Impact of Tommy's clinics

Our NHS-supported clinics deliver high quality specialist pre-conception and pregnancy care, recruiting families to clinical trials and putting our latest research findings into practice.
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All of our clinic work has the goal of improving health outcomes and developing evidence based practice to reduce the number of babies who die during pregnancy or birth.

Tommy’s funds 5 pioneering research centres across the country. As part of our innovative research model, each research centre is associated with a number of NHS antenatal clinics and recurrent miscarriage clinics. At these clinics, members of our research team translate medical research into clinical practice in real time. This means that patients can access cutting-edge clinical care, as well as have the opportunity to participate in medical trials.

Tommy’s National Centre for Miscarriage Research

Tommy’s National Centre for Miscarriage Research runs recurrent miscarriage clinics across 3 different sites in the UK.

At our recurrent miscarriage clinics, women and their partners are given the opportunity to take part in research trials, accessing cutting-edge treatments and tests. 

“The staff at the Tommy’s clinic at Birmingham Women’s Hospital seemed to understand how we felt and didn’t diminish what we’d been through. For the first time we felt hope. In the end, Tommy’s gave us more than hope; they gave us our rainbow baby.”

Kirsty from Preston had 3 miscarriages before she was referred to Tommy’s National Centre for Miscarriage Research clinic in Birmingham. Read Kirsty’s story here.

  • High patient satisfaction levels: 100% of patients attending the clinic reported that they would be likely or extremely likely to recommend our services to friends and family if they needed similar care or treatment (Birmingham Women’s and Children’s NHS Foundation Trust Friends and Family Test survey).
  • 100% reported that our clinical staff always explained things in a way that they could understand and expressed that they had always been kept informed about their care in a way that they could understand and found acceptable.
  • At our Coventry clinic, 100% of patients reported the service given as excellent and said they would recommend it to a friend in a similar situation. 78% felt that the services that they had received had helped them a great deal to cope more effectively with the problem and the remaining 22% felt somewhat helped. If they were to seek help again, 92% said they would definitely return to the services and the remaining 11% thought they would do so.
  • Numbers of patients seen in the clinics: In total, our clinics saw around 16,099 patients between 2019-2020. Approximately 80% of patients attending our clinics over the past year were from the local population and 20% from elsewhere in the UK and even abroad.
    • New recurrent miscarriage referrals: 8,102
    • Early pregnancy consultations: 7,997
  • Individuals recruited to pregnancy-related clinical trials: In total 1,788 individuals were recruited over the past year to pregnancy related clinical trials in progress at our centres. (Birmingham: 491, Coventry: 984, Imperial: 313).

Tommy’s Manchester Research Centre

Our dedicated team of researchers in Manchester run a network of 5 research clinics. At our clinics, we offer specialist care to women at high risk of pregnancy loss. These women have a chance to take part in clinical studies that improve our understanding of stillbirth, fetal growth restriction, hypertension (high blood pressure) and diabetes. The clinics allow us to translate research breakthroughs into clinical practice.

Our model is very successful. Since 2010, our research centre has reduced the stillbirth rate in the Greater Manchester area by 32% against a much lower national average rate of reduction.

 

At our clinics, we offer patients the latest evidence-based tests and treatments, and give them the opportunity to participate in clinical trials to advance our life-saving research. In 2020, we:

  • Performed 5,300 ultrasound scans in our clinics; which equates to approximately 442 women scanned per month, and is over a 1,000 more than in 2018/19.
  • Recruited a total of 1,999 participants to clinical trials at our centre (661 to trials funded by Tommy’s and 1,338 to trials funded from external sources)
  • Improved our patient score from an average of 88% in 2019 to 100% of the women surveyed so far this year saying that they would recommend our clinics to friends and family.
  • Are seeing more women from Black and minority ethnic origin: 15% of women seen in our research clinics are Black, and 19% are of Asian origin, compared to 12% and 17% of women seen at St Mary’s Hospital respectively.

“The Rainbow clinic scans were so reassuring. We don’t know why our daughter died at full term but we had been told its likely due to the placenta failing. Alex’s scans and explanations of how the placenta is working has reassured us so much."

We have now treated 35 women with Chronic Histiocytic Intervillositis (CHI) attending the research clinics who have received a bespoke treatment plan for this condition. To date, all pregnancies continuing beyond 20 weeks’ gestation ended in a live birth. This is particularly remarkable given that CHI is a condition with a 50% mortality rate.

  • Over the eight years that the translational clinics have been in place at St Mary’s Hospital, there has been over 50% reduction in the number of babies with Fetal Growth Restriction born after 38 weeks.
  • The Rainbow Clinic, which provides specialist support in pregnancy following a stillbirth or neonatal death, has now been adopted by all maternity care providers in the Greater Manchester Strategic Clinical Network. There are 13 active Rainbow Clinics, with another 3 ready to launch and 21 clinics in development.
  • Since 2015, the stillbirth rate across the Greater Manchester and East Cheshire Strategic Clinical Network fell by 19% from 4.64 per 1,000 births in 2015 to 3.8 per 1,000 births in 2019, which is greater than the national rate of decline. 

“We can’t thank you enough for seeing us with our 2nd pregnancy. You’ve given us hope to dream again, that we might actually bring home Eliza’s sister. Thank you. Totally worth the 3-hour drive each way. We’d do it again in a heartbeat.”

Tommy’s London Research Centre

Our research centre in London is home to 3 flagship research clinics which provide exemplary evidence-based care to women with high-risk pregnancies and improve outcomes for mothers and babies.

The clinics provide best-practice care and recruit women to participate in research. The information and samples collected are vital for our researchers, enabling them to explore promising areas and make significant discoveries that will improve the chances of at-risk babies.

  • Tommy’s Preterm Surveillance Clinic
  • The Hypertension in Pregnancy (HiP) Clinic
  • Diabetes in Pregnancy Clinic

 

Clinic highlights 2020

  • Complex case referrals: In 2019, the clinic received approximately 12-15 new high-risk referrals per month.
  • Patients accessing specialist care: In total, over 1000 patients received care at our specialist hypertension clinic in 2020, meaning that approximately 20 women per week are receiving improved care pathways
  • Individuals recruited to pregnancy-related clinical trials: In total, 423 women were recruited over the past year to clinical trials

The CHAMPION study interviewed women with chronic hypertension about their experiences of antenatal care at three different NHS Trusts: Our specialist clinic saw significantly higher rates of target blood pressure documentation (77% vs 23% and 38% respectively). Our unit was the only unit to provide women with an information leaflet about hypertension in pregnancy. Women in our clinic saw the same doctor and midwives at every appointment. In clinics at other units where this did not happen, women reported lower satisfaction.

Best practice for shared decision-making was established at our clinic which formed the basis for the development of the shared decision-making tools that have been endorsed by NICE hypertension in pregnancy guidelines and available for all centres to use.

  • Since March 2020, during the peak of the COVID pandemic, the prevalence of gestational diabetes (GDM) in our centre rose from 16% to 26% of women screened with the oral glucose tolerance test (OGTT), resulting in more than 400 women in our clinic between March and August alone. We are currently undertaking an evaluation for pre, during and post COVID. We have supported around 900 women in 2020 through our clinic.
  • 20 staff were trained in 2020 in the diabetes clinic.
  • We recruited a total of 425 women to clinical trials in diabetes and metabolic diseases of pregnancy.

Since Oct 2019 we have been caring for most of the women in the clinic with gestational diabetes virtually. We are currently preparing a user survey to assess satisfaction in order to improve the service.

We began the use of the GDm-Health app in our clinic prior to COVID-19 and benefitted enormously from its use during the pandemic when all care had to be delivered virtually. As we had instituted the app prior to the pandemic, we have been able to share our experiences and protocols with other Trusts. Catherine Williamson, Helen Murphy and Catherine Nelson-Piercy spoke about new research findings that have influenced clinical practice at the Fetal Medicine Foundation webinars during the Covid pandemic (approximately 6,000 attendees internationally) and at the RCOG and Macdonald Obstetric Medicine Society Education webinars (approximately 1,500 participants).

  • Thousands of high-risk patients accessing specialist support: In 2020, approximately 3,120 women were seen in our clinic, equating to 60 women seen per week
  • We receive over 60 new referrals each week – half of which are from outside the area and are from both the UK and abroad. 
  • Approximately 10 new staff trained in the clinic each year, with monthly visits from outside NHS staff to learn how we run this specialist clinic
  • Cutting-edge procedures: transabdominal cerclage service now established and commissioned to perform 50 procedures per year. The procedure has been increased in the clinic to weekly (including 20 performed over the lockdown period).
  • All women are receiving QUiPP app screening through our clinic, which was developed at our London centre to better predict and prevent preterm birth. 
  • Individuals recruited to pregnancy-related clinical trials: In total, 351 women were recruited over the past year to preterm birth related clinical trials.

Tommy’s Edinburgh Research Centre

Our research centre in Edinburgh is home to 2 flagship research clinics which provide evidence-based care to women with high-risk pregnancies and improve the chances of mothers having a healthy baby.

 

Clinic highlights 2020

In 2020, we:

  • Supported over 550 women in our Tommy’s clinics (15% of all women delivering at Royal Infirmary Edinburgh)
  • Recruited over 400 women to clinical trials
  • Embedded NHS support within both the metabolic and preterm birth clinic

 

  • In 2020, our specialist clinic received 304 new patient referrals and supported 271 women. There were over 1,550 appointments. The clinic follows high risk pregnancies very carefully, detecting potentially life-threatening problems early so they can offer timely intervention, personalised treatment and careful monitoring of the pregnancy. Of those referred, 17 (5.6%) had a first trimester loss prior to their clinic review. 
  • Feedback from women who attend is universally positive with 100% of women being either very satisfied or satisfied with their overall experience.
  • We continue to innovate and optimize care delivery for women to attending our clinic. Changes over the past year include aligning our care pathway with the RCOG guidelines for managing pregnancy in the obese (which we led), and the virtual diabetes clinic which has been increasingly used during the Covid-19 pandemic.
  • 160 women at very high risk of preterm birth were referred to the clinic.
  • Over 150 were recruited to clinical trials.
  • Eleven staff have been accredited for cervical length scanning as a result of training through the preterm birth clinic. Obstetric trainees attend our clinic every week for training in the management of women at risk of preterm birth.
  • We have started offering postnatal counselling for women in Lothian who have a preterm birth or pregnancy loss below 28 weeks.
  • We have increased third trimester attendance at the clinic in response to feedback from women and evidence that continuity of care reduces preterm birth. 
  • We offer all women without a contraindication to aspirin prophylactic aspirin. We offer smoking cessation consultations within the clinic.
  • We are contributing to the implementation of the Best Start Maternity Strategy and in discussions with Scottish Government about pathways of care for women at risk of preterm birth.