby can get the care they need.”
“I’m really proud that I helped to create the inherited cardiac care team here. We looked at children with inherited conditions and said ‘whole families are affected by this, let’s treat them together’. So the initial team was set up with an adult and two paediatric nurses working together.”
Professor Thomas Lüscher, consultant cardiologist and director of education, research and development
“Today, in the UK, mortality for heart attack is just ten per cent if you make it to hospital. And remember, these days we manage to bring patients in terrible condition into hospital. Just look at Harefield: they come by helicopter, or by ambulance, sometimes after having been resuscitated.
“These patients are frequently much, much sicker – they wouldn’t even have reached hospital in days gone by.”
Dr Vias Markides, consultant cardiologist and director of the heart division at Royal Brompton Hospital
“One of my patients was on holiday on a Greek island, and he called me and said, ‘I didn’t feel very well last night, I think I might have had a rhythm problem.’ He has a home monitoring device which he takes everywhere, so he just sent a transmission and I could immediately look into his heart rhythm events and advise.
“This is already established, and offers just a glimpse into what the future of what we may be able to offer patients could look like.”
Mr Andre Simon, director of heart and lung transplantation and ventricular assist devices
“When I first came here we did seven heart transplants a year. Over the past year alone, between April 2017 and March 2018, we have performed 33 heart transplants, 59 lung transplants and five heart and lung transplants. Last year, we implanted five total artificial hearts and 37 ventricular assisted devices.
“When I started at Harefield Hospital, my vision was to offer high-end medicine, to be competitive with leading institutions around the world, and be at the forefront of getting new valuable technology and pioneering new techniques. I think we’re making good progress.”
Read all the blogs