Inside London’s new COVID-free ‘hubs’: Part 2 – a safe place for collaboration and innovation

In this part of our 'London hubs' episode of 'In conversation with...', we discuss the positive changes and innovations to come out of the new hub treatment system.

In part one of our interview with London-based consultant oncoplastic breast surgeons Mr Massi Cariati, Mr Petros Charalampoudis, Mr Ash Kothari and Mr Hisham Hamed, we discussed the set-up of the innovative ‘hub’ system helping to restore ‘normal’ cancer services to the UK and ensure patients receive treatment more quickly and safely.

As our interview continued, we wanted to find out more about how surgeons are encouraging patients to come in for treatment, how collaboration across hospitals has led to new innovative approaches and what positive changes made to protect against COVID may remain in the future.

Maintaining patient safety

Previously, we had discussed the reconfiguration of treatment across London into a hub system, where COVID and non-COVID cases are separated. In this part we learned about the different principles put in place to make sure patients are safe and treatment can continue in the hub setting.

Some of the new principles to patient safety include:

  • Reducing the number of patients seen in individual clinics
  • Widening the gaps between appointments to allow thorough cleaning
  • Reducing the number of patients in waiting areas – allowing social distancing
  • Asking patients and clinicians to wear face masks

By taking these steps, the four London surgeons have been able to treat nearly all of their patients without building up a backlog - while also encouraging more patients to come forward for treatment.

“We have been able to establish a very safe pathway… with no positive COVID screens in patients.”Mr Massi Cariati, Consultant Oncoplastic Breast Surgeon, University College London Hospital (UCLH)

Rebuilding patient confidence

Patient confidence is so important. At the beginning of the pandemic, there was a significant drop in the number of patients presenting for diagnosis or treatment; Massi told us that "some breast clinics were seeing just 15-20% of their usual number of patients."

In the interview, everyone agreed on the importance of showing that services were still open to patients and that as much as possible had been done to make it extremely safe to get treatment.

“Our mission is to start reinvigorating the concept of safe healthcare even within the COVID era, and the hub creation can play an instrumental role with that.”Mr Petros Charalampoudis, Oncoplastic and Reconstructive Breast Surgeon, University College London Hospital (UCLH)

Collaboration has increased innovation

A remarkable thing we learned was that through the new hub set-up, they felt a 'spirit of innovation' and collaboration had that not previously been felt. This had manifested itself in an increase in collaborative working between clinicians from different hospitals, that wouldn’t ordinarily have had the chance to work together.

We were told how there have been opportunities to gain access to - and use - new innovative technologies, such as the Magseed® marker, to improve their options for care, offering wider treatment options and able to treat more patients. Now, not only are they using these new methods but they’re also teaching other Trusts how to perform them too.

“[Fellow surgeons] came and saw us in the Hub using Magseed and they were mesmerised - and said 'why can’t we do this!'”Mr Ash Kothari, Consultant Oncoplastic and Reconstructive Breast Surgeon, Guy’s and St Thomas’ Hospitals

What about a world after COVID19?

These four surgeons believe that many of the changes will carry through from this hub experiment, regardless of what the future brings. It has taught them that a better ‘new normal’ is possible and that utilizing shared knowledge could be key.

“I think we are fortunate to have a group of clinicians who are willing to work with each other and willing to learn with each other for the, again, for the good of the patients.” Hisham told us.

"It’s been a great lesson. Whether a second wave happens or not, we know we’ll be prepared for it. And there’s confidence in knowing that."Massi Carriati, Consultant Oncoplastic and Reconstructive Breast Surgeon, University College London Hospital (UCLH)