Royal Free London NHS Foundation Trust Staff, members, and governors’ magazine // May / June 2026 Introducing our shared commitments Act with integrity Champion inclusion Deliver excellence Care with compassion
L-R: Isabel Sutton, trainee clinical psychologist and Claire Franklin, clinical psychologist Pippa Hartley Follow our X account @RoyalFreeNHS to see what our patients and staff are saying about us Patient praises ‘incredible’ brain injury support group to the May/June edition of our bi-monthly staff, members and governors’ magazine. This edition marks the launch of our new RFL shared commitments. These principles have been developed by you to help unite us and guide us in our day-to-day work, and showcase what it is we stand for. A significant amount of work has been involved in making sure these accurately reflect who we are as an enlarged organisation. Thank you to every colleague who shared their ideas, feedback and reflections which helped shape them. Read more on page 6. We are now the largest provider for breast screening in the whole of England after expanding our services to encompass everything north of the River Thames and stretching right to the M25. This is an incredibly exciting opportunity for the RFL to screen thousands more women every year, helping to diagnose cancer at the earliest opportunity. More information can be found on page 8 following the work of this team. On page 5, our North Mid diabetes team highlight the success of their collaborative community work which has seen a significant reduction in emergency department admissions for those with type 2 diabetes. You can also discover the story of one of our patients, Lisa, who recovered from a brain tumour at our neurological rehabilitation centre on page 3. I look forward to seeing many more achievements from our colleagues and services across the group. Thank you, as always, for all your hard work. When Pippa Hartley was rushed to hospital with a severe headache in December 2024, she never expected her symptoms to be a result of a brain tumour. “I hadn’t been feeling well for a number of years,” Pippa, 55, shared. “I was fatigued and fell asleep everywhere, I’d fallen a few times and was getting terrible headaches, but I’d always suffered from migraines – I never in a million years thought I’d have a tumour or mass on my brain.” She underwent brain surgery to remove the tumour a month later, before being referred to the neurological rehabilitation centre (NRC) at Edgware Community Hospital. There, she received support to help her regain her speech and manage fatigue. It was while she was receiving this treatment that staff recommended taking part in a new educational support group for people with acquired brain injuries – this includes those with a benign brain tumour, head trauma or who have recently had brain surgery. The six-week group intervention, run by clinical psychologist Claire Franklin and trainee clinical psychologist Isabel Sutton, aims to educate patients about the impact of having a brain injury and teach coping strategies. The initiative was introduced earlier this year, and Pippa was part of the first cohort to complete the course. “I remember being sceptical about how the group would work. I also hadn’t shared my journey with anyone else and was still experiencing sensory issues,” Pippa recalled. “But the group has been incredible.” From memory to concentration, sensory changes and communication, as well as managing fatigue and understanding the emotional impact, the group focused on a new topic each week to help patients understand how their brain works and build on skills to manage any challenges. Pippa said: “You can look fine on the outside but there’s so much that people don’t see. I can still have issues with speech and memory – when there’s Hello and welcome I hadn’t shared my journey with anyone else “ “ Peter Landstrom Group chief executive 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 lots of noise there’s a delay in processing and formulating words. “The education group allowed me to have the space to process and address these changes. It was helpful to understand the situations where I struggle to process information, and to recognise that I sometimes need to tell people I’ve had brain surgery so I can ask them to slow down or repeat things, ensuring I’ve understood before they continue.” 3 Claire explained the importance of teaching patients in a group setting: “Although we share tips on living life well after a brain injury, one of the crucial parts of this educational group is the peer support. “We encouraged patients to share experiences whenever they felt safe to do so and this group really did connect and share stories and resources with each other. I’ve never seen such positivity and consistent attendance from patients before.” Pippa added: “Being surrounded by a group of people who understand what I’ve been through, whilst being informed about what’s going on inside your brain, made me feel less alone. “Outside in the real world, there’s lots of empathy and care but it’s hard for people with brain injuries to have a voice in it. The group gave me that opportunity to have a voice and without a doubt helped with my recovery. I hope others who have had a brain injury get to experience a group like this one.” Care with compassion Act with integrity Champion inclusion Deliver excellence
5 4 The installation of new state-of-the-art breast imaging equipment at CFH marks a major step forward in cancer detection and care for the local community. The new contrast enhanced spectral mammography (CESM) technology, funded by the Royal Free Charity, uses a small intravenous injection of contrast dye prior to breast imaging, enabling areas of concern to be visualised with far greater clarity This enhanced imaging capability supports earlier cancer detection and improves diagnostic accuracy for clinical teams. In many cases, the new CESM pathway also removes the need for additional MRI examinations, which are more time-consuming and can be uncomfortable for patients who experience claustrophobia. As a result, average appointment times have been cut in half to approximately 45 minutes, improving both patient experience and service efficiency. While CESM technology is still relatively new within the UK, it has already been widely established across Europe. The new unit at CFH is one of the first in the country with an additional biopsy capability. Specialist staff have undertaken dedicated training to ensure they are fully equipped with the skills required to operate the system and accurately interpret the enhanced images. Adrian Trinidade, interim group imaging director, said: “This could ultimately mean that the patient’s diagnostic pathway is significantly shortened, allowing treatment to begin earlier and improve patient outcomes.” The imaging suite underwent a comprehensive upgrade to meet the safety requirements of the more advanced imaging system. The total investment in the refurbishment and equipment was approximately £300,000, helping to future-proof the service for years to come. This has been a collaborative effort “ “ Improving diagnostics equals quicker cancer treatment L-R: Christine, Ciara, Kleya and Gentiana Staff from the mammography team at CFH Staff from the North Mid diabetes team Patients are benefitting from more timely diabetes care in the community thanks to a co-ordinated approach led from North Mid. A service improvement and health inequalities project, led by a multidisciplinary team (MDT) working with GP practices, has reduced emergency department attendances related to type 2 diabetes by 30% within a year. Key to success has been upskilling diabetes specialist nurses (DSNs) to handle more complex cases. In addition, assessment templates have been improved to keep diabetes consultation focused on reviewing and initiating treatment. The work has also included strengthening the community referral form to make provision for vulnerable patients, so issues such as mental health, language barriers or mobility issues are flagged. This enables referrals to be prioritised, ensuring these patients are seen in clinic as soon as possible. Additional intervention includes a health inequality project which sees weekly MDT discussion of 10 patients with high glucose levels. Patients are identified through case finding by a DSN alongside a clinical pharmacist, GP or practice nurse in primary care. The project focuses on the most deprived areas of the borough where health inequalities are higher. By maintaining lower glucose levels, people with diabetes can reduce the risk of long-term complications, such as heart, eye and kidney disease. Each session runs for two hours or more and the care of patients is closely analysed. Nneka Agbasi, clinical nurse lead for the Enfield community diabetes service, explained: “Seeing this huge reduction in emergency ED attendance for this group of patients demonstrates how effective our interventions have been. The service improvement will ensure this reduction is maintained.” Improved communications between ED and Same Day Emergency Care Community focus for Type 2 diabetes patients (SDEC) is helping to avoid readmissions. Patients who are admitted are given a plan so once discharged their care can be smoothly transitioned to the community. Swapna Mutharath, lead nurse for diabetes and endocrinology at North Mid, added: “This has been a collaborative effort between the community team and primary care, SDEC and ED.” Dr Chidambaram Nethaji, diabetes and endocrinology lead at North Mid, said: “We look at each patient individually to help them avoid coming to hospital. Any measure we can take to reduce the number of patients presenting at ED or being referred to SDEC is welcome.” Dr Hillary Tindall, diabetes consultant and health inequalities consultant lead, said: “This early interventional approach sits very well within the government’s 10-year-plan and the trust’s own population health focus. We have shown we can improve people’s ability to manage their diabetes at home.” Dr Tindall added: “We can do still more work to champion this neighbourhood approach, working across all sectors to move care closer to home.” When Kleya and Ciara met in the first year of secondary school they quickly became close. It was only later that they discovered something extraordinary: both had been treated for leukaemia at BH at the same time, when they were just three years old. “I’d never met anyone who had had leukaemia when they were younger,” said Kleya, 14. “It was cool to have someone I could relate to.” “It’s really nice to have someone who understands it,” added Ciara, 14. For both families, the memories of that time are shaped not only by the challenges they faced, but by the care and compassion they received. They recalled the difference NHS staff made, as well as the extra charity-funded touches that helped lighten difficult days – from visits by therapy dogs to celebrations marking the end of treatment. Now fully recovered, Kleya and Ciara remain great friends. Childhood cancer survivors giving back to NHS staff Their shared experience is the reason both families are now taking part in Walk for Wards 2026, a fundraising event organised by the Royal Free Charity bringing together patients, families and NHS staff to raise funds for services across the RFL. “We’re doing Walk for Wards to give something back because the doctors, nurses and charity have been amazing – they don’t just do their jobs, they go far beyond that,” said Gentiana, Kleya’s mum. Christine, Ciara’s mum, added: “I don’t know how I would have got through it without them.” Walk for Wards will take place on 19 September in Trent Park, Enfield. Sign up at qrco.de/walkforwards.
6 Guiding everything we do They help us make the right decisions, even under pressure, and ensure every interaction reflects the standards our patients and colleagues deserve. Our shared commitments build trust. When we act consistently and with compassion and integrity, patients, families, and staff feel safe, respected, and confident in our care. Our shared commitments unite us. Healthcare is a team effort. Shared commitments help us work together with purpose, clarity, and mutual respect – no matter our role. Our shared commitments shape our culture. They create an NHS where people feel supported, included, and motivated to do their best every day. Our shared commitments drive better care. By living our shared commitments, we demonstrate compassion, inclusion, integrity and deliver excellence for those in our care. They are for everyone, in every role. Over the coming months, teams will explore what they mean in practice and how we can all play a part. Speaking about the launch, Peter Landstrom, group chief executive said: “This is a key moment for our organisation. Our new shared commitments have been actively developed by our staff, patients and communities. They set out not only what we stand for, but how we will provide outstanding care every day. “But they need to be more than just words. We need to continually bring them to life in our daily work as both individuals and teams, building our culture in a way that ultimately delivers the best possible experience and outcomes for our patients and the people we serve.” You will see our staff featured on banners and other artwork throughout our satellite sites and hospitals – look out for them in your department. Shaped by you: our new shared commitments 7 Care with compassion We treat every patient, family member, and colleague with dignity and respect, listening carefully and responding with kindness. Act with integrity We take responsibility for the care we provide, acting honestly, fairly, and speaking up when it matters. Our new shared commitments are here – four simple statements that reflect who we are and how we care. Shaped by you, they set out the everyday behaviours we promise to each other and to our patients across the RFL. We will care with compassion, champion inclusion, act with integrity and deliver excellence. They redefine how we commit to behave, what good looks like in our teams, and how we’ll support and hold each other to account. You told us you wanted commitments that are short and easy to remember, easy to put into practice, focused on fairness, dignity, safety and inclusion and clearly linked to real behaviours. These bring these expectations to life in a simple, practical way. Thomas Pounds, group chief people officer, reflected: “These shared commitments are incredibly meaningful to me because they’ve been shaped by the voices and experiences of our people – both our staff and our patients. Bringing them into our organisation is now about creating the kind of culture we all want to be part of. I’m proud of the role we’ve all played in really listening, and creating these together, and we couldn’t have done it without you, thank you.” Care with compassion Act with integrity Champion inclusion Deliver excellence We value diverse perspectives and backgrounds, working to ensure equity, access, and opportunity for everyone. Champion inclusion Deliver excellence We hold ourselves to the highest standards, working together to provide outstanding care and improve outcomes.
8 9 Meet the team that knows breast If there’s one team in the trust facing a particularly exciting challenge in 2026, it has to be the breast screening service. On April 1 the RFL added West of London and Outer North East London breast screening services to the areas it already covers, making us the largest provider in the country, responsible for screening everywhere north of the Thames right out to the M25. That’s an additional 310,000 women, bringing the total number served by RFL to 750,000. In practice it will mean that women will have a greater choice over the location of their screening, and more flexibility to book appointments at a time convenient to them. The trust now covers four of London’s six breast screening services. In addition, the hub which is run by RFL is already responsible for the administration work for all of London, equating to 1.3 million women. Service with a strong track record The service wasn’t always the enormous operation it is today. It has grown over the years, and with that has come the knowledge, expertise and track record to enable the expansion. The team now numbers more than 220 staff, including mammographers, radiographers, clinical nurse specialists and administrative staff. Kenneth Blake is assistant operations manager for the London administrative hub. Outside of London each individual service provides an end-to-end provision, but since 2016 the RFL has been responsible for the call centre, scheduling (both staff and patients) and data collation across London. “We handle over 20,000 calls a month,” said Kenneth. “Our call centre is open seven days a week and I’m proud to say the average waiting time for the call to be answered is less than 30 seconds. “Patients can book their screening online and we are now investigating the possibility of introducing a web chat function, but it doesn’t end there. The hub ensures that all eligible women are communicated with effectively, whether that be an invitation, attendance outcome or GP notification. All patients referred for cancer treatment have their data logged and recorded on national breast screening systems.” We have already identified a number of cancers in women who might otherwise have not attended “ “ We have built resilience into our workforce “ “ Take-up of screening in London is historically lower than other areas of the country due to a number of factors, including a diverse population and greater movement. Letters and reminder texts often go unanswered. “We do everything in our power to get the women to attend their appointments, but we know more can be done,” said Claire Mabena. Claire is the lead clinical nurse specialist (CNS) for the breast screening service, and as well as leading a team of nurses she is also in charge of a health promotion team. She said: “It’s about contacting women, engaging with them and reassuring them. Sometimes it means breaking down common myths, such as concerns about the amount of radiation being used. It’s also about making reasonable adjustments for patients with learning difficulties, special needs, physical disabilities or mental health issues. This is work that makes a difference. We have already identified a number of cancers in women who may not otherwise have attended without our intervention.” There is a lot of primary care community engagement, especially with underrepresented groups such as the Somali, Bangladeshi, Romanian and Greek communities. The health promotion team regularly trains champions within those communities to build trust. Claire added: “Now our geographical area has grown we will need to look at other ethnicities concentrated in the new areas.” The team also feeds into the primary care network meetings to encourage GPs to run health and wellbeing events in their surgeries, which the health promotion team can be a part of. Early diagnosis is key More than 10,000 women are screened each month, with 400 of those brought back for further tests such as ultrasound and biopsies, and about 1,000 people are diagnosed every year – 75% at stage 1 or 2 which means less aggressive treatments and better long-term prognosis. As the screening programme continues year on year, the size of cancers found is smaller and image quality has improved greatly. Of course, with the growth in the service these numbers will all rise. Kim Stoddard, senior operations manager and Kenneth Blake, assistant operations manager for the London administrative hub Breast screening senior team colleagues William Teh, director of screening and Stephanie Scott, superintendent radiographer Staff from the London administrative hub Kim Stoddard, senior operations manager, said: “We’ve spent a lot of time and hard work developing our teams. We know the expansion will bring challenges, but we embrace that. We have built resilience into our workforce and we make sure there is senior oversight and support, so our staff have that reassurance.” North London has its own particular needs. People of Jewish heritage have a significantly higher risk of carrying a mutated BRCA gene compared to the general population. As part of an extension to routine screening, a high-risk programme is in place with an extended age range. Within this programme approximately 75 women a month require MRI scans to assess their breasts and approximately 500 women aged from 25 to 71 will have a mammogram each year. Research is also an important element of the screening service, with three large trials concluding and others commencing. One which recently closed compared 2D with 3D imaging, and another compared surgery with active monitoring for women with low risk ductal carcinoma in situ (DCIS). More than 11,000 women have been involved in breast screening research at the RFL over the last two years. William Teh, director of screening at the RFL, said: “As well as waiting to hear the results of the large trials, we also have a small trial taking place where we are looking at removing a small tumour – less than 15mm in size and classed as grade 1 – by using a vacuum needle, instead of the current standard care, which involves a surgical approach. All these trials could end up changing how women are treated in the future. “We are also looking to introduce a study to assess how we can harness AI to improve cancer detection. A further piece of work supported by AI could potentially be used to help us reach out to non-attendees.” Steven Davies, operations manager, is excited about the opportunities on the horizon. He said: “By being bigger we have more shared staff resources, which will enable us to increase patient choice and flexibility, and offer more research and development opportunities; all with the aim of improving patient care.” Although there is a national shortage of mammographers, the numbers are robust in the trust’s service. The team is proud of its strong recruitment and retention rates and ability to promote staff from the apprentice programme and internal development initiatives.
Governors’ update Become a member of the RFL and help make a difference Become a member of the RFL for free if you live in England, are 16 or over, or are a carer for a patient that is under 16 years old. By becoming a member, you’ll be able to stand for election as a RFL governor or elect governors to represent your interests, keep up to date with latest developments and news and be invited to events about your local health services. More information can be found on our website, or you can email rf.membership@nhs.net 10 11 Shaping a smarter approach to frailty Meet your new governors In the race to stop type 1 diabetes in its tracks Frailty – one of the biggest challenges facing the NHS – was our focus as we launched the 2026 Medicine for Members programme. Chaired by elected patient governor, Richard Helyer, the event brought together more than 90 patients, colleagues and members of the public to explore how the trust is reshaping frailty care through innovation, partnership and a focus on patient experience. If you missed the event, you can catch up on the RFL website. Maurice Cohen, divisional director for integrated medical specialities and therapy and clinical director for the London Frailty Network, opened the session by defining frailty and highlighting the profound impact it can have on patient outcomes. He also spoke about the growing importance of neighbourhood care, showing how shifting resources, expertise and support into the community can help more people receive safe, effective care in their own homes. Dev Chauhan, clinical lead for geriatric medicine and lead for the frailty clinical practice group, explained how the RFL is working to reduce variation and improve outcomes through its frailty clinical pathway. This work brings together multidisciplinary teams from across the trust to share best practice, develop consistent approaches and embed equity at every stage of frailty care. Get to know some of your newly elected public governors. • David Hawley is a partner in the world’s largest professional services firm, where he has spent over 30 years advising companies on their strategy and governance. David has been a RFL patient for several decades and is committed to ensuring the trust continues to provide world class care to its local communities. • Jennifer Boateng is a support worker and is actively engaged in promoting public initiatives aimed at enhancing community wellbeing. She was previously a general advice volunteer for the Citizens Advice Bureau. • John Orr is a chartered structural engineer and Professor of Structural Engineering at the University of Cambridge. He is passionate about how the design of spaces we use impacts our health and improving patient experience. • Melike Koymen has over nine years’ experience working in local government as well as the voluntary sector. She is dedicated to ensuring the voices of our local communities are heard and helping inform the trust’s decision-making process. Every few days Gabriella Fiddler patiently makes the journey from her home in Hendon to the RFH. The 22-year-old, who has type 1 diabetes, attends the Clinical Research Facility (CRF) as part of a potentially ground-breaking study. Professor Lucy Walker, from the UCL Institute for Infection Immunity and Transplantation (IIT), who is chief scientific investigator for the SMART study, said there are reasons for hope in the type 1 community as teplizumab has been shown to delay the need for insulin by an average of three years. She said: “The landscape is really starting to change. For the first time we are attempting to stop the immune response that destroys insulin-producing cells, rather than just replacing insulin by injection. The hunt is now on to develop even more effective treatments to delay onset even further and that’s what we’re aiming to do.” one. Participants also have regular blood tests and their lymph nodes are sampled. Lucy said: “Although some immune cells are in the blood, most are contained in the lymph nodes. I want to understand how the treatment is affecting the nodes, not just the blood, and to see whether this can be used for monitoring response to treatments. The combination therapy being tested was developed by the research team in the Pears Building next to the RFH. It’s truly home-grown research.” In the future, treatments like these may be offered to people even before they develop symptoms of type 1 diabetes. By intervening early, it may be possible to prevent the condition from developing, which the trust is contributing to through the ELSA screening study. The principal investigator on the SMART study, Dr Sarah Ali, said: “It’s an exciting time for type 1 diabetes research as treatment is on the cusp of change. The trust can be very proud of the work taking place in this area.” Gabriella said: “I was diagnosed with type 1 diabetes in 2022. A couple of months before I ended up in hospital I’d started to feel weak, tired and even struggling to breathe. Luckily, I was at home when I collapsed and my dad called an ambulance. I’d gone into diabetic ketoacidosis and would have died if I hadn’t been diagnosed and treated quickly. I got an insulin pump and although that has made life easier it’s still a massive adjustment. “I believe we might be able to find a cure for type 1 in my lifetime and even if it’s just for those who are newly diagnosed, playing a part in that makes me feel good.” The hunt is now on to develop even more effective treatments to delay onset “ “ Staff involved in the SMART study David Hawley Richard Heyler Maurice Cohen Dev Chauhan John Orr Jennifer Boateng Melike Koymen Gabriella Fiddler Twenty-four patients are being recruited to the SMART study which is open to people with type 1 diabetes aged 18 to 50 who were diagnosed in the last five years. The study involves a new combination therapy: the first drug is given as an infusion four times over two months. The second drug is self-administered as an injection twice a week over 16 weeks. Half of the participants receive both drugs and the others just The evening wrapped up with an energetic and interactive Q&A session, giving attendees the chance to join the conversation and put their questions directly to our speakers. It covered topics from pressure ulcer prevention to hospital‑at‑home services, neighbourhood care timelines and how frailty services adapt as needs progress. Both speakers emphasised the importance of compassionate, person‑centred care, strong leadership and involving patients and carers in service design.
12 60 seconds with… Dr Rapti Mediwake consultant rheumatologist and general physician Tell us about yourself and your team I have been at BH since 2007 across both rheumatology and general medicine. In that time, our team has grown significantly – we now have seven rheumatology consultants across BH and CFH, with four of us also contributing to general medicine. Our team includes four specialist nurses, administrators and an internal medicine trainee. It’s very much a team effort, and that’s what allows us to run the service effectively. What has driven the expansion of the rheumatology service? The main driver has been increasing demand, alongside major advances in treatment. Over the past 20 years, therapies – particularly biologics – have expanded significantly, allowing us to treat more complex conditions. However, these advancements also require more patient monitoring and ongoing support, which has increased workload and contributed to the growth of the service. What are some of the challenges the team faces? One of the key challenges is managing capacity, particularly reducing our waiting lists and the need for ongoing follow-up. Outpatient clinics are often busy, as appointments bring together clinical care, education and counselling in one setting. That said, there are positives. Digital systems have improved communications, coordination and recordkeeping, and the team has adapted well to support patients. Also patients today are far more informed and engaged in their care, often coming to appointments with a good understanding of their condition, and for many this is something you can live well with, rather than something that significantly limits your life. Are there any innovations in the team that stand out? One key development was helping to establish the medical day treatment unit. It allows treatments that once required hospital admission to be delivered on an outpatient basis, which is much better for patients and reduces pressure on beds. We also run a rheumatology advice line for GPs and junior doctors, helping to provide early guidance and prevent unnecessary admissions. Alongside that, our admin and nursing teams play a crucial role in keeping communication flowing and supporting patients proactively. What are your ambitions for the future? We’d like to continue expanding – particularly increasing nursing capacity, which is essential to how we deliver care. Beyond that, it’s about strengthening the patient experience and bringing some more in-person patient groups together. That helps build a supportive, informed community around care. How do you like to unwind outside of work? I’m very sporty and enjoy running and being active outdoors. Recently, I completed a 120km Santiago de Compostela hike with friends over five days, which was a fantastic experience. For me, exercise and spending time outdoors are the best ways to relax and recharge after work. 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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