Respiratory medicine

A year of innovation

The Trust is a world leader in the diagnosis, management and treatment of lung disease. Patients from the UK and overseas are treated for the full range of respiratory disorders.

2008/09 highlights

Diagnosing and staging lung cancer: an innovative new service

• Dr Andrew Barlow, consultant respiratory physician, launched an innovative new service at Harefield Hospital in January 2009 involving a procedure known as Endobronchial Ultrasound (EBUS) which uses new technology combining on ordinary bronchoscope with an ultrasound probe. EBUS is particularly useful in diagnosing and staging lung cancer and means that some patients can avoid having a surgical procedure.

The world’s largest trial of gene therapy for cystic fibrosis

• The world’s largest trial of gene therapy for cystic fibrosis continued at Royal Brompton during 2008-09. The trial is being conducted by the UK Cystic Fibrosis Gene Therapy Consortium, made up of approximately 80 clinicians and scientists in the UK from Royal Brompton/Imperial College and Oxford and Edinburgh Universities. It is led by Professor Eric Alton, consultant physician, and principally funded by the Cystic Fibrosis Trust (approximately £33 million to date).

Free lung health checks for commuters at Victoria station 

• In November 2008 commuters travelling through Victoria station in London were able to take advantage of free lung health checks and advice from Trust experts, including Dr Nicholas Hopkinson, senior lecturer and honorary consultant physician in respiratory medicine. Staff in the lung division organised a stand in the busy station to mark World COPD Day. COPD (chronic obstructive pulmonary disease) kills around 30,000 people a year in the UK yet it is estimated that around three million people with the disease are unaware they have the condition. The Trust’s advanced COPD clinic receives referrals from all over the UK and offers cutting edge experimental therapies for people with severe emphysema including endobronchial valve insertion and transpleural airway bypass.

Positive results for hayfever tablet vaccine, Grazax

• Research undertaken at Royal Brompton, led by Professor Stephen Durham, confirmed that the tablet vaccine for hayfever, Grazax, shows positive results for four years with maintained improvement for at least one year after treatment has stopped. This vaccine is now approved in the UK and Europe.

£500,000 MRC grant to study ACE-inhibitors

• A £500,000 Medical Research Council grant was secured in 2008-09 to study the use of Angiotensin-Converting Enzyme (ACE)-inhibitors to reverse muscle wasting. This research is led by Dr Nick Hopkinson and Professor Mike Polkey.

Service developed to manage non-tuberculous mycobacteria infections

• Research carried out at the Host Defence Unit at Royal Brompton has supported the development of a service providing expertise in managing non-tuberculous mycobacteria infections. In the past few years, these have been increasingly recognised both as causing primary infection of the ung in previously well people, and more commonly as an infection that complicates pre-existing lung damage.

Royal Brompton expands its severe asthma clinic

• Royal Brompton’s dedicated severe asthma service, the largest in the UK, has developed significantly in the past year leading to the recruitment of a second asthma clinical nurse specialist who is responsible for the care of 32 patients. Trust experts are at the forefront of research into novel treatments for severe asthma and have one of the largest clinical services for the administration of Omalizumab therapy for severe atopic asthma. This is the first of a range of targeted therapies for severe asthma that have been approved by NICE.

Lind ward patients are well versed in the arts

• In November, a ‘poetry wall’ was created by artist Michelle Johnson in the bronchoscopy recovery room on Lind ward as part of the rb&harts programme. The installation has provided a welcome distraction for patients as they recover from their procedure.

Patients say ‘it’s good to talk’ to the appointments department

• A new telephone system was introduced in the appointments department in April 2008 to improve the service given to patients who call every day. The service has had overwhelmingly positive feedback from both patients and staff.
  

Accolades for staff

• Professor Anthony Newman Taylor was honoured with a knighthood in the Queen’s 2008 birthday honours list. The award was given in recognition of his public service. Sir Anthony joined Royal Brompton in 1977 as a consultant respiratory physician and built the largest clinical and research department in Europe, investigating the occupational and environmental causes of lung disease, particularly asthma. He is a non-executive director of the Trust and deputy principal of Imperial College’s Faculty of Medicine.

• Drs Mary Morrell and Anita Simonds were awarded a £1.5 million National Institute for Health Research Health Technology Assessment grant to investigate the role of nasal continuous airway pressure therapy in elderly patients with obstructive sleep apnoea. Bridging the gap between cardiology and respiratory medicine, the sleep team is working with Professor Martin Cowie on a pioneering European multicentre trial of adaptive servo-ventilation in heart failure patients with central sleep apnoea.