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Schoolboy’s dental transformation inspires traumatised children

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A schoolboy who lost his front teeth and suffered serious facial injuries in a holiday water park accident has had his smile restored thanks to Swansea Bay University Health Board’s Community Dental Services team.

Louis Richards, 13, from Bridgend, smashed into a slide at a water park while on holiday with his family in Antalya, Turkey. 

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Louie after his dental transformation (Image: Swansea Bay NHS)

The impact forced three of his front teeth into his nasal cavity, knocking his nose sideways. He received emergency treatment in Turkey and flew back to the UK with a medical brace protecting his teeth. 

Now dramatic before-and-after pictures of Louis are being used to support other children who have suffered dental trauma.

Dr Rohini Mohan, Swansea Bay’s Clinical Lead for Community Dental Services successfully treated Louis at the Neath Port Talbot Resource Centre following the August 2019 incident – and gave him back a perfect smile. 

She took pictures of him before and after the procedure using a telemedicine app that enables dentists to take data-compliant photos of patients’ teeth. 

Dr Mohan said: “The pictures of Louis have been inspirational to show other children who have suffered a trauma that you can come through it. It helps their parents as well. The worst can happen, and you can still come out with a beautiful smile.

“Until they see it on the app, they don’t believe it’s possible.”

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Consultant Connect, the UK’s leading telemedicine provider to the NHS, launched the innovative app with Swansea Bay UHB in March 2021– making it the first region in the UK to trial it for community dentistry.

Hundreds of patients who are vulnerable because they live in remote areas, care homes or have physical or learning disabilities have been helped. 

More than 250 data-compliant photos have been sent on using the PhotoSAF function from dentists to consultants since the app was rolled out. 

Dental therapists on face-to-face appointments can seek advice from specialist consultants using the photo messaging function of the Consultant Connect App. The specialist can tell them whether the patient needs to be referred to see a consultant – or that the problem is minor and can be dealt with by the dentist on the scene.

This swift decision-making saves hospitals and orthodontic specialist sites from unnecessary referrals while also ensuring vulnerable patients with genuinely serious conditions are treated quickly. 

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The service has also been valuable in ensuring patient records and relevant medical documents are easily imported into a patient’s notes.

And it has enabled dentists in smaller clinics which don’t have specialist camera equipment to use the app to take pictures of successful treatments which can then inspire other patients, particularly children. 

Dr Mohan, Swansea Bay’s Clinical Lead for Community Dental Services (Image: Swansea Bay NHS)

Dr Mohan added: “I don’t know what we would do without it now. It’s been a life saver for us, a game-changer. We all count ourselves lucky that we’ve been the first area in the country to use this service in dentistry.

“It’s provided better outcomes to vulnerable patients because the right decisions are made quicker. And it’s been immensely beneficial to take pictures of treatments which can then be shown to other patients.” 

Jonathan Patrick, CEO of Consultant Connect, said: “We’re delighted to be giving such a successful service to dentists, to consultants and ultimately to patients in Swansea Bay. These are challenging times in the health service, and we want to give all patients in Wales the best outcomes possible.”

How it works

Sue Davies, Lead Dental Therapist for the Dental Transformation Programme, Swansea Bay UHB, works three days a week carrying out dental checks on some of Swansea’s 2,500 care home residents.

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Sue Davies, Lead Dental Therapist for the Dental Transformation Programme (Image: Swansea Bay NHDS)

She checks for lesions inside a patient’s mouth. If she finds any, she will use the Consultant Connect PhotoSAF function to take a picture of the lesion. 

She then types in the patient’s NHS number which links the photos to the patient’s records. She can add in notes using a Dictaphone feature or by typing them in. The photos are then saved to the secure cloud – and not to Sue’s phone. 

The photos can then be sent to a clinical lead, such as Dr Rohini Mohan, to check if they need to be referred to the maxillofacial unit in Swansea.

Photos can also be used as a reference point to check if an ulcer is improving or getting worse. 

Sue also checks areas around a patient’s nose and mouth for anything suspicious and if she finds anything of concern also sends on.

And she uses Consultant Connect to print out pictures of patients with poor oral hygiene to help with training and to show to care home managers to make sure they are aware of the issues.

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She said: “The Consultant Connect App is great. I get reassurance from a consultant that I’ve made the right decision and we’re saving time and money. I would definitely recommend Consultant Connect to other dental care professionals.”

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Swansea Bay NHS

Maggie’s making a big difference for adults with learning disabilities

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For over a decade, Maggie Higgins has made a big difference to the lives of people with learning difficulties and hearing loss – contributing to work which can help reduce the risk of them developing dementia.

Her support has even helped one adult hear birds singing clearly once again.

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For others, it helps fulfil their potential and maximise their independence despite any difficulties they may face.

Now her work has been recognised through a major NHS award.

Maggie’s responsibilities within the speech and language service, which is managed by Swansea Bay and hosted in Cardiff and Vale, involves supporting adults with a learning disability, particularly hearing loss.

She has helped improve services around successful assessment, diagnosis and ongoing support for hearing loss, while a key part of her role includes overseeing the Positive Approaches to Supporting the Senses (PASS) group, which she set up with clinical psychologist Dr Sara Rhys-Jones.

PASS works closely with audiology experts to support patients, many of whom have had no concerns highlighted about their hearing, or had not been assisted in attending hearing tests or follow up appointments.

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Significantly, Maggie’s work has led to a sustained sevenfold increase in referrals to audiology services for people with a learning disability – lowering the likelihood of undiagnosed or misdiagnosed hearing losses, which can decrease the risk of developing dementia.

Maggie has helped develop innovative new innovative learning disability and sensory impairment awareness training for professionals, families and carers. (Image: Swansea Bay NHS)

Maggie said: “This is particularly encouraging following a Lancet Commission report in 2020 which identified that ‘unsupported hearing loss is the single greatest preventable risk factor for developing dementia.’

“People with a learning disability are at far greater risk of having undiagnosed or unsupported hearing loss and are known to be three times more likely to develop dementia than the general public.

“I raise awareness and get people seen and supported appropriately to reduce the risk where possible.

“Sensory loss is particularly prevalent and frequently undiagnosed and unsupported amongst people with a learning disability. The responses that might indicate someone has a problem hearing are very often mistaken for characteristics of their learning disability.

“It is essential that we understand what someone can see and hear so that we provide the best possible support. We cannot accurately estimate the impact of a person’s learning disability unless we are aware of what they can see and hear.”

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Now in her 20th year with the speech and language service, Maggie has spent the last 12 years focusing on the impact of sensory loss on people with learning disabilities.

It is an area which she is particularly passionate about.

She said: “When I started this work, the link between unsupported hearing loss and dementia was not known but that was not the primary reason that I started to work on it.

“It was the fact that people weren’t recognising the signs of sensory loss and people were not accessing assessments. The work has become even more important now that we understand there is a link.

“You can’t underestimate the difference it can make to the lives of people with previously undiagnosed issues who go on to have hearing aids fitted.

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“One lady left her hearing aid fitting appointment and burst into tears because she could hear the birds singing.

“It is terribly frustrating for individuals who, given the right support, could be involved to a much greater degree.

“When hearing aids are fitted or communication is adapted appropriately, the difference in people’s ability to engage with others and their environment can be overwhelming to see, irrespective of whether or not they use verbal communication.”

Maggie also created My Hearing Action Plan to help people with learning disabilities and their carers understand their hearing loss and the methods they can implement.

Following diagnosis of hearing loss, Maggie and her team support individuals, carers and staff to understand the impact of that person’s particular hearing loss on their communication and daily living.

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Working with Occupational Therapist Maura Shanahan, she developed innovative learning disability and sensory impairment awareness training for professionals, families and carers, which enables them to experience particular levels of hearing loss.

It has led to an increase in the use of sensory-supportive approaches that help people with learning disabilities improve their health, well-being and quality of life.

Her efforts over the past decade have recently gained recognition in the form of being named the outright winner of The NHS Employers Award at the 2022 UK Advancing Healthcare Awards.

The award category identifies an outstanding achievement by an apprentice, support worker or non-registered technician in an allied health professional or healthcare science service.

She added: “I was totally amazed to be shortlisted, let alone win the award in my category.

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“I have thoroughly enjoyed working in the speech and language service for 20 years, so it was a really lovely way to celebrate that landmark.

“Working with adults with a learning disability is an absolute privilege.”

(Lead image: Swansea Bay NHS)

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Morriston

New regional centre at Morriston Hospital to treat lung conditions given go-ahead

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photo of doctor holding x ray result

Plans for a new multi-million pound Adult Thoracic Surgical Centre for South Wales can go ahead at pace following a major boost from Welsh Government.

The new centre, to be based at Morriston Hospital, Swansea, will treat lung cancer patients and others who need surgery for a range of chest conditions.

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It will be able to operate on an increased number of patients, potentially upwards of 20% more, and will be the third largest centre in the UK.

Following extensive public consultation in 2018, it was agreed that the new centre will provide a single service for South Wales for residents living in the Swansea Bay; Hywel Dda, Cwm Taf Morgannwg; Aneurin Bevan, Powys and Cardiff and Vale Health Board areas. The centre is expected to be open within the next three to five years.

Patients will be treated as much as possible within their local health board area, only having to travel to the Morriston centre for pre-admission assessment and the surgery itself.

The endorsement of the proposal by the Minister for Health and Social Services, Eluned Morgan will enable the next key stage – the development of detailed plans – to now get underway.

Siân Harrop-Griffiths, Swansea Bay University Health Board’s Director of Strategy and project lead, said: “Developing this scheme and getting the agreement of all the clinicians and organisations across South Wales has been time consuming and complex.

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“But we are delighted that this endorsement by the Minister means we can now take this work forward at pace to provide better thoracic surgical services for everyone across South Wales.”

Malgorzata Kornaszewska, Consultant Thoracic Surgeon at Cardiff and Vale University Health Board and Clinical Lead for the South Wales Adult Thoracic Surgical Services Programme said: “The new centre will be a centre of excellence with access to modern technology, and will be able to offer a comprehensive, modern, timely and high standard service to our patients.

“It will also create an excellent opportunity for teaching, training and research. This is an exciting time for the thoracic teams and Welsh thoracic patients.”

The South Wales Adult Thoracic Surgery Centre will standardise the delivery of these services across South Wales, improving the long-term sustainability of the service.

Having the specialist service in one dedicated centre will improve equity of access and patients’ experiences, and most importantly provide better health outcomes.

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The single site thoracic surgery centre will be designed in line with best practice and the recommendations of various reviews and consultation processes.

As a centre of excellence, it will provide dedicated thoracic surgery to meet national standards, enabling sub-specialisation of surgeons, which in turn will enable a higher standard of complex surgical procedures to be performed.

All health boards in South Wales, led by Swansea Bay UHB, have worked together alongside the Welsh Ambulances Services Trust and community health councils to develop and agree a plan to develop this new unit at Morriston Hospital.

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Morriston

Carpenter still at work after nearly slicing off his fingers says thanks to Morriston Hospital

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A retired carpenter who almost sliced off his fingers is still crafting away in his workshop thanks to the skill of Morriston Hospital staff.

Colin Taylor was working on turning a piece of wood into a teapot-shaped plant potholder when his wood cutter slipped and went into his hand.

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But despite slicing two fingers through to the bone, he is not just busy in his garden workshop but has also rediscovered his artistic skills as a way of thanking hospital staff.

The 73-year-old said: “I had put the wood in a vice and started shaping it with an electric cutter. I had a new blade which was able to cut everything including metal.

“It had gone well, when I had an itch on my nose and went to scratch it. I took my hand off the cutter and it cut across the timber and across my hand.

“There was blood spurting up in the air. I knocked the cutter off immediately, and my wife called my daughter who is a good first aider. She came up and my fingers were hanging off. I’d damaged them all, but particularly my middle and index finger, and had severed two tendons.

“My daughter took me to Prince Charles Hospital in Merthyr but they contacted Morriston Hospital who told me to come down straight away.

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“From the moment I went in it must have been the best treatment in my life. The people were so nice and courteous. I was seen to first by a young lady who cleaned me up, and then the doctor came and took a look at it and said I’d have to have an operation.

“They injected my finger and the operation didn’t take too long, and I went home and my left hand was in a plaster for in six weeks. The surgeon fixed the tendons.

“It is not 100%, but it is what it is. I have got to get on with it. It’s a bit stiff in the morning and I can’t bend my middle or index finger like I used to.”

The grandfather of three has since produced a couple of paintings which he has presented to staff at Morriston Hospital by way of thanks.

He added: “I did some painting a long time ago. I always enjoyed painting and carpentry, although I know I’m no Picasso.

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“But the people in hospital were so good to me I just wanted to do something to thank them.

“I’m not surprised the NHS has such a good reputation with people like that working there.”

Specialist hand physiotherapist Iona Davies added: “Following surgery and initial assessment at Morriston Hospital, Mr Taylor was able to access our specialist hand therapy services virtually, at a time when local therapy services were constrained due to Covid.

“This eliminated the need for him to travel from Tredegar, where he lives and cares for his disabled wife.

“He has been dedicated to his rehabilitation and exercises, and as a consequence has been able to achieve his treatment goals, returning to woodwork and painting. The outcome following such an injury is dependent as much on patient’s motivation and commitment as it is on surgical skill and therapy input.

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“We were delighted to receive his gift.”

Lead image: Colin and daughter Heather with the painting of Morriston Hospital (Image: Swansea Bay NHS)

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