HEALTHCARE IN LONDON www.healthcareinlondon.com
VOL 1 NO 1 – JUNE 2022
Dealing with post-lockdown problems
Endometriosis No longer a taboo subject
Detecting and treating
prostate cancer Sports medicine
Not just for athletes
What you need to know
Pioneering robotic surgery Enabling better patient outcomes
At Cromwell Hospital, our advanced surgical programme includes the da Vinci robot. This highly advanced tool offers significant benefits, providing surgeons with enhanced vision, greater precision and control. The benefits to patients include faster recovery times, and in many cases improved clinical outcomes.
Image ©2021 Intuitive Surgical, Inc.
Lord David Evans, Publisher, Healthcare in London
warm welcome to the launch edition of Healthcare in London magazine – our new quarterly publication highlighting the wealth of medical expertise and world-class hospitals and clinics in the UK capital. With each issue, we hope you will enjoy the illuminating interviews with some of London’s leading medical specialists, each sharing their knowledge and insights in terms that are easy to understand. Our aim is to remove the mystery and stigma that so often surrounds medical matters, as well as informing our readers about how to access diagnosis and treatment. This edition’s lead interview explores the growing issue of diabetes with nurse consultant Jeannette Woods of the London Clinic. She explains why the condition is increasing in prevalence worldwide and discusses the steps that can be taken to manage diabetes and even to prevent its onset. As the world emerges from the restrictions of the pandemic, many of us need to catch up with medical tests and treatments that we were unable to access over the past couple of years.
Cancer consultant Professor Chris Nutting of the Royal Marsden reminds us of the importance of testing and early diagnosis, while a similar message is targeted at men by Professor Mark Emberton of King Edward VII’s Hospital, who talks us through testing and treatment for prostate cancer. Focusing on women’s health, we learn how endometriosis is becoming less of a taboo subject, and how specialists such as Mr Amer Raza of the Cromwell Hospital are giving hope to sufferers from this debilitating condition. Meanwhile, Nightingale Hospital medical director Dr David Oyewole considers the impact of the pandemic on mental health and welcomes the return of in-person therapies, while OneWelbeck’s Natasha Beach explains why sports medicine isn’t just for athletes, but also deals with a broad range of everyday injuries. Plus don’t forget to explore our Experience London section, which shines a spotlight on the luxury leisure, shopping and fine-dining attractions that extend the appeal of the city as a medical tourism destination. We look forward to welcoming you soon!
www.healthcareinlondon.com Published by Senate Publishing www.senatepublishing.co.uk | +44 (0) 20 7723 9825 | firstname.lastname@example.org Chairman Lord David Evans | Chief executive Caroline Minshell Editorial director Barry Davies | Designer Carly Hurd Image credits: Shutterstock, unless otherwise stated
© 2022. The entire contents of this publication are protected by copyright. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher. The views and opinions expressed by independent authors and contributors in this publication are provided in the writers’ personal capacities and are their sole responsibility. Their publication does not imply that they represent the views or opinions of Senate Publishing and must neither be regarded as constituting advice on any matter whatsoever, nor be interpreted as such. The reproduction of advertisements in this publication does not in any way imply endorsement by Senate Publishing of products or services referred to therein. The information in this publication (including, but not limited to, text, graphics, images and other material) is for informational purposes only and is not intended to be a substutute for professional medical advice, diagnosis or treatment. The publication of links to external websites does not imply endorsement by Senate Publishing, nor responsibility for their content. JUNE 2022 • HEALTHCARE IN LONDON 3
Contents In your June issue
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Detecting and treating prostate cancer
Professor Mark Emberton stresses the importance of prostate cancer testing for men over 50 and outlines the treatment options for those diagnosed with the disease
What you need to know about diabetes
Whether an injury occurs on the sports field or as a result of everyday activity, the diagnosis and treatment journey for patients is identical
Living with endometriosis
Women with endometriosis have often suffered in silence, but increasing openness about the condition has raised awareness and seen more patients coming forward 4 HEALTHCARE IN LONDON • JUNE 2022
Catching up with cancer testing Professor Chris Nutting explains the effects of the Covid lockdowns on cancer testing and treatment, and urges people with concerns to see a specialist as soon as possible
Jeannette Woods, diabetes nurse consultant at the London Clinic, explains what it means to be diabetic and the best methods for managing the condition
Sports medicine: not just for athletes
Dealing with postlockdown mental health problems Life under lockdown tested the world’s mental wellbeing, but in-person mental health treatment is now available again
Experience London 40
There’s something for everyone on Regent Street and St James’s
From fashion and art to fine dining and entertainment, all interests are catered for in this prestigious part of the West End
An urban retreat in the heart of London Hotel Café Royal’s Akasha Holistic Wellbeing offers a range of specialist hydrotherapy treatments
A taste of India in London’s West End
Michelin-starred restaurant Veeraswamy has been serving authentic Indian cuisine for almost a century
The fine art of bespoke shirt-making
Emma Willis MBE talks about her journey to becoming one of the world’s leading bespoke shirt-makers
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Detecting and treating
cancer With one in eight men diagnosed with prostate cancer in their lifetime, the importance of screening cannot be overstated, says Professor Mark Emberton
ancer of the prostate – the walnut-sized gland situated at the base of the bladder and surrounding the first part of the uretha, the tube that carries urine and semen – is the most commonly diagnosed cancer in the UK and is second only to skin cancer among men globally. According to the charity Cancer Research UK, more than 52,000 men are diagnosed with prostate cancer each year in the UK, with an average of 35% of new cases in men aged 75 or over. About one in eight of men in the UK will be diagnosed with prostate cancer in their lifetime, rising to one in four among black men of Caribbean and African origin. However, despite such concerning statistics, the good news for older men is that prostate cancer is among the most
treatable and manageable of cancers. “The important thing to realise is that, unlike other cancers, not every prostate cancer will result in that individual suffering, or indeed dying, of it,” explains Mark Emberton, a professor of Interventional Oncology and Dean of the UCL Faculty of Medical Sciences, and a consultant at London’s King Edward VII’s Hospital. “The key question is not whether a patient has prostate cancer, but whether it is clinically significant – in other words, cancer that can affect quality or quantity of life.”
Regular testing is key
The likelihood of a man developing prostate cancer is dependent on a number of factors, including his age, genetics and family history of the disease, and lifestyle. So what can men do if they are concerned about prostate cancer? As the early stages produce no symptoms, regular testing is the key to identifying whether cancer is present and its extent, when detected. “If you have a symptom from prostate cancer then, unfortunately, it usually means it is too late to be treated, as the cancer will be either locally advanced or will have spread,” says Professor JUNE 2022 • HEALTHCARE IN LONDON 7
Emberton. “The only way to find cancer early is to test for it. As prostate cancer is so age-related, testing wouldn’t be required before the age of 50, because the risk is so low prior to this time, and the frequency of testing would depend on the level of cancer detected.”
Initial testing for prostate cancer is a straightforward process, requiring a simple blood test that detects levels of prostatespecific antigen (PSA). “If your PSA is less than one, you can pretty much ignore it,” says Professor Emberton. “If the PSA is above one, then it is probably worth having a test every couple of years. Should the PSA levels start going up rapidly – in other words, if the doubling time gets close to two to three years – then it would be advisable to see a specialist.” Professor Emberton warns that no test in medicine is perfect and that the PSA blood test is no exception, occasionally producing ‘false positives’ when there is no underlying cancer present. “The way we can improve the performance of the blood test is to combine it with magnetic resonance imaging (MRI),” he explains. “MRI scanning for the prostate
was developed in the UK, where we were among the first to use this method, and it is now recommended all over the world when a man has a high PSA.” One factor that has, perhaps, made men reluctant to come forward for testing is the thought of a doctor examining for an enlarged prostate using their finger, inserted into the patient’s rectum. However,
95% of patients can expect to be free from progression of the cancer after 10 years, if it is detected at an early stage. Men with low-risk prostate cancer often require only monitoring to make sure that the disease does not develop, while those with aggressive cancer will require their whole prostate to be treated, often with surgery and radiotherapy.
“As prostate cancer is so age-related, testing wouldn’t be required before the age of 50” this method is now somewhat outdated, as Professor Emberton confirms: “Although this procedure can still be carried out, it’s not very precise. A finger can only feel the back of the prostate, so this isn’t a good method for estimating size or whether cancer is present. As a cancer test, the finger is among the poorest performing.” Modern developments in treatment and monitoring of the disease mean that up to
RIGHT: Robotic systems have become the standard in the UK for prostate cancer surgery (PHOTO: KING EDWARD VII’S HOSPITAL)
LEFT: Professor Mark Emberton performs the NanoKnife focal therapy technique (PHOTO: KING EDWARD VII’S HOSPITAL)
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“There has been a revolution in surgical techniques, which have gone from open to keyhole surgery, and robotic surgery” However, most patients fall in the middle of this range, with a small amount of clinically significant cancer, which Professor Emberton explains can now be tackled with a new method of treatment – focal therapy. “This represents a major breakthrough, which has only come about because of improvements in diagnostics due to MRI. Such therapy needs to be carried out in a hospital under anesthetic, but much of it is non-invasive and involves projecting sound waves, electric current, lasers and ice balls to remove parts of the prostate in a targeted fashion.” The work of Professor Emberton and his fellow specialists has seen London become the world centre for focal therapy, in terms of both capability and the capacity to offer such treatments. “One example of focal therapy is NanoKnife, which exposes the cancer to high-voltage electricity that blows holes in
the cell membrane of the cancer cell and forces it to kill itself.” A further benefit is that that NanoKnife is usually pain-free and completed in around 45 minutes, with patients requiring a catheter for a couple of days following the treatment. “It’s a very low-impact procedure, and the next day they can be out walking and exploring London,” says Professor Emberton.
Preserving key structures
“With focal therapy, we eliminate the cancer plus a margin, but try to retain the areas of the prostate that are healthy, and thereby preserve some of the key structures around the prostate that typically become damaged when the whole gland is treated.” These structures include the bladder neck and the rectum – damage to which could result in urinary and fecal incontinence – plus the nerves
and blood vessels that supply the penis to give and maintain erections. A common concern for men being treated for men with advanced prostate cancer is that their sexual function will be affected following treatment, but Professor Emberton is able to provide some words of reassurance. “Most men will lose their erections when the whole prostate gland is treated,” he says. “But recent work led from London has demonstrated that, if a man is treated focally with the aim of preserving as much tissue as is reasonable, he has a 95% chance of being able to have erections afterwards.” Looking ahead, Professor Emberton sees a role for new technologies in helping to identify cancer as early as possible. “Currently, we rely on the radiologist’s eye,” he says, “but images may be interrogated more effectively using artificial intelligence.” He also expects continuing developments in terms of treatment. “There has been a revolution in surgical techniques, which have gone from open to keyhole surgery, and robotic surgery, which has become the standard of care now, and I’m not aware of anybody in the UK that isn’t using this. There may be some development in terms of augmented reality to assist the surgeon with an operation, and there are new energy sources that will allow us to treat prostate cancer with great precision.”
RIGHT: Professor Mark Emberton (centre) and his team (PHOTO: KING EDWARD VII’S HOSPITAL)
OPPOSITE: A patient arrives at the hospital’s main reception (PHOTO: KING EDWARD VII’S HOSPITAL)
For more information on prostate cancer services at King Edward VII’s Hospital, scan the QR code
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What you need to know about
diabetes Diabetes is becoming an ever-greater health issue around the world, accounting for at least 1.5 million deaths per year. Jeannette Woods, diabetes nurse consultant at the London Clinic, explains what it means to be diabetic and the best methods for managing the condition
What is diabetes?
RIGHT: People with diabetes will usually have to monitor their blood sugar on a daiyl basis, but sensor technology is making this task easier
Diabetes is a condition whereby the body is unable to control blood sugars, because there is a problem either in the production or the action of insulin. This is a hormone in the made in the pancreas and, effectively, its job is to convert our food into energy. Without sufficient insulin, or without insulin working properly, our bodies are unable to utilise our food for energy. Food is our battery – it’s what makes our bodies work – but it only becomes that energy when the sugar from the food moves from the bloodstream into the
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blood cells, and it is insulin that carries that sugar across from the fluid part of the blood into the blood cells. There are two types of diabetes: type 1 and type 2. Type 1 covers a very small percentage of all diabetics in the world – fewer than 10% – and is an autoimmune disease, meaning that the body turns on itself and kills off the cells that make insulin. We have no means of predicting who will get type 1 diabetes and, even if we did, there is no way of preventing or curing it. Somebody with type 1 diabetes is producing no insulin at all, and without insulin we can’t live, so these people need to inject insulin multiple times a day to control their blood sugar. The majority of diabetics have type 2 diabetes, which is genetic in origin. We’re born with or without the predisposition for type 2 diabetes – it doesn’t mean we will definitely get it, but if we receive the right stimulants at the right time, then we can get it. Unlike type 1 diabetes, we can predict who is likely to get type 2 by considering their ethnicity, their family history of both diabetes and cardiovascular disease, and their waist circumference. Type 2 diabetes is very much related to lifestyle, which is why we see many more diabetes cases today than we have previously. This is mainly because as
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ABOVE: With specialist help, patients can learn how to control their diabetes
BELOW AND RIGHT: Losing excess weight and maintaining a healthy lifestyle are key to avoiding the onset of Type 2 diabetes
a people, in general, are much less active and we tend to carry more weight than our predecessors did. We tend to eat a lot of refined sugar in our diets, and this will often lead to the onset of type 2 diabetes. With type 2 diabetes, the main problem is what we call ‘insulin resistance’. Even though the body is producing insulin, it’s not really capable of utilising it effectively, so the body has to produce increasing
amounts of insulin in order to get the sugars under control. If this goes on for too long, then the pancreas can become tired and then have a problem with producing sufficient insulin. Among the places where we see the most diabetes is in countries that have developed quickly. For example, in the Middle East, where countries such as Kuwait developed rapidly with the advent of the oil industry, the traditional lifestyle and diet has been largely replaced with fast and processed food, as well as increasing car ownership, meaning less physical activity. Genetics haven’t caught up in such a short space of time, so the increase in type 2 diabetes is exaggerated in countries where there has been such rapid change.
Is there any action we can take to prevent or delay the onset of type 2 diabetes?
In some people, prevention is possible, but for the majority of people the onset of type 2 diabetes can be delayed 14 HEALTHCARE IN LONDON • JUNE 2022
“The onset of type 2 diabetes can be delayed significantly, often by decades. The key is leading a healthy lifestyle” significantly, often by decades. The key is leading a healthy lifestyle, by eating healthily, losing weight and being active. Activity is so important because the more active we are, the less resistant to insulin we are. With a healthy lifestyle, someone with type 2 can manage their condition and get to a position where they don’t need any outside treatment. It isn’t a cure, so if previous unhealthy habits return then blood sugar levels are going to go back up. A very high percentage of people with type 2 diabetes don’t need to suffer if they change their lifestyle significantly enough. Type 2 used to be called ‘mature onset’ diabetes, because almost all those who developed it were in their late sixties and seventies. We cannot say that anymore and the average age of onset for diabetes comes down year on year, to the extent that now our lifestyles are often so unhealthy that we even have children developing type 2 diabetes, which was previously unheard of.
What symptoms might someone notice if they are suspected of having diabetes? Whether a person has type 1 or type 2 diabetes, the symptoms are the same, but with type 1 these are much more
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ABOVE, RIGHT AND OPPOSITE: Eating well, avoiding sugar and taking regular exercise are all key factors in remaining free of diabetes
obvious. That is because the speed of onset of diabetes is very different in each case, with a type 1 patient presenting with diabetes within weeks of onset, as their lack of insulin occurs very quickly. The two most common signs of either newly diagnosed or uncontrolled diabetes are passing a lot of water and the need to drink a lot. When there’s too much sugar in the body, it tries to produce more insulin to lower the level of sugar in the blood, but if you are not producing insulin or it is not functioning then the body can’t do that. Instead, it tries to get rid of the sugar by passing it out through the kidneys. As sugar is very absorbent, it takes lots of water with it, so we become thirsty to replace the water and avoid becoming dehydrated. As I mentioned before, sugar is our battery. It’s our energy, but you still have to keep living, even if you can’t use that sugar. So the body turns to its own fat stores and
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starts breaking those down in order to get some energy out of it. Obviously, that leads to very rapid weight loss, which tends to happen with type 1. The problem with type 2 diabetes is that the onset is very slow, so people who are diagnosed will certainly have had it for months, perhaps even for years. The
person with type 2 diabetes has reached a high sugar level over maybe the previous 18 months, so the body has adapted very slowly and the patient doesn’t recall how much better they were feeling a year or two earlier. Often, our patients only realise how poorly they had been feeling a couple of weeks after starting their treatment. It is quite common that people with type 2 diabetes are diagnosed incidentally when they have a routine health check for insurance, for example, or have a blood test in preparation for a hospital procedure. Also, sadly, another way that diabetes is often diagnosed is when the patient presents with a complication of diabetes, such as a black toe or a sight problem, or they might have shown some kidney problems in a blood test. At that point, the patient will have had diabetes for a long time, without any treatment, and that is when complications can occur.
What would be the typical patient journey for someone diagnosed with diabetes?
Often, when someone is diagnosed by their general practitioner, their doctor may prescribe tablets and suggest a follow up in, say, six months. However, it is best if the patient is educated on how to manage their diabetes from day one.
Diabetes is very much a selfmanagement condition, but obviously this can only happen with knowledge. Education really is the key, but sadly many people don’t receive that education and
“Diabetes is very much a self-management condition, but obviously this can only happen with knowledge” then they and their doctors are puzzled at why their control isn’t very good. When people come to our practice at the London Clinic, they would first see our specialist – consultant in endocrinology and diabetes Dr Richard Sheaves – who would spend an hour with them to talk through their condition, the type of diabetes they have and what
their blood sugar reading means. My role is then to talk more about day-today management of diabetes, most importantly starting with understanding the patient – who is the patient? What do they do for a living? What do they like to do for leisure? What treatments might suit them best and what might they struggle with?
What technology is available to help diabetes patients manage their condition?
Generally, patients will monitor their blood sugar on a daily basis, often on multiple occasions. Monitoring is the biggest issue for patients, as it is irritating to constantly having to measure your blood sugar, and when you have to prick your finger for a blood test it’s also painful. Fortunately, these days we have technology such as continuous glucosemonitoring sensors that can sit under the skin and monitor blood sugar every five minutes, send that information to your phone. At all times patients can their blood sugar levels, and that’s a huge educational tool – in a short period the patient can learn exactly what foods JUNE 2022 • HEALTHCARE IN LONDON 17
ABOVE: Fingerprick blood tests have long been a painful daily chore for diabetes patients
BELOW: Pumpsthat are connected to a sensor can deliver insulin whenever it is needed, replacing the need for the patient to monitor levels and inject themselves
affect their blood sugar, by how much and for how long. In the first few weeks of using a sensor a patient will learn more than they would have done previously in a year or two, which has changed the lives of so many people. For example, patients may not need to give up particular foods completely, but can learn what is a sensible portion size for them. Insulin pumps are also making a big difference to patients’ lives. An insulin pump is a small device that you can wear that infuses insulin constantly, right under the skin, which the patient controls with their phone or a handset. It’s a very complex way of managing diabetes and, when used in combination with glucose-monitoring sensors, can mean a type 1 patient would only need to inject insulin every three days, at the time when the pump is changed. This has also led to the development of a hybrid system – an artificial pancreas, essentially – with pumps that can connect directly to a sensor, so that the patient doesn’t have to make the decisions on a constant basis about how much insulin should be administered. This means they can keep their blood sugar within normal limits almost all the time.
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For more information on diabetes services at the London Clinic, scan the QR code
endometriosis A Women with endometriosis have often suffered in silence, but increasing openness about the condition has raised awareness and seen more patients coming forward
reluctance to talk about women’s health has meant many women have suffered in silence with sometimes debilitating conditions, rather than seeking help. Thankfully, recent mainstream media coverage of such issues has led to greater openness, not least about the topic of endometriosis. Prominent women that have spoken about their experiences of endometriosis include music legend Dolly Parton, comedian Amy Schumer and movie actors Susan Sarandon, Whoopi Goldberg and Daisy Ridley. The subject is also being highlighted on screen in the BBC drama
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BELOW: The painful symptoms of endometriosis are most commonly experienced in the days leading up to a period
Conversations with Friends and in a new documentary, Below the Belt. The latter, directed by Shannon Cohn, includes among its executive producers former US Secretary of State and presidential candidate Hillary Clinton, who has also suffered from endometriosis.
“Young women are becoming more educated about endometriosis due to the welcome increase in media coverage about the condition over the past couple of years, which has been very important,” says Mr Amer Raza, consultant gynaecologist leading the team at the International Centre for Endometriosis at London’s Cromwell Hospital. “Endometriosis wasn’t talked about before and was considered a taboo subject, but highprofile women sharing their experiences publicly has helped to bring about a huge change in awareness. Charities are becoming very active as well. As a result, women are visiting doctors with their symptoms much earlier than previously.”
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Considering the lack of public dialogue about endometriosis, it is perhaps surprising to learn that as many as 20% of women suffer from the condition. “Endometriosis is quite a common condition among women aged from 15 to 50, in which the symptoms include pelvic pains, period pains, painful intercourse and, at times, fertility issues,” says Mr Raza, who explains that it is a condition where “the inside lining of the womb, called the endometrium, comes out through the fallopian tube in the abdominal walls and make tissues stick together. This stickiness and scarring inside the abdomen leads to severe pelvic pain. “Symptoms are reflective of the area in which endometriosis grows – for example, if it grows in the back of the uterus, near the rectum, then bowel symptoms will be predominant; if it grows in the bladder, then painful urinary symptoms will be common.” The most common symptom of endometriosis is pain experienced in the days leading up to a period, which worsens before getting better, meaning that it is a
“When a new patient arrives at our clinic, it is most important to gather their full and detailed history”
ABOVE RIGHT: Consultant gynaecologist Mr Amer Raza and his team use robotic surgery techniques that allow surgeons to work with high precision (PHOTO: CROMWELL HOSPITAL)
RIGHT: When a new patient arrives at the clinic, the first step is to gather a detailed history of their symptoms
cyclical problem for most sufferers. Severe fatigue may also occur during the period, as well as pain while passing urine and stools. “As the disease starts to grow around the uterus and involves more structures, it then adopts a chronic pattern, meaning that the cyclical nature of the pain will prolong and cover the entire month,” says Mr Raza. “Such pain will be particularly severe during the period itself and, sometimes, during ovulation. “In some women, endometriosis starts to grow inside the ovaries, which can then start to swell. This is known as ovarian endometrioma, or a cyst with an endometriosis, which can have an impact on fertility. About 20% of women with endometriosis experience fertility issues.”
When seeking an initial diagnosis, most patients visit their general practitioner (GP), with symptoms such as pelvic pain and period pains, before being referred to the Cromwell Hospital by their doctor or via other hospitals. Also, some patients approach the Cromwell’s endometriosis centre directly.
Detailed patient history
“When a new patient arrives at our clinic, it is most important to gather their full and detailed history to determine whether they indeed have endometriosis,” explains Mr Raza. “The symptoms can overlap with other conditions that may not be endometriosis – for example, irritable bowel syndrome, which involves bloating
and constipation, or bladder conditions. Once we’ve established a history, then examination is the key. A thorough vaginal examination helps us to feel the nodules of endometriosis in moderate to severe cases.” In milder cases, examination may not be as effective in making a diagnosis, so the patient will have scans to determine the extent of their endometriosis. “The other main step in our investigation is the transvaginal ultrasound scan, from which we can detect endometriosis in the ovaries. It can also help us to see endometriosis in the back of the uterus, involving the bowel,” says Mr Raza. “Some patients will also need a pelvic MRI [magnetic resonance imaging] scan, which is a very sensitive and detailed assessment of the pelvis that helps us understand not only the quantity or amount of endometriosis in the pelvis, but also the other organs that are involved.” Where examination and scanning cannot fully diagnose the disease, patients will then require laparoscopy – an operation under general anesthesia to simultaneously diagnose and treat the problem. As endometriosis is a hormonal disease, in which oestrogen increases the severity of the condition, most medical treatments are based on hormonal JUNE 2022 • HEALTHCARE IN LONDON 21
RIGHT: Most medical treatments for endometriosis are based on hormonal therapies, such as oral contraceptive pills
therapies that suppress or reduce the oestrogen. “If mild endometriosis is causing pelvic pain, then treatment with hormones will suffice,” says Mr Raza. “This will include combined oral contraceptive pills, progesterone pills, and even a Mirena IUS
“If mild endometriosis is causing pelvic pain, then treatment with hormones will suffice”
RIGHT: According to Mr Raza, the International Centre for Endometriosis serves the needs of both patients and specialists (PHOTO: CROMWELL HOSPITAL)
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(intrauterine system) coil – a hormonal contraceptive inserted into the uterus.” In moderate to severe cases, where the condition is causing an impact on quality of life, a patient would proceed to laparoscopic surgery, for which robotic surgery techniques are used, allowing surgeons to work with high precision to reduce tissue trauma and bleeding, resulting in a faster recovery. Where endometriosis is present around the uterus, around the ovaries or on the pelvic side walls, laser or electrical energy is used to remove the scarring and adhesions inside the abdomen, relieving pain. According to Mr Raza, the creation of a specialist endometriosis centre at the Cromwell Hospital has brought significant benefits for both patients and specialists. “We felt there was a great need for a specialised centre, bringing together under one roof all the endometriosis expertise, such as colorectal surgery, fertility, physiotherapy, psychological support and chronic pelvic pain support,” he says. “We provide a one-stop service where a patient can come in, be seen, have their ultrasound scan on the same day and walk away with a provisional diagnosis either confirming endometriosis or excluding it.” The facility is recognised
as an accredited endometriosis centre by the British Society of Gynecological Endoscopy, which monitors and governs the services provided.
As the name would suggest, the International Centre for Endometriosis is well suited to private patients from abroad, whose treatment and recovery plans can be arranged even before they set foot in London. “The patient journey usually begins with an online video consultation, before MRI scans are carried out at their local hospital,” Mr Raza explains. “The images from these scans are then transferred to the radiology system
at the Cromwell and analysed by our endometriosis experts.” A further video consultation will then take place, during which the scan images can be displayed and discussed, before a decision on surgery is made. If surgery is required then the patient will travel to the Cromwell for their operation, for which they can expect to stay in hospital for only one or two nights. “About 60% of post-surgery recovery happens within the first week, and patients are 80% to 90% recovered after two weeks,” says Mr Raza. “At this point, most patients are able to fly home, where they will receive follow-ups via further video consultations.”
For more information on endometriosis services at the Cromwell Hospital, scan the QR code
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not just for athletes Whether an injury occurs on the sports field or as a result of everyday activity, the diagnosis and treatment journey for patients is identical, regardless of their athletic prowess
hink of ‘sports medicine’ and, for many of us, an image is conjured up of elite athletes receiving the kind of treatment reserved only for those occupying the higher echelons of the sporting world. However, the reality is quite different, with the same treatment processes also on offer to all patients visiting London, regardless of their athletic ability or lifestyle. “The term ‘sports medicine’ is a slight misnomer, as we are not only treating
athletes, but also regular people with problems such as back pain or chronic knee arthritis,” explains Dr Natasha Beach, a consultant in sports and musculoskeletal medicine at OneWelbeck Orthopaedics. “For this reason, we are trying to change refer to ‘sports and musculoskeletal medicine’, because of the common misconception that we only treat athletes. “I’ve heard patients say, ‘Oh, I’m not an athlete, am I in the right place?’, but yes, they are! We treat everybody in the same way as an elite athlete, using all the same principles that we use with professional sportspeople. If you’re an elite tennis player and you’ve got tennis elbow, the injury is no different to that of a new mother who is suffering elbow pain after lifting her baby up all the time.” Dr Beach’s patients are mostly referred by physiotherapists with some experience of sports medicine, although patients may also approach the clinic directly. “We might be the third or fourth port of call for many patients, who are visiting us with an ongoing problem that hasn’t been solved by their previous treatment. At that point, people are starting to get almost desperate.” JUNE 2022 • HEALTHCARE IN LONDON 25
BELOW: Tennis elbow doesn’t affect only players of the sport, but can be caused by everyday actvities
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When patients arrive at the clinic, the focus is on finding out the cause of an injury. “We take a holistic approach in sports medicine,” says Dr Beach. “For example, if somebody is suffering from knee pain then we are not just interested in what the problem is, but also why it has happened. Are they overtraining, are they wearing the wrong shoes, or are they running up and down a hill with an
unusual camber? If we can identify and fix what caused the injury in the first place, that goes a long way towards making the patient better.” Following an initial consultation, which will also consider any reports from previous diagnostic scans taken elsewhere, patients are provided with the appropriate imaging – which includes ultrasound, magnetic resonance imaging
LEFT: Skiing is a common cause of knee problems during spring, as people return from their vacations
and X-ray – to ascertain their injury. “We’re fortunate at OneWelbeck that we are able to perform diagnostic imaging on-site, which means that we can often do a consultation and then carry out an MRI scan the same day,” says Dr Beach. “I can then see the results without having to call another hospital or clinic.”
Treatment and rehabilitation
After the imaging results have been received, most patients will move on to a course of physiotherapy, but others may require additional treatments, such as steroid injections or pain relief. “The time frame for rehabilitation depends on the severity of the injury,” advises Dr Beach. “For many people, rehab will take six to eight weeks, but for some it will be faster and for others it will take considerably longer. For instance, someone with a stress fracture will be on crutches or wearing a protective boot for six weeks before they can start their rehab.” Dr Beach’s expertise in the field of sports medicine means that she spends
much of her working week with elite athletes at the Lawn Tennis Association, which oversees the sport in Great Britain, as well as working with national organisations for athletics, triathlon and
ABOVE: After receiving their imaging results, most patients will move on to a course of physiotherapy
“If somebody is suffering from knee pain then we are not just interested in what the problem is, but also why it has happened” hockey. Her practice at OneWelbeck also brings her into contact with nonprofessional sportspeople, whose training regimes are often comparable to those of the elite, as well as recreational athletes. Dr Beach’s caseload, and many of the injuries that are presented, varies in
line with the sporting seasons. “In the autumn, we’ll see more traumatic injuries associated with rugby, such as fractures and concussions,” she says. “In the spring, we tend to see a variety of injuries from skiing, so anterior cruciate ligament ruptures, nasty knee injuries and JUNE 2022 • HEALTHCARE IN LONDON 27
LEFT: Thousands of runners take part in the London Marathon each year, leading to a sharp increase in related injuries
“Massparticipation events, such as the London Marathon, also bring their fair share of complications, including stress fractures and tendon injuries” 28 HEALTHCARE IN LONDON • JUNE 2022
problems as a result of falls on the slopes.” Mass-participation events, such as the London Marathon, also bring their fair share of complications, including stress fractures and tendon injuries. Working in a modern facility such as OneWelbeck, where there are departments dedicated to numerous medical disciplines, can also be helpful when patients arrive with issues that are more difficult to diagnose, or which may have previously been mistaken for a different
problem. “One surgeon I work with is often referred patients who potentially have a hernia, but his examination reveals that it is actually a hip problem, so he can then refer them to me,” explains Dr Beach. “Likewise, I’ve had patients referred with a potential hip injury, but I’ve then realised that it may be a different issue and have referred them to my colleague.” Inevitably, the pandemic brought about necessary changes to how patient appointments were carried out, with many consultations taking place online. Such innovations have continued and have been of particular benefit to those visiting London from abroad for their treatment. “Since the start of the pandemic we’ve offered remote video consultations, which have been very popular among patients who require follow-ups and are unable to travel for an in-person appointment,” says Dr Beach. “I think these consultations work brilliantly – patients like the fact that I can follow them up with them on a Zoom call, having seen them face to face and carried out all their imaging. Pre-Covid, we’d have never thought to do that, but now around 80% of my patients choose these remote consultations, particularly my international patients.”
LEFT: Autumn brings a seasonal element to the cases seen by sports medicine specialists, with injuries to rugby players, for example
For more information on sports medicine services at OneWelbeck, scan the QR code
Catching up with cancer testing Covid lockdowns resulted in a sharp decline in cancer testing, and people are being urged to see a specialist about any concerns as soon as possible ABOVE: Professor Chris Nutting is a consultant in clinical oncology at The Royal Marsden, which takes in thousands of cancer patients each year (PHOTO: THE ROYAL MARSDEN)
overnments all over the world are still counting the cost of more than two years of restrictions caused by the Covid pandemic, both in economic and societal terms. Among the key issues that many countries are addressing is the disruption to healthcare systems throughout this period, not least the reduction in the detection and diagnosis of cancer. A sharp fall in the number of face-to-face appointments at hospitals and doctors’ surgeries during Covid lockdown periods had a dramatic effect on screening programmes and diagnostic testing. JUNE 2022 • HEALTHCARE IN LONDON 29
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As a result of the pauses in screening, the referral of new cancer cases saw a marked decline, as Professor Chris Nutting, consultant in clinical oncology at The Royal Marsden NHS Foundation Trust and clinical director of The Royal Marsden Private Care at Cavendish Square in central London explains: “A major hospital, such as The Royal Marsden, takes in tens of thousands of cancer patients a year at a fairly constant rate. However, after the first UK lockdown started in March 2020, the referral rate dropped considerably.”
LEFT/BELOW: When a patient is referred to The Royal Marsden they receive a specialist examination and any necessary diagnostic tests (PHOTOS: THE ROYAL MARSDEN)
Professor Nutting is also concerned about potential patients who may have cancer symptoms that have not been correctly assessed. “I think there is a specific subset of patients with cancer symptoms that resemble those of Covid – for example, those with lung cancer. Their common symptoms are coughing and breathlessness, which could quite easily be mistaken for Covid. “Some of the people with these symptoms will have had undiagnosed lung cancers that were not detected as quickly as they should have been. Such
delays in diagnosis are a major concern for cancer specialists.” So, what can a patient expect when they are referred by their doctor to a specialist cancer centre, such as The Royal Marsden? “We offer a comprehensive cancer service, which caters for patients coming in at all stages of the journey,” says Professor Nutting. “When a patient is referred they will be examined by a specialist and may also have some tests, such as a biopsy of a lump, or a scan. Should the tests confirm a diagnosis of a cancer, then the patient’s case is discussed in what is called a multidisciplinary team, or MDT.” This process brings together all of those involved in a patient’s treatment – doctors, nurses, surgeons and specialists in chemotherapy and radiation – to formulate an individual treatment plan that is regularly reviewed by the team. Early diagnosis of cancer presents an obvious advantage in tackling the disease, increasing the efficacy of treatment and boosting survival rates. Screening for breast and cervical cancer in women and prostate cancer in men are among the best-known procedures to identify any
“We offer a comprehensive cancer service, which caters for patients coming in at all stages of the journey”
JUNE 2022 • HEALTHCARE IN LONDON 31
32 HEALTHCARE IN LONDON • JUNE 2022
LEFT/BELOW: Those with concerns about their symptoms are encouraged to come forward for testing, before any disease becomes too advanced
“We’re particularly interested in... lung health, for patients who have been smokers in the past” issues before symptoms appear. Early detection of other common cancers is also of interest to Professor Nutting and his colleagues. “One of the areas we’re particularly interested in is lung health, for patients who have been smokers in the past and are at risk of getting lung cancer, including those who gave up smoking as much as 10 years ago,” he says. “Too many patients present with lung cancer that is well advanced, perhaps even with disease that is no longer curable at that stage. Similarly, those with abnormal moles and lumps in the skin are also encouraged
to come forward for testing, before any disease becomes too advanced.” While many diseases and medical conditions can be diagnosed using a blood test, the most common cancers, including bowel and lung cancers, historically could not be detected in this way. Such diseases usually require scans or more invasive examinations in order to be diagnosed.
However, hope is on the horizon that such cancers can be detected by a blood test at an early stage, and treatment monitored in the same way, as Professor Nutting explains. “In the past few years it has been discovered that, if a patients’ cancer is slowly growing, it is releasing debris into the bloodstream, so there are new methods emerging to try and identify this genetic material – known as circulating tumour DNA (ctDNA) – in the blood. “Obviously, cancer cells have a different genetic make-up to the patient’s own DNA. So, if this additional material disappears after the treatment, then you can be confident that it has been successful. This technique is already being used for treatment monitoring, but the hope is that the detection of ctDNA in the blood could also become a method of screening for a wide range of cancers, in a way that hasn’t been possible so far. That’s a very exciting potential advance for the future.”
For more information on cancer services at The Royal Marsden, scan the QR code
JUNE 2022 • HEALTHCARE IN LONDON 33
Dealing with post-lockdown
mental health problems
Life under lockdown tested the whole world’s mental wellbeing. With Covid restrictions ending globally, in-person treatment for those facing mental health problems is now accessible again
34 HEALTHCARE IN LONDON • JUNE 2022
ven for the most resilient among us, the global restrictions brought about by the Covid-19 pandemic have proved challenging. Although the mental health of the majority of people remained stable during the trials of the past couple of years, certain sections of the population have been more vulnerable to deteriorating mental health as a result. Recent analysis by the UK Government’s Office for Health Improvement & Disparities showed that women, young adults and those with pre-existing conditions were among the groups most likely to have experienced greater anxiety and worsening mental health while the lockdowns were in place –
JUNE 2022 • HEALTHCARE IN LONDON 35
LEFT: The lockdown restrictions that led to deserted streets also had a profound impact on mental health
at a time when mental health services were more difficult to access, with inperson appointments particularly affected. “The first effect was a sudden reduction in referrals and hospital admissions for common, or even severe, mental health problems as people remained at home during the lockdowns and didn’t attend appointments,” explains Dr David Oyewole, medical director and consultant psychiatrist at London’s Nightingale Hospital, which specialises in mental health. “Also, those providing mental
health services were unable to run their usual outpatient facilities.” Unsurprisingly, the easing of Covid restrictions saw a reversal in the situation as both private and National Health Service clinics were inundated with requests and referrals. Dr Oyewole reports that requests for new patient assessments at the Nightingale Hospital increased by around 30%. “One particular area in which there has been a surge of referrals is in adult ADHD,” he says. “This is likely to be
“Mild to moderate symptoms of ADHD that could otherwise have been handled became far more prominent and disturbing for individuals” because people had to transition to working from home, without the kind of structures that you get in the office, so that mild to moderate symptoms of ADHD that could otherwise have been handled became far more prominent and disturbing for individuals.” The feeling of isolation while lockdowns were in place and the uncertainty over their duration were, perhaps, an obvious cause of increased mental health issues. However, the removal of restrictions also brought its own problems. “The initial 36 HEALTHCARE IN LONDON • JUNE 2022
anxiety about how long the lockdowns would last added to some people’s feelings of being isolated, depressed and anxious. The loss of freedom and desire to be free contributed to the deterioration and difficulties in general mental health,” says Dr Oyewole. “For some, this was replaced by anxiety about society opening up again, being allowed to return to work and what that really meant. So, in a way, people have suffered both during the restrictions and in the opening-up.”
For those seeking help with a mental health problem that has occurred or has been exacerbated during the pandemic, Dr Oyewole offers guidance on the methods of approaching the Nightingale Hospital for assistance. “On our website we have a form so that people can fill in information online to enquire about our services, or even to describe some of the difficulties they may be having if they don’t quite know which way to turn,” he explains. “Of course, all of this information remains confidential. Alternatively, our patient services department is available by phone. We can then help patients to find the right service, whether at the Nightingale or elsewhere. Also, we have always received referrals from general practitioners, some of whom have also built up relationships over time with our consultants.” The first step on any patient’s journey is a detailed assessment, which is normally carried out by a specialist consultant psychiatrist, who will explore the patient’s background and make a specific diagnosis or, in some cases, a range of diagnoses. “An individual treatment plan can then be agreed and implemented by the consultant,” says Dr Oyewole. “Other individuals may also be involved with this, but all with the agreement and consent of the patient.” Support from family members can benefit those receiving treatment mental health issues, and the Nightingale offers
ABOVE: The need for working from home during lockdowns left many people feeling isolated RIGHT: Group support and a return to in-person meetings has been helpful for many patients
various levels of support for patients and their relatives. “Some parents or spouses prefer and are able to join the patient in consultations with their specialist and that can be very helpful and supportive,” explains Dr Oyewole. “Of course, that may not be suitable for everyone, and relatives or carers can have separate appointments with specialists, where the patient has agreed and given consent.” Group support can also be helpful for patients, such as when dealing with addictions and eating disorders. JUNE 2022 • HEALTHCARE IN LONDON 37
FACTFILE What is ADHD?
ABOVE: London’s Nightingale Hospital has been providing private mental healthcare for more than 30 years
Following a period of conducting group sessions via video conferencing due to Covid restrictions, there are plans to return to in-person meetings. However, one area in which remote video calls remain a useful tool is in carrying out initial assessments for patients outside the UK. The Nightingale Hospital, which has provided services for international patients for several decades, can offer online assessments without the need to attend an appointment in person, where there is agreement between the patient and their specialist. Video conferencing can also play a role in aftercare for overseas visitors. When patients are discharged they are given a summary of their diagnosis and the treatment received, as well as their agreed aftercare plan. This summary is also provided to their specialist at home, and guidance on discharge planning can include video conferencing with both the patient and their specialist. 38 HEALTHCARE IN LONDON • JUNE 2022
“Group support can also be helpful for patients, such as when dealing with addictions and eating disorders”
“We also provide a pharmacy service that can send out a patient’s medication directly to their home address, if required, on a repeat prescription basis,” concludes Dr Oyewole. “This can be helpful where a patient may not have a local source for their medication.”
Attention deficit hyperactivity disorder (ADHD) is a behavioural condition in which people may appear restless, have difficulty concentrating and show a tendency to be impulsive. Sleep and anxiety disorders are also common additional symptoms. ADHD symptoms tend to be noticed in childhood, mostly between the ages of three and seven, but diagnosis can also be made in adulthood. Although symptoms usually improve with age, many patients continue to experience problems in adulthood. The precise causes of ADHD are unknown, but there is evidence that the condition can run in families. While ADHD is more common in those with learning difficulties, it can occur in people of any intellectual level. Difficulties experienced by adults with ADHD can include problems with organisation and time management, following instructions and coping with stress. Some adults may also find relationships and social interaction challenging.
For more information on mental health services at the Nightingale Hospital, scan the QR code
EXPERIENCE LONDON www.healthcareinlondon.com
Your guide to the capital’s finest leisure, shopping and fine dining
There’s something for everyone on
Regent Street and St James’s
From fashion and art to fine dining and top-class entertainment, all tastes and interests are catered for in this prestigious part of London’s West End
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ocated in the heart of London’s West End, Regent Street is one of the world’s most prestigious lifestyle destinations, famous for its flagship stores and international brands. Named after the Prince Regent, the street was built in 1819 under the direction of architect John Nash and its Grade II-listed facades represent some of the most distinguished architecture in London. Following its construction, Regent Street became the original shopping street for the capital and has grown into a world-renowned destination that curates year-round memorable experiences that go beyond world-class shopping. The street has continually evolved during
these 200 years, taking inspiration from the past while always innovating and looking to the future. Regent Street’s position in the heart of London and the West End means that it is just a stone’s throw away from other vibrant destinations, including Oxford Street, Carnaby Street, Soho and Covent Garden, as well as the open spaces of Green Park.
Famous brands and flagship stores Regent Street’s stores pride themselves on going above and beyond. The street is home to an array of famous British and international fashion brands, including Burberry, Tommy Hilfiger and Hugo Boss, as well as flagship stores from technology giants such as Apple and Microsoft.
The appeal of Regent Street isn’t confined to shopping and fashion. From in-store cafés and bars to beauty experiences and more, there is something for everyone to discover and enjoy. Wellness experiences can be found in the likes of Glow Bar and DryBy, as well as Psycle, Barry’s Bootcamp and Rapha. For those seeking sustenance, Regent Street and neighbouring Heddon Street boast an incredible array of drinking and dining options that are truly unmissable.
With cuisine ranging from Australian-style brunch restaurants to Japanese, Spanish and Argentinian, as well as vegan and vegetarian options, there is something JUNE 2022 • HEALTHCARE IN LONDON 41
for everyone to enjoy. Experience awardwinning restaurants such as the Araki and Sabor, to fine dining Italian at Frescobaldi, local coffee haunt Hagen and casual dineins and takeaways such as Neat Burger.
“No visit to London would be complete without taking afternoon tea at one of the city’s finest establishments” No visit to London would be complete without taking afternoon tea at one of the city’s finest establishments, and there is no better location than the Hotel Café Royal, where their award-winning afternoon tea 42 HEALTHCARE IN LONDON • JUNE 2022
is served in the historic Grade II-listed surroundings of the Oscar Wilde Lounge. Visitors to the West End during the winter months can also enjoy Regent Street’s spectacular Christmas lights display. The street became the first-ever central London destination to introduce Christmas lights in 1954, and the annual display, known as ‘The Spirit of Christmas’, is the largest and most famous in the UK. At the south end of Regent Street lies St James’s, an area of London that celebrates shopping, dining and culture. Forming part of the West End, it is also bordered by Piccadilly to the north, St James’s Park and The Mall to the south, Green Park to the west and Haymarket to the east. Its four corners are considered as St James’s Palace, The Ritz, Piccadilly Circus and Trafalgar Square.
The area was founded by permission of King Charles II on St James’s Fields, developing in the 17th century as a residential location, while since the Second World War the area has transitioned from residential to commercial use.
A hidden gem
This serene neighbourhood has long been considered one of London’s hidden gems. While the famous landmarks, streets and open spaces of St James’s remain the same to this day, the area continues to evolve. Today, it offers a diverse range of drinking and dining options, arts and culture, and retail built on craftsmanship, as well as residential and office space. Found within St James’s are a rich variety of shopping locations, including St James’s Market, Jermyn Street, Piccadilly, Princes Arcade, Piccadilly Arcade and Royal Opera Arcade, as well as an art district in the west of the area. St James’s is one of London’s top shopping destinations, packed with highend fashion, established artisans, Royal Warrant holders and food experiences. For over 300 years, St James’s has had
a long-established reputation as the home of craftsmanship, quality food and extraordinary art, which continues to evolve thanks to the retailers, restaurants and galleries that call the area home. The world-renowned Jermyn Street, the original home of menswear, remains one of the most fashionable and historic streets in London with its collection of quirky independents and high-end brands. In art, St James’s contains Christies, the world’s oldest fine art auctioneer, which has been located on King Street since 1823. A large number of art galleries are also concentrated in the area, including the White Cube Gallery and the Royal Academy of Arts (RA) with their must-see exhibitions. Food lovers will not be disappointed either, as St James’s has a plethora of dining options, spanning modern hangouts, inspiring eateries and international cuisine. From the established Quaglino’s to the contemporary St James’s Market – which has a selection of acclaimed international restaurants, including starred Aquavit and world top-100 ranked Ikoyi
– all the local eateries and bars offer something different and special. The area is also home to upmarket department store Fortnum & Mason on Piccadilly, which has been offering extraordinary food and unforgettable experiences since 1707. As well as providing the finest produce in its food hall, the store also has restaurants, bars and tea rooms for visitors to enjoy. For evening entertainment, St James’s also has three of London’s finest theatres – The Theatre Royal Haymarket, Her Majesty’s Theatre and Jermyn Street Theatre – which host some of the capital’s most popular productions, including Andrew Lloyd Webber’s Phantom of the Opera at Her Majesty’s.
For more information on Regent Street and St James’s, scan the QR code
JUNE 2022 • HEALTHCARE IN LONDON 43
44 HEALTHCARE IN LONDON • JUNE 2022
retreat in the heart of London O
pened in 1865, Café Royal was originally a wine store, restaurant and the space for the city’s most illustrious events. The haunt of famed patrons, from royalty and celebrities to the creative and the notorious, Café Royal was an established and iconic landmark on the British capital’s social scene for a century and a half. In its recent reincarnation as the luxurious Hotel Café Royal, it remains an established favourite for locals, while becoming a global destination. Located at the heart of Regent Street, with elegant Mayfair to the west and creative Soho to the East, the hotel is perfectly positioned within walking distance of London’s finest shopping streets, tourist attractions and theatreland.
Within the hotel, grand historic areas have been sensitively restored, while 160 guestrooms and suites (including seven signature suites) have been created in a contemporary yet refined style. Continuing its celebrated legacy of excellent hospitality and dining, the hotel offers a selection of restaurants and bars. For those seeking some respite from the stresses of everyday life, or simply a special treat, Hotel Café Royal’s Akasha Holistic Wellbeing offers a range of specialist hydrotherapy treatments that are the first of their kind available in London’s hotels. These unique experiences include Watsu, or water shiatsu, held in an especially designed private Watsu pool, Vichy shower treatments and private Hammam experiences. JUNE 2022 • HEALTHCARE IN LONDON 45
An urban retreat in the heart of London, Akasha Holistic Wellbeing leads in its holistic approach to wellbeing by uniting the four basic elements of nature; earth, water, fire and air. All of the hydrotherapy treatments are designed to allow guests valuable time to return the body’s essential balance, decreasing stress and allowing the body to return to optimum health.
With nine treatment rooms, Akasha offers a wide variety of signature treatments that marry innovative Western practices with ancient Eastern traditions. Facilities include a private Hammam for purifying scrubs and massages, a Vichy shower for hydrotherapy rituals, an 18-metre large lap pool, sauna and Jacuzzi. Akasha also boasts London’s first Watsu pool, for tailored hydro-treatments and guided meditation carried out by certified staff. Akasha is also home to a number of wellness specialists, completing its 360-degree approach to personal wellbeing. Their areas of expertise range from nutrition to intuitive counselling, and Reiki to Watsu. For those focusing on fitness, Akasha also houses a large and spacious gym area, spanning more than 300 square metres. Tailored fitness programmes combine a variety of disciplines, with each
overseen by experienced instructors. Fitness classes at Akasha include calisthenics, bodywork and TRX, alongside a wider offering of holistic courses, such as yoga and Pilates. Gym visitors can enjoy cutting-edge technology, including LifeFitness equipment, personal entertainment centres with 19-inch touch screens and iPad docks, complemented by a ceiling of changing LED lights to enhance and motivate. For one-on-one sessions and personalised classes, private studios provide relaxing spaces for disciplines ranging from yoga, Pilates and meditation to TRX, boxing and cardio classes. After enjoying spa treatments or getting active in the gym, guests can relax in the serenity of Akasha’s lounge bar, which offers a selection of healthy and nourishing dishes. Designed in collaboration with a nutritionist, the Four Elements Menu incorporates ingredients
“After enjoying spa treatments, guests can relax in the serenity of Akasha’s lounge bar” LEFT: Hotel Café
Royal is an iconic presence on London’s Regent Street
ABOVE: Akasha boasts
London’s first Watsu pool, for tailored hydro-treatments and guided meditation
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reflecting the four elements upon which the concept of Akasha is built. Herbal teas, cold pressed juices and energising drinks are also served.
A day of rejuvenation and luxury
Become immersed in the world of Akasha for a day of complete rejuvenation and luxury. Our day spa options include access to the four elements of Akasha; earth, water, fire and air. Guests can enjoy nourishment in the lounge bar, full use of the pool, Jacuzzi, sauna and steam room and gym with leading fitness equipment. A selection of spa packages is on offer, created to allow visitors to make the most of their time at Akasha, all of which include access to the facilities. Enjoy a weekday escape packed with award-winning experiences at Hotel Café Royal. Your spa day will include
a 90-minute Ultimate Aromatherapy Associates massage and relax by the pool complete with sauna, Hammam and Jacuzzi. Enjoy the spa facilities, with access for 90 minutes before or after you enjoy a delicious two-course lunch. The Four Elements spa package at Akasha is a designed according to the four elements of nature. Firstly ‘water’ – a therapeutic treatment performed in warm water, whilst being supported by your therapist. This is followed by ‘earth, fire and air’ – a combination of soothing foot massage, restorative heat for your back and a relieving scalp massage. The Fitness Reset package includes a bespoke personal training session with one of our top personal trainers, using cutting-edge gym facilities. This is followed by a relaxing 90-minute deep-tissue Theragun or Aromatherapy massage to ease any aches and pains.
impressive facilities include an 18-metre large lap pool
Hotel Café Royal 68 Regent Street London W1B 4DY +44 (0)20 7406 3333 www.hotelcaferoyal.com
For more information on Akasha Holistic Wellbeing, scan the QR code
JUNE 2022 • HEALTHCARE IN LONDON 47
A taste of
in London’s West End Michelin-starred restaurant Veeraswamy has been serving its clientele for almost a century, presenting authentic Indian cuisine in opulent surroundings
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pened in 1926 by Edward Palmer, the great-grandson of an English General, and a north Indian Mughal princess, Faisan Nissa Begum, Veeraswamy is the UK’s oldest Indian restaurant. Soon after opening, on Swallow Street, just off Regent Street with magnificent views of the iconic street’s curve, the restaurant quickly became a fashionable rendezvous for the establishment. Among its frequent early visitors were Edward, Prince of Wales, and the King of Denmark, who were drawn not only to Veeraswamy’s remarkable cuisine, but also to its Rajinspired, opulent interiors.
“One of the key aspects that makes Veeraswamy special is its illustrious history, which we have sought to renew and update,” says Ranjit Mathrani, chairman of the MW Eat Group, owner of Veeraswamy. “The restaurant has been in the same location for 96 years and was opened on almost the same day as the birth of Her Majesty the Queen. There are very few restaurants that have been in the same location for such a length of time. “Veeraswamy started off very much as an establishment restaurant, serving the aristocracy and ruling classes of Britain. This included people who, by virtue of their background, had a strong interest in India, such as generals, civil servants
ABOVE: A long history has seen the restaurant occupy the same location for 96 years
RIGHT: Veeraswamy has been restored to its position as one of the leading restaurants serving fine Indian food
and businessmen with an interest in India. From the outset, the restaurant was serving the very cream of London society.” Today, Veeraswamy exudes the same extraordinary glamour and rich essence of its legendary past, having been restored to its position as one the leading restaurants serving fine Indian food, with opulent and sumptuous interiors offering a timeless aura of sophistication. The surroundings reflect the decade in which Veeraswamy opened, when the Maharaja Palaces in northern India were influenced by Art Nouveau. The exquisite décor includes silver-clad ceilings and handmade Venetian style chandeliers, resplendent furnishings JUNE 2022 • HEALTHCARE IN LONDON 49
such as glorious teak dining tables, and hand-woven carpets, all of which have been expertly crafted in India. Evocative monochrome photographs of the ruling elite of India from the era adorn the walls, along with humorous paintings from the Kalighat School of painters in Bengal. “MW Eat purchased Veeraswamy in 1997, making us the second-longest owners of the restaurant, and during that period we have refurbished on three or four occasions,” explains Mathrani. “Each time, we have ensured that the restaurant retains its contemporary relevance and is not just a museum piece. It’s been a constant evolution that is reflected in everything we do. We finished a 50 HEALTHCARE IN LONDON • JUNE 2022
refurbishment earlier this year, taking the opportunity to refashion the restaurant, bringing in new furniture and lighting. It is very important when you have a restaurant of the history and heritage of Veeraswamy that people feel there is something new and different that they can experience and enjoy.”
Elegant private dining
When it comes to private dining, Veeraswamy’s sophisticated Mughalinspired Palmer Room exudes glamour, elegance and exclusivity. The room can comfortably seat up to 22, or up to 50 can be accommodated for cocktailstyle functions. “The Palmer Room is in
ABOVE: For private
dining, the elegant and sophisticated Palmer Room can seat up to 22 people
ADVERTISING FEATURE RIGHT: The entire
restaurant was recently refurbished, bringing in new furniture and lighting
great demand because of its romantic and playful décor,” says Mathrani, “with Baccarat chandeliers, flickering candle lights and elegant silk curtains to create a romantic atmosphere. We ensure that the history is interwoven with not just the design and the style, but also the cuisine. We’re creating an experience, which is something that people enjoy and appreciate when eating at a fine-dining restaurant of this level. It’s not just the food, but the ambiance, the service and the totality of what people feel.”
Classical meets contemporary
ABOVE: Flavours from
several regions of India are refined and adapted for modern tastes
Veeraswamy offers a comprehensive menu of long-established classical dishes, comfort food and contemporary creations, prepared to the highest standard in a modern culinary style. The tastes and flavours from the palaces and gourmet homes of several regions of India are refined and adapted, with spices sourced directly from the best producers in India, combined with the best local ingredients. “Our cuisine is the classical gourmet food of India, tuned to the tastes of the current century. In essence, we’ve created a gastronomic tour of the whole of the whole country,” says Mathrani. “It should be remembered that India is the size of Western Europe, with 16 different cuisines, and each one is as different from the other. We have looked to reflect that, so we have nine highly experienced chefs from different regions of India, each cooking their own cuisine, because that is the only way we can
maintain the gastronomic and culinary integrity. We were proud to be awarded a Michelin star in 2016.” Veeraswamy’s traditions also extend to its patrons, with generations of the same families revisiting the restaurant for special occasions. “When you think of Veeraswamy as an institution, it has been a place where many people have had their first dining experience, dating back as far as the Second World War,” says Mathrani. “We often receive emails and messages from people in their eighties who perhaps met their spouse at Veeraswamy and wish to celebrate an anniversary or special occasion – we’ve even hosted a 100th birthday celebration with four generations of the same family present. We pride ourselves on making such experiences as memorable as possible.”
Veeraswamy, Mezzanine floor, Victory House, 99 Regent Street London W1B 4RS Tel: 020 7734 1401 www.veeraswamy.com
For more information on Veeraswamy, scan the QR code
JUNE 2022 • HEALTHCARE IN LONDON 51
The fine art
of bespoke shirt-making Emma Willis MBE talks about her journey to becoming one of the world’s leading bespoke shirt-makers and describes the elements that make a great shirt
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How did your career in shirtmaking begin and what were the origins of your business?
I started off in the fine arts side of the creative world, studying at Slade School of Fine Art. After leaving Slade, and to fund my artistic career at the time, I worked for a company that sold clothes, including men’s shirts. Soon after, in 1989, I set up my own small company doing the same thing, selling shirts from a wonderful little bespoke shirtmaker in south-east London. I found there was a real market for beautifully made shirts in beautiful fabrics. I became very interested in how such products are manufactured and came across a Swiss mill with wonderful cottons that I still use today. I visited my
customers personally, including travelling to New York and Paris. At that stage, most of my customers came to me through introductions and word of mouth. After about 10 years, I decided it was time to put down roots and find a shop in London. The obvious place was Jermyn Street in St James’s – a pilgrimage to the heart of the bespoke world.
What is the process for being fitted for an Emma Willis shirt?
Our bespoke shirt service can be provided in our Jermyn Street shop or online. When a customer visits us in person, we take their measurements and discuss the particular fit they would like, as well as their collar size and sleeve length.
After selecting the fabric, an initial shirt is made up for the customer to try, which normally takes about four weeks. Once the correct fit has been confirmed then the remaining shirts are produced, with a minimum order of four for our bespoke service. Our online bespoke service follows the same process, but our customers provide their own measurements and design details online. When we are cutting the patterns in our factory, we send our customers a photo of their shirt being cut, with their name written on the pattern, and being sewn as well. This gives the customer a connection with their shirt being made and a truly personalised service. We also keep each customer’s pattern for future orders.
How many people do you have on your team and what is their background?
Our factory is in an 18th-century townhouse in Gloucester, where we have about 20 people on our creative production team, almost all of whom are from the local area. Our top seamstress, Katja, has 35 years’ experience of making bespoke shirts, and she trains all the people who join us. We have trained a number of young people who are interested in coming into the trade, but haven’t had any previous experience in sewing. This ensures that we maintain and harness these important shirt-making skills for the next generation. JUNE 2022 • HEALTHCARE IN LONDON 53
What are the factors that go into making a great shirt?
Aside from the skills of our shirtmakers, the quality of the fabric is fundamental to a beautiful shirt and how long it will last, and how it’s going to feel when worn. We start with a very high-quality raw cotton – most likely Egyptian or West Indian Sea Island. Most of our cotton comes from the Nile Delta, which has a perfect climate and soil, and where they have hundreds of years’ experience of cultivation. The spinning, weaving and finishing methods of the cotton are also extremely important. A proper finish will ensure there is no shrinkage and a lovely smooth finish. Neat, tidy stitching is also very important. We use single-needle stitching on all our seams, rather than the twintracked seams that are more associated with mass-produced shirts. Our singleneedle stitching takes longer to do, but it creates a very neat seam. We match all our patterns at the seams, so checks, stripes and patterns – even florals – are carefully matched, which takes much more skilful cutting and a lot more time. This makes the finished shirt aesthetically very pleasing.
The collar is the hardest part to make and requires a lot of experience. The collar pattern is very important – I created two patterns many years ago, which we continue to use today. Both work well with or without a tie, which is so important these days. We also use real mother-of-pearl buttons, which are very pretty and have a lovely iridescence –with either white or naturally smoked buttons, for the dark shirts. It is this kind of attention to detail that is appreciated and sets our product apart from the standard shirtmaking process.
BELOW: A unique pattern is cut for each customer, which is kept for future orders (PHOTO: EMMA WILLIS)
Finally, are there any well-known people we might have seen wearing an Emma Willis shirt?
Among the famous people for whom we’re proud to have made shirts are His Royal Highness The Prince of Wales, James Bond star Daniel Craig and fashion model David Gandy. Our shirts have also been seen in various movies, being worn by Benedict Cumberbatch, Kenneth Branagh and Colin Firth, for example. It’s fun to see how they’re styled, depending on the drama and situation.
Emma Willis 66 Jermyn Street, London SW1Y 6NY Email: email@example.com Tel: +44 (0) 20 7930 9980 www.emmawillis.com
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54 HEALTHCARE IN LONDON • JUNE 2022
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