Royal Free London NHS Foundation Trust Staff, members and governors’ magazine // May / June 2025 Martha’s Rule Asking, listening, acting
The triplets at 30 weeks old, just after being born All three babies doing well at home Follow our X account @RoyalFreeNHS to see what our patients and staff are saying about us Three little miracles born at North Mid 3 to the May/June edition of our bi-monthly staff, members and governors’ magazine. This edition of Freepress comes at a time of important milestones for me. We are approaching the anniversary of the launch of our of clinical strategy and I recently completed my second year as group chief executive of the RFL. It’s always fantastic to hear about all the ways we’re already delivering on our group clinical priorities – cancer, cardiovascular disease, and organ failure and transplantation. On page 9, you can read about how two of our consultant cardiologists performed a new technique to remove a blood clot from a patient’s lung. Research is also a key focus underpinning our strategy. As we work towards becoming a leading research trust, it’s great to see our research and development sample service spotlighted on pages 6 and 7. Their work is crucial to the studies and analysis we do here at the RFL. Patient safety is a prominent feature in this edition with the latest update about the launch of Martha’s Rule on page 4, where teams are carrying out the national programme for reporting concerns around patient deterioration. We also have a remarkable tale about one of our midwives who was actually brought into the world by two of her colleagues. You can read about this fullcircle story on page 8. During a time which feels quite changing, in the NHS and the wider world, please remember to take care of yourselves and each other. I want to say a massive thank you for continuing to deliver the best care for our patients, day in and day out. A proud mum from Enfield recently gave birth to – not one, not two, but three bundles of joy at North Mid. After waiting years to conceive again, 48-year-old Safiya Warsame became a mother of four daughters after giving birth to a ‘miracle’ set of triplets earlier this year. The triplets, two of whom are identical, were born at 30-weeks-old and weighed just two pounds each. Mum Safiya, who works as a caterer in the NHS, had been trying to conceive since her first daughter was born in 2020. She eventually became pregnant with the triplets via in-vitro fertilisation (IVF). Two became three She said: “For me, it’s a miracle and they are miracle babies as I was waiting a long time for another child. When I had my first scan, they told me they could see two babies. After three months, they told me I was having triplets! “Me and my husband were shocked. At first, I thought ‘how can I manage three babies?’ – but then I said, ‘as long as I’m healthy and they’re healthy, I’ll be happy’. I’m not looking for another child now though.” High blood pressure meant Safiya had to have an emergency C-section to deliver the babies almost 10 weeks early. With only 100 sets of triplets born across the UK each year, it was an exceptional day at North Mid when they arrived. Henna Rather, maternal medicine consultant and labour ward lead at North Mid, said: “We had prepped for an early delivery due to Safiya’s blood pressure. Hello and welcome “It’s important to time the delivery to balance mum’s health and the babies’ wellbeing. Safiya was a trooper throughout.” Chloe Hall, resident doctor, helped deliver the triplets. Recounting the experience, she said: “It’s rare to deliver triplets, so I was very privileged to be a part of this. There was a lot of preparation to ensure the operation went smoothly, from equipping theatres for three preterm babies to having a blood bank on hand in case it was needed. “It really was a special day – we all felt it in theatre. It’s something that will stay with me for the rest of my career.” The babies were then looked after by staff in the Starlight neonatal unit for more than eight weeks before they returned home. They have since settled into life at home with mum, dad and their older sister. “They are doing well at home – they’re healthy and happy,” said Safiya. “When the babies were in the hospital, my five-year-old daughter was always asking me when they were coming home. Now that they are, she keeps asking to play with them. I hope they will all be best friends.” When they are old enough, Safiya also hopes to take the triplets to visit family living in Somalia. She shared a message of hope to others: “People shouldn’t give up on having a family if they want children. I almost gave up, but my family helped me and I took another chance. Now, I have four beautiful daughters.” Peter Landstrom Group chief executive It really was a special day - we all felt it in theatre “ “ Key to abbreviations: Barnet Hospital: BH Chase Farm Hospital: CFH North Middlesex University Hospital: North Mid Royal Free Hospital: RFH Royal Free London: RFL 2
5 4 The RFL has embedded Martha’s Rule – a vital patient safety initiative that gives healthcare staff, patients and their families a clear pathway to raise concerns about deteriorating conditions. With Martha’s Rule, patients, their families and carers are encouraged to tell staff if they are worried a health condition is getting worse. It recognises that those who know the patient are often best placed to notice changes that could be an early sign of deterioration, and places importance on acting upon those concerns. The RFL has been a pilot site since the start of the programme and is contributing to the national picture for Martha’s Rule, along with over 140 other sites. Nationally, data from September to December 2024 shows 1,433 calls were made, of which 663 (46%) related to acute deterioration. Some of the calls have led to transfers to intensive care units and changes in the management of care, highlighting the importance of early intervention and patient and family/carer advocacy. Patients asked every day how they are feeling Components of Martha’s Rule include staff asking patients daily about how they are feeling, and if they are getting better or worse. At BH and RFH, these questions can be logged in electronic patient record (EPR), and on Care Flow at North Mid. Staff can escalate patient concerns based on the daily wellness questions, or if they are concerned themselves. This is carried out via the regular patient at risk and resuscitation team (PARRT)/critical care outreach team (CCOT) bleep numbers. Patients or their families can now also request a rapid review from a different team if they notice any deterioration that is not being addressed by the local care team. This can be done via the PARRT/CCOT mobile phone number available for each hospital, which are being shared on our website and on posters in ward areas. At North Mid, Florence Cobbold, senior matron for the CCOT, said patients are feeling “reassured by another way for them to raise concerns”, while at BH, Sarah Bingley, lead nurse specialist for PARRT, said staff are working hard to embed the elements of Martha’s Rule. Nichola Demery, lead PARRT nurse at the RFH, said: “Early data highlights just how important the Martha’s Rule escalation process is for patients, families and staff, to help ensure those experiencing deterioration can be identified and treated as early as possible. “With Martha’s Rule, patients say they feel safer, and that staff are listening to their concerns right up until they are discharged.” PARRT and CCOT colleagues recently held a webinar to update staff on Martha’s Rule. Search ‘PARRT’ on Freenet to view and for more resources. Difference between Martha’s Rule and a second opinion Martha’s Rule allows inpatients and their families to seek a rapid review if their condition, or the condition of a loved one, is deteriorating. A second opinion is when you would like to see another consultant to discuss any diagnosis or treatment. I was so happy to be offered this surgery as a day case so I could sleep in my own bed the same night “ “ Martha’s Rule: detecting deterioration Staff at BH pictured implementing the wellness questions element of Martha’s Rule L-R: Abhishek Reekhaye, consultant urological and robotic surgeon, Gulshan Uddin and David Cullen, lead nurse for kidney cancer Martha’s Rule is a patient safety initiative named after Martha Mills. Martha died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that 13-year-old Martha would probably have survived had she been moved to intensive care earlier. A kidney cancer patient who had robotic surgery at the RFH to remove a tumour was able to return home to his family the same day. Gulshan Uddin, 52, from Bethnal Green in London, underwent the two-hour robotic partial nephrectomy surgery, via a back incision (retroperitoneal approach), in April. His surgery began just before 9am and he was discharged at 7.30pm – the first time the surgery had been done as a day case at the hospital. Mr Abhishek Reekhaye, a consultant urological and robotic surgeon, performed the operation. Patients recover faster with less pain He said: “Although this surgery isn’t suitable for everyone, by going through the patient’s back we don’t have to move the bowel out of the way which makes it quicker, and patients recover faster with less pain. This is not the first time we have done the surgery by this route, but it is the first time the patient has been able to leave the same day.” For traditional partial nephrectomies, via the abdomen (transperitoneal approach), the patient will have to remain in hospital for one to two nights but going via the back avoids any potential bowel complication. This means once the patient is safely able to eat and drink again they can potentially go home. The bladder catheter is removed in the operating theatre at the end of the surgery before the patient wakes up. Abhishek added: “This day surgery approach will be suitable for patients who are otherwise in reasonable health, ideally under 60 and live within an hour of the hospital and have someone at home with them.” David Cullen, lead nurse for kidney cancer, said: “Our clinical nurse specialists (CNSs) are key to providing education and support for all our patients before surgery to help them understand what’s going to happen during admission and the possible side effects of surgery. This helps people to plan their aftercare once discharged from hospital. “The kidney cancer team invites all patients to our presurgery kidney cancer surgical school, provides direct access to a CNS for information and support, as well as providing written information and a link to a pre-surgery patient information video.” Gulshan was referred by his GP for a scan after he developed a urine infection in December, and he was subsequently diagnosed with kidney cancer. He took the decision to delay his surgery to enable him to take part in Ramadan. All in a day’s work He said: “I was on bed rest for a couple of days after the operation and in regular contact with Mr Reekhaye and it took two or three weeks for me to feel back to normal. I’m now looking forward to returning to my security work for bars and clubs.” In 2022 we reported on 22-year-old Luke Tolchard who became the first patient in London to be discharged home just hours after undergoing surgery to remove a kidney. This latest day surgery marks another step forward for patient care as a partial nephrectomy is generally considered more complex than removing the whole kidney. This is because it involves intricate procedures to isolate blood vessels supplying the kidney and remove the kidney tumour, while preserving normal kidney tissue.
6 7 Human sample service plays crucial role in research When it comes to research, the RFL is a world leader in a range of specialist areas – including liver and kidney disease and haemophilia. But behind all these achievements in clinical research is a crucial service which keeps many of the trust’s studies on the road – the research and development sample service or RADSS. The service – which has a team of 15 staff – collects patient samples, including tumours, skin, liver biopsies and blood samples, that are a vital part of the research process. The service also provides some analysis of the samples before they are sent to researchers here at the RFL, as well as across the UK and worldwide, where they contribute to vital discoveries about disease and new treatments. The RFL has one of the largest sample services in the NHS, with the RADSS team collecting thousands of samples each year for clinicians, academics and commercial organisations as far away as New York or Japan. RADSS is made up of three separate elements – the RFL research tissue bank, where samples are stored; the tissue access for patient benefit (TAPB) service, where researchers request particular samples they need for their studies; and the good clinical laboratory practice (GCLP) lab, where samples can be analysed. A new space and an ambitious plan This summer, the tissue bank and TAPB service will move to a new GCLP lab space next to the clinical research facility on the second floor of the RFH, where new equipment will be installed allowing them to expand their service and carry out more advanced analysis of samples. Amir Gander, the RADSS head of service, said: “We have an ambitious plan for the service. We want to expand and improve the type of sample analysis we can carry out in our GCLP lab. “Our RADSS service spans the entire research pipeline – from identifying the nature of disease, to clinical trials and diagnostic validation – and because we link researchers with clinical services, data and academic expertise, we aim to be the go-to place for biomedical research globally. “And this is all underpinned by the fact that the Royal Free London has a really diverse patient population.” Meet the RADSS team Satyarth Rathore is the clinical research data manager for the service. When a clinician or researcher approaches the RADSS team to ask for a sample, it’s Satyarth’s job to obtain patient clinical data and make sure it is anonymised. “For their studies, researchers might be looking for a patient with a particular type of tumour and they may need to be a certain age or disease stage so we will look through the patient database to find someone who matches,” he said. “Once I have found a patient I consider suitable, I will contact their clinician to see if it’s appropriate to ask them to donate a sample. If the clinician agrees, I will ask one of the clinical research practitioners at TAPB to approach the patient for consent to participate in research – usually they do this when the patient is attending a clinic.” It’s Jason Robley’s job as a clinical research practitioner to approach patients to ask if they would consider donating tissue or blood samples for specific research projects. Often this might be a part of a tumour that is due to be removed in surgery and would otherwise be destroyed. Jason always lets patients know they are not obliged to donate any samples but he says they often do because they are keen contribute to the discovery of new treatments – even if they won’t benefit personally. He said: “Patients are provided with information about research at RFL in several ways, so they know we are a big teaching and research trust and patients want to be a part of that too. Some have been with their clinical team for a long time and they want to give back and help them with their work. Staff from the RADSS Diana Kateregga, clinical trial practitioner L-R: Satyarth Rathore, clinical research data manager; Carolina Ramos-Rivera, operations manager; Rukan Arsu, clinical research laboratory coordinator; Amir Gander, RADSS head of service L-R: Satyarth Rathore, clinical research data manager; Jael Boateng, clinical research practitioner; Diana Kateregga, clinical trial practitioner; Jason Robley, clinical research practitioner If patients agree to donate, Jason will collect the sample, which may involve taking a blood sample or going into the operating theatre to collect a part of a tumour that has been removed by a surgeon. Often, it’s only a tiny part of the tumour that’s needed – 0.5 or 1g. Jason loves his job and would recommend it to people who have an interest in research. “I love interacting with patients and knowing that I am part of the process that will mean improved treatments for all sorts of conditions,” he added. Carolina Ramos-Rivera is the operations manager for the TAPB service, which means she engages with researchers to help design studies so innovative ideas can be translated towards clinical treatments and care much faster. She manages the finances, the contracts and delivery of studies with other organisations who require the sample service the RFL provides. Carolina said: “When we are approached by a researcher for samples, we discuss if it’s feasible and what the costings are. “I love how we are supporting patient care. For example, we have been collaborating with the liver team on developing a way of providing dialysis for patients with liver disease.” Rukan Arsu, the clinical research laboratory coordinator, ensures the lab runs smoothly so samples are stored and tested in the right way. In the lab the samples are stored in either -80ºC freezers or liquid nitrogen and maintaining the equipment is a vital part of the service. Rukan carries out centrifuge and fridge maintenance and ensures the fridges are defrosted regularly. She said: “I love the job; I love being involved in research and knowing that all the tasks I carry out are so important – everything has to be rigorous because our researchers and clinicians need precise results and we are often dealing with vulnerable patients.” I love interacting with patients ... “ “ Going further Hanish Anand is the GCLP laboratory and biobank facility manager. He said a recent grant from the National Institute of Health and Care Research has allowed the team to buy £1 million-worth of cutting-edge equipment for the GCLP. “Currently we have a lab in the RFL Biobank where we have limited capabilities. When we move to our new lab and install the new machinery, we will be able to do more advanced analysis and develop it to have GCLP certification. “Once the new lab opens, we will be able to isolate and extract DNA and RNA from cells, perform tissue analysis, and carry out tests to establish what type of immune cells someone has in their blood. “Currently, our clinicians have to go outside of the trust for this kind of analysis but once the lab opens, external organisations will come to us.”
8 Imagine working alongside the people who brought all 2.6kg of you into the world. For 23-year-old Katerina Kasapi that’s exactly what has happened. Born at CFH, Katerina now works at BH as a midwife alongside Collette Spencer and Anne Fowler, the midwives who delivered her. Katerina discovered the unique link after asking her mother to request her birth notes because she wanted to find out what had been involved in her care and how the notes were written up. As the records are only kept for 25 years the young midwife knew her mother had to do it sooner rather than later. Katerina said: “I was intrigued to see my notes. My mother recalled it as being a quick birth and it was, just four hours from start to finish.” Collette said: “Katerina will have noticed a lot of changes as notes nowadays are a lot more detailed and include before, during and after delivery, and of course everything is electronic.” Collette began her career in 1988 and now job shares her head of midwifery role with Rose Villar which she says gives her fantastic work life balance at this stage of her career. Anne, who was a student midwife at Katerina’s birth, qualified in 2000 and is now a senior band 7 midwife. Both moved from CFH to BH when the maternity unit there closed. Katerina says her interest in the job was sparked by a science course at college which drew her attention to A video game entrepreneur has praised doctors at the RFH after they used a new technique to remove a large blood clot from his lungs. Justin Gaffney, 54, from Putney, says his life is now back to normal thanks to the excellent care he received, and is urging others not to ignore the signs of deep vein thrombosis (DVT). A clot which usually develops in the leg or pelvis can move up the body and end up in the lungs. Doctors at the RFH are among the first in the UK to offer a procedure called mechanical thrombectomy to remove these clots, known as pulmonary embolism (PE). An 8mm diameter catheter tube is passed through a vein at the top of the leg through a keyhole incision, goes through the right side of the heart and is directed from there into the lung, where it is used to ‘suck’ out the clot. Consultant cardiologists, Gerry Coghlan and Tushar Kotecha, have delivered the highly effective treatment to more than 65 patients, ranging in age from 17 to 88. Because many of their patients are referred from other hospitals, the RFH has delivered the most mechanical thrombectomies in the UK. A major cause of DVTs is immobility, for example the patient has been in a cast or is bedbound, but a clot could also result from a long flight. Certain cancers, genetics and even COVID-19 are known to increase the risk of developing blood clots. RFH pioneers new blood clot treatment the possibilities of a career in midwifery. Katerina says her role keeps her busy but admits she has one eye on the horizon. She said: “My first job was in Nando’s and there was another member of staff who flew planes. I was fascinated and started taking flying lessons myself. I’m now qualified to fly small aircraft but my long-term plan is to work towards getting a commercial licence. Maybe one day I can harness both my skills in somewhere remote and underdeveloped.” Collette added: “It feels surreal but what an incredible full-circle moment! It’s so heartwarming to witness someone you’ve helped bring into the world following in your footsteps as a midwife. Moments like this truly highlight the beauty of our profession – what a special connection to share.” After three long-haul flights in close succession, it did cross Justin’s mind he might have developed a DVT when his left calf began to feel sore. But because it wasn’t hot to the touch or red, Justin shrugged it off and stuck to his plan to go on a walking holiday – despite also developing what he thought was a chest infection. Delivering the healthcare professionals of the future 9 Katerina as a baby L-R: Collette Spencer, head of midwifery; Katerina Kasapi, midwife and Anne Fowler, senior midwife L-R: Cardiology consultants Dr Tushar Kotecha and Dr Gerry Coghlan in one of the RFH’s cath labs Moments like this truly highlight the beauty of our profession “ “ Even a trip to the loo felt like I was climbing Everest “ “ Justin, (pictured above), said: “The pain in my calf came and went but as the week went on I was so out of breath that even a trip to the loo felt like I was climbing Everest.” After returning home and calling his GP, Justin was told to go to A&E where a CT scan revealed he had a large PE in his lungs. He said: “I’ve since learned that there can be different presentations of DVT and you should get checked out if you have any concerns. Genetics was ruled out but coincidentally just a few weeks later my brother developed DVT as well. Luckily, because of what happened to me, he quickly raised the alarm and was able to receive standard blood thinner treatment.” Symptoms of a PE include chest pain, difficulty breathing and coughing up blood. In the most severe cases there is risk of organ failure and death. Dr Coghlan said: “Dr Kotecha and I see some of our PE patients like Justin as emergency cases and will treat them immediately. For patients presenting less severely, we will initially try standard treatment, which is blood thinning medication, and then plan for interventional treatment if that is not effective. “Blood thinners might not be appropriate for some patients as a condition might mean there is a significant risk of bleeding, and we may go straight to the thrombectomy.” Once the procedure is complete, patients recover quickly and are usually discharged within a few days and scheduled for a follow-up in a few months to check lung and right heart function. Both doctors are keen to share their expertise and deliver regular training courses to doctors worldwide.
Governors’ update Get in touch: Our governors are elected to represent and listen to the views of staff, patients, and the public. If you would like to get in touch, please email rf-tr.governors@nhs.net A new MRI scanner awarded to the RFH clinical research facility (CRF) is set to expand greener research at the trust. The machine, known as a low-field MRI scanner, is more cost and energy-efficient than its standard counterparts. It has been granted by the National Institute of Health and Care Research as part of a national investment in NHS CRFs. Where most MRI scanners can use over 1,000 litres of liquid helium to keep the machine cool during use, the low-field scanner uses just 0.7 litres. This is because its lower strength magnet produces less heat. Consultant cardiologist, Dan Knight, said: “This scanner means we will be able to expand our imaging research in cardiovascular diseases, particularly for patients with pulmonary hypertension, a rare heart condition where they 10 11 Transforming cancer care Growing our RFL community Margherita has reclaimed the dancefloor Greener MRI scanner set to expand RFL research opportunities experience increased blood pressure in the lungs. “It also creates clearer pictures around tricky areas like the lungs, offering a great opportunity for patients with lung diseases to benefit from imaging without radiation.” The team hope to become the first UK site to undertake MRI-guided cardiac catheterisation using a low-field MRI scanner, a procedure which helps diagnose pulmonary hypertension. Lucy Parker, interim director of research and development, said: “The addition of the scanner to the CRF will help widen the portfolio of studies we are able to participate in and the type of research we can carry out.” Our latest Medicine for Members’ event, ‘Leading the fight against cancer: groundbreaking research at the RFL’, showcased our commitment to revolutionising cancer care. If you missed it, you can catch up by watching the recording on our website. Leading clinicians provided an overview of our clinical research facility (CRF) at the RFH. This state-of-theart unit opened in 2021, thanks to generous start-up funding provided by the Royal Free Charity. Currently, 29 clinical trials are underway at the CRF, involving 186 patients. The speakers showcased several of these, highlighting how they are contributing to the discovery of new and more effective cancer treatments. A patient receiving palliative care can dance again – thanks to specialist massage therapy provided by the Royal Free Charity. Margherita Serpaglia had lymph nodes removed during her treatment for breast cancer in 2018. She has since had swelling in her arm caused by lymphoedema, a malfunction of the lymphatic system that leads to a build-up of fluid in the body’s tissues. After six sessions of manual lymphatic drainage (MLD) – a series of techniques that help to drain fluid – Margherita can dance again. She said: “I’m in palliative care now but with these treatments, maybe I will get to the end of the road, and I will have suffered a little less. I am keeping my mobility because of the massages. “Before, my arm was tight; after three minutes of ballroom dancing, it would be burning. After the second MLD session I could feel the liquid in my arm going down. “By session six, I could raise my arm and dance in hold. I can dance for longer which means my quality of life is better. It has improved my overall wellbeing.” The charity’s massage therapists underwent a training course to learn the techniques for MLD prior to treating patients at the RFH. The therapists also teach patients how to perform similar techniques at home, helping them to ease discomfort for themselves. Rozalia, who treated Margherita, said: “It brings enormous relief to patients like Margherita. They are more comfortable and as a result, we feel we can help prevent some readmissions to hospital.” Margherita said: “You relax the minute you lie down. I think the therapists are so important to the whole hospital system.” Lymphoedema patients can access six free sessions of the MLD service through a clinician referral. L-R: Margherita and Rozalia, massage therapist Consultant cardiologist Dan Knight with the low-field MRI scanner Governors have been encouraging patients and the public to join our growing network of over 21,000 trust members. Patient governors Sneha Bedi, Julian Goodkin and Linda Bogod have hosted information stalls across our hospitals. They’ve been speaking with staff, patients and the public about the benefits of becoming a member, how to get involved with the Council of Governors and their own experiences. Sneha said: “I became a Royal Free London member in 2017 and I have served as a governor for almost eight years. It has been an incredibly rewarding experience. “It has given me an opportunity to share my feedback about the amazing work of staff as well as share constructive feedback to ensure that local communities are receiving the best care. “Knowing that my contributions have helped improve patient and staff experience has given me an enormous sense of pride.” We would be grateful for your support in spreading the word and helping us grow our RFL community – please encourage your friends, families and colleagues to join our membership, details of which can be found on our website. From sharing feedback about our services to being able to stand for election as a governor, they will have a chance to make a real difference. Members are kept up to date with the latest RFL developments and news, and invited to events to increase their understanding of local health services. L-R: Linda Bogod, patient governor; Julian Goodkin, patient governor at North Mid; Sneha Bedi, patient and lead governor RFH first hospital in the country to recruit patient to global study This included the HERTHENA study, which is testing a drug for patients with advance cancers that have stopped responding to standard treatments. The RFH was the first hospital in the country to recruit a patient to this global study. Speakers also showcased the PRIMER-1 study, which is investigating whether medications currently used for advanced liver cancer could be introduced earlier – before surgery – to make treatment more effective and reduce the chance of the cancer returning. Cancer care is a key part of our trust’s five-year clinical vision, which is our blueprint for bringing the best of the NHS to all of our patients. Medicine for Members’ events are hosted by our governors and focus on topics which are important to patients, staff and the local community.
12 60 seconds with… Avril Beesley Nurse in the BH and CFH paediatric diabetes team Tell me a bit about your role I am one of five nurses in the team, along with dietitians, clinical psychologists, doctors and admin support. We look after children with diabetes – mostly type 1 but we do see children with type 2 – and currently have about 250 families in our care. The role involves helping children through their diagnosis and showing them that diabetes is manageable once they have experience and commit to learning the nature of the condition. We bring hope; it can be quite traumatic for a child to get a diagnosis, and we support the whole family through that in a positive way. How did you get into this role? I previously worked in adult nursing. When I came back from a career break after having children, I did a returning to nursing course and got really interested in paediatrics. A role came up in this area in another hospital, and then I moved to the RFL in 2018. Since that time, funding for insulin pumps and blood glucose sensors for children has become the norm, so we are really lucky to work in an area that has the funding and technology to support our patients. This is automating parts of diabetes management and making life a bit less stressful for our families. What would you say to someone who is thinking of a career in this area? I would tell them that it is incredibly varied and rewarding. We really get to know our patients, as they stay with our team until they are 19-years-old. Because we are able to get in early and educate the patient, families and schools on how to best manage diabetes, results show that these children can go on to become healthy adults. What are the most significant challenges in your role? A paediatric diabetes diagnosis impacts the whole family, so you really need everyone to get on board with supporting the child. With that, you come up against language barriers, lack of engagement or parents not being comfortable with technology. For example, part of monitoring the pump involves calculations – we train them and help them get to grips with that. Experts say it takes about a year to understand diabetes as you need to get through the first holiday, the first Christmas, or the first Eid – whatever it is that applies to the family. Changes in lifestyle and food production are also leading to more type 2 diabetes diagnoses, which can be linked to socioeconomic conditions. These are all factors that influence the care we provide. The most important thing is to challenge stigma and be positive as much as possible, because diabetes is manageable. What is the proudest moment of your career? Last year, our team won the group RFL Oscar for clinical team of the year. We got that for improving access for patients and finding solutions such as interpreters and alternative training methods for families where English is a second language. We were delighted to be recognised as there are so many people you need to engage with like GPs, schools and parents. How do you like to unwind away from work? I am quite active. I love Argentinian tango so I do that a couple of times a week. I have also recently got interested in pottery, and I play badminton. Taking care of your wellbeing Every day, our staff go above and beyond to care for our patients. Please take the time to also look after your own wellbeing: • 24/7 helpline (out of hours) contact Care First on 0800 174319 (24/7) service) for emotional and psychological support or access online via carefirst-lifestyle.co.uk; login details can be found on Freenet • Contact the Samaritans (on 116 123), NHS Helpline (111) or your GP • Cost of living worries can have a huge impact on our mental health – visit our financial wellbeing page on Freenet • Visit Freenet for a range of resources, information and other wellbeing tips
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