Chelsea and Westminster Hospital NHS Foundation Trust operates Chelsea and Westminster Hospital and West Middlesex University Hospital (since 1 September 2015). The Foundation Trust was created on 1 October 2006. The Trust's chief executive is Lesley Watts and its chairman is Sir Thomas Hughes-Hallett.The Trust also manages a number of highly specialised sexual health clinics at 56 Dean Street and Dean Street Express in Soho, 10 Hammersmith Broadway (formerly West London Centre for Sexual Health at Charing Cross Hospital) and John Hunter Clinic at St Stephen's Centre.Brian Eno has volunteered to help transform the casualty department. He is to refine the A&E’s acoustics. He is one of several artists backing a £600,000 appeal by Chelsea and Westminster Health Charity to provide visual and aural features. Appeal patron Hugh Grant, who lives near the hospital, said: "The charity is working with artists and designers to do clever and cunning things with lighting, with sound and with the design."As of 2018, the trust employs 6,339 staff.
Background Complicated consent procedures for bloodborne virus (HIV, HBV and HCV) testing present barriers to implementation, particularly in non-specialist healthcare settings. European and global guidelines no longer recommend written consent. An overview of testing consent requirements in Europe is lacking.Methods An online survey on legal and policy frameworks and implementation/practice was developed by a working group under the EuroTEST Initiative and disseminated to clinical and community-based testing facilities and national public health institutions and/or HIV/hepatitis organizations/societies in the countries of the WHO European Region. Data collection and validation occurred between October 2023 and April 2024. Responses were validated via email and/or bilateral discussions if diverging across same-country respondents to obtain one answer per country.Findings A total of 84 responses from 36 community-based testing sites, 33 healthcare facilities and 15 public health institutes in 34 countries were included. Written or documented verbal consent remained a policy requirement for HIV testing in 12 countries (4/18 western, 6/11 central, 2/5 eastern). For viral hepatitis, opt-out testing was much more common and written/documented verbal consent a policy requirement in five countries only. Practices for how consent is obtained in reality varied by setting and did not always follow legal/policy requirements.Interpretation Written/documented consent remains a requirement for HIV testing in more than a third of responding countries. Removing the need for written/documented verbal consent and expanding opt-out testing will reduce testing barriers, reduce HIV exceptionalism, align national requirements with global standards and support European countries in reaching the first UNAIDS 95-95-95 target of 95% of those infected, diagnosed.
BACKGROUND:In neonatal trials, verbal opt-out consent has been used to reduce burden on families and make recruitment more efficient and representative. It involves information provision through posters and leaflets before randomisation, and parents can verbally 'opt out' of their baby being randomised to the trial. There is limited understanding of how opt-out consent is operationalised in a multicentre neonatal trial, and its acceptability to staff and parents. OBJECTIVE:To explore views and experiences of verbal opt-out consent in neoGASTRIC, a neonatal randomised trial comparing routine and no routine measurements of gastric contents in preterm babies. METHODS:A mixed methods (questionnaires, interviews and focus groups) process evaluation within a trial. SETTING:Four UK neonatal units. PARTICIPANTS:253 participants: 167 staff (149 questionnaires; 18 across two focus groups), 86 parents (85 questionnaires; 15 interviews; 14 took part in both). RESULTS:Parents and staff supported opt-out consent in neoGASTRIC as interventions were viewed as low risk and non-invasive. Parents appreciated an appropriately timed research conversation; only 21% noticed study information banners/posters. Operationalisation of opt-out consent varied in terms of when information was provided and randomisation timing. Women approached during labour or within hours of birth reported feeling overwhelmed and lacking capacity to consider research. Some staff operationalised a modified opt-in approach. CONCLUSIONS:An appropriately timed verbal opt-out approach to consent was seen acceptable as proportionate in the neonatal context in a low-risk trial comparing different accepted clinical, non-pharmaceutical, practices. Findings informed neoGASTRIC and will guide approaches to consent in this setting.
Aims:The Reimers migration percentage (MP) is the gold-standard radiological parameter used to aid decision-making regarding surgical management of hip displacement in cerebral palsy (CP). Accurate measurement is important to risk stratify patients and allow timely onward referral from community teams to paediatric orthopaedic services. We performed a study to determine whether experts and novices could use a free smartphone app (HipScreen (HS) app) as a valid method for measuring MP in CP. Methods:Using the HS app, two groups measured MP in 20 pelvis radiographs (40 hips) at weeks 0 and 2. The 'inexperienced' group included four community physiotherapists with no CP experience. The 'experienced' group included four community physiotherapists and two paediatricians with CP experience. All participants watched the tutorial videos on the HS app website. HS app measurements were then compared with gold-standard picture archiving and communication system (PACS) measurements conducted by a senior paediatric orthopaedic surgeon. Modified Pearson correlation (r) was used to determine inter-rater reliability between HS app and PACS measurements. Intraclass correlation coefficient (ICC) was then used to assess intrarater reliability. The mean absolute deviation (MAD) was calculated to compare raters with the gold standard. Results:HS app measurements in the experienced and inexperienced groups showed highly significant correlation with the gold-standard measurements (p < 0.001). There were no significant differences between intra- or inter-group measurements at weeks 0 and 2 with r > 0.86 and p < 0.001. Both inter- and intra-rater reliability were excellent with ICC > 0.9. There was no statistically significant difference in the MAD within individual measurements and compared with the gold standard. Conclusion:The HS app is accurate in measuring MP in CP when used by non-specialists and specialists. Non-specialists do not require additional supplementary training. These findings suggest app efficacy and safety in regional and national hip surveillance programmes for children with CP.
