RM M A G A Z I N E WINTER 2018
IN SAFE HANDS How our anaesthetists play a vital role, in and out of theatres Outstanding: the Trust gets top marks We treat the first-ever UK patient on our MR Linac
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At The Royal Marsden, we deal with cancer every day, so we understand how valuable life is. And when people entrust their lives to us, they have the right to demand the very best. That’s why the pursuit of excellence lies at the heart of everything we do.
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EXECUTIVE NOTES
CONTENTS 4 Bulletin What’s happening around The Royal Marsden 12 The MR Linac comes to life
The milestones in the journey of this groundbreaking machine 14 From scrubs to suits Our anaesthetists play a vital role, both in and out of theatres 18 Meeting of minds Why our experts attend conferences around the world 20 A day in the life Security Porter Lisa Lawrence helps Sutton run smoothly 22 Quality counts How we achieved our ‘outstanding’ CQC rating 25 It happened to me You, Me & the Big C’s Deborah James tells her story 26 Fundraising News from The Royal Marsden Cancer Charity 28 Foundation news Updates from our Foundation Trust and Governors
WELCOME to the winter 2018 edition of RM, the magazine for our staff, patients, carers and Foundation Trust members. In this issue, we celebrate the achievement of treating the first patient in the UK on the MR Linac. We take a look back at the key milestones throughout the journey from conception to completion of this pioneering radiotherapy machine (page 12). On page 14, we take an in-depth look at our Department of Anaesthesia and Perioperative Care and how the work of anaesthetists has evolved dramatically in recent years. We are pleased to announce that we now have an ‘outstanding’ rating from the Care Quality Commission (page 22), following the inspections in May and July. My thanks go to all our staff for the exceptional quality of care they provide to patients, which is reflected in this result. We also find out why international cancer conferences are so important, enabling our experts to network, share research and ensure we’re at the forefront of the world’s best treatment and care (page 18); and we hear from one of our unsung heroes, Security Porter Lisa Lawrence, on why she loves her role (page 20). I hope you enjoy reading this issue of RM.
30 Puzzles and prizes Test your wits and win a prize with our crossword 31 Stay in touch Your comments on social media, plus hospital contacts
Cally Palmer CBE, Chief Executive, The Royal Marsden
ON THE COVER Dr Ramanathan Kasivisvanathan, Head of Anaesthesia and Perioperative Care
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B U L L E T I N W H AT ’ S H A P P E N I N G A R O U N D T H E R O YA L M A R S D E N
Care in a cocoon CONCLUDING OUR SERIES of archive images to celebrate 70 years of the NHS, this shot from the early 1970s shows a young patient at The Royal Marsden being treated through plastic sheeting. This was one of the earliest examples of reverse barrier nursing, or protective isolation, which is the physical separation of a patient at high risk of infection from micro-organisms carried by other people. This practice made bone marrow transplants possible in cases of acute leukaemia, with the first successful transplant taking place in 1973. Protective isolation is still carried out today, but instead of being surrounded by plastic sheeting, patients may be placed in isolation rooms with measures taken to prevent infection, such as hand hygiene and controlled ventilation.
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? DID YOU KNOW? The Trust’s Catering Department has retained its Food for Life accreditation, achieving Silver status for its ethically sourced and nutritional patient catering.
THREE CHEERS Professors Mitch Dowsett, Ian Smith and Trevor Powles
Highest honour for breast cancer expert CONSULTANT MEDICAL ONCOLOGIST Professor Ian Smith has won the 2018 William L. McGuire Memorial Lecture Award for his lifelong work in breast cancer oncology. The award is widely regarded as the highest international honour in this field. In December, Professor Smith will give the lecture at the San Antonio Breast Cancer Symposium, the main international breast cancer conference of the year, which attracts more than 7,000 attendees. The conference organisers said that Professor Smith had changed the direction of breast cancer treatment in the UK and internationally, with colleagues describing his contributions as “formidable”. This means that The Royal Marsden’s Breast Unit is the only one in the world to have had three
recipients of both the McGuire and the Susan G. Komen for the Cure Brinker awards, with Professor Smith following in the footsteps of Professor Mitch Dowsett, Head of the Ralph Lauren Centre for Breast Cancer Research, and Professor Trevor Powles, now retired. Professor Smith said: “The advancements in breast cancer treatment since I first started working in the NHS over 40 years ago have been staggering. We understand so much more about the biology of cancer, so have been able to increase the amount of individualised medicine, reducing toxicity and using targeted therapies against molecular abnormalities in cancer cells. “It is a great honour to be the recipient of this award. It reflects the wider pioneering approach that lies at the heart of The Royal Marsden.” RM magazine 5
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Librarian’s Twitter takeover
New ‘Marsden Manual’ out now The first e er oyal arsden anual of ancer ursin rocedures is now a ailable ublished by iley, this companion olume to the renowned oyal arsden anual of linical ursin rocedures is aimed at practitioners who wor specifically with oncolo y patients The manual was written by oyal arsden nursin staff and co edited by ara ister, ead of astoral are and sycholo ical upport, and isa ou herty, ndependent urse onsultant ara said The ori inal arsden anual has, o er years, become the nurses bible and is relied on by almost e ery ward in the country This new boo will ensure cancer nurses all o er the and further afield will ha e access to the best possible e idence based practice
YIWEN HON, LIBRARIAN and Knowledge Resources Manager at The Royal Marsden School, spent a week debunking the librarian stereotype by conducting a ‘takeover’ of the @NHS Twitter feed in August. Over five days, 34,500 Twitter followers learned about YiWen’s role and her impact on patient care. Her takeover was a huge success, with her engaging tweets sparking numerous conversations. “For the NHS to work efficiently and effectively, decisions should be based
on the best available evidence,” said YiWen. “That’s where librarians like me, and The Royal Marsden School, play an important role.” Her busy job involves teaching and training clinicians, and evaluating healthcare information; over the past 12 months, she has conducted more than 120 hours of teaching. She also carries out literature research for clinicians – saving them 250 hours in the past year – so she has a real, albeit indirect, impact on patient care. She recently researched
two different chemotherapy regimens for The Royal Marsden’s Pharmacy, which helped to inform decisions made by clinicians. The takeover project has proved popular, with Therapeutic Radiographer Gillian Smith also tweeting about her work on our MR Linac radiotherapy machine in October.
Librarians like YiWen have a real impact on patient care
SOCIAL STAR YiWen Hon
191 1,600 tweets
likes
428
321
retweets
link clicks
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BULLETIN
(FURRY) FRIENDS OF THE ROYAL MARSDEN
MICRO MACHINE Young patient Frankie Cheek and his mum play with the miniature scanner
Mini MRI is child’s play A NEW MINIATURE SCANNER is being used in the Oak Centre for Children and Young People to help prepare young patients for MRI scans. The Siemens Magnetom Mini is just 19cm high and 40cm long, and is used by the Play Specialist Team to demonstrate what will happen during the procedure.
The miniature scanner replicates the sounds of the full-size version
Replicating the sounds of the full-size MRI scanner, it can help to reduce anxiety and educate young patients about the importance of staying still. This means they may be able to avoid having a general anaesthetic, which is often required for children undergoing MRI scans. Senior Play Specialist Tanya Turner said: “By ensuring that our young patients become more familiar with the MRI procedure, we hope to improve their experience. We’d also like to express our thanks to The Royal Marsden Cancer Charity, who funded this new piece of equipment.”
? DID YOU KNOW? Pat Cattini, Lead Nurse and Deputy Director for Infection Prevention and Control, has been elected as President of the Infection Prevention Society.
More than 80 dog walkers and 50 of their canine companions got together for the first-ever Dogtails in the Park event in May 2018, walking two or four kilometres around Kensington Gardens to raise money for the Friends of The Royal Marsden, Chelsea. The event, sponsored by Rathbones, raised £1,800 for equipment, services and amenities at the hospital. With a line-up worthy of Crufts, there was a mix of breeds, from Tiny the Chihuahua to enormous Quinn the Leonburger. Linda Wimble, Vice Chair of the Friends at Chelsea, said: “We felt very privileged to have such wonderful dogs and equally wonderful and charitable owners involved, and to have Rathbones’ sponsorship.” The event was held in loving memory of Jac Craig, a beloved friend and volunteer at The Royal Marsden, Chelsea.
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NEW MACHINE BOOSTS DNA SEQUENCING Thanks to a very generous donation from the Denise Coates F oundation to The Royal Marsden Cancer Charity, The Royal Marsden’s Molecular Diagnostics team has invested in the Illumina NovaSeq 60 0 0 DNA seq uencing technology. If we know the cancercausing mutations in a patient’s DNA, we can target treatment as precisely as possible, ma imisin patient benefit and reducin side effects Previously, we could examine only a handful of genes at a time. However, the NovaSeq 60 0 0 can seq uence six trillion bases of DNA in a single run, and can simultaneously search for cancer- causing variants in 20 0 genes from over 20 0 patients – all in less than a week. This huge increase in capacity will provide new ways to diagnose cancer earlier and enable the development of new personalised treatments.
Robotic surgeons perform pioneering operation SURGEONS AT THE ROYAL MARSDEN have carried out what is believed to be the UK’s first robotic total pelvic exenteration. Advanced rectal cancer patient Dean Walter, 41, underwent the radical procedure, which involves the removal of all of the organs from the pelvic area. This is the first time such an operation has been performed using the pioneering da Vinci surgical robot, which was funded thanks to the generous supporters of The Royal Marsden Cancer Charity. Mr Shahnawaz Rasheed, the Consultant Surgeon who led the procedure, said: “Our traditional approach would be to do what we call an ‘open’ operation. A large incision would have been made from the chest down to the pubic bone in order to access and remove the organs and tumour. It would have taken substantially longer and is hugely invasive,
meaning a longer recovery time and significant scarring for the patient. “In contrast, by using robotic technology, we could perform a minimally invasive procedure. It’s hugely important for this young man to help him get back to leading a normal life as safely and quickly as possible.” Dean said: “I was relieved knowing that I wouldn’t have a huge scar across my chest and stomach. I’m looking forward to getting back to leading a normal life again.”
“By using robotic technology, this radical procedure can be minimally invasive”
LEADING EDGE Mr Shahnawaz Rasheed (left) and patient Dean Walter (above)
IN THE GENES DNA sequencing using the NovaSeq 6000
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BULLETIN
5
FAST FACTS Genomics
£1m
was donated to The Royal Marsden Cancer Charity by the Denise Coates Foundation to fund the NovaSeq 6000 DNA sequencer
A WARM WELCOME Karl Munslow Ong
A new face in the leadership team THE ROYAL MARSDEN’S Board has a new member with the appointment of Karl Munslow Ong as Chief Operating Officer. Karl succeeds Dr Liz Bishop, who has left her role as the Trust’s Chief Operating Officer and Deputy Chief Executive to join Clatterbridge Cancer Centre as Chief Executive. Karl joins The Royal Marsden from Chelsea and Westminster NHS Foundation Trust, where he was Deputy Chief Executive.
“I’m delighted to be joining such a fantastic trust”
He has extensive operational management experience, having served on the boards of two acute hospitals in northwest London. He started his career as a management consultant for PricewaterhouseCoopers before moving to work for the Strategic Health Authority. Karl is already familiar with The Royal Marsden through our collaborative work with Chelsea and Westminster and Royal Marsden Partners. Karl said: “I’m delighted to be joining such a fantastic trust that has a long history of delivering outstanding care to patients and being at the forefront of clinical research and innovation.”
15,000 genomes have been tested at The Royal Marsden in 2018
6 trillion bases of DNA can be sequenced in a single run on the NovaSeq 6000
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Genomic Laboratory Hubs are delivering DNA testing for patients across England
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DNA bases – A, C, G and T – are read and reported by the NovaSeq 6000 RM magazine 9
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IN BRIEF
done in these numbers. We were aiming to find out new information by testing the genetic makeup of the tumours to understand the type of mutations that lead to this form of cancer. If clinicians know what mutations to test for, they can identify treatments that may be more effective for the patient.
A new Professor
Q What have you discovered so far? A I have just presented some promising initial data at this year’s World Conference on Lung Cancer. We found, for the first time, that the presence of a genetic abnormality – found in 41 per cent of the cases – changes across the tumour. This genetic abnormality has been shown, in some circumstances, to be treatable in other types of tumour.
James Larkin, Consultant Medical Oncologist, has been awarded the title of Professor by The Institute of Cancer Research. As a trial leader, Professor Larkin has made a vital contribution to the approval of new drugs for the treatment of melanoma and kidney cancer.
Research prize
Dr Anna K irby and colleagues have won the 20 17 F rank Ellis Medal for their paper on the multi- centre testing of heart- sparing breast radiotherapy. The prize is awarded to the paper published in Clinical Oncology that has most contributed to advancing the cause of science in cancer treatment.
Developing leaders
The first 21 clinicians and managers have graduated from the Academic Health Science Centre (AHSC) Leadership and Development programme. The AHSC is a joint initiative between Imperial College London, Imperial College Healthcare, Royal Brompton & Harefield and The Royal Marsden. The course equips clinicians with the skills needed to operate at board level in healthcare.
Q&A: PLEOMORPHIC LUNG CARCINOMA Dr Adam Januszewski, an Academic Clinical Fellow who is part-funded by The Royal Marsden Cancer Charity, explains why he and Consultant Medical Oncologist Dr Sanjay Popat are analysing the DNA of rare lung tumours Q What is pleomorphic lung carcinoma? A It is a rare type of lung cancer that occurs in less than one per cent of cases. It is associated with a poor prognosis and low survival rates; sadly for patients, current conventional treatments are generally found to be ineffective. The complexity of cancer is a constant challenge
to developing effective treatments and, so far, pleomorphic lung carcinoma has not been well studied. Q What has your research involved? A We analysed samples of tumours from 80 patients who had pleomorphic lung carcinoma. This is the first time such a study has been
Q What will your findings mean for clinical practice and further studies? A This research has given us a solid base from which we hope to increase our knowledge of pleomorphic lung carcinoma, and I anticipate that we will present more data in the next few months. Based on these findings, we recommend that clinicians test their patients to see if they have any of these treatable genetic mutations. Crucially, this new information could offer hope for patients with this rare and difficult-to-treat form of lung cancer.
ant t find t h h tat ns ad t th s rar r n an r
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BULLETIN
Making a splash PATIENTS AT THE ROYAL Marsden’s Diane McCarthy Medical Day Unit (MDU) in Chelsea can now make the most of long treatment days, thanks to exercise-loving Emily Travis. Emily, a stage 4 sarcoma patient from Wiltshire, is one of many ‘two-stop’ patients who live a long distance from the hospital and have a gap of three or more hours between a morning doctor’s appointment and treatment in the MDU that afternoon. She said: “I discovered the nearby Chelsea Sports Centre and would go for a swim during the wait. It gave me such a sense of achievement, even on the days I was tired and could only manage a five-minute swim.” With the support of The Royal Marsden’s Patient and Carer Advisory Group and the sports centre, Emily has negotiated a special deal whereby patients and their guests can pay £1.80 to use
KEEPING FIT Emily Travis
A DAY IN THE LIFE
the pool or £3.80 for the gym during off-peak hours. “There is so much evidence that exercise helps people cope better with treatment, both physically and mentally,” said Emily. “It may not be for everyone, but I hope other people like me will take advantage.”
Want to know more? Apply for no-contract discounted access by completing a consent form and health questionnaire – available from the Patient Advice and Liaison Service – and handing them in at Chelsea Sports Centre
“Exercise helps people cope better with treatment, physically and mentally”
? DID YOU KNOW? Mr Cyrus Kerawala, Consultant Oral and Maxillofacial Surgeon, has been elected as President of the British Association of Head and Neck Oncologists.
To mark Allied Health Professionals ( AHPs) Day on 15 October, Eamonn Sullivan, Chief Nurse, and Jonathan Spencer, Divisional Director of Clinical Services, shadowed AHPs for a day to gain a deeper insight into their varied roles and responsibilities. The 14 AHP roles include therapists across different disciplines, such as physiotherapists, speech and language therapists, dietitians and occupational therapists. Dr Ione de BritoAshurst, Head of Therapies, said: “ Among our therapists, we have nationally and internationally renowned experts such as Consultant Dietitian Dr Clare Shaw and Speech and Language Therapist Dr Justin Roe. “ Our AHP leaders have an impressive research and publication portfolio in distinguished scientific ournals and ha e a si nificant positive impact on the lives of people living with and beyond cancer. They are also actively involved with, or leading, their national professional associations.”
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THE MR LINAC COMES TO LIFE The Royal Marsden and the ICR have made history by treating the first patient in the UK on the MR Linac, a groundbreaking machine that combines MR imaging with radiotherapy. Here are the key stages in its journey from conception to completion
Birth of an idea
In 2012, University Medical Center Utrecht in the Netherlands, cancer treatment technology manufacturer Elekta and its MR technology partner Philips formed a consortium of seven globally renowned cancer centres, including The Institute of Cancer Research (ICR) and The Royal Marsden, to make the dream of a magnetic resonance linear accelerator – or MR Linac (above) – a reality. Two years later, the Medical Research Council awarded the ICR and The Royal Marsden a £10-million grant, which was supported by additional funding from The Royal Marsden Cancer Charity and the ICR. “For decades, oncologists had dreamed of combining magnetic resonance imaging [MRI] and radiotherapy so we could see cancers as we treat them,” says Professor Uwe Oelfke, Head of the Joint Department of Physics at the ICR and The Royal Marsden. “We knew it would be particularly effective for patients with tumours that change position when they breathe, their bladder fills, or they have changes in the bowel.”
Under construction
Building work to accommodate the new MR Linac in Sutton began in January 2015. Almost 12,000 tonnes of rubble was excavated to create a bunker – large enough to hold 24 double-decker buses – to house the machine. A year after building began, the gantry and, a few months later, the five-tonne magnet (top and above) were lowered carefully through the skylight in the hospital’s car park. “This was a hugely complex and ambitious project,” says Sunil Vyas, Director of Projects and Estates. “The build required collaboration between my department, physicists and clinicians to ensure we created the ideal environment for this pioneering machine.”
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MR LINAC
Prestigious guests
In November 2016, the Mayor of London, Sadiq Khan, officially opened the MR Linac facility (top). He was followed by The Royal Marsden’s President, HRH The Duke of Cambridge, who visited in May 2017 to meet the clinicians and physicists working on the project (above). Cally Palmer, The Royal Marsden’s Chief Executive, says: “The team were working extremely hard behind the scenes, and having such high-profile visitors gave them a real boost and provided everyone with an opportunity to share their excitement about the project.”
Testing it out
By February 2017, the MR Linac was ready to be tested. The team needed to scan an object to see if the image quality changed when the radiation beam was turned on and off. They chose to scan a dead crab (top) in a nod to Hippocrates’ description of the disease as carcinos, the Greek word for crab – later translated into Latin as cancer. Dr Simeon Nill, Head of Translational Radiotherapy Physics at the ICR and The Royal Marsden, says: “Crucially, the two identical scans showed that the radiation did not affect the quality of the image.” Then in November 2017, we scanned the first healthy volunteers, including Paul Scully MP and Ross Lydall, the Evening Standard’s Health Editor (above), in a clinical study to test the scanning element of the MR Linac. Dr Helen McNair, Lead Research Radiographer, says: “Seeing the images for the first time was a pivotal moment as it reinforced everything we were working towards.”
Treating the first patient
Our efforts came to fruition in September 2018, when we treated the first patient in the UK on the MR Linac (top and above). Prostate cancer patient Barry Dolling, 65, made history as part of the PRISM (Prostate Radiotherapy Integrated with Simultaneous MRI) clinical trial. “This will give me a better quality of life and minimal side effects in comparison to other treatments,” Barry says. “I want to be able to keep swimming and cycling.” Leading the trial is Consultant Clinical Oncologist Dr Alison Tree, who says: “With this technology, we can better target the tumour while avoiding the neighbouring rectum, so we can safely deliver higher doses of radiation with fewer side effects. “The MR Linac is a dream come true. To be able to see the patient’s anatomy in the same moment that you treat them, and to be able to change where you put the dose with such accuracy, is incredible.” RM
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FROM SCRUBS Our anaesthetists aren’t limited to simply providing anaesthesia
CHANGING ROLES From left to right: Dr Pascale Gruber, Dr Torsten Beutlhauser, Dr Susanna Walker, Dr Shaman Jhanji, Dr Ramanathan Kasivisvanathan and Dr Ravishankar Rao Baikady
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ANAESTHETICS
TO SUITS
during surgery: they increasingly play a vital role outside the operating theatre >
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ANAESTHESIA IN NUMBERS
17
consultant anaesthetists –
8
consultants in anaesthesia and critical care –
4
consultants in anaesthesia and pain medicine –
10
registrars and 10 fellows –
10,000 procedures requiring anaesthetic services are performed every year –
6,000
patients attend preassessment clinics every year –
THE ROLE OF the modern anaesthetist has changed dramatically in recent years. The Royal Marsden’s service has been renamed as the Department of Anaesthesia and Perioperative Care to reflect that its work is not just limited to anaesthetising patients on the day of surgery. “Anaesthesia is seen as a practice that takes place in the operating theatre,” says Dr Ramanathan Kasivisvanathan, Head of Anaesthesia and Perioperative Care. “But the scope of our work also incorporates perioperative care, meaning we are involved outside the theatre and throughout the patient’s journey. “Our unique preassessment service ensures we operate on patients at the right time and get them as well as possible before surgery. We also do a lot of work with them afterwards to make sure they have the best possible recovery.” Fitness first The pre-operative assessment clinic is one of the Trust’s largest outpatient services, seeing around 6,000 patients each year. “We assess whether patients are fit enough to have anaesthesia and surgery,” says Dr Pascale Gruber, Consultant Anaesthetist. “The clinic provides screening, advice and education, and undertakes a range of tests, including cardiopulmonary exercise testing [CPET].” Dr Alex Oliver, Head of CPET, adds: “We’ve been running CPET
500
portacaths and IV lines are inserted every year for chemotherapy treatment
since 2009 and have performed nearly 3,000 tests in that time. “We measure many different physiological factors to assess a patient’s fitness and how well their body delivers oxygen to where it is needed. We can then discuss these results with the patient to give them and their clinical teams a more informed decision about any risks prior to major surgery.” Another preassessment service is iron therapy for anaemic patients. Up to 90 per cent of cancer patients undergoing major surgery will be affected by anaemia during their hospital stay. “The Royal Marsden was one of the first trusts to use this therapy around a decade ago,” says Dr Ravishankar Rao Baikady, Consultant Anaesthetist and Lead for the Iron Transfusion Service. “So far, we have safely treated more than 1,000 patients with iron infusions. This costeffective, simple service prevents
unnecessary blood transfusions and related side effects.” Anaesthetists also play a vital role in ensuring patients are safe. Dr Rohit Juneja, Consultant Anaesthetist and Lead for Patient Safety, directs the Patient Safety Fellowship Programme, the longest-running of its type in the UK. He says: “We pride ourselves on a culture of safety, with a truly collaborative approach that sets us aside from other UK centres.” Simulation exercises are run twice a year by Dr Juneja and Dr Olivia Mingo, Consultant Anaesthetist and Medical Lead for Simulation, and are attended by all theatre staff. The training helps to develop skills in crisis resource management and human factors in a safe environment. Education and research The Royal Marsden is a recognised training centre for anaesthetists. We run a competitive fellowship
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ANAESTHETICS
GETTING IN SHAPE FOR SURGERY
programme that is consistently rated highly by the General Medical Council and attracts senior trainees from the UK and overseas to courses in perioperative medicine, patient safety, management and leadership. Dr Susanna Walker, Head of the Fellowship Programme, says: “Trainees benefit from a unique consultant-led programme that covers all medical specialities, including surgery, medical oncology, radiology and paediatrics. This has helped the Trust recruit a range of extremely talented trainees seeking specialist experience towards the end of their training.” Over the past five years, the department has also developed a research portfolio encompassing anaesthesia, critical care and pain research, and has, for the first time, been awarded a theme by the NIHR Biomedical Research Centre (BRC). Dr Shaman Jhanji is leading this work under the
Targeted Physical Therapies theme. The department is also one of the highest recruiters for NIHR studies within the perioperative research portfolio. The department also manages several other pivotal services. These include the vascular access service, led by Dr David Chisholm; the chest drain service, led by Dr Michael Frow; and sedation and anaesthesia for around 2,000 infants, children and young people every year, led by Dr Torsten Beutlhauser. “Despite being a small department, we are proud that two of the 12 nationally appointed anaesthetists to the Association of Anaesthetists of Great Britain and Ireland are from The Royal Marsden – Dr Robert Self and Dr Ravishankar Rao Baikady,” says Dr Kasivisvanathan. “This gives the Trust an influential role in steering the national direction of anaesthetics.” RM
SAFE AND SOUND Dr Rohit Juneja (above); Dr Alex Oliver conducts a preassessment (above left); Dr David Chisholm (below left)
The NIHR-funded Royal MILE (Marsden Integrated Lifestyle and Exercise) programme is aiming to get cancer patients fitter through exercise prior to gynaecological surgery. Chemotherapy is known to reduce patients’ physical fitness, yet the standard advice has historically been to rest during treatment. “Our programme will counteract the side effects of chemotherapy by encouraging patients with ovarian cancer to stay active,” says Louisa Shovel, an Anaesthetic Clinical Fellow. “They will be invited to participate in a comprehensive nineweek programme of exercise and nutritional and psychological support, as well as treatment for anaemia. “Patients can take part in group classes at the hospital or they can exercise at home, plus everyone in the programme will be given a pedometer to track their daily step count. “We’re one of the only trusts in the UK to roll out a programme like this, which will be integrated into routine care for our ovarian cancer patients, alongside chemotherapy treatment. “The broader aim is to improve the general health and fitness of our patients, especially as more people are living longer with and after cancer.”
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CHICAGO
CHICAGO
American Society of Clinical Oncology (ASCO) Annual Meeting
American Association for Cancer Research (AACR) Annual Meeting
SAN FRANCISCO American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium
TORONTO International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer
SAN DIEGO American Society of Hematology (ASH) Annual Meeting and Exposition
MEETING OF MINDS Global conferences provide an essential platform for The Royal Marsden’s clinicians to share their research and collaborate with colleagues from around the world
ATTENDING MAJOR ONCOLOGY conferences is an important part of cancer researchers’ work, providing a valuable opportunity to share new data, hear about the latest advances in research, and collaborate with worldleading researchers in order to develop and improve treatment and care for patients. The European Society for Medical Oncology (ESMO) Congress attracts more than 20,000 people each year, and 40 Royal Marsden clinicians presented their work at October’s meeting in Munich. This followed the International Association for the Study of Lung Cancer’s World Conference, held in September in Toronto, where three clinicians from the Trust presented new data. Dr Chris Parker, Consultant Clinical Oncologist, presented
SAN ANTONIO
San Antonio Breast Cancer Symposium
findings at ESMO that have already changed standard NHS treatment for men with metastatic prostate cancer, by showing the effectiveness of radiotherapy for the first time in this group of patients. He says: “International conferences shine a spotlight on potentially game-changing studies, which, in turn, inspire further research. They also provide opportunities to meet colleagues from around the world face to face and it’s those meetings that lead to new ideas and collaboration. “One longstanding and fruitful collaboration of mine wouldn’t have happened if it wasn’t for a chance meeting with a Danish colleague at the American Society of Clinical Oncology (ASCO) conference over 10 years ago. An idea for another successful clinical trial originated
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CONFERENCES
GLASGOW
AMSTERDAM
National Cancer Research Institute (NCRI) Cancer Conference
International Society of Geriatric Oncology (SIOG) Annual Conference
MUNICH European Society for Medical Oncology (ESMO) Congress
BARCELONA
PARIS
SINGAPORE
Molecular Analysis for Personalised Therapy (MAP) Congress
European Society for Medical Oncology (ESMO) Asia Congress
European Association of Dermato-Oncology (EADO) Congress
from a conversation during a long wait for transport after a meeting near Toronto.” Dr Susana Banerjee, Consultant Medical Oncologist, agrees: “Conferences are extremely valuable, whether you’re presenting new data, attending the educational sessions or networking with peers. “As a presenter, you receive reactions to your work first-hand, which is really important for shaping future research. It’s also vital to keep up with developments in your field, including advances that could benefit patients in your clinic.” Dr Banerjee serves on the ESMO Executive Board and Women for Oncology Committee, and was Scientific Co-Chair for the ESMO Asia Congress, which took place in Singapore in November. She was also ESMO 2018’s Track Chair
for Gynaecological Cancers, an influential role responsible for moderating meetings and selecting the best abstracts for presentation. She adds: “Oncology meetings are also a valuable experience for our clinical fellows and trainees, where they can gain recognition on the world stage, develop their speaking and presenting skills, and make connections that will benefit their research careers. “For example, from my team, Dr Cecilia Orbegoso presented in the prestigious proffered paper session at ESMO Asia, and Dr Lucy Dumas presented at the International Society of Geriatric Oncology Annual Conference. Both have won awards for their research.” Dr Naureen Starling, Consultant Medical Oncologist and Associate Director of Clinical Research, says
key conferences give our clinicians the insight to ensure that The Royal Marsden remains an international thought-leader. “We want to offer our patients the most innovative and effective care, so these meetings allow us to stay on the front foot with how we’re approaching the latest issues in oncology,” she says. “Conferences also give patient advocates a voice, and the platform to share their views with the global oncology community, which is immensely valuable. “In the Gastrointestinal Unit, our approach is to find research related to our respective areas of expertise, then come back to discuss what’s sparked our interest and how we can use it to inform our own work at The Royal Marsden and, ultimately, benefit our patients.” RM RM magazine 19
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A DAY IN T HE L IF E OF
LISA L AWRENCE SECURIT Y PORTER
MY SON’S FRIEND was a patient on Bud Flanagan East Ward about 10 years ago. When I came to visit, I was struck by how caring and helpful all the staff were. It felt like a special place to be and I thought how nice it must be to work here. I joined the Trust a few years later and worked in ward catering before becoming a security porter. There are seven security porters who cover the hospital in Sutton. We share some duties with general porters, such as moving patients in wheelchairs and beds from one part of the hospital to another – but it’s so much more than just transporting people from A to B. I get to know the patients really well and I’m a familiar face when they arrive. I’m also able to see the change in people, from their first day of treatment when they arrive feeling nervous and anxious, to seeing them become more relaxed and at home, through to their last days of treatment. Ensuring safety As our job title suggests, we also have security responsibilities. Security porters are often the
first responders when there’s an emergency. If someone falls or collapses, I get a resuscitation bag with all the necessary first aid equipment from the nearest critical care room and take it to the scene, where I meet the medical team. We all have mandatory first aid and fire training. We also answer incident calls – if someone has activated the disabled bell in the bathroom, for example, or if a person is causing a disturbance. Recently, I was called to attend to someone who was behaving aggressively. I took him to sit outside on a bench and we talked
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A D AY I N T H E L I F E
for half an hour. I found out he was there for his first appointment and was terrified. The next day, he came in and apologised to everyone. While there’s never an excuse for that kind of behaviour, it happens rarely and doesn’t come from a bad place – it’s often caused by anxiety and fear. It could be first-treatment nerves or someone who’s been given bad news. I used to work with children with autism as a learning support assistant, which taught me how to be patient and calm. Throughout the day, I carry out security checks around the hospital. I check that the alarms and access
controls are working so that areas such as the Oak Centre for Children and Young People are secure. A helping hand I also cover for the dispatch team, which entails taking calls from staff needing a porter. We enter the time of the call, the patient’s name, where they are, where they’re going and how they are travelling, then dispatch the job to a porter. I also help out in the post room when they’re short-staffed, taking deliveries and sorting the letters. Out of hours, we’re responsible for changing over the gas and
A FRIENDLY FACE Lisa’s role helps the hospital to run smoothly and safely, and means she gets to know patients and staff
oxygen cylinders in the manifold room. The switchboard is alerted when the cylinders are running low or there’s a fault, and we’ll then change them over. We also take oxygen cylinders to the wards when needed and, out of hours, we carry blood samples from the wards to the labs, which is done by healthcare assistants during the day. I can’t walk down a corridor without being stopped by someone I know. I find my job so rewarding. In four years, I’ve never had two days the same, and The Royal Marsden is the friendliest place I’ve ever worked. RM RM magazine 21
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QUALIT Y COUNTS The Royal Marsden is proud to have been rated ‘outstanding’ by the Care Quality Commission. We highlight what the inspectors said about the Trust’s services IN THE SPRING, The Royal Marsden welcomed a team of inspectors from the Care Quality Commission (CQC), the independent regulator of health and social care services in England. As part of their visit to the Trust, the team evaluated Outpatients in Sutton and Community Services. They also assessed whether we are ‘well-led’ – a process that was introduced after the CQC recognised a strong link between the quality of the overall management of an NHS trust and that of its services.
We’re delighted to announce that following these inspections, which built on our previous inspection of April 2016, the CQC rated The Royal Marsden as ‘outstanding’ overall, ‘outstanding’ for being well-led, and both Chelsea and Sutton hospitals as ‘outstanding’. They also recognised the improved quality of our Community Services, which were rated ‘good’. The inspectors reached their decision by asking whether the services we provide are safe, effective, caring, responsive and well-led, marking us against a rigorous set of criteria. We scored
ABOVE AND BEYOND The CQC inspectors saw examples of our staff providing exceptional care for patients
‘good’ for ‘safe’ and ‘effective’, and ‘outstanding’ for ‘caring’, ‘responsive’ and ‘well-led’, contributing to our overall ‘outstanding’ rating. Here, we explain more about what they found in response to these five key questions. Are services safe? At The Royal Marsden, providing the safest possible healthcare for patients is paramount, with a transparent safety culture that is led and monitored from the board to the ward. This instils confidence in patients, informs their choices,
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CQC REPORT
Inspectors witnessed the ‘Marsden Magic’ at first hand They also noted that staff always have access to up-to-date, accurate and comprehensive information on patients’ care and treatment, and understand their roles and responsibilities under the Mental Health Act and Mental Capacity Act.
and enhances pride in the organisation among our staff. The CQC inspectors noted that we have safe staffing levels, that our staff have the skills and training to keep people safe from avoidable harm, and that we plan for emergencies. They also found that staff keep appropriate records of patients’ care and treatment, and that we prescribe, give, record and store medicines well. Our staff understand how to protect patients from abuse, and the service works well with other agencies to do so. They have training on how to recognise and report abuse, and know how to apply it. The inspectors also noted how well we control infection risk, which is vital for keeping patients, staff and visitors safe.
“We’re using the latest methods to protect and treat patients whose immune systems are suppressed due to cancer treatment,” says Pat Cattini, Lead Nurse and Deputy Director for Infection Prevention and Control. “We always balance the risk of infection with the risk of delays or cancellations, ensuring we can run an efficient service for patients while managing any infection issues.” Are services effective? The inspectors found that our staff are competent for their roles, work together as a team for the benefit of patients, provide care and treatment based on national guidance and evidence of its effectiveness, and give patients enough food and drink to meet their needs and improve their health.
LEADING THE WAY Medical Director Dr Nicholas van As is part of our ‘outstanding’ leadership team
Are services caring? We were highly rated for the question of whether our services are caring, based on the inspectors seeing at first hand examples of our staff going above and beyond for their patients. This is something we proudly refer to within the Trust as the ‘Marsden Magic’ – whether it’s a volunteer remembering a patient’s favourite biscuit, or nurses organising last-minute weddings or playing a patient’s favourite song. The inspectors also found that staff involve patients and those close to them in decisions about their care and treatment, as well as providing emotional support to patients to minimise their distress. “Working on the front line of cancer care is a privilege in so many ways,” says Eamonn Sullivan, Chief Nurse. >
Our CQC ratings Safe Effective Caring Responsive Well-led Overall
Good Good ★ Outstanding ★ Outstanding ★ Outstanding ★ Outstanding RM magazine 23
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CQC REPORT
Our leadership, governance and culture were rated as ‘outstanding’ “Our nurses get to work with so many different types of people at the happiest and saddest moments in their lives. Being able to tune in to people and know how to comfort and support them is a skill we pride ourselves on.” Are services responsive? The inspectors found that the Trust plans and provides services in a way that meets the needs of local people, and that people can access the services when they need to. They also noted that the Trust takes account of patients’ individual needs. In addition, the inspectors reported that we treat concerns and complaints seriously, investigate them and learn lessons from the results, which are shared with all staff.
WORKING WELL CQC inspectors praised the way in which our staff care for patients with compassion (above) and how they work as a team to benefit patients (above right)
“Our ‘outstanding’ rating doesn’t mean that we are perfect,” says Chief Executive Cally Palmer. “But the CQC appreciated that we take any mistakes extremely seriously, dissect them and take steps to reduce the risk of the same mistake happening again.” Are services well-led? In order to determine whether the Trust is well-led, the inspectors interviewed the entire executive team, as well as several nonexecutive directors and senior staff from across the hospital. They examined performance and quality reports, papers to the board, minutes of board meetings, audits and action plans, as well as attending a board meeting. We were rated as ‘outstanding’ because the leadership, governance
and culture of the Trust are used to drive and improve the delivery of high-quality person-centred care. The inspectors commented on our “compassionate, inclusive and effective leadership at all levels”, and noted that “the Trust’s strategy, supporting objectives and plans were stretching, challenging and innovative, while remaining achievable”. They also saw that we celebrate innovation, stating: “There was a clear, systematic and proactive approach to seeking out and embedding new and more sustainable models of care and a strong record of sharing work locally, nationally and internationally.” RM
Want to know more? Read the full report at cqc.org.uk/ provider/RPY
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IT HAPPENED TO ME
THE ROYAL MARSDEN HAS KEPT ME ALIVE. NOW WE’RE CHANGING THE CONVERSATION AROUND THE BIG C Deborah James, 37, stage 4 cancer patient
many others benefit from research in cancer prevention and cure. When I was diagnosed, I had to put my career in education on hold. But rather than disappear into a cave, I started a blog – Bowelbabe – to debunk the myth that young women don’t get bowel cancer and to raise awareness of symptoms. That led to a weekly column for the Sun, Things Cancer Made Me Say, which in turn led to my best-selling debut book, F*** You Cancer, published by Penguin in October. I also co-host the BBC Radio 5 Live podcast You, Me & the Big C, which I began with Lauren Mahon, a fellow patient from The Royal Marsden, and Rachael Bland, a
“Rachael Bland was one of my closest friends. She moved so many people”
MY WHOLE WORLD turned upside down when I was diagnosed with stage 3 bowel cancer just before Christmas in 2016. I remember the feeling of total disbelief – I was only 35 years old, with Christmas presents to buy for my young children and husband. This wasn’t part of the plan! A few months later, the disease spread to my lungs and was at stage 4. Since then, I’ve had four operations to remove tumours
from my bowel and lungs, plus multiple rounds of chemotherapy at The Royal Marsden. Now I’ve also embarked on pioneering CyberKnife radiotherapy to treat a tumour wrapped around an artery. I’m incredibly grateful to The Royal Marsden’s medical team, who keep me alive and always give me options. I’m constantly amazed by the passion and drive of Professor David Cunningham and his team, who ensure that I and
BBC journalist with breast cancer who came up with the idea. Rachael, who became one of my closest friends, sadly died in September, having transformed how we talk about cancer and dying. She was so popular and her story moved so many people. As a result, our podcast went to number one in the charts and we recently won a major award at the Audio and Radio Industry Awards (Arias). This success and support from the public has blown us away and, as per Rachael’s wishes, we’re carrying on with the show. The last thing she’d want is for people to stop talking about the Big C. RM
Professor David Cunningham
Consultant Medical Oncologist, Head of the Gastrointestinal and Lymphoma Unit and Director of Clinical Research “Deborah is an extraordinary person who continually inspires the people looking after her. More importantly, she gives hope and support to patients with cancer the length and breadth of the country by being prepared to articulate and share the ups and downs of her rollercoaster cancer journey. “I was honoured to be invited to take part in one of the You, Me & the Big C podcasts to talk about research, the placebo effect and strength of mind. Nothing is off limits on the show and it’s all done with a brilliant sense of humour.”
Want to know more? To listen to the You, Me & the Big C podcast, visit bbc.in/2I74P4V. Follow Deborah on Instagram at instagram.com/bowelbabe RM magazine 25
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Team Marsden needs you! MORE THAN 300 people pulled on their trainers and ran 13.1 miles through Hyde Park, Green Park, St James’s Park and Kensington Gardens to raise money for The Royal Marsden Cancer Charity. Held in October, the Royal Parks Half Marathon is one of the UK’s most beautiful challenge events, taking runners on a jaw-dropping route past London landmarks such as Buckingham Palace, Horse Guards Parade and the Royal Albert Hall. Our runners – Team Marsden – included 12 members of Royal Marsden staff alongside former patients and their friends and families, as well as supporters from our corporate partners such as Ralph Lauren, Google, Macfarlanes, Clive, and Blake Morgan.
Now, we’re looking a few months – and another 13 miles – ahead to the 26.2-mile Virgin Money London Marathon. The most famous race in the UK takes place on 28 April 2019. If you were lucky enough to get a place in the ballot, we would love you to join Team Marsden and help us continue to save and improve the lives of people affected by cancer at The Royal Marsden and beyond. If you or anyone you know is running, please join us! We’ll be supporting Team Marsden every step of the way to help our runners to train and fundraise, with one-to-one support throughout the whole journey.
Want to know more? For more information about running for Team Marsden, contact rachel.johnston@rmh.nhs.uk
ON THE RUN Team Marsden runners on this year’s Virgin Money London Marathon (left) and Royal Parks Half Marathon (above)
Having a ball The Arora Charitable F oundation held its fourth Arora Ball on 27 October, raising £1.1 million for The Royal Marsden Cancer Charity and Macmillan Cancer Support. The ‘Cherry Blossom’themed evening, held at the InterContinental London – The O2, was hosted by television presenter Christopher Biggins and saw guests enj oy a champagne reception, three- course dinner and special performances. The ball featured an auction of exclusive prizes, held by antiq ues expert Charlie Ross. Prizes included a gourmet dinner for 10 guests at 11 Downing Street – with Chancellor of the Excheq uer Philip Hammond as sommelier and his wife Susan and Arora Group Chairman Surinder Arora as waiters – and a trip to ir liff ichard s vineyard in Portugal. Sunita Arora, F ounder of the Arora Charitable F oundation, said: “ We were delighted to hold our fourth Arora Ball in support of The Royal Marsden Cancer Charity and Macmillan Cancer Support. “ This year is particularly poignant for us, as sadly we’ve lost a colleague from the Arora Group and a dear friend to cancer.”
Want to know more? Find out more at aroracharitablefoundation. com/arora-ball 26 RM magazine
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T H E R O YA L M A R S D E N C A N C E R C H A R I T Y
A NEW START
Come and join us on the new-look, newly named Banham Marsden March! AFTER EIGHT YEARS of the ever-popular walk between The Royal Marsden’s hospitals in Chelsea and Sutton, for 2019 we’re making a fresh start – literally. The starting line in Chelsea is moving from Dovehouse Street to Dovehouse Green,
increasing the walk slightly to 15 miles and giving everyone more space to limber up and mingle with other walkers. The five-mile option, which starts at King George’s Playing Fields in Morden and finishes with everyone else in Sutton, remains the same. IN THE FRAME Supporters get ready to march
Also, the event is now known as The Banham Marsden March – thanks to a new three-year partnership with Banham, who have generously sponsored it for the past four years. As ever, the incredible day will be finished off with a big party for all our walkers and spectators. Since it began in 2011, the event has raised £11.8 million for The Royal Marsden Cancer Charity, funding state-of-the-art equipment and pioneering research for the benefit of patients at The Royal Marsden and beyond. So sign up today and we’ll see you at the (new) start line!
Want to know more? The Banham Marsden March will take place on Sunday 10 March 2019. Registration closes on 11 January, or sooner if the event fills up. Sign up today at royalmarsden.org/march
Gifts in Wills help research continue The Royal Marsden’s nuclear medicine research programme will have the continued support of Trial Manager Shital Patel ( pictured) , thanks to gifts left in Wills to The Royal Marsden Cancer Charity. Shital has been working on a Royal Marsden- led imaging trial since November 20 17, comparing the use of a novel imaging techniq ue with the
standard isotope used in PET/ CT scans for patients with metastatic neuroblastoma. Dr Sue Chua, Consultant Radiologist and Nuclear Medicine Physician, said: “ I thought we were going to lose Shital after the original funding for her post runs out in the spring. I am so grateful to the donors who left gifts in their Wills.”
Contact The Royal Marsden Cancer Charity Telephone 020 8770 0279 Email charity@royalmarsden.org Visit royalmarsden.org Registered Charity No. 1095197
Hello Google, meet George Google has chosen George and the Giant Pledge, a fundraising initiative to help beat childhood cancer with The Royal Marsden Cancer Charity, as its inaugural UK Charity of the Year. Vicki and James ‘Woody’ Woodall created George and the Giant Pledge to raise money for The Royal Marsden’s paediatric oncology team after their son, George, was diagnosed with a rare form of childhood cancer and treated at the hospital in 2017. Donations to the Woodalls’ fundraising campaign will support other families coping with childhood cancers, and will help the Charity to continue to fund much-needed research into these diseases at The Royal Marsden’s Oak Centre for Children and Young People. The George and the Giant Pledge campaign recently smashed the £800,000 mark, and the Google partnership is set to propel it to its £1-million target.
Want to know more? Visit giantpledge.com
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A GLIMPSE OF THE FUTURE ATTENDEES AT THE ANNUAL General Meeting, held in Chelsea in September, had the chance to see two fascinating clinical presentations from two of the Trust’s leading consultants. As is customary, Chairman Charles Alexander, Chief Executive Cally Palmer and Chief Financial Officer Marcus Thorman first updated attendees on the Annual Report and Accounts for 2017/18, as well as the Trust’s performance, activities and achievements throughout the past year. Then, Professor Vinidh Paleri, Consultant Head and Neck Surgeon, spoke about robotic surgery. He discussed the breadth of surgery offered at The Royal Marsden using the da Vinci Xi
robots, the advantages these procedures provide to patients, and the influence Royal Marsden surgeons have on the roll-out of robotic surgery across the country. Dr Christina Messiou, Consultant Radiologist, then spoke about the use of artificial intelligence (AI) in whole-body cancer imaging, particularly for
myeloma. Using current patient case studies, she talked about the MALIMAR trial being run at The Royal Marsden and Imperial College London, and explained how, using AI, we will be able to diagnose patients earlier and treat them more quickly, increasing the chance of survival and reducing the risk of long-term side effects.
HI-TECH ADVANCES Professor Vinidh Paleri (above left) and Dr Christina Messiou
Using AI, we will be able to increase survival and reduce the risk of long-term side effects
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F O U N DAT I O N N E W S
Dates for your diary Council of Governors meeting 12 December 2018, 11am1pm, Chelsea
MYSTERY TOUR The Guv’nors on the hunt
MEET THE GUV’NORS IN SEPTEMBER, a team of five intrepid Governors took part in The Royal Marsden Cancer Charity’s interactive treasure hunt, the Marsden Mysteries. Calling themselves ‘The Guv’nors’, Fiona Stewart, Duncan Campbell, Dr Charmaine Griffiths, Maggie Harkness and Dr Carol Joseph took to the streets of Chelsea to follow in the footsteps
YOUR VOICE MATTERS
of the remarkable Victorian surgeon Mr Marsden. They solved cryptic clues and riddles and took on unexpected challenges to uncover the parts needed to build a mystery medical device. The Guv’nors, together with the other teams taking part in both Sutton and Chelsea, raised funds that will help our own ‘detectives’ at The Royal Marsden to discover
The Trust would like to thank all the members who attended and contributed to the Annual Quality Account Members’ Event, held in November at Chelsea. Hosted by Eamonn Sullivan, Chief Nurse, the event gave members the opportunity to hear and give feedback on the Trust’s q uality improvements priorities for next year. l ne nderson, eputy hief Nurse, gave a presentation on the Trust’s priorities, and attendees voted on which one should be selected as part of the Quality Accounts review process. Members also heard from Emma Masters, Advanced Nurse Practitioner, and arly nowball, i isional urse
new life-saving treatments and provide the best care for more cancer patients in the UK and across the world. Fiona said: “The day was so much fun. The Marsden Mysteries took us all over a beautiful and sunny southwest London, from Chelsea to Pimlico and Victoria. “We were taking part in memory of our much-loved and admired Governor colleague Dr Peter Lewins, who sadly died earlier this year. We are delighted that with the generous support of our friends and family, The Guv’nors raised £800 in Peter’s name.”
irector for hildren and oun eople and Adult Haematology, who talked about the advances made in teenage and young adult care. Jatinder Harchowal, Chief Pharmacist, Emma F oreman, Consultant Pharmacist, F leur Harvey, Lead Haemato- oncology Pharmacist, and nnette ussallam, eputy ead Pharmacist for Clinical Research & e elopment, then presented on the latest developments in targeted drugs.
Council of Governors meeting 20 March 2019, 11am-1pm, Chelsea To attend any of these meetings, please call 020 7808 2844 or email trust. foundation@ rmh.nhs.uk
Keep in touch To contact your Governor, email governors@ rmh.nhs.uk or telephone 020 7808 2844. Sign up and become a member at royalmarsden. nhs.uk/ membership
Want to know more? To attend future events, please contact Rebecca Hudson on 020 7808 2844 or email rebecca.hudson@rmh.nhs.uk
RM magazine 29
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PUZZLES & PRIZES
PRIZE CROSSWORD
Send your crossword with your name and contact details to RM, PR and Communications Team, The Royal Marsden, Fulham Road, Chelsea, London SW3 6JJ. The entry closing date is Monday 28 January 2019. See below for prize draw rules. Autumn 2018 crossword solution Across 1 Afghan Hound 6 Cur 7 Italian 8 Teach 9 Drake 11 Haydn 13 Meals 15 Lacquer 16 Ode 17 Excessively Down 1 Ascot 2 Germany 3 Amish 4 Hoard 5 Dance 10 Abalone 11 Halve 12 Nouns 13 Merci 14 Seedy Congratulations to Miss Strinder, the winner of the autumn 2018 issue’s crossword prize. 2
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12 14 15
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FOR THE ROYAL MARSDEN
4 3 7 2 6 5 4
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6 8 7 5 9
2 2 9 4 6 3 7
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Across 1 Describes woods (5) 4 Makes beer (5) 6 Neptune’s weapon (7) 8 Way out (4) 9 Potters’ ovens (5) 12 Ice house (5) 13 Roman garment (4) 15 European country (7) 17 A person living away from their country (abbr.) (5) 18 Composer (5)
Down 1 Dancer (9) 2 Dog (7) 3 Abominable snowman (4) 4 Could be finished in 9ac (6) 5 First lady (3) 7 Section of the Bible (9) 10 Big cat (7) 11 Fictional detective (6) 14 Shopping complex (4) 16 Drink small amounts (3)
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WINTER 2018 PRIZE CROSSWORD ENTRY FORM Fill in your details below when sending in your crossword competition entry. See above for details of our address. NAME ADDRESS
POST CODE TELEPHONE
Try the fiendishly tricky numbers puzzle – it’s just for fun
CROSSWORD CLUES
5
6
THE TEAM
1 6 8 9
The lucky winner of our prize crossword will receive a £50 John Lewis & Partners gift card.
1
SUDOKU
PRIZE DRAW TERMS AND CONDITIONS 1. The Prize Draw is open to all readers of RM except employees of the Press Office at The Royal Marsden and Sunday, who produce RM magazine. 2. The closing date for receipt of all entries is Monday 28 January 2019. Only one entry per person per draw. 3. Responsibility cannot be accepted for entries that are incomplete, illegible or not received. Proof of posting is not proof of receipt. No cash alternative is available and prizes are not transferable. Value of prize is correct at time of going to press. 4. Winners will be notified by post within 14 days of closing date.
5. The Promoter’s decision on any aspect of the promotions is final and binding. No correspondence will be entered into. 6. The Promoter reserves the right to substitute a prize of equal or greater value should circumstances make this necessary. 7. Entry implies acceptance of rules. 8. The winner of the crossword prize of a £50 John Lewis & Partners gift card will be the first correct entry drawn out of the bag. 9. The Promoter is The Royal Marsden, Fulham Road, London SW3 6JJ.
Rachael Reeve Director of Marketing and Communications Elaine Parr Head of PR and Communications Abby Samuel PR and Communications Manager Catherine O’Mara Senior PR and Communications Officer Hannah Bransden Senior PR and Communications Officer Jack Stonebridge Senior PR and Communications Officer
FOR SUNDAY Marc Grainger Editor Mark Wheeler Art Director Sian Purdy Designer Gill Tait Account Director Richard Robinson Group Editor Matt Beaven Creative Director Toby Smeeton Managing Director
RM magazine is published by The Royal Marsden in partnership with Sunday: wearesunday.com © The Royal Marsden 2018. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor. The Royal Marsden and Sunday accept no responsibility for the views expressed by contributors to the magazine. Repro by F1 Colour. Printed by Pureprint.
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S TAY I N T O U C H
COMMENT, LIKE, SHARE Join the conversation on Twitter @royalmarsden and @royalmarsdenNHS Facebook @royalmarsden Instagram @royalmarsden Twitter
Paul Scully MP @scullyp Congratulations to all at @ royalmarsdenNHS. Lovely to see @BBCBreakfast covering the milestone of the first MR Linac treatment The Royal Marsden Cancer Charity @royalmarsden Get in the festive spirit by naming a gold star for somebody you love #CelebrateaLife James Wilson @jwils82 Proud to have raised £1313.75 for @royalmarsden after running the royal parks half marathon. Thank you to all my supporters making me hit the top 5% of fundraisers on JustGiving for October
Eleanors Voice @ERStollery Treatment 12 had to take place @royalmarsden today as there is a national shortage of Eleanor’s #chemo drug called #vinblastine. As usual we were looked after impeccably. Leaving enough time to celebrate her Dad’s #birthday @IvyCafeTW9 #eleanorsvoice [above]
Gemma Beard I was there for a check up the day the CQC were inspecting this wonderful place! The staff were a bit nervous but with absolutely no reason to be – this place couldn’t be any more deserving of an Outstanding result! So pleased you’ve got the recognition you deserve as I’m sure all of us who are/were treated there will never ever feel like ‘thank you’ is enough Helen Ansell Absolutely brilliant... the Marsden is a wonderful place... let’s hope cancer treatment gets better and better xx
Instagram Dizzy Dalton @dizzdalton 6 months, 12 intensive rounds of chemo and finally, one Dancing Queen beginning her road to recovery [above]... thank you to everyone and especially the amazing team at the @royalmarsden for putting up with our noisy hordes every other week
CONTACT US CALL THE ROYAL MARSDEN, CHELSEA
020 7352 8171
CALL THE ROYAL MARSDEN, SUTTON
CONTACT THE ROYAL MARSDEN HELP CENTRE For confidential chat, support and information, call
020 8642 6011
0800 783 7176
VISIT US ONLINE royalmarsden.nhs.uk
or visit royalmarsden.nhs.uk/your-care/ royal-marsden-help-centre
WANT TO WORK AT THE ROYAL MARSDEN? Visit jobs.royalmarsden.nhs.uk READ RM MAGAZINE ONLINE royalmarsden.nhs.uk/rm-magazine
For general feedback, compliments, concerns or complaints, send us a message royalmarsden.nhs.uk/ contact-us/get-in-touch
STAY IN TOUCH WITH THE ROYAL MARSDEN CANCER CHARITY CALL US
020 8770 0279 EMAIL US charity@royalmarsden.org VISIT US ONLINE royalmarsden.org Registered Charity No. 1095197
Look out for the spring 2019 issue of RM – coming March 2019 RM magazine 31
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Registered Charity No. 1095197
Together we walk Sign up today and proudly walk amongst thousands of fellow supporters on 10 March 2019 for The Royal Marsden Cancer Charity. Whether you choose the 5 or 15 mile route, every step you take will help raise vital funds that make a big difference to the lives of cancer patients everywhere. Sign up at royalmarsden.org/march RM37_p32_OBC_v1.0.indd 32
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