Mr Richard Krysztopik South West The South West region comprises Devon, Cornwall, Somerset, Wiltshire, Avon and Gloucestershire. Our UGI cancer surgical centres are Plymouth, Bristol and Gloucester. An additional 10 DGHs form our cancer networks, divided between the two cancer alliances of Peninsula and SWAG. Although cancer is rightly an important part of our regions work, our network of hospitals includes enthusiasts and leaders in bariatric and benign UGI surgery. Research and education are strong interests.ROMIO and ByBand Sleeve continue to recruit and lead the way in pragmatic research. Education and collaboration have been seen in benign UGI surgery, with a regional meeting on severe acute pancreatitis. A multidisciplinary gathering involving intensivists, gastroenterologists and surgeons – leading to guidelines for care and tentative steps to a regional network for managing this difficult condition. On 4th July 2018, AUGIS will be hosting a benign UGI education day in Bristol, for our senior trainees and consultants. Barrett’s, bariatrics, bile duct stones and pancreatitis – something for everyone. Next year, we are planning a meeting onrefluxanditssurgicalmanagement. Education and collaboration have been hugely enjoyable and largely lead by the interest and enthusiasm of our regions clinicians and AHP’s. As your regional representative, I welcome your ideas, suggestions and comments. richard.krysztopik@nhs.net Mr Iain Cameron Trent The summer holidays are fast approaching and it has been a really busy first half of the year both locally and nationally for AUGIS. In April I attended the council meeting in London with Dawn Drury, who has been appointed as the Allied Health Professional (AHP) lead for the Trent region. We gave a joint presentation regarding our plans for the AHP group and our first task will be to appoint a deputy to work with Dawn, with a complimentary specialist interest. We have 11 AUGIS members in the Trent AHP group, the majority of whom are cancer Clinical Nurse Specialists (CNS) and our aim is to expand both the number and breadth of the membership. At a local level in Trent we have had a busy year with a successful local Trent AUGIS meeting at the Nottingham Doubletree Hilton on 18th May 2018. We had 87 registered delegates, over half of whom were trainees, and receiveduniversallypositivefeedback. Sessions included complications of bariatric surgery, tips and tricks with difficult cholecystectomy, an ERCP vs. Laparoscopic CBD exploration debate, an interactive benign biliary MDT and a session on career options in Upper GI and HPB surgery. I would like to extend my personal thanks to all colleagues who gave talks, chaired sessions or just travelled to attend the meeting. Unfortunately Professor Ashley Dennison from Leicester was unable to attend due to a mix up with unleaded petrol and a diesel car. The Midlands HPB meeting is due to take place in Oxford on 6th July at Balliol College organised by Mr Keaton Jones and Mr Michael Silva, which will be an excellent meeting. Looking ahead to the latter half of 2018, the highlight promises to be the annual AUGIS meeting in Edinburgh with the new Wednesday afternoon to Friday lunchtime format in place. Finally I must wish good luck to Nottinghamshire CCC (defending 50 over and T20 Blast champions), with many a wasted hour to be spent at Trent Bridge over the next couple of months. All that only leaves me to wish you all a great summer and holiday period (anyone bodyboarding in Polzeath in mid-august look out!) and I look forward to catching up with many of you in Edinburgh in September. Reports from the Regional Representatives AUGIS Summer 2018 Newsletter In this issue we report from the South West, Trent, and North Thames regions Mr Dinesh Sharma North Thames The Liver Transplant and HPB Unit at Royal Free and the Barts and London HPB Unit is part of the London Cancer which provides the HPB service in the region. The HPB units have continued to grow especially at the Royal Free since the unification a few years ago of the Royal Free and UCH. The Royal Free Liver Transplant Programme is the fastest growing adult liver transplant programme in the country and performed 116 liver transplants in the last year. The combined sites from Royal Free and Royal London held a combined London Cancer Liver Education Afternoon at the Royal Free London on the 18th April 2018. This was a multidisciplinary meeting which was well attended from various sites and received very good feedback and extolled the plans to revamp the patient pathways especially at the RoyalFree,aspartofimprovingpatient pathways through the improving delivery of service vanguard. In addition to excellence in clinical work the region has been very active in HPB research too. To mention some of the achievements: • First trial on goal directed therapy post OLT now completed on target. (NIHR RfPB funded) • Data being analysed and results will be presented soon. • LAVA trial on resection vs ablation for CRC mets has unfortunately closed due to recruitment failure. • Current recruitment to trial of ward based goal directed fluid therapy in acute pancreatitis is ongoing. • Successful NIHR i4i funding to further develop the UCL image guided lap liver surgery system. London Cancer incorporates the geographical areas of North Central and East London and West Essex with a population of 3.7 million. Since 2016, London Cancer has become one of the six principal programme of the UCLH Cancer Collaborative. The Upper GI (OG) Cancer Tumour Pathway Board is a cancer care specific board which was led by Prof Muntzer Mughal until March 2018. In April 2018 Mr Dip Mukherjee took over as Tumour Pathway Director. 2017/18, as part of the UCLH Cancer Collaborative, the Upper GI (OG) Tumour Pathway Board has worked collaboratively with our Vanguard partners in Manchester and London on developing a new best practice timed pathway for OG patients. This year has been our second full year after the reconfiguration of OG cancer surgery at UCLH. The focus has been to ensure and maintain the success of this reconfiguration. Some achievements in Upper GI cancer services are: • 70 oesophago-gastric cancer resections and 9 benign-complex operations were performed during 2017. This is a reduction in activity compared to 2016 (93 cancer resections and 14 benign-complex operations) as expected due to the improvements in staging. Surgical outcomes have remained excellent, and the 90-day mortality reported in the 2017 National Oesophago Gastric Cancer Audit was 1.1%. The centre was one of 6 out of the 37 centres nationally to have a mortality of less than 1.5%. • The service has successfully passed Gateway 5 and 6 assurance documents for the reconfiguration of specialist surgical treatment to UCLH. • The service this year has been involved in a number of research projects including LASER (lasting symptoms after esophageal resection) study and is taking part in the genomics of gastric cancer study as part of the 100,000 genomics project. • An exciting new project is the development of a micro-CT to enable imaging of endoscopic and surgical cancer resections to a resolution of onemicron,whichhasreceivedagrant of £950,000 from the Engineering and Physical Sciences Research Council. This will provide histology-level information rapidly. The project is led by Professor Alessandro Sandro from the Dept of Medical Engineering at UCL and the team includes Professors Laurence Lovat, Muntzer Mughal and Marco Novelli. The micro-CT scanner is currently being built and trials will start in 2019. We were successful in the award of a Macmillian grant of £100,000 to develop digital health innovation to improve the care of oesophageal cancer patients. This is a joint project between the OG Pathway Board (represented by Professors Mughal and Pritchard-Jones) and the Department of Primary Care and Population Health, led by Dr Henry Goodfellow working with Professor Elizabeth Murray. Reports from the Regional Representatives AUGIS Summer 2018 Newsletter 18 19