Devon Hammond - KHPeople

What is your role within King’s Health Partners?  

I lead the clinical side of an exciting service between King’s College London and South London and Maudsley NHS Foundation Trust (NHS FT) called the Brain Health Clinic. The service directly integrates research and clinical investigations and support - offering one of the first remote services in the England specifically for people with Mild Cognitive Impairment (MCI).  

We aim to identify people who have MCI or the early stages of dementia where it might be due to Alzheimer’s Disease (the most common cause of dementia). We support in improving time to diagnosis for people with dementia. We are also examining the feasibility and acceptability of a remote service for this client group, and the benefits it may bring them and those who support them. 

I have lived experience of mental and physical ill health, and have faced accessibility challenges when engaging with services myself. The Brain Health Clinic shows huge potential in promoting ease of access to care.  

By virtue of being a remote clinic our assessments and follow-up appointments are conducted via video call, meaning clients and carers can join from the comfort of their own homes or chosen location. Understandably it isn’t for everyone and patients still have the option of follow-up in their local memory clinic if they prefer face-to-face, but some of our clients have accessibility needs which makes attending clinics difficult.  

We’ve had great feedback on this, particularly from those who care for our clients who may have tight schedules or live far away (we’ve had carers dial in from the USA!) so we promote carer involvement as well as aim to improve ease of access via digital means for clients. 

What do you enjoy most about your role?  

I have the privilege of working alongside the most passionate and driven team of expert clinicians and researchers. I work with four amazing consultants who have extensive clinical and research backgrounds, and a wonderful team of researchers. We also have a team mascot who works with us, Corbyn the cockatiel (pictured).  

Everyone in the team plays an important role and the environment encourages learning and development in the name of improving patient care. The passion the team has in working to improve the lives of people living with cognitive impairment is truly inspiring; even team meetings are a pleasure! (Really!) 

What inspired you to get into this work? 

When researching the topic of antipsychotic overuse in people with dementia for my nursing dissertation, I couldn’t help but notice how little there is for these clients in terms of prevention as well as management of symptoms as their illness progresses. 
 
Dementia and cognitive impairment in general are areas which significantly lag behind in practical developments compared to some other areas of healthcare. Yet, it is one of the biggest challenges facing our aging population. In reality there has been little progress made over the last 20+ years in terms of diagnosis and treatment of this growing client group.  

Something needs to change.  

How will your work impact the lives of patients?  

We need to be better and more efficient at identifying dementias so people can access treatment and support they deserve, plan for the future, and ensure they live well. To be successful in fighting something we must first know thy enemy. 

Clients with MCI frequently say they feel lost after diagnosis – they are excluded from a lot of the psychosocial support currently available for people with cognitive impairment as they focus on people with dementia, which MCI is not. There is also no medication to offer these clients either, without confirmation of the cause of their MCI. 

Under our research protocol the Brain Health Clinic performs cerebrospinal fluid analysis for Alzheimer’s Disease (AD) biomarkers. This is not routinely offered across memory service pathways. Confirmation of AD biomarkers helps clients further understand the cause of their MCI and opens the doors to novel disease-modifying medications and associated trials.  

For our clients in whom AD is ruled out, this can offer reassurance and help identify other contributing factors that could be addressed to improve cognition and reduce the risk of developing dementia. 

Alongside further investigation and monitoring, the Brain Health Clinic also offers expert advice for keeping well with MCI and lowering dementia risk factors, helping to empower people to make life improving changes. 

Current medications for Alzheimer’s Disease approved on the NHS are only for people with certain dementias rather than pre-dementia/MCI. While they can help to ‘mask’ symptoms, their efficacy is limited. They do not change progression of the disease and are, simply put, not good enough.  

We must be proactive and not merely reactive to help people, and that is our aim. 

What are the benefits of working in partnership?  

Making genuine change.  

I have 12 years of clinical experience in the field of cognitive impairment so I’m well aware of the challenges our clients face with current pathways. There are many ideas to improve systems in theory, but applying this to practice brings its own challenges.  

There is little value to research if the outcomes can’t be realistically implemented in service delivery to improve peoples’ lives.  

The marriage between our active clinical work and research helps us identify some of these potential challenges and practicalities in applying these new innovations at every step of the way. 

We adapt and adjust approaches directly based on feedback from clients and other services during the process, ultimately improving research outcomes and providing the most valuable, evidence-based clinical outcomes for the people we see.  

By working in partnership we put research in to practice and hope to streamline our model in to being applied on a wider scale with some of these potential obstacles already addressed. 

What would be your career top tips?  

1. Be curious; keep learning! The old adage of “there are no stupid questions” is true.  
“Why” and “how” are two of the most important tools in the arsenal of those working in healthcare. You will never know everything! Frequently we get stuck in our ways, we do things in healthcare as “that’s how it’s always been done,” and it isn’t until we stop and ask “why” that change then occurs for the better. 

2. Be an agent of change. As above, if something can be made better for patients/clients; make it. If you can’t do it yourself, find out who can and work together!  

3. Be brave – try something new. I had never considered working in research until meeting my current team, which actually came out of my experience of remote working through the COVID-19 lockdown. I had seen how many clients benefited from remote assessment within the comfort of their own home so when the opportunity to join the Brain Health Clinic came I took the leap – I couldn’t have made a better choice! If you have that little spark of interest in something, follow it. You never know what you’ll find or the difference you will make.