Cardiovascular and Respiratory

The Cardiovascular and Respiratory Partnership is comprised of Guy’s, St Thomas’, Royal Brompton, Harefield, and King’s College Hospitals, alongside King’s College London.

We collaborate widely across the NHS and academia (including strong links to two universities King’s College London and Imperial College London), and are part of two integrated care systems and multiple clinical networks of differing geographies with local, national, and global reach for people living with heart and/or lung conditions. We also have EPIC, the new electronic health record system – helping us deliver seamless patient care, and enabling us to take a population health approach delivering value to the system, through data driven insights.

Our Vision

A world-leading collaboration: building on the expertise of all our partners in heart, lung and critical care, to deliver the best outcomes for patients through pioneering care, research and education.

Being known as the best place:

  • To be cared for - by delivering the best outcomes for patients, wherever they receive care, improving health and wellbeing of patients throughout their lifetime;
  • To work, learn and develop careers - by attracting and supporting the best staff and influencing international practice;
  • For academic & industry partners to work with - by leading ground-breaking research to meet population health needs.

The Partnership Programme Team

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 & 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.

Working across the system

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.

Our Clinical & Academic Strengths

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 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:

Education & Training

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:

Patient Public Engagement and Involvement

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.

Key Publications

Gramegna, Andrea, Charlotte Addy, Lorna Allen, Egil Bakkeheim, Catherine Brown, Thomas Daniels, Gwyneth Davies et al. "Standards for the care of people with cystic fibrosis (CF); Planning for a longer life." Journal of Cystic Fibrosis (2024).

Ezad, Saad M., Matthew Ryan, Nicholas Barrett, Luigi Camporota, Justyna Swol, Marta V. Antonini, Dirk W. Donker et al. "Left ventricular unloading in patients supported with veno-arterial extra corporeal membrane oxygenation; an international EuroELSO survey." Perfusion 39, no. 1_suppl (2024): 13S-22S.

Russo, Manuela, Kathryn Watson, Katie Richards, Rachel Rowan Olive, Barbora Krausova, Rashmi Kumar, Joanna Burridge et al. "Study protocol for a cross-sectional online survey investigating patient preferences and experiences of waiting for elective cardiac surgery." BMJ open 14, no. 3 (2024): e079692.

Eftychiou, Linda, Dionne Matthew, Rosalind Nerio, and Catherine French. "Supporting integration: the creation of a framework to support the design and delivery of clinical academic integration across a complex system." Future Healthcare Journal 10, no. 2 (2023): 161.

Vas, Venessa, Loretta Gyambibi, Linda Eftychiou, Hassan Al-Omari, James Glass, Mark Smith, and Dionne Matthew. "Identifying value in healthcare transformation initiatives: an evaluation of an approach to benefits realisation." BMJ Open Quality 12, no. 4 (2023): e002349.

Ezad, Saad M., Matthew Ryan, Dirk W. Donker, Federico Pappalardo, Nicholas Barrett, Luigi Camporota, Susanna Price, Navin K. Kapur, and Divaka Perera. "Unloading the left ventricle in venoarterial ECMO: in whom, when, and how?." Circulation 147, no. 16 (2023): 1237-1250.

Makhecha, Sukeshi, Linda Eftychiou, Victoria Tsang, Venessa Vas, Nanna Christiansen, Joanne Crook, and Siân Bentley. "Patient and family perceptions of the provision of medicines as part of virtual outpatient consultations for children during COVID-19 pandemic." BMJ Open Quality 11, no. 4 (2022): e001916.

Matthew, Dionne, Linda Eftychiou, Catherine French, and Alanna Hare. "‘Just in time’ rapid learning during COVID‐19." Medical Education 55, no. 11 (2021): 1300.

Milne, Benjamin, Sinead Helyar, Thomas Gilbey, Daveena Meeks, Carol Pellowe, Eugenia D'Andrea, Marlies Ostermann, and Gudrun Kunst. "Adoption of a novel biomarker-guided quality improvement treatment bundle for patients with subclinical acute kidney injury after cardiac surgery: a Royal Brompton Hospital-King’s Health Partners Innovation Project." British Journal of Anaesthesia 128, no. 3 (2022): e251-e252.

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