Staff Publication

Introducing Structured Bedside Teaching for Resident Doctors PDSA 1 (2026)

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Type of publication:

Service improvement case study

Author(s):

*Rameesha Hussain, *Prajakta Jahagirdar

Citation:

SaTH Improvement Hub, May 2026

SMART Aim:

To increase structured bedside teaching for resident doctors from a baseline of 0 sessions per month to at least one structured session per month, and to improve learner satisfaction, by July 2026 through stepwise PDSA cycles.

Link to PDF poster

Elective Hub High Flow Theatre List: Combined Robotic & Non-Robotic Double HIT List (2026)

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Type of publication:

Service improvement case study

Author(s):

*Saurav Chakravartty, *Adam Farquharson, *Rebekah Tudor

Citation:

SaTH Improvement Hub, June 2026

SMART Aim:

To improve elective performance by increasing cases per list and achieving >85% theatre utilisation on 23 June 2026.

Link to PDF poster

Routine pre-operative CT imaging in Grade 2 endometrial cancer: A two-year retrospective review of clinical impact (2026)

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Type of publication:

Conference abstract

Author(s):

*Alayande G.

Citation:

BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BGCS 2026 Book of Abstracts. Bristol United Kingdom. 133(Supplement 2) (pp S14), 2026. Date of Publication: 01 Jun 2026.

Abstract:

Background: The British Gynaecological Cancer Society (BGCS) guidance does not recommend routine pre-operative CT imaging in low-grade endometrial cancer due to its low diagnostic yield and limited impact on outcomes. At Shrewsbury and Telford Hospital NHS Trust, however, all patients with confirmed Grade 2 (or higher) endometrial cancer undergo preoperative CT-TAP in line with local guidance.
Objective(s): To assess adherence to local guidance and determine whether pre-operative CT influences gynaecological management. A secondary aim was to evaluate the frequency and consequences of incidental findings.
Method(s): We retrospectively reviewed patients diagnosed with Grade 2 endometrial cancer between April 2023 and May 2025 using the Somerset Cancer Register. Patients diagnosed postoperatively were excluded. Electronic records were examined to assess whether CT findings altered management, defined as referral to a tertiary centre.
Result(s): Of 52 identified patients, 46 met inclusion criteria. All underwent pre-operative CT imaging. Findings suggestive of metastatic disease were reported in 13% (6/46), prompting tertiary referral in four surgically fit patients; one was later found to have stage IA disease, representing potential overtreatment. Incidental findings occurred in 45% (21/46), with 38% (8/21) requiring further investigation. Most were clinically insignificant, though one led to a new breast cancer diagnosis.
Conclusion(s): In this cohort, routine pre-operative CT imaging in Grade 2 endometrial cancer influenced management in a clinically meaningful way. Nevertheless, potential overtreatment and the implications of incidental findings should inform imaging decisions.

DOI: 10.1111/1471-0528.70281

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Risk mitigated day case total thyroidectomy for thyrotoxicosis: analysis of factors allowing same day discharge (2026)

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Type of publication:

Journal article

Author(s):

*Crossdale M.; *Walkden G.; *Hari C.

Citation:

Ambulatory Surgery. Conference: British Association of Day Surgery Annual Conference. London United Kingdom. 32(3) (pp 185), 2026. Date of Publication: 01 Jul 2026.

Abstract:

Introduction The day case potential of total thyroidectomy has been limited by three primary risks: post-operative haemorrhage, recurrent laryngeal nerve injury with subsequent airway embarrassment and symptomatic hypocalcaemia. In response to rising elective backlogs, transitioning to a day-case model offers significant resource optimisation and improved patient satisfaction. We present the initial outcomes of a pilot day-case total thyroidectomy pathway within an NHS Trust. Methods Five consecutive patients underwent total thyroidectomy under a standardised day case protocol. The pathway prioritised: * Patient selection and education: strict surgical, anaesthetic and social criteria, informed consent and education around day case management. * Pre-operative optimisation: prophylactic loading with oral calcium and alfacalcidol. * Surgical strategy: meticulous surgical strategy (advanced bipolar techniques, haemostatic adjuncts, and Valsalva manoeuvres) to avoid drain insertion. * Biochemical monitoring: immediate post-operative PTH and serum calcium measurement. * Intended same day discharge: minimum postoperative stay 6 hours and until 20:00. * Post-operative safety net: discharge on a calcium/ alfacalcidol regimen with day one telephone follow-up and mandatory 48-hour biochemical review. Results The pilot achieved a 100% same-day discharge rate (n = 5). No post-operative haemorrhages or hematomas occurred. One patient was readmitted following the 48-hour review for mild hypocalcaemic symptoms, requiring one night of oral optimisation. The remaining four patients remained asymptomatic with stable biochemistry. Conclusion Preliminary results suggest day-case total thyroidectomy is feasible for selected patients when supported by a pathway that mitigates post-operative anaesthetic and surgical risks. While hypocalcaemia remains a concern, prophylactic supplementation and structured follow-up facilitate safe management in an ambulatory setting.

Resolving inflammatory bowel disease risk variants to genes and cell types (2026)

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Type of publication:

Journal article

Author(s):

Fachal L.; Zhang R.; Gettler K.; Haritunians T.; Cleynen I.; Stevens C.R.; Zhang Q.; Tastad C.; Medici C.; Do R.; Abreu M.T.; Achkar J.-P.; Ahmad T.; Kok K.B.; Bernstein C.; Brooks J.; Bujanda L.; *Butterworth J.; Clark K.; Cummings F.; D'Amato M.; Buono J.D.; Duerr R.H.; Ellinghaus D.; Foley S.; Franchimont D.; Franke A.; Hancock L.; Hart A.; Hooper P.; Irving P.; Jarvis M.; Johnston E.; Julia A.; Kemp C.; Kennedy N.; Kupcinskas J.; Latiano A.; Lewis J.; Li A.; Limdi J.; Louis E.; McLaughlin J.; Moayyedi P.; Moran G.; Mowat C.; Newman B.; Oglesby A.; Pekow J.; Perez K.J.; Pollok R.; Prescott N.; Radford-Smith G.; Raffals L.; Raine T.; Ramadas A.; Ramakrishnan S.; Reinisch W.; Newberry R.D.; Rogler G.; Sands B.E.; Satsangi J.; Scharl M.; Schreiber S.; Selinger C.; Shedwell S.; Silverberg M.S.; Singh S.; Steed H.; Steel A.; Uhlig H.; Verma A.; Vermeire S.; Weersma R.K.; Xavier R.; Halfvarson J.; Daly M.J.; Lamb C.; Parkes M.; Huang H.; Lee J.; McGovern D.P.B.; Rioux J.D.; Anderson C.A.; Cho J.H.

Citation:

medRxiv. (no pagination), 2026. Date of Publication: 13 May 2026.

Abstract:

Inflammatory bowel diseases (IBD), principally Crohn's disease (CD) and ulcerative colitis (UC), are common chronic disorders involving inflammation and often progressive tissue damage. Genome-wide association studies have mapped many risk signals, but the causal variants, effector genes and relevant cellular contexts remain difficult to resolve, limiting mechanistic interpretation and therapeutic translation. Here we performed a multi-ancestry GWAS meta-analysis of 125,992 individuals with IBD and more than 1.2 million controls, identifying 619 independent association signals (374 novel) at 420 IBD regions that account for 77-80% of SNP-based heritability. Fine-mapping resolved 81 high-confidence variants, 41 not previously reported. Although most signals were shared between CD and UC, 39% showed subtype specificity, with UC signals showing stronger enrichment in functional annotations from intestinal epithelial, secretory and enteroendocrine cells, and CD showing stronger genetic correlations with circulating inflammatory biomarkers, including C-reactive protein and glycoprotein acetylation. Latent causal modelling supported a causal effect of decreased high-density lipoprotein on CD risk. By integrating bulk and single-cell eQTL and pQTL resources using colocalisation and Mendelian randomisation, together with coding-variant evidence from exome sequencing, we prioritised 664 candidate effector genes across 341 signals, including 390 newly implicated IBD genes, revealing new biological mechanisms and candidate therapeutic targets supported by human genetics.

DOI: 10.64898/2026.05.13.26352926

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Melphalan dosing in autologous stem cell transplant. Should we still dose adjust for older patients? (2026)

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Type of publication:

Conference abstract

Author(s):

Lloyd R.; McIlroy G.; Odusanmi S.; Litt E.; Swart-Rimmer I.; Shafeek S.; Jouni H.; Ahmad H.; Smith L.; Wandroo F.; Ferguson P.

Citation:

British Journal of Haematology. Conference: 66th Annual Scientific Meeting of the British Society for Haematology. Liverpool United Kingdom. 208(Supplement 1) (pp S48), 2026. Date of Publication: 01 Apr 2026.

Abstract:

Background: High dose melphalan with autologous stem cell transplant (ASCT) has formed the basis of consolidation therapy in newly diagnosed multiple myeloma for around 2 decades. In the UK, patients deemed fit for transplant are prescribed either 200 mg/m2 (HImel) or 140 mg/m2 (INTmel) of melphalan based on renal function or age. As populations remain fit into older age, more patients >=65 have been treated with 200 mg/m2 melphalan. There is a lack of evidence base in this population. Analysis aims to determine if there is any difference in efficacy and toxicity in treating patients >=65 with high dose melphalan in a ASCT.
Method(s): Patients with multiple myeloma treated with single agent melphalan ASCT between 2013 and 2023 were included in data collection. Patients undergoing second or tandem autologous transplants were excluded. Dosage of melphalan was decided by the clinician at the time of review. Primary endpoints were PFS and OS, secondary endpoints were toxicity and length of hospital stay.
Result(s): 679 patients were eligible with an average age of 61.14 years. A total of 446 patients received HImel with 85 of these >=65. 232 patients received INTmel with 189 of these >=65. 20 patients were admitted to ITU (2.9%), 4 patients were >=65 with 2 receiving HImel and 2 receiving INTmel. 6 patients (0.88%) died from transplant related complications. 3 of these patients were <65 and received HImel. 3 patients were >=65 and 1 received HImel. There was a significant difference in the length of admission for the <65 HImel group compared to the >=65 HImel group (18.1 vs 21.2days, p value=000286). This difference was not replicated in the INTmel group 21.3 vs 21days. (p-value 0.404328). Overall, there was a statistically significant shorter length of stay for the <65 cohort compared with the >=65 cohort (p value 0.00057). There was no statistically significant difference in overall survival between the groups (<64 HImel 88 months, <65 INTmel 74.3 months, >=65 HImel 74.71 months, >=65 INTmel 73.7 months). There was no significant difference in PFS between the groups (<65 HImel 53.8 months, <65 INTmel 50.4, >=65 HImel 57.46, >=65 42.09 months).
Conclusion(s): The study demonstrates that there is no OS or PFS advantage with treating older patients with high dose melphalan. There were longer hospital stays associated with increasing age. Patients who present older, but still fit for transplant have little evidence on the best way to proceed with treatment.

DOI: 10.1111/bjh.70471

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