Churchill support

Churchill Support

The Churchill Hospital is a centre of excellence for cancer services and other specialties; together with the nearby John Radcliffe Hospital, it is a major centre for healthcare research, housing departments of the Oxford University Medical School and Oxford Brookes University's School of Healthcare Studies.

The Churchill Hospital has a modern purpose-built Centre for Upper Gastrointestinal Surgery and Oncology. The hospital provides facilities for both inpatient and outpatient treatments with surgery, radiotherapy, chemotherapy, immunotherapy, other targeted treatments, stent insertion and palliative care services. Specialist endoscopic assessments and treatments take place at the John Radcliffe Hospital.

The hospital provides a wide range of medical and surgical services including:

Diagnostic services (including endoscopy, histopathology, radiology services such as CT scans, MRI scans, PET/CT scans, breast screening and laboratories).
Cancer medicine services (including clinical and medical oncology, clinical haematology and radiotherapy).
Interventional services (including surgery for gastrointestinal, breast, and gynaecological cancer and non-cancer ailments).
A base for University research teams, working in partnership with NHS colleagues.

Key services for OOSO patients are split into the following sections:

Note - Whilst some of the sections below provide contact numbers, OOSO is not responsible for urgent or emergency contacts with these services and patients should use any numbers that they have been provided with by the relevant Churchill/Oxford University Hospital services.

You can find out more about the Churchill Hospital at Churchill Hospital - Oxford University Hospitals (ouh.nhs.uk)

Oxford Oesophagogastric Cancer services

The Oxford Oesophagogastric Cancer Services covers all services for oesophageal and gastric cancer patients throughout the Oxford University Hospitals NHS Foundation Trust (John Radcliffe Hospital, Churchill Hospital and Horton General Hospital).

These services are provided through a multi-disciplinary team (MDT) that functions both locally to the OUH NHS foundation trust and as a wider specialist cancer centre for referring hospitals across the Thames Valley Cancer Alliance (TVCA) network, including Milton Keynes General Hospital, Great Western Hospital, Swindon, Stoke Mandeville and High Wycombe General Hospitals. Since 2013, patients from Berkshire (Royal Berkshire Hospital, Reading and Wexham Park Hospital, Slough) have been referred to the Oxford MDT for consideration of oesophagogastric surgery or radical treatments. Referrals are also received from outside of this area for second opinions. All oesophagogastric surgery takes place in Oxford

The specialist Oxford Oesophagogastric Cancer MDT provides oesophagogastric cancer services to a population of approximately 2.3 million people.

The Oesophagogastric Cancer Multi-Disciplinary Team (MDT)

Purpose

The aim of the Oesophagogastric Cancer MDT is to ensure a coordinated, rapid and high-quality approach to diagnosis, treatment and care services for all patients with a suspected or confirmed cancer of the oesophagus and the stomach, irrespective of age or stage of disease and will be reviewed by the MDT at the weekly MDT meetings.

Objectives

The main objectives of the MDT are to:

strive for the highest standard of care, patient outcomes and evidence-based practice, in accordance with the latest research, Improving Outcomes Guidance (IOG) and the TVCA agreed guidelines.
provide a rapid assessment and diagnostic service for patients.
discuss individual treatment plans and follow up arrangements to ensure that each patient receives treatment and care in a timely fashion and in accordance with network-agreed clinical pathways and guidelines.
identify a key worker, usually the Specialist Nurse for each patient.
ensure prompt and full communication about the patient’s diagnosis, MDT treatment decisions and treatment plans with primary care and palliative care.
provide comprehensive up to date information, advice and support for all patients and their carers, including information about the local support group.
be committed to productive and highly effective teamwork within the MDT, valuing and supporting each member of the team for their specialist expertise, commitment, hard work and goodwill.
be committed to ongoing service development through audit activities, including agreed audits, research, patient experience surveys and education.
be committed to data collection analysis for cancer minimum data set, local and national audits.
incorporate new knowledge, new research and best practice into patient care.
involvement in and assessment of potentially eligible patients for recruitment into clinical trials.

Team composition

The Oesophagogastric Cancer Multi-Disciplinmary Team (MDT) is made up of a group of healthcare professionals who have a specialist interest, Knowledge and expertise in the management of patients with cancers of the oesophagus and the stomach.

The core members of the team consist of:

Specialist Surgeons – who specialise in surgery of the oesophagus and the stomach
Specialist Oncologists – who specialise in cancer treatments such as chemotherapy, radiotherapy, immunotherapy and other targeted treatments.
Specialist Gastroenterologists – who specialise in the diagnosis and non-surgical treatment of diseases in the digestive system.
Specialist Pathologists – who examine body tissues to look at particular cell types and to stage cancers.
Specialist Radiologists – who perform and interpret x rays, including CT scans, PET/CT scans and MRI scans.
Specialist Nurses – who offer a point of contact for information and support.
Specialist Dietitians – who offer support with nutrition
Multi-Disciplinary Co-Ordinator – who co-ordinates MDT meetings and assists with ‘tracking’ of care.

Many of the clinicians have dual roles within NHS and Oxford University research teams

Importantly, members of the MDT work with the wider teams on the wards, intensive care, palliative care, in clinic, administration teams, and other specialist services, amongst many other teams. They also work with the teams in the referring hospitals.

MDT Meetings

The MDT meet weekly every Monday morning. Each patient’s case is discussed when they reach important points with their diagnosis and treatment pathways. The MDT will discuss your case history, x-ray images and pathology results, together with any other relevant information. As a team, they will work out appropriate options for treatment and care. This plan will be discussed with you over the telephone, at an appointment in clinic or on the ward.

You can find out more about the MDT and its members at Oxford Oesophagogastric MDT

The Oxford Upper GI Surgery Centre

The Oxford Upper GI Centre is a surgical ward for patients undergoing specialist oesophagogastric and hepatobiliary and pancreatic surgery. A programme of Enhanced Recovery was implemented in major oesophagogastric surgery in 2013.

Nick Maynard, Lead Surgeon and founder of the Unit says

“So much has changed since the Unit was created in 1997 - we have grown in that time into one of the biggest oesophagogastric cancer units in the country and now have six Consultant Surgeons operating four days a week on patients with oesophageal or gastric cancer.

Our team of consultant surgeons include myself, Bob Marshall, Bruno Sgromo and Richard Gillies, Richard Owen and Sheraz Markar. The strengths of the unit are of course the excellent clinical outcomes from this surgery which are as good as anywhere in the world.

The team is always striving to improve, and much attention has focused on improving our ERAS (Enhanced Recovery after Surgery) pathway. We have seen a remarkable reduction in length of stay following oesophagectomy, with many patients now going home on the seventh post-operative day.

 Our ward (the Upper GI Centre) continues to thrive and is continually talked about throughout the Trust as “the best ward in the hospital” – indeed the Upper GI Ward and Team are winners of the team award of the year, an annual event hosted by the Oxford Mail Hospital Heroes.

This success is in large part due to the dedication and hard work of all our ward staff and specialist support clinicians, and I wish to thank them all for their inspirational work.”

Upper Gastrointestinal Specialist Nurses

Upper Gastrointestinal Specialist Nurses are senior Nurses, who work as core members of the Multi-Disciplinary Team. They have a specialist interest, knowledge and expertise in the management of patients with cancers of the oesophagus and the stomach.

Specialist Nurses offer patients and their carers a point of contact for information, support and advice from the point of diagnosis, during investigations, treatment and care.

The Specialist Nurse can offer:

Specialist assessment and emotional support to deal with a cancer diagnosis and effects of treatment.
Specialist information about cancers of the oesophagus and the stomach and treatment options.
Specialist advice about symptoms, treatment side-effects and their management.
A link with other staff and services involved in patient care.
An opportunity to discuss any other issues or concerns or comments.

Contact details for the Oxford Specialist Nurses: 01865 235058

Please note that the Specialist Nurse service is not an emergency service.

For urgent help or advice, please use the emergency numbers given to you by your Doctor/Nurse for the oncology triage service in your area or the Upper GI Surgery Ward, the out-of-hours service (111) or the emergency services.

Anne-Margrethe Phillips, Senior UGI Specialist Nurse writes,

“I am writing on behalf of the Upper GI Specialist Nurse GI team at the Oxford University Hospitals NHS Foundation Trust to endorse the clinical team’s support for the work that the Oxfordshire Oesophageal and Stomach Organisation (OOSO) offers to our group of patients, their families and carers. In addition to this, as a clinical team, we appreciate enormously the support for the hospital team itself and the provision of such an important service, which supplements the care that we offer throughout the patient pathway and gives hope to our patients. On a personal level, it is a great honour for me to be a Trustee of OOSO over so many years”

Oncology services

The Churchill Hospital’s Medical Oncology team provides chemotherapy and other drug treatments for patients. The consultant team has strong links with the University of Oxford and Cancer Research UK and is a base for world-leading research in the field, so that patients have rapid access to a wide range of new treatments.

Appointments

Soon after cancer has been detected, most normally by biopsy from tissue samples taken during an endoscopy, an outpatient’s appointment with a Consultant Oncologist will be made. The Churchill Hospital Outpatient Department is located on the ground floor close to the main entrance.

A new patient will be assigned a Consultant Oncologist, who will discuss and advise each patient of their cancer type and treatment plan. The Oncologist will make arrangements for treatments to go ahead, usually within 2 weeks of the outpatient’s appointment, though delays aren’t unusual, given the number of patients and the need to prepare bespoke drug combinations.

Chemotherapy

The Day Treatment Unit is for patients undergoing chemotherapy and other procedures with the Oncology and Haematology services. At the Churchill Hospital it is located next to the Outpatient Department, close to the main entrance.

Upper GI patients are typically treated by infusion, either once a week or once a fortnight, over a 4-hour pre-arranged session, as directed by the patient’s Consultant Oncologist.

Further details on what chemotherapy entails are provided in the non-surgical treatments chemotherapy section.

The team works closely with the Vascular Access Service, who place peripherally inserted central catheters (PIC lines) for patients requiring them, and home care teams, who organise treatment to be delivered to, or given in, the patient's home; the team is also supported by specialist pharmacists. Normally, Upper GI patients are invited into the Day Treatment Centre for their infusions.

Rather than having to travel to the Churchill Hospital for infusions, patients can be offered their treatment at a hospital closer to their home. Ask about this when you meet with your Oncologist.

Triage service

The Triage Assessment Team is a specialist nursing team, skilled and competent in haematology and oncology triage for patients receiving treatment. This ensures appropriate and consistent advice is given, allowing for the early recognition of potential emergencies, treatment complications and the provision of a follow-up structure for higher-risk patient groups. This has had a positive impact on the efficiency of emergency care within cancer services with improved support to patients.

Clinical Trials

Clinical trials are an important aspect of the work that Oncologists and Surgeons perform on a daily basis. Quite often the research involves testing out new drug treatments either used on their own or in combination with more established drug treatments or radiotherapy in patients with oesophageal and gastric cancer. This is vital work if clinicians are to improve the number of patients being cured of their cancer or living longer with it. The research is often combined with having surgery for cancer.

The primary aim of clinical trials is to make a difference in improving treatment for patients in the future. Trials are often ‘randomised’ meaning they compare a new drug or combination of new and old drugs and test which one is better. Patients or their doctor cannot choose what treatment is selected for them. These trials are the final testing phase of potential new treatments; if a new treatment is found to be better, it will lead to a change in treatment for all patients with oesophageal and gastric cancer.

Being on a trial doesn’t necessarily mean the patient will receive a cure, but it does provide some added reassurance that the treatment is being tested and monitored carefully and may well be beneficial. Not every patient is suitable or eligible for a trial, because new treatments are often targeted at particular groups of patients at different stages of their illness. It is always best to discuss trials and eligibility with the Oncologist.

For information explaining clinical trials in more detail click here.

The Cancer Research UK web site has a search facility. To search for trials that are currently underway click here.

Radiotherapy Services

Radiotherapy Departments are equipped with specialised planning and treatment facilities to enable the delivery of state-of-the-art therapy. The therapy radiography staff work together with consultant clinicians and nurse practitioners to ensure the best treatment and care is delivered to all patients.

Further details on what radiotherapy entails are provided in the non-surgical treatments radiotherapy section.

Dietetic Services

The Dietetic Service is a small team of dedicated and enthusiastic Dietitians with specialist experience and interest in working with patients who have cancer of the oesophagus and stomach or patients with benign oesophageal or gastric conditions.

The team works as core members of the Oxford UGI multidisciplinary team covering both surgical and oncology clinics and aim to supports patients from the time of diagnosis, through preoperative chemotherapy or chemoradiotherapy, surgery, post operative treatment and beyond. Its aim is to help minimise the impact of the disease and treatment on nutritional status and fitness for surgery and to help minimise the effects of surgery on long term health and quality of life.

The team understands the massive impact that dietary changes following surgery can have on an individual and are keen to help to support its patients in managing the long-term dietary consequences of surgery and treatment.

IIf you have not heard from this team recently and have a question, please do get in touch. They now have a dedicated UGI dietetic support worker who can pick up your calls daily and arrange either a call back, book a telephone appointment at a convenient time for you or deal with your query directly.

IIf you have recently been diagnosed and have not yet met a Dietitian, please do get in touch or if you have concerns about your weight, whether this is due to unintentional weight loss or if you are unsure if you should be losing or gaining weight, the team be happy to hear from you.

The Dietetic Service can help provide you with information regarding vitamin and mineral supplements blood tests, gastrointestinal symptoms that may have developed since your surgery, healthy eating advice, advice regarding good gut health, and the most recent cancer prevention advice for those following cancer treatment.

Who are we:

Amy Calladine. Amy is our new Macmillan UGI dietetic support worker. She is helping to improve our telephone clinic booking system, deal with telephone calls promptly and liaise with our out-of-county colleagues at Swindon, Bucks, Milton Keynes and beyond.
Liz Ward. Liz has worked with the UGI team for many years and now works part time providing face-to-face clinic and telephone support to patients.
Emma Fox. Emma has worked in the UGI team for several years and also works part time, providing patient support in clinic and via the telephone.
Jess Budd. Jess is our ward-based dietitian and will meet most of our patients on the ward following surgery. She also runs our pre-operative virtual group education session for those waiting for surgery, and has a weekly telephone clinic.
Holly Harrold. Holly has re-joined the team recently and is providing support on the ward following surgery but also to our local patients who are receiving pre and post-surgery chemotherapy.
Alison Howard. Alison is a radiotherapy dietitian and works with all our UGI patients who have preoperative chemoradiotherapy or chemoradiotherapy treatment alone.

How to contact us:

We are available on our extension 01865 228305. Please leave a message and someone will get back to you. Please do try to leave your name and hospital number or date of birth.

Physiotherapy Services

Prior to any surgery, it is important to be prepared. Part of this preparation involves optimising cardiovascular fitness and strengthening of muscle groups.

The Preoperative Physiotherapy Service at the Churchill Hospital in Oxford offers advice and education to help patients prepare for surgery. This includes strength training and exercise advice, inspiratory muscle training, and providing information relating to the post-operative experience on the ward with the therapists.

Appointments are delivered through virtual group presentations, or where required, by individual assessments. These can be either virtual, via the telephone or face-to-face. When needed, the team will continue to stay in touch with a patient in the lead up to surgery, including throughout any other course of treatment that may occur.

The focus of the Preoperative Physiotherapy team is on helping patients to avoid complications that can occur following surgery, specifically problems related to breathing. The aim is to aid and enhance recovery and reduce the length of time spent in hospital.

The team will contact patients to organise an appointment, but if you have any questions regarding physiotherapy, please contact them on (awaiting email for preop team to be approved).

Here for Health Service

The Here for Health team offers health and wellbeing support. it works alongside other services at the hospital. The team offer consultations focusing on what matters to you and offer a range of support methods to help you plan for:

becoming more active
giving up smoking
reducing alcohol intake
improving sleep and managing fatigue
self-care for general wellbeing
eating a healthy diet (in conjunction with the Dietetic Service)

The team tailor your consultation to your individual needs, to make it as easy as possible to adopt small, sustainable, and realistic lifestyle changes to improve your health and wellbeing.

The team have a wide range of resources and can help you access a variety of community services, including support with becoming more active, stopping smoking and weight management.

The team offer telephone and video call support Monday to Friday and booked face to face appointments.

The Here for Health team can be contacted via:

Telephone on 01865 221429 Monday to Friday 9.00am - 5.00pm. (if necessary please leave a message and someone will get back to you), or
Email at hereforhealth@ouh.nhs.uk

Further details can be found at www.ouh.nhs.uk/HereforHealth.