Cardiovascular and Respiratory Partnership

The programme team supports colleagues across the partnership to deliver the vision through strategic, operational and cultural change. Our core mandate includes the delivery of:

One team, multiple sites integration - Designing models of care and delivering integration across care pathways, using the Clinical Academic Integration Framework. By developing models of care that are evidenced-based, we can ensure all patients are receiving the right care and/or treatment, at the right place, at the right time. As well as benefitting from the vast specialist expertise across the Partnership.

Education and training - Ensure opportunities are maximised to learn collaboratively across the system. Making the Partnership the best place to train and develop, including attracting and retaining our workforce through an education and training offer delivered by world-renowned experts across the Trusts and universities in heart, lung and critical care.  

Clinical-academic integration and translational research - Develop the clinical-academic model and ensure an evidence-based approach underpins all that we do. Patients have increased access to cutting-edge research studies and clinical trials, unlocking new evidence and treatments that can best opportunity to participate in cutting-edge research, improving outcomes, and unlocking new solutions and treatments that can lead to better patient outcomes. The scale and size of our patient cohorts places us as global leaders in research, making our learning and evidence available globally through high-impact publications and guidelines.

We work in partnership across a complex system with patients, clinical, academic and operational colleagues to deliver the Partnership vision. We support integration and collaboration across and between heart, lung, and critical care services in the Partnership, as well as strategic priorities within the Heart, Lung, Critical Care (HLCC) Clinical Group structure at Guy’s and St Thomas NHS Foundation Trust.

We have various forums that are made up of multidisciplinary and multi-professional teams, that help govern our work. Some of these are existing structures while others are currently in development including: 

Oversight Groups and HLCC Clinical Committees

• These groups focus on one team, multiple sites integration, as well as supporting partners to come together around the new electronic health record system, EPIC. A large focus of the clinical committees will also be on operational/tactical strategic delivery.

KHP Clinical Academic Groups (CAGs)

• We support the set-up and delivery of KHP CAGs for Cardiovascular, Respiratory & Allergy, and Critical Care (in development). These groups deliver against the KHP priorities: 1) Population Health 2) Personalised Medicine and 3) Digital and Data Sciences.

Maximising opportunities in EPIC, the electronic health record system

We have supported clinical teams to maximise opportunities and leverage the benefits of the EPIC system. For example, supported:

• Pharmacy and nursing colleagues to harmonise 79 medicines policies and guidelines, ensuring they are EPIC ready to enhance clinical safety and best practice;
• MyChart programme (patient record) to establish Heart, Lung, and Critical Care as early adopters within Guy’s and St Thomas’ NHS Foundation Trust;
• Development of cross-partnership order-sets and MDT proformas.

Cardiovascular

• We have the largest network in the UK for various heart conditions such as congenital heart disease (~>20,000 adults and children) and inherited cardiac conditions;
• Largest volume of inpatient spells in the UK for cardiac surgery intervention;
• Largest transcatheter structural intervention programme, and first in the UK to deliver minimally invasive mitral valve therapy;
• First and largest dedicated cardio-oncology service in the UK and one of the leading services in Europe;
• 5 year programme grant has been awarded by the British Heart Foundation to support Diffusion CMR and they are the first in the world to acquire a Magnetom Cima.X Magnetic Resonance Imaging (MRI) system which is a non-invasive diagnostic tool capable of depicting human heart muscle in 3D, as well as modelling heart microstructure, and function. It will help improve diagnosis, prognosis and therapy management and increase research opportunity on diffusion CMR and PhDs.

Respiratory

• Together, we form the largest interstitial lung disease (ILD) and sarcoidosis service in Europe caring for more than 7500 patients;
• Internationally recognised sleep, ventilation and weaning service, caring for over a quarter of London’s sleep patients;
• We have one of the largest global Bronchiectasis, Cystic Fibrosis and Respiratory Infection cohorts;
• Flagship lung cancer service encompassing interventional bronchoscopists at the forefront of endoluminal robotic therapies, with internationally leading histopathologists, radiologists and thoracic surgeons;
• We have Europe’s first successful double heart and lung transplant centres and remains one of the top centres in the world for these transplant procedures;
• International reputation for severe asthma services across the Partnership and are considered centres of excellence;
• We have a world class specialist COPD clinic and COPD rapid access clinic to provide assessment and optimum clinical management for patients with COPD, including a range of tests and treatments such as lung volume reduction capability and are committed to reducing the environmental impact of our treatment by supporting patients to transition to low-carbon inhalers where possible;
• A Therapist-led Virtual Cough Therapies Group service, open to referrals across all of the partnership organisations.

Critical Care

• We have unparalleled expertise in critical care including cardiovascular, thoracic, trauma, neuro, renal, liver, transplant, haematology, oncology, advanced obstetrics, complete portfolio of surgical specialties;
• We are home to two nationally commissioned ECMO centres and access to a retrieval service;
• King's College Hospital has the largest Critical Care Occupational Therapy workforce in all of Europe;
• Co-delivered the first UK ECPR Summit in June 2023, bringing together multidisciplinary teams from every ECMO centre across the UK, prehospital and cardiology teams to discuss the implementation of extracorporeal membrane oxygenation cardiopulmonary resuscitation.

Academic

• The School of Cardiovascular and Metabolic Medicine & Sciences at King’s College London is host to 400 personnel and 110 PhD students. The School hosts the British Heart Foundation Centre of Research Excellence at King's, which brings together a unique range of internationally recognised scientists and clinicians from across the School and King’s College London.
• The King’s Centre for Lung Health is the academic home launched in 2022 with a vision to promote lung health throughout the lifetime, by preventing, diagnosing and treating lung disease. The Centre also aims to build specialist respiratory infrastructure to support further high-quality research and research capabilities across the Partnership.
• Our Imaging services in Cardiac MRI is the largest in the world, linking to outstanding innovative research opportunities through the School of Biomedical Engineering at KCL, and strong collaboration with Imperial College London.
• We are first in the UK to launch the National Total-Body PET platform for drug discovery, bringing together data from two state of the art total-body PET imaging scanners at St Thomas’ Hospital (jointly managed by KCL and Imperial College London), and The Royal Infirmary of Edinburgh.
• Royal Brompton Hospital has also become the only NHS site in London and amongst three in the country to acquire a new Gamma Camera with the ability to combine SPECT and CT Imaging. The new Gamma camera will enable the department to deliver high-quality diagnostic scans promptly using cutting-edge solid-state digital technology by enabling high-quality, faster, 3D diagnostic scans for children and adults.
• 400+ clinical trials in cardiovascular and respiratory research, with 3,050+ participants recruited. Consistently, perform 3-4x above average in the Top 1% most cited documents, which is an indicator of research excellence.
• 15+ research-active nurses in heart, lung and critical care.

Pump priming for research and innovation projects

We have supported two clinical academic innovation funding rounds with £910k invested in 22 projects that have delivered innovation in care to benefit patients; provide career development opportunities for staff; and leverage investment for growth. This has led to the additional generation of ~£3m from charity, pharma, SMEs, and NIHR grants.

These projects have led to improvements in care as well as informed health policy such as:

• Saved travel time through remote monitoring of lung conditions; virtual medicine pathways; and acute kidney injury care bundle implementation;
• Improved patient experience;
• Reduced the number of bed days and avoided readmissions in patients requiring organ support for acute kidney injury after cardiac surgery;
• NHSE and CF Trust guidelines;
• National Sleep Pathway Optimisation.

We also support teams to develop innovative development opportunities for staff such as through over 30 education and training courses, webinars, and research conferences, with over 2,850 attendees attended since 2019.

For example, we have delivered:

• Three Respiratory Medicine in Primary Care short courses;
• Two COVID-19 webinars from cardiac and paediatric colleagues; 7 weekly just-in time COVID-19 learning sessions;
• Two transformation forums;
• One Invasive Tracheostomy Ventilation training;
• One CPD Accredited Cardiac CT e-Learning;
• Eight Cardiovascular research conferences.

We want to ensure the voices and experiences of people with lived experiences of heart and lung conditions and/or who are using heart, lung and critical care services across our partner sites, are central to the development of our strategy, good practice and improvement of services through co-design. We will ensure that voices are also representative of the communities we serve.

We are currently refreshing our Patient Public Reference Group which was established in 2018 by joining up with the Heart, Lung, Critical Care Patient Public Engagement Group.

By coming together, this will increase opportunities for our patients’ views and experiences to be heard and acted upon and will ensure:

• The experience of people with heart and/or lung conditions, and who use our clinical services or participate in research, are involved in and influence what is developed and delivered, based on what matters most to them, contributing to the delivery of the best health and care outcomes, regardless of hospital or service;
• issues that are raised by patients are a priority and inform future direction of the group;
• different voices and experiences are heard from across the different hospitals and services and are representative of the people and communities we serve;
• patient input, views and experience are used to support quality improvements; shape our future planning; promote patient leadership in this work.

For more information or to get involved please email: KHPCVandRPartnership@gstt.nhs.uk.

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