Tommy's has state of the art NHS clinics in all four of our research centres: London, Manchester, Edinburgh, and our National Centre for Miscarriage Research.
The Tommy’s Preterm Surveillance Clinic
Run by Professor Andrew Shennan, the Tommy’s Preterm Surveillance Clinic at Guy’s and St. Thomas’ Hospital has been providing specialist care to women at risk of preterm birth for over 10 years. Experts state that rolling out this clinic’s model nationally could prevent almost 9,000 premature births each year in the UK. In 2017, the total number of referrals from women at high risk of giving birth too early doubled compared to 2016. We are now seeing an average of 200 referrals each month.
Read more about the Preterm Surveillance Clinic
This unique Preterm Surveillance Clinic – funded by Tommy's as part of our research at St Thomas' Hospital, London – has won an NHS Innovation Challenge Prize for its success in reducing the number of premature births in South East London. Over 10 years, the clinic has reduced premature birth locally and regionally by 10%. It remains the most research-active prematurity clinic in the country.
The clinic’s work on the QUIPP application – a tool that can help clinicians assess pregnant women at risk of premature birth – won a further two prizes in 2016:
- 1st prize – Health Tech Innovation Award King’s College London Lion's Den Challenge
- 1st prize – Health Service Journal Award for the use of IT to drive value in clinical services
The impact of the clinic
- Over 90% of high-risk women seen at the clinic have had a healthy baby at full-term, compared to a national average of 50-70% of women.
- Despite increasing referrals of high risk women, there has been a 21% reduction in preterm births at St Thomas’ Hospital in the last year.
- Now the largest preterm clinic in the world, it has influenced development of similar specialist clinics in the UK (London, Birmingham, Liverpool, Manchester and Belfast) and abroad (USA, China and India).
- The clinic has pioneered a test that more accurately predicts preterm birth in women at risk. The test, developed by Hologic, measures the exact level of a protein known as fetal fibronectin (fFN) that reliably indicates whether a woman will give birth prematurely, and as such has led to significant cost-savings. For each patient admitted from the pre-term clinic, the test saved an average of £1,800 per patient because many women didn’t receive unnecessary treatment and could be discharged home. Given the expense of the 60,000 premature births per year in the UK, the national uptake of this new test could lead to national NHS savings of over £100 million a year.
The Hypertension in Pregnancy Clinic
Based in St. Thomas’ Hospital and led by Professor Lucy Chappell, the hypertension in pregnancy (HiP) clinic gives specialist care to pregnant women with high blood pressure (hypertension). Since it opened in May 2015, the clinic has seen over 150 women, who directly benefit from the research taking place in Tommy’s centres.
The Diabetes Clinic
The Tommy’s Diabetes Clinic at Guy’s and St. Thomas’ Foundation Trust works to help women with gestational or pre-existing diabetes, and as well those suffering from endocrine disease and other disorders like obstetric cholestasis. These increase the risks of stillbirth, pre-eclampsia, and premature labour.
The vital research carried out in the clinic has been a driving force for the adoption of universal screening for gestational diabetes. We are one of the largest centres in London which now practice this screening strategy. It has increased the detection rate of gestational diabetes threefold and we are optimistic that this will lead to improved pregnancy outcomes.
The Placenta Clinic
In 2009, we opened the UK’s first placenta clinic run by Dr Alex Heazell, which works with pregnant women whose babies have growth restriction. After 9 years and over 10,000 appointments, the Manchester Placenta Clinic has fulfilled its goal of becoming a hub for research into fetal growth restriction both in St. Mary’s Hospital and the North West region.
Read more about the Placenta Clinic
We monitor and care for women throughout their pregnancy, and study the placenta to find the links between the baby’s life-support machine, growth restriction, and stillbirth.
Problems with the placenta can affect a baby’s growth, causing fetal growth restriction. This happens in around 5% of all pregnancies, and can lead to miscarriage or stillbirth – but we believe it can be discovered early on, giving the baby the best possible chance.
The clinic keeps on growing, and we now see more than 1,000 women a year. As well as conducting its own research, it also helps recruit women for other, national trials. In the STRIDER study on sildenafil, a drug that could be used to treat fetal growth restriction, the Tommy’s Placenta Clinic recruited 41 of the 126 women involved. Findings from our research can be put into practice straight away, so women can benefit from medical advances as fast as possible.
The Rainbow Clinic
The Tommy’s Rainbow Clinic, established in 2013 at St. Mary’s Hospital, provides specialist care and support for parents who have suffered a stillbirth or neonatal death. Run by Dr Alex Heazell, the clinic has been so successful that we have now opened a second Rainbow Clinic at Wythenshawe Hospital in South Manchester. This has enabled us to increase the number of families who can access the Rainbow Clinic by 30%.
Read more about the Rainbow Clinic
Becoming pregnant after a stillbirth is an incredibly daunting prospect. Around half of all stillbirths are unexplained, leaving parents feeling powerless to stop it happening again.
The standard of care given to women who have suffered a stillbirth varies a lot. Women can be left having to explain over and over again what they have gone through.
Tommy’s decided that this could not continue. That’s why, in 2013, we set up the Rainbow Clinic at St. Mary’s Hospital in Manchester. Here, we give women who have had stillbirths the best possible care, to help them have safe, healthy pregnancies.
Our Rainbow Clinic has now seen over 500 families, and cares for 150 women every year. For every £1 invested, the Rainbow clinics provides specialist care for women who fall pregnant following a stillbirth, generated £6.10 of value, particularly improving the psychological wellbeing of women and their families.
In March 2017, we held a study day for medical professionals from over 25 units in the UK. Six of these units now have the resources to open Rainbow Clinics where they are.
The Lupus in Pregnancy (LIPs) Clinic
As part of the Manchester suite of clinics, Tommy’s is supporting this specialist clinic run by Dr Clare Towers. The clinic helps women with the autoimmune disorder Systemic Lupus Erythematous, and related diseases. These increase the risk of problems such as pre-eclampsia, premature birth and growth restriction. Tommy’s supports the clinic through access to our research midwives.
The Manchester Antenatal Vascular Service (MAViS)
Run by Jenny Myers at St. Mary’s hospital in Manchester, this clinic gives extra monitoring and pregnancy care to women with a history of high blood pressure, and those at risk of related complications. MAViS is currently home to exciting research funded by the National Institute for Health Research. Tommy’s supports the clinic through access to our research midwives.
Tommy's Metabolic Antenatal Clinic
In 2008, Tommy’s funded a specialist clinic to help women with severe obesity to have safe and healthy pregnancies. The Metabolic Antenatal Clinic is home to specialists in pregnancy care and diabetes, as well as midwives and a specialist dietician. It is constantly growing, and now provides care to 25-30 women every week. Last year, women attending the Tommy’s clinic were an astounding eight times less likely to have a stillbirth than women attending clinics not specialised in helping obese women.
The care provided in the clinic includes frequent check-ups of mothers and babies, as well as personalised advice about healthy eating. We also educate women about the risks involved in obese pregnancy.
Read more about the Metabolic Antenatal Clinic
Obese women have a higher risk of complications during pregnancy including gestational diabetes and high blood pressure. Currently in England around half of all women of childbearing age are either overweight or obese. The role of clinics like this is crucial in helping women who face these risks, to give their babies the best chance at health in both the short and long term.
As well as lowering the rate of stillbirth, women attending the clinic were also less likely to have a baby with a low birth weight, and more likely to have their blood sugar tested. Blood sugar testing is important to check whether expecting mothers have diabetes – the earlier we know, the more we can do to make sure mother and baby stay healthy.
The clinic is an example of clinical excellence both nationally and internationally. It provides what we believe to be the optimal clinical care for obese pregnant women. This year, it has been visited by doctors from as far as India and Australia who want to learn how the clinic is helping lower the risks of obese pregnancy.
Throughout 2017, the clinic has been looking at the risks of obese women developing type 2 diabetes after giving birth. From studying a database of 858 women with a BMI of 40 or more, we found that having gestational diabetes results in a sevenfold increase in the rate that type 2 diabetes develops.Hide details
Tommy's Lothian Preterm Birth Clinic
The success of our metabolic antenatal clinic prompted us to open our new Preterm Birth Clinic in October 2016; the first of its kind in Scotland.
The aim of the clinic is to continue Tommy’s work in reducing preterm birth rates and late miscarriage rates, to improve the quality of care for women and to develop our expertise in managing complex cases.
Read more about the Lothian Preterm Birth Clinic
We know that continuity of care is so important. Women in Lothian are now able to attend a clinic where they can have investigations, treatment and ongoing support within the same setting.
At the moment we see women at the highest risk of preterm birth. We offer assessment and individualised treatment, and well as ongoing support and counselling. Women at the highest risk of preterm birth or late miscarriage (a miscarriage that happens after 14 weeks of pregnancy) can have treatment to prevent pregnancy loss and preterm birth, personalised to their preferences.
In our first year, we have had in excess of 100 referrals and 49 deliveries. We’re pleased to report that 45 women have participated in our research studies.
Miscarriage is the most common complication of pregnancy: one in four women experience at least one miscarriage during their lifetime. The work of Tommy’s National Centre for Miscarriage Research is therefore personally relevant to millions of families across the UK and beyond.
Tommy’s National Centre for Miscarriage Research spans three universities and four hospitals, all with a passion for better understanding miscarriage and improving the lives of those who experience early pregnancy loss.
Our aim is to make a significant reduction in preventable miscarriages in the UK, especially among couples with a history of recurrent miscarriages. Every year we care for 24,000 couples with early pregnancy complications. We aim to make a difference by finding answers for these families.
Our clinics are based in:
- Birmingham Women’s Hospital
- University Hospital Coventry and Warwickshire
- St. Mary’s Hospital London
- Queen Charlotte’s and Chelsea Hospital London