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The Walton Centre NHS Foundation Trust will become the first centre of excellence for spinal services to give surgeons and medical device manufacturers detailed insight on the long term effectiveness of spinal surgeries and implants through a new partnership with Northgate Public Services (NPS).

The move will enable bespoke reports to be made available to the very people who develop and manufacture medical devices, allowing them to assess exactly how effective the devices have been at improving the health and quality of life for the patients receiving them. 

The Spinal Improvement Partnership (SIP), brings together the clinical excellence of The Walton Centre with the data collection and reporting expertise of NPS. The SIP team are working collaboratively with device manufacturers to agree the outcomes most appropriate to collect and report on, in order to satisfy regulatory authorities that implants are safe, effective and deliver the expected benefits to patients. 

Richard Armstrong, head of health registries at Northgate Public Services, said: “This partnership represents a maturity in the relationship between hospitals and medical device suppliers, both of whom have a fundamental interest in ensuring products are safe and effective. Having access to accurate information on the success of treatments involving medical devices in different patient groups is essential for improving patients’ long-term prospects for recovery. Our partnership with The Walton Centre will put better information into the hands of those who need it to improve treatments and keep patients safe.”

The Walton Centre is an active contributor to Spine Tango, an international spinal registry from EUROSPINE that tracks and monitors outcomes for patients of spinal and neck injuries. The latest development builds upon the data routinely collected in the registry, enabling clinicians and manufacturers to collate and review additional information to ensure a device is safe, achieves the intended clinical benefits and to also inform decisions about patient treatment options.   

The service will speed up and improve the cycle for collection and analysis of clinically relevant data about implant safety and effectiveness.

Tim Pigott, consultant neurosurgeon at The Walton Centre, said: “Through our partnership with NPS, we have created a fantastic model for combining clinical expertise with a rich data set recorded in the Spine Tango registry. We are now putting this data to use on an ongoing basis to continually improve patient safety and the effectiveness of medical implants and devices used in spinal procedures.”

NPS technologies support a number of medical registries such as the National Joint Registry (NJR), the largest orthopaedics registry in the world, and the Indian Joint Registry (IJP) all of which collect data to help clinicians, regulators and industry deliver evidence-based treatments for patients.  

A grant worth over two million pounds has been awarded to clinical researchers from The Walton Centre, University of Liverpool and King’s College London to investigate the neurological and neuropsychiatric effects of COVID-19.

The COVID-19 Clinical Neuroscience Study (COVID-CNS) will look at 800 UK patients who were admitted to hospital with COVID-19and had neurological or neuropsychiatric complications, to understand how these problems occur and develop strategies to prevent and treat them.

Project co-lead, Dr Benedict Michael, Consultant Neurologist at The Walton Centre and Senior Clinical Scientist Fellow at the University of Liverpool, said: “COVID-19 patients frequently suffer brain complications during the infection and are left with brain injuries which can have lifelong consequences. Similar problems have been seen in previous pandemics, including Spanish influenza over 100 years ago, but how and why this occurs is poorly understood.

“Without understanding how the virus causes these problems, we are not able to know which existing medications to use or to develop new medications to treat these neurological effects. We’re going to look at cases in detail, exploring clinical data, and laboratory and imaging markers of brain inflammation and injury.”

This project is also supported by and is an integral part of the National Institute of Health Research BioResource (https://bioresource.nihr.ac.uk/), which provides research infrastructure to speed up clinical research and clinical trials. Patients of the COVID-CNS study will be consenting to the NIHR BioResource and will be re-contactable to participate in further research into COVID-19.

The project involves more than a dozen research centres from all four nations of the UK and is being led by the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at the University of Liverpool in collaboration with King’s College London.

Project co-lead Professor Gerome Breen, Professor of Psychiatric Genetics at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said: “These brain complications of severe COVID-19 infection could cause long terms problems for patients and their families. We want to compare patients with these complications to similarly ill hospitalised patients who did not have these problems. We will monitor their outcomes and integrate social and environmental risk factors into our analyses alongside all the biology information we will measure.”

“This project brings together scientists and clinicians in all four UK nations, across neurology, psychiatry, genetics, epidemiology and immunology. By working together, we aim to rapidly improve our understanding and design better treatments.”

COVID-CNS has been awarded £2.3m by UK Research and Innovation and the Department of Health and Social Care through the UKRI-NIHR COVID-19 Rapid Response Rolling Call.

Clinicians from The Walton Centre have led an early stage national study of hospitalised patients who developed brain complications in patients with COVID-19.

Lead researcher Dr Benedict Michael, a consultant neurologist with the Trust, worked with the CoroNerve Studies Group, a collaboration between the universities of Liverpool, Southampton, Newcastle and UCL, to study 153 patients treated in UK hospitals during the acute phase of the COVID-19 pandemic.

The findings, published this week in The Lancet Psychiatry, describe a range of neurological and psychiatric complications that may be linked to the disease, including stroke and an altered mental state such as brain inflammation, psychosis and dementia-like symptoms. The study provides valuable information for clinicians and researchers taking the next steps in neuroscience COVID-19 research and planning.

All of the patients included in the study were selected for inclusion by expert doctors and therefore likely represent the most severe cases. It is not possible to draw conclusions about the total proportion of COVID-19 patients likely to be affected based on this study and in light of these findings further research is now needed, the authors say.

Dr Michael said: “Whilst an altered mental state was being reported by some clinicians, we were surprised to identify quite so many cases, particularly in younger patients, and by the breadth of clinical syndromes ranging from brain inflammation (encephalitis) through to psychosis and catatonia.

“Clinicians should be alert to the possibility of patients with COVID-19 developing these complications and, conversely, of the possibility of COVID-19 in patients presenting with acute neurological and psychiatric syndromes.”

To investigate the breadth of COVID-19 complications that affect the brain, researchers set up a secure, UK-wide online network for specialist doctors to report details of specific cases. These portals were hosted by professional bodies representing specialists in neurology, stroke, psychiatry and intensive care. Data was collected between 2 April and 26 April 2020, during the exponential phase of the pandemic.

Co-author Professor Tom Solomon, also a consultant neurologist at The Walton Centre and Director of the National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections at the University of Liverpool said: “This study provides a great snapshot of the spectrum of COVID-19 associated neurological disease in the UK.

“Now we can recognise these problems, we need to understand in more detail why some patients are developing these complications, and what we can do to stop it. It will also be interesting to see how these data compare with other countries.”

Read the full Lancet article.

The Walton Centre is getting a touch of the high life as Project Wingman opens a ‘first class lounge’ at the hospital.

Project Wingman is a group of airline crew from across every UK airline, united by their profession and dedication to serving NHS staff during the COVID-19 pandemic. In June, the project is providing a space for Walton staff to unwind, de-compress and destress before, during and after a shift.

Project Wingman Co-founder Emma Henderson said: “We are really excited about partnering with The Walton Centre. It has worked well at other trusts and we’ve been overwhelmed by the high level of gratitude from staff. We wanted to put our skills to good use and it’s amazing to see it happen. NHS staff are working so hard to save lives, it’s the least we can do right now to support them.”

Staff will be able to relax in the pop-up lounge on Jefferson Ward and have a chat and refreshments served by cabin crew from 7am – 7pm seven days a week.

Deputy Chief Executive and Director of Operations and Strategy Jan Ross said: “Project Wingman has already made such a difference to our hard working staff. The First Class Lounge they have set up gives our staff somewhere to go to unwind and relax that is away from the clinical environment. We are bowled over by what Project Wingman has done for The Walton Centre and are so grateful for the difference they’re making and the many hours they are volunteering to support the NHS frontline.”

The Walton Centre Charity applied to Project Wingman for a chance to have a lounge.

Head of Fundraising Madeleine Fletcher said: “I am delighted to count Project Wingman as one of our many supporters. They have provided a massive boost to our staff already and it’s really great to see crew members on site in their full airline uniform supporting NHS staff. We are one of only a few locations in the North West to have Project Wingman on site and we’re honoured to be able to work with them and their volunteer crew.”

Check out The Walton Centre’s Facebook, Twitter and Instagram accounts for the latest updates.

A score to help clinicians define mild head traumas has been developed by a team of staff from The Walton Centre NHS Foundation Trust and Liverpool University Hospitals NHS Foundation Trust.

The Liverpool Head Injury Tomography Score (Liverpool HITS) was recently published in The British Journal of Neurosurgery. The new scoring system defines ‘surgically significant’ mild traumatic brain injuries in a bid to improve communication between neurosurgical centres and referral centres.

Consultant Neurosurgeon, and Lead for Trauma at The Walton Centre, Catherine McMahon said: “I’m delighted that Liverpool HITS has proven so effective in categorising mild head traumas.

“This could improve the head injury referral process by a significant amount and what’s even better is that the score has a very high sensitivity, so clinicians unsure of whether or not to refer a patient would be given the confidence that they are acting in the best interests of the patient.”

Over half of the patients studied would never have required a referral to the neurosurgical centre meaning unnecessary workload in local A&Es and telephone consultations with neurosurgeons could have been avoided.

Lead Radiology Registrar for the Cheshire & Merseyside Collaborative, Chris McLeavy, said: "The Liverpool HITS Team is proud to have developed such a robust and easy to use scoring system that will streamline head injury referrals. Liverpool HITS will improve communication, reduce unnecessary referrals, give staff more time to spend with sick patients and ensure all head injury patients are managed quickly and effectively."

The University of Liverpool’s Connor Gillespie, who worked on the research project, said: “I’m excited about the implications of Liverpool HITS. We want referring centres to be supported in their decision making, that not all mild head traumas need to be referred to specialists like The Walton Centre, rather provide guidance locally to empower local trauma units how best to manage these patients

“During a time of increasing demand on the NHS this system has the potential to significantly reduce workload without affecting patient care” 

The score has attracted great interest nationally and will be rolled out across the North West and hopefully incorporated into referral processes across the wider NHS.”

To read the full paper online, click here: https://www.tandfonline.com/eprint/G2QSTJ5Y76KYUJDUHJIX/full?target=10.1080%2F02688697.2019.1710825&