Clinical nurse specialists - Royal Brompton Hospital
- Anna Anscombe
- Emma Peters
- Helen Smith
- Philip Walters
These nurses have undergone advanced specialist training enabling them to carry out their extended nursing roles. This training includes physical assessment, phlebotomy (taking blood), spirometry, cardiothoracic nursing care, critical care and health promotion.
The team’s role is to support and educate patients and their relatives undergoing heart surgery and to perform clinical assessments in a variety of settings to ensure patients are ready for their operation. During the inpatient recovery period, the team will speak with patients regarding cardiac rehabilitation and make any necessary referrals to their local community providers. The team is also involved in the post-operative care of some patients through the short-stay programme and the nurse-led heart valve clinic.
The team acts a clinical resource for staff in the hospital, undertaking both formal and informal teaching sessions and through involvement in the induction programme for the junior doctors. The team also provides specialist advice and support to health professionals and co-workers in the community
The team provides a range of services for patients undergoing heart surgery.
Fit for surgery programme
This programme is designed to enable our patients to get maximum benefit from the surgery that is planned for them. It aims to identify our patients' risk factors, and then helps them to undertake the lifestyle changes that will improve their overall health. We also use this opportunity to screen patients as soon as possible after they join their surgeon’s waiting list. This helps to avoid unnecessary delays while waiting for surgery.
The programme is either delivered by telephone or by a home visit (if the patient lives within 90 minutes drive of the hospital).
These clinics are an essential part of our patient care as it enables the surgical team to ensure patients are ready for surgery and to avoid last minute cancellations
The clinic involves a consultation with one of the nurses who records the patient’s previous medical history, performs a clinical examination, takes blood tests and organises any other necessary investigations.
Clinics are held four times a week in the pre-admission suite at the hospital and patients will be contacted by our team to arrange a convenient date for this assessment.
Surgical information seminars
The purpose of these optional education sessions is to help reassure and prepare patients and their families for surgery and to offer information about what to expect while waiting for surgery, the operation and hospital stay, and their care after discharge home.
These regular seminars are run by the clinical nurse specialists who give a presentation and answer any questions patients may have. Other health practitioners involved in the patient’s care may also give short presentations.
Topics covered in the seminars include how the waiting list is arranged, physiotherapy and physical activity, nutrition, pain control, wound care and infection control, blood transfusions, restrictions to activities of daily living and cardiac rehabilitation. A short DVD that was filmed by the British Heart Foundation at Royal Brompton Hospital is also shown at the end of the seminar.
Patients are welcome to bring a guest with them and are encouraged to ask any questions or raise any concerns they may have.
All patients waiting for adult cardiac surgery will be sent an invitation to attend a seminar.
Referral for phase 3 cardiac rehabilitation
The team identifies patients suitable for cardiac rehabilitation following heart surgery and refers them to their local centres for phase III of this programme.
Nurse-led heart valve clinic at Royal Brompton Hospital
When it commenced in September 2004, this weekly, nurse-led clinic was the first of its kind in the UK.
Patients are seen annually (or biennially if stable) following their heart valve surgery at Royal Brompton and patients undergo echocardiography to ascertain their valvular function, an ECG to assess their heart rate and rhythm, and a blood test to review BNP levels plus any other relevant tests required. The clinic is overseen by a senior cardiac consultant.
A routine clinical assessment is also performed to assess for changes in symptoms, medications and for any signs of heart failure.
Advice is given concerning antibiotic prophylaxis to reduce the risk of endocarditis and the use of statins to prolong the life of a tissue valve. Secondary prevention advice related to weight reduction and smoking cessation is also given if required.
Referrals to other specialists, such as heart failure or the arrhythmia specialists, can be made if required.
A letter summarising the clinic findings is sent to the patient and their GP.
Read more about our heart valve clinic at Royal Brompton Hospital.
Advanced nurse practitioners (ANPs)
- Heather Wyman
- Debbie Williams
- Latha Gurusamy
- Libby Blewett
- Natasha Shand
- Katie Skinner
- Ida Atti
The ANPs are highly experienced nurses with skills in advanced physical assessment and clinical management; some are non-medical prescribers, which means they are able to review your medication.
Each ANP works closely with a specific surgeon, along with a senior registrar (SpR), and they are your link to the surgeon. You will see the SpR and ANP every morning of your stay, and the ANP throughout the day.
The ANP also works with your multidisciplinary team to coordinate your care.
Fitness for surgery team
- Hannah Ashpole
- Hillary Schrauwers
- Heather Bennett
- Rudi Keshwara
- Bibi Persaud-Rai
- Nancy Browne
Contacting the team at Harefield
To contact any of the advanced nurse practitioners in adult cardiac surgery team at Harefield Hospital, please call the switchboard on 01895 823737 and ask for bleep 6401 or 6146.
"Everyone in the lab was amazing through the whole procedure - as I was awake, everyone was talking to me telling me I was okay which for a very nervous person like myself helped so much. I then got admitted to Acorn ward for an overnight stay where the night nurse was great to me.
"All in all, the staff in Harefield are exceptional! There was not one person who I spoke to who was not lovely and friendly and willing to help. I would recommend this hospital to anyone. Thank you Harefield."
- Review on NHS Choices, November 2016