Women have been “making it happen” at Birmingham Women’s Hospital for generations.
In the 1930s, BWH consultant Hilda Lloyd developed the first maternity “flying squads”, combining maternity care and the capacity to resuscitate and administer blood transfusions outside of the hospital to more vulnerable women. Partly in recognition of this she was made a Dame and was the first female president of the Royal College of Obstetricians and Gynaecologists.
A decade later another BWH doctor, Mary Crosse, pioneered care for premature babies which is now the standard around the world. It’s a tradition that continues today. So this Sunday 8th March we will be celebrating International Women’s Day by taking a look how today’s BWH women who are making a difference locally and globally in genetics, finance, obstetrics and gynaecology.
Dr Stephanie Allen
Dr Stephanie Allen is a Consultant Clinical Scientist and Head of Prenatal Diagnosis and Reproductive medicine for the Regional Genetics Service at the Women’s Hospital. Stephanie heads up routine testing to diagnose conditions prenatally where there is an increased chance of a baby having a chromosomal or genetic abnormality.
These diagnostic tests, known as Amniocentesis and CVS (Chorionic Villus Sampling) involve taking a sample of fluid from the womb or placenta to test the genetic information in the cells when a particular condition is suspected such as Down’s syndrome. However, as these are invasive tests, they do carry a risk of miscarriage.
Stephanie is now leading on a major development for Non Invasive Prenatal Diagnosis (NIPD) after receiving a grant from the Health Innovation Challenge Fund. NIPD does not have miscarriage risks and instead involves taking blood from the mother’s circulation rather than a sample from the womb or the placenta. Using incredibly complex technology known as Next Generation DNA Sequencing, it is possible to look at cells which contain a baby’s genetic material which are present in a pregnant mother’s blood.
The grant will be specifically for the NIPD of muscle disorders including Duchenne and Becker Muscular Dystrophies, Spinal Muscular Atrophy and Congenital Adrenal Hyperplasia, all very serious life limiting conditions.
Stephanie commented, “So far the development is looking very promising and the aim will be to start using this diagnosis routinely for NHS patients in 2016. Moving forward we also want to integrate non-invasive diagnosis into all screening in the future. Currently, the only NIPD taking place is in the USA and China and patients have to pay for this service. However, we are planning to be one of the first laboratories in the country to be able to offer non-invasive screening for Down’s syndrome and other genetic disorders and as technology improves, we will be able to offer more testing for more women and families.”
Stephanie has been a scientist in the Genetics Laboratories at the Women’s Hospital for the past 12 years and has been a Consultant for the past year. Together with other colleagues, she is also involved in the 100,000 genomes project which
was launched in December 2014. As part of a collaboration with the University of Birmingham, University Hospital Birmingham, Birmingham Children’s Hospital and Academic Health Science Network. Birmingham Women’s Hospital is one of 11 centres across the country that is leading the way in delivering the 100,000 Genomes Project.
The three-year project will transform diagnosis and treatment for patients with cancer and rare diseases and involves collecting and decoding 100,000 human genomes – complete sets of people’s genes – that will enable scientists and doctors to understand more about specific conditions.
Sara Webb – Midwife
Sara Webb is passionate about being a midwife and research and is equally passionate about bringing the two together for the benefit of our women.
A midwife for the past 15 years, Sara is one of only a handful of midwives in the country to be awarded a National Institute of Health Research (NIHR) Clinical Doctoral Fellowship. She is using her clinical fellowship to gain a PhD whilst at the same time working clinically as a midwife.
Sara has been a specialist perineal midwife for the past 10 years and runs a number of clinics for women who have received perineal tears during childbirth. Whilst this is not something that is widely discussed it affects up to 80% of women, many who ‘suffer in silence’ with long term problems.
Sara’s fellowship is for a study into the affects that severe childbirth perineal injuries can have on women, highlighting a common problem that women want answers to. Sara is also the only midwife in the country who can perform specialist scans for women with severe perineal trauma and her ‘one-stop’ specialist scan clinic was shortlisted for the Nursing Times Awards in 2014.
Sara now receives regular visits from Doctors and Midwives across the country looking to set up their own dedicated service and she is invited to talk at various national conferences about her specialist area.
Sara explained, “Everything we do is patient-centred and research based and so it’s important to me to lead by example. Not many midwives are involved in research and yet clinical work and research go hand in hand. Perineal trauma is a ‘Cinderella’ service in maternity and I am keen for this area to be highlighted so that women can get the care that they need and want. What’s great about the Women’s Hospital – and quite rare as I’ve found visiting other hospitals – is that Doctors and Midwives here work very well together, putting our women at the forefront of our care. I have always received fantastic support from my colleagues.”
Assistant Finance Manager, Magda Mastoszka is also making a global impact at Birmingham Women’s Hospital after recently achieving a world class result.
Magda has a key role in advising budget holders on spending, translating what they want into financial values and ensuring that patient care is always at the forefront of what we spend.
Ensuring that we look after the finances is incredibly important within the NHS, we are accountable to the public that we serve and Magda’s role involves ensuring that we get the best value for money whilst still maintaining quality.
Whilst not busy doing the day job, Madga is studying to become a Chartered Accountant with CIMA (Chartered Institute of Management Accountants). This is an international qualification which requires a series of examinations. On her last exam, Magda obtained the highest mark in the world for Financial Reporting; this was sat by 6403 candidates worldwide.
On her achievement Magda commented, “When I first saw the result, I couldn’t quite believe it. It’s pretty amazing to be doing something with so many people worldwide! The course is also enabling me to gain a better insight into the work I do for the hospital, giving me the tools I need to do my job. I have eight more exams to do now and hope to qualify within the next 2-3 years.”
Consultant Obstetrician and Gynaecologist, Dr Manjeet Shemar specialises in early pregnancy care and acute gynaecology.
In 2010, Manjeet set up one of the country’s first Hyperemesis Day Centres at the Women’s, now a well-established nurse-led service. Hyperemesis is extreme pregnancy sickness and can be very harmful to women during pregnancy as it causes dehydration and metabolic problems. Now bought into the limelight through Kate, the Duchess of Cambridge, this extreme form of sickness affects around 1% of pregnant women.
In the past, women suffering with hyperemesis would have to be admitted to hospital and placed on a drip. However, the day centre at the Women’s enables women to come in for a few hours, receive the treatment they need and then they are able to go home
The nurse-led clinic has been very well received and once a woman has been referred, she has open access to come when she needs to, plus there’s always someone available to provide advice and support over the phone, so support is always available.
Manjeet explained, “Our innovative service is a much more efficient way of treating women and provides a much better patient experience. Previously women have had terminations such is the severity of the sickness, so it’s a really important service to help women get through difficult pregnancies.
As a sufferer of hyperemesis myself, I was passionate that there was a service available to women. I can see the service from a patient and clinical perspective which helps. We receive people from around the country to look at how our service works and I am leading on a group writing the national guidelines on pregnancy sickness for the Royal College of Obstetricians and Gynaecologists, this will cover the broad range of pregnancy from conception to delivery.”
Manjeet has worked for the Women’s Hospital for the past seven years, joining initially as a Clinical Lecturer before becoming a Consultant; she is now the Clinical Director for Gynaecology. Believing in the importance of getting to know her team really well, Manjeet works well with staff of all disciplines in her team and across the hospital.
“The NHS is under so much pressure that we need to stick together. Most importantly, we must all remember why we are doing the job and how it will affect our patients.”
Dr Pallavi Latthe is a Consultant Obstetrician and Gynaecologist specialising in Urogynaecology and Paediatric and Adolescent Gynaecology. Pallavi has developed a specialist FGM service at the women’s hospital. FGM stands for female genital mutilation and whilst illegal in the UK and recognised as a violation of human rights, it is prevalent in some communities in Birmingham and can cause complications for pregnancy and childbirth.
Pallavi sees a number of cases through gynaecology and can perform a simple reversal operation for women and girls. The midwifery led clinic provides support and care for pregnant women with FGM who are either referred by their midwife, GP or are self-referrals.
A national survey of members and fellows of RCOG done by Birmingham medical school under supervision of Pallavi concluded that the professionals were still either not aware or not confident of how to deal with women with FGM. Pallavi with a number of other multidisciplinary team professionals has been instrumental in developing a national e-learning package for the Health Education, England and Department of health. This will provide knowledge, skills and attitude for all frontline medical staff about dealing with FGM.
Pallavi said, “It is a real achievement to have developed this training package to ensure that health professionals have the knowledge and confidence when dealing with patients with this condition, it is so important that FGM is being taken seriously at the highest level. Healthcare staff are now picking up more cases of FGM because there is more awareness and the learning package will only serve to improve awareness and further understanding across NHS.”
Jennie Bell is the Deputy Director of the Regional Genetics Laboratories at the Women’s. Our Genetics laboratory is the largest in Europe, testing over 50,000 patient samples a year for the West Midlands and further afield. Jennie has a lead role in a number of national projects including the 100,000 genomes project and the Cancer Research UK Stratified Medicine Programme.
Both projects are breaking new ground in the field of cancer genetics and whilst 100,000 genomes aims to bring genomic medicine into the NHS by sequencing 100,000 genomes from patients by 2017, the stratified medicine programme’s focus is to tailor the right drugs to the right patients using genetics.
Jennie commented, “It’s really exciting to be involved in making a difference, not only nationwide, but worldwide. The CRUK project is a collaboration of the NHS, research, charity, pharmaceutical industry and patients. There is nowhere else in the world where this partnership working would be happening, so it’s a fantastic time to be in healthcare science, particularly in genetics.”
For nearly every patient diagnosis, a scientist will have been involved in some way and as part of modernising scientific careers, Jennie has a key role in promoting healthcare science to individuals coming into science. She is also the Professional Lead at the National School of Healthcare Science with a responsibility in training for scientists in the cellular sciences and genetics, supporting trainers and trainees. Jennie is also involved in patient and public involvement to ensure that patients have a voice in all that we do.
Jennie began her career as a scientist in genetics in the NHS in 1990 and joined the Regional Genetics Laboratory in Birmingham in 1999, “There have been some huge changes over the years and every day is different, when I first joined the NHS at a London hospital, there were just three staff in the genetics lab, I now work with over 200 staff at the Women’s, such is the importance of genetics in modern day medicine.”
For further information about the release, please contact
Communications Birmingham Women’s Hospital
Phone: 0121 623 6984/07870 587759
Note to Editors:
Birmingham Women’s NHS Foundation Trust provides a range of health care services to women and families across the West Midlands and further afield.
We treat 50,000 people a year, carry out 3,000 operations and test 50,000 genetic samples. More than 8,000 babies were born under our care last year, making our maternity unit one of the busiest in the country.
We provide a full range of gynaecological, maternity and neonatal care as well as a comprehensive genetics service. Our fertility centre is one of the most successful in the country and our fetal medicine centre which provides care for the unborn baby and women during pregnancy receives referrals from across the region and further afield.
100,000 Genomes Project
The project has the potential to transform the future of healthcare. It could improve the prediction and prevention of disease, enable new and more precise diagnostic tests, and allow personalisation of drugs and other treatments to specific genetic variants.
Some participating patients will benefit because a conclusive diagnosis can be reached for a rare and inherited disease more quickly, or because a treatment for cancer can be targeted at the particular genetic change that is present in the cancer. But for a number of patients, the benefit will be in the improvement in our knowledge of the influence of genetics on disease and how it is expressed in an individual, how other people can be helped with similar diseases in the future, and how different types of tests can be developed to detect changes beyond the genome.
The 11 designated Genomic Medicine Centres (GMCs) in this wave 1 selection process are based across the country, covering areas including Greater Manchester, Merseyside, Oxford, Birmingham and the West Midlands, Southampton, Cambridge and the East of England, Exeter and the South West Peninsula, and the North East. Over the lifetime of the project NHS England’s ambition is to secure over 100 participating NHS trusts. Recruitment to the project will begin from 2nd February 2015.