Tag Archives: TLC

Breast reconstruction, nipples and other important procedures

Reassurance is a priority for everyone



You don’t get appointed  Fleet Surgeon for an event such as the

Round the World Millenium Race, unless you are a

particularly special person


Meeting Christopher Inglefield, who held this post, you realise why he was appointed for this incredibly daunting job.

And today he applies his interest in cutting edge medicine, working in difficult situations, to problems that face so many breast cancer patients after a mastectomy, or lumpectomy.

With his feet firmly on terra firma, he works as a specialist surgeon in London’s private medical sector.

I went to see him in his consulting rooms in an elegant Georgian building in Wimpole Street, to ask about breast reconstruction and other things;  as co-chairman of  a LINk cancer group I am constantly talking about problems associated with this field – so wanted to know more.

Choosing a reconstruction

Reconstruction can be one of the most important parts of treatment,  that helps emotional recovery and wellbeing.  Inglefield emphasises that it is vitally important to have complete trust and faith in your surgeon;  what was reassuring was his comment that he always thinks “is this in the best interests of the patient?”

So what are steps to a successful reconstruction?

  • Discuss your options with the surgeon who is going to do the operation
  • ask to see photographs of operations he or she has done
  • talk it over with your breast care nurse
  • and/or ask to meet someone who has had the same type of reconstruction.

Types of reconstruction

There are two main types of breast reconstruction:

  1. reconstruction using an implant
  2. reconstruction using your own tissue.

You may have a number of choices available to you, although one type of operation may be more suitable depending on your shape and build, and whether you are having or have had radiotherapy treatment to the breast.

You should discuss with your surgeon the best time for you to have reconstruction work carried out;  there is no definite  ‘best’ time – it all depends on the patient, their life-style and how it fits in with their plans.

Then ask yourself, and tell your surgeon, what you want out of the reconstruction.

And, most important, discuss the possible effects of the treatment on you.

One idea that I liked was using fat from the patient’s own body – but this is an option that must again be carefully discussed, although Inglefield was very much in favour of this technique.

What is most frequently asked question?

According to Mr. Inglefied, it’s  “can I restore my breast shape?”

After this comes the question of cost, and he says that more and more patients are opting to pay for reconstruction  themselves, rather than relying on the NHS.  This is something that his team can discuss in a sympathetic fashion, and when I asked for costs – he didn’t hesitate to say these started at £2,500 – but warned for complicated procedures it could go up to £15,000.

He also said that Nipple Reconstruction was something they frequently carried out at London Bridge, and was adamant that whatever a patient chose, “it should be a positive experience”.  They also do work on scars, helping reduce or eliminate unsightly ones, and work on lumpectomies too.

His phylosophy is  “I like patients to feel part of the family”, and this is very evident when we talked – and he listened attentively.

Contact:  London Bridge Plastic Surgery    www.lbps.co.uk

54 Wimpole Street, London W1G 8YJ   020 7487-0900




Enhanced by Zemanta

Breakthrough's Westminster Fly-In gathers even more MPs

Breakthrough Breast Cancer team put on a good show


Do you recognise yourself in the picture above? Or a friend?

As usual, the Westminster Fly-in was bigger than ever, for its 12th annual event.  Over 60 MPs were lobbied by the group above.

The night before the Lobby meetings, there was a Reception where all of a sudden you were talking to an MP, who “came over because I just wanted to see what it was about”, or a Lord who told me, “I came in to see what I could do to help”.

Those on the platform constantly congratulated and thanked Breakthrough’s CAN members, and the whole event showed how much their efforts were appreciated.

The TLC campaign

One of the main messages at the event was TLC.  For once this wasn’t what we wanted from our medical team, but the campaign message

  • TOUCH your breasts.  Can you feel anything unusual?
  • LOOK for changes.  Is there any chance in shape or texture?
  • CHECK anything ususual with your doctor.

However, it is as well to remember that many of us suffer with doctors who ‘pooh pooh’ concerns we have over cancer, so there should be information about what patients can do IF their doctor won’t listen.


Georgina Kaim, Senior Development officer, was my main contact in the year leading up to the Fly-In, and kept on supplying me with information and support.   As it happened, ‘my’ MP chickened out – he works with the Cabinet and anyone in that position is worried about fall-out from Health Bill.  But no worries – we intend to follow up!

Opening Plenary

At the door to greet us when we arrived was Maggie Alexander and her team.  They knew us all by name, and were determined to see that we were welcomed and felt welcome.

Then Maggie, as Director of Policy and Campaigns, set the tone for the event during the first session.  From then on we were on an interesting  roller-coaster.  Workshops followed, designed to take ‘new’ CAN members through what would happen during their MP meeting – and the team made sure everyone was extremely well briefed.


These are usually full of people wasting time before the evening dinner – not at this event!

It was buzzing with Trustees who had bothered to turn up and TALK, and various MPs and members of the House of Lords who had come over to see what it was all about (interestingly it was mainly men).

One MP  who turned up was James Arbuthnot, M.P. for North East Hampshire, and we talked about dogs (James has several and wants to breed Irish Wolfhounds).  As you see he was bravely photographed at another event wearng a pink waitcoat for Wear Pink Day;  I only hope the troops don’t pull his leg, as his other job is in Defence.

The party was was hosted by Annette Brook and Stephen Brine, Co-Chairs of the All-Party Parliamentary Group for Breast Cancer, who both gave light-hearted but inspiring speeches.



Next morning the efficient team from Breakthrough marshalled  ‘their’ charges off to meet the MPs.  In an orderly fashion, they gathered CAN members together, made sure they had a briefing pack and all the literature they would need, and even supplied a memory stick with Breakthrough’s loge.  They hoped these would lie around on member’s desks and spread the word!  Very good PR!


By lunchtime everyone was well away, talking and exchanging information.  I sat between two CAN members who also worked for Kidney cancer, and we spent lunch discussing how, now that most people talk openly about breast cancer,  we need to join up with all the other cancers and present a united front to the Minister of Health, and all the politicians.

Currently, there is a feeling that the Dept. Health is happy that cancer charities pursue their own agenda.  If  charities don’t talk between each other, it is easier to ignore or brush aside concerns.  As I found out last month, my local hospital is totally ignoring that we are allowed to top-up drugs with co-payments.  I was refused, and bullied, being told that the hospital knew nothing.

But a united front, and a thundering ’round-robin’  letter to the hospital, signed by the major charities’ CEOs, and the hospital would have had to listen.

During the conference

Maggie Alexander was repeating that we have to ensure that Breast Care Nurses aren’t allowed to be made redundant.  Perhaps this could be the subject of a letter from united cancer charities, because it isn’t only breast care nurses that are threatened with redundancy, but other specialised cancer nurses as well.

One disappointment was that the session on personalised medicine wasn’t to do with the new treatment paths in the United States.  In fact to someone who follows what is going on in America, it was bewildering that Breakthrough isn’t campaigning more strongly for this.  After the last San Antonio Conference, doctors across the States declared emphatically that their surgeries were definitely going to be offering this to every suitable patient.  Yes, it will make them money – but if tests might avoid side effects such as heart and eye problems, nausea, hot flushes, carpal tunnel syndrome,  etc.  surely, if the NHS copy this, it will save money?

The All-party Parliamentary Group on Breast Cancer was represented by Annette Brooke and  Steve Brine.  Brine announced that the Fly-in is like their AGM, and both said how brilliant this event is for getting to meet people and hear their concerns.  However, he repeated the same mantra that was being aired at every session, and constantly repeated by Andrew Lansley and David Cameron:  according to the World Health Organisation Britain lags behind the rest of the world when it comes to cancer treatment and survivorship.

As a patient I am getting tired of hearing this.  We know that we lag behind.  So why aren’t we told what is going on in other countries, so we can copy their treatments and hopefully live longer?  Having been to France, Germany, Italy, Austria and Switzerland for treatment for different side effects from drugs, for me it wasn’t about expensive drugs or equipment, but the way European doctors take time to go through problems, and use common (er-rare?) sense.  Every bit of superb treatment I received depended on this rare sense;  not once did I need an expensive drug.  But every treatment could be copied so easily, if only there weren’t arrogance from our medics.

Other points

Over the teas and coffees, we talked about NHS services already being withdrawn, and how it was going to be up to patients themselves to question hospitals, GPs and the new Commissioning Boards.  If they don’t provide the services – how and whom do we ask WHY?

One delegates mentioned that consultants are now starting to ask the NHS to allow them 15 or even 20 minutes for each appointment.  Hurrah – let’s all lobby for that!  In Europe a ten-minute appointment draws gasps of horror – and the thought of our ‘clinic’ system where patients are seen by a different doctor each time is anathema.

Many patients don’t realise they are entitled to a second opinion, and in fact this is normal in many countries.   But when it comes to joined-up thinking, one delegate cited that her hospital had just opened a MacDonalds – now how many calories does a Big Mac contain?  !!  Yet we are told obesity can be a factor in getting cancer.

And overall delegates were in agreement that Patients must be at the centre, consulted and listened to.  But when the Royal College of Nursing and other medical associations are sponsoring conferences, ostensibly dealing with patient care, but NO PATIENTS ARE ASKED TO SPEAK – one wonders if they will ever get it.

One criticism of the Central Hall venue.  Breakthrough offered us lunch, but the caterers hadn’t thought who was going to eat this.  There were lovely-looking eats, but no labels to show what they contained.  My first mouthful of what looked like a fish cake was full of chillie flakes – so after that I had to go round asking staff what was in food.  A simple sign listing things like mayonnaise, chillies, spices, etc. which drugs don’t like would be helpful.

Still, at least after the Westminster Fly-In, MPs have got it!

Long wait for medical referral? It's all up to you to get faster attention

Postcodes and other Lotteries

When I first started these web pages, I was going to write about the nice things that help  us recover;  massage therapies;   skincare products; short breaks with TLC from top health centres, etc.

But sadly, events have overtaken this website.  Instead of writing about nice things, it has become obvious that health care in Britain is going through a crisis.  Often medical treatment becomes ‘survival of the fittest’,  and it is up to patients to fight for the best care.  We have to keep an eagle eye on what is happening, to ensure that those entrusted with NHS (our) money, spend it wisely, and not on things like ‘Away day outings for managers’, etc.

The latest information from the Patients’ Association gives one food for thought – and perhaps ammunition if you are caught up in increasing delays for treatment.

A report published by the health think tank, the Kings Fund, has found that some patients are having to wait longer for referrals than others. The review was led by a panel of experts over the course of two years.

The report has shown that in some areas some patients were waiting 8 times as long for a referral compared to patients at other nearby practices. The report has also found that just over a quarter of patients were unable to see their preferred doctor and that there were wide variations in the number of patients who had been admitted to hospital for conditions that could be treated outside hospital.

Chris Ham, chief executive of the King’s Fund, said there was no room for complacency, even if general practice in England remained “the envy of the world. While many practices have been at the vanguard of innovation and quality improvement, too many GPs remain unaware of significant variations in performance and do not give priority to improving quality.”

Dr Laurence Buckman, Chair of the GP committee at the British Medical Association said “Increasingly practices are working more closely together meaning they will be able to offer the wider range of service that patients expect. However, we should not assume that bigger always means better. Many patients value smaller practices and, as they consistently perform well clinically, it is important that this choice remains.”

Katherine Murphy, Chief Executive of the Patients Association said, “As the government hands responsibility for commissioning services to GPs, it needs to make sure that it offers support to those GPs who are struggling to perform and make sure that these practices are not allowed to fall further behind. Patients should be receiving a quality service regardless of the GP practice they attend. It should not be a lottery of care with your postcode determining the level of service you receive.”

For more information, please visit http://www.telegraph.co.uk/health/healthnews/8401157/Gaps-and-variations-in-GP-care-revealed-by-study.html

Report of an independent inquiry commissioned by The King’s Fund
SitemapClose sitemap
Current projectsCurrent projects
Building world class commissioningChoice at the End of LifeEnhancing the Healing EnvironmentFrom Ward to BoardGSK IMPACT AwardsInformed ChoiceInquiry into the Quality of General Practice in EnglandPartners for Health in LondonPatient choicePractice-based commissioningPredicting and Reducing Re-admission to HospitalProgress made by the NHS in the last 13 years: 1997-2010Quality and Outcomes FrameworkQuality in a Cold ClimateReforming the health system: local experiencesSafer Births: supporting maternity services to improve safetySocial care: reform of funding & deliveryTechnology in the NHSThe 21st century doctorThe Point of Care: Improving Patients’ ExperienceCompleted projects
Acute careCommissioningCo-operation and competitionDarzi reviewEnd-of-life careGovernance, regulation and accountabilityHealth inequalitiesLeadership and managementLong-term conditionsMaternityMental healthPatient-centred carePrimary and community carePublic healthQuality of careSocial careTechnology and telecareWorkforce and professionalism
PublicationsThe King’s Fund publications
BlogThe King’s Fund Blog
LibraryLibrary & Information Service
How we can help youAsk an expertCurrent Awareness ServiceNHS Evidence Specialist CollectionsReading lists
Venue hireVenue hire
Virtual toursInteractive room guideContact venue hire
EventsConferences & seminars
Upcoming eventsPast event catch-up
Open programmesLeadership staffCommissioned programmesConsultancy workBoard Leadership Programme
About usAbout usJobsContact usHow to find usWho’s whoPartnerships and fundraisingHow we are fundedOur historyPress
Press releasesContact our press teamParliamentary activities
The King’s Fund
11-13 Cavendish Square
Tel: 020 7307 2400
enquiry@kingsfund.org.uk View location map
AccessibilityContact usFeedbackPrivacy policyT&Cs© The King’s Fund, 2011Registered charity: 1126980
Site by Torchbox

Enhanced by Zemanta

How to qualify to work in today's NHS

A patient having his blood pressure taken by a...

Image via Wikipedia


The press release made no bones about it:

Healthcare professionals attending the UK’s largest disability, homecare and rehabilitation show Naidex National (Birmingham NEC, 5 – 7April) will once again have the opportunity to enhance their CPD (Continuing Professional Development).

This means 5,000 healthcare professionals who attended the last exhibition to “benefit from and experience the latest new products, learn about the issues facing the profession”, could gain CPD certificates to “demonstrate their commitment to finding out about cutting edge changes to their profession”.

It’s like Engineering students being awarded brownie points towards their engineering degree, if they attend the Motor Show.

Day out

Attend an exhibition – have a day out being chatted up by sales staff, sit in the chairs – the old faithfulls that one used to see at the Ideal Homes Exhibition and others – visit the Taiwanesse, Danish and other national pavilions to see what their countries are making to sell to NHS and disabled – and attend a seminar (if you have time).  Oh – and don’t forget the ‘Product Launches’ that are promised by manufacturers eager to sell their goods.  As the Taiwanese etc. have been promised, this will be a showcase for ‘increasing their business in the UK’.

Once you have done this, you get CPD more brownie points towards your qualification.

And to think I used to think healthcare staff were there to look after patients, and spent their training learning how to look after us.

Recently professional conferences aimed at nurses and NHS staff have offered CPD points to those attending;  but each conference has been in the form of lectures by professionals – even though advertised by some title such as “What do patients need?”  or “How to attend to patient’s needs in the re-structured NHS” or something equally vague.

When I phone to ask which patients will be speaking, the answer – when it comes – is always “our speakers are chosen by a committee/panel/the association, etc.”  And never is anyone a genuine patient of today – although they might have been patients years ago.  Consequently they have no experience of what patients actually need.

But it is very obvious when one comes across today’s health professionals they are experts at ticking the boxes and following the latest mantra – but TLC?  Forget it.  They’ve got their CPD certificates – that’s all they think they need in order to work with patients.