New way of using surgical robots ‘could revolutionise prostate cancer operations’

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PS 1

Prostate surgeon Prasanna Sooriakumaran: Procedure is revolutionising treatment for patients

A London surgeon is trialling a new method of using robots to treat prostate cancer that aims to encourage more men to undergo surgery.

Prasanna Sooriakumaran, a consultant urological surgeon at University College London Hospitals, says the new procedure is akin to a car mechanic going under the vehicle to carry out repairs rather than lifting the bonnet.

Early trials on 50 patients suggest it could be up to 10 times less likely to leave men suffering from continence problems after surgery.

Incontinence and impotence are two of the most common side effects of prostate removal, due to the risk of the surgery damaging surrounding nerves and bladder muscles.

Surgical robots are now used in the majority of prostate cancer operations, with UCLH leading the way with about 600 operations last year.

Mr Sooriakumaran, known as PS, said this could lead men to choose surveillance or radiotherapy and hormone therapy rather than surgery.

He said the “retzius sparing” procedure, which was first used in Italy and South Korea, could make surgery more appealing to younger, more active men.

Mr Sooriakumaran, who carries out most of the operations at UCLH at Westmoreland Street, in Marylebone, said: “Normally when you do the operation, you do what is called ‘dropping the bladder’ – you approach the prostate from above and move the bladder out of the way.

“It’s a bit like when women give birth. The pelvic floor is like a hammock and the support structure gets weaker. When the woman coughs or sneezes, the bladder drops and the woman leaks.

“With this new technique, you go towards the rectum and ‘look up’. It’s like being a mechanic lying under the car rather than standing over the engine and fixing things looking down.

“It’s technically more challenging – you are doing everything upside down – but you don’t damage any of the [internal] structures.”

He added: “It’s revolutionising the outcomes for patients. After the catheter comes out, 94 per cent have been dry within a week. Normally it is about 10-15 per cent.”

Prostate cancer is the second most lethal cancer in UK men, after lung cancer, and kills 11,800 a year. Only 7,000 men a year opt for surgery, which is normally considered “curative” unless the cancer has spread.

One patient, Howard Anderson, 66, a retired computer science lecturer from Woodford Green, underwent the procedure on March 21 after a PSA blood test raised concerns.

He said he was dry as soon as the urinary catheter was removed about a week after surgery.

He said: “I was delighted, to be honest. There was no problem at all. It’s perfect. The results are absolutely fantastic.

“Some of the older techniques, such as open surgery, looked pretty hair-raising. The literature from the hospital said that the outcomes depend on the skill of the surgeon and how many operations they performed. When I discovered it was PS doing it I was over the moon.”

Mr Anderson said he fear of being left incontinent was a “major concern”. He said: “But the alternative, which is six months of hormone therapy and two of radiotherapy, struck me as being far worse.”

  • An edited version of this story appears in tonight’s Evening Standard.
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St Mary’s hospital thanks crowds (and media) for ‘behaving beautifully’ while awaiting birth of royal baby

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Staff morale at the hospital where the Duchess of Cambridge gave birth has been bosted by the new arrival, bosses said today.

Lesley Powls, site director at St Mary’s, in Paddington, thanked the crowds who gathered outside the private Lindo wing on Monday for “behaving beautifully” and enabling the rest of the hospital to operate as normal.

She told the Standard: “It’s fantastic for our hospital and fantastic for the staff, though it does make for a slightly more challenging than normal day for me and the team.

“We are managing a very acute major trauma centre and a busy hospital, while managing everything else that goes with that. The crowds are very welcome, as are the well-wishers. Everyone behaved themselves beautifully. I think people are very aware it’s a functioning hospital.

“The staff are enormously proud of St Mary’s generally. That level of pride and feelgood factor rises a notch when you have such a high-profile event.

“We were extremely well prepped for it. We had way-finders and volunteers in on the day to make sure that patients who were not necessarily aware what was going on wre able to navigate our site as normal.”

Wills and Kate at Evelina

Meanwhile, bosses at Evelina London children’s hospital expressed their thanks after being chosen by William and Kate to receive charitable donations marking the birth of the new prince.

Both the duke and duchess had recently visited the Evelina, beside St Thomas’s hospital in Lambeth, over the last few months, and it is due to mark its 150th anniversary.

Marian Ridley, director of Evelina London, said: “Their warmth and immediate sense of connection with the children and families that they met left a deep impression on all of us.

“Their visits brought joy, sympathy and appreciation and I know this gesture will mean a huge amount to our staff, patients and families. We are very grateful for their support, and wish their family a happy and healthy future together.”

Health alert issued for ‘hottest London Marathon ever’ as runners told to ditch the silly costumes

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Marathon camel

London Marathon runners were today told to ditch the furry costumes as a health alert was issued ahead of what could be the hottest race in history.

Medical director Sanjay Sharma advised the 47,000 entrants to abandon hope of achieving a personal best – and not to run at all if they have suffered a high temperature this week.

Heat stroke is a major concern, with 160 doctors and 1,500 St John Ambulance first aiders on standby. Medical tents are being erected every 1,000m from the nine-mile mark, with ice flannels to enable the rapid cooling of runners in distress.

Six “run-through” showers will be spread across the 26.2 mile course and extra drinks will be available.

Professor Sharma said heat stroke normally affected one in 3,500 runners but more sufferers were likely on a hot day. In 2014, runner Robert Berry died from heat stroke.

Professor Sharma, of St George’s, University of London, said: “The hottest on record is 21C. That was 2007. They’re forecasting anything between 18C and 24C. There is the potential it could be the hottest.”

Runners were advised to dress very lightly and “avoid heavy, warm costumes”. Those most at risk are “large males trying to beat four hours”, those with a with a history of heat stroke and people on medications such as anti-depressants.

Runners should keep well-hydrated but “drink according to thirst” as too much water can also be dangerous.

Professor Sharma said: “Nobody wants a death. It’s the biggest sporting event in the country. We want to make sure that people enjoy the marathon and are safe. We are taking every precaution we possibly can.

“We could be expecting 15 or 16 cases of heat stroke, based on previous experience. We are confident we can deal with it.

“One your body’s temperature goes above 40C, the functioning of your brain goes down. You feel light-headed and might collapse. It affects the heart muscle and you can run into all sorts of trouble, and very rarely cases can be fatal.”

The NHS worker who’ll run the London Marathon almost as quickly as Mo Farah

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Kojo Kyereme

Kojo with a portable echocardiography scanner at St George’s hospital

A London health worker will line-up alongside the world’s elite athletes when he takes part in Sunday’s race.

Kojo Kyereme, 43, is such an accomplished runner, with a best marthon time of 2.21.28, that he will start alongside the specially-invited professional athletes. His running blog is runkojo.com

He is the lead cardiac physiologist in the cardiac investigations team at St George’s Hospital, Tooting, and is raising funds for a £35,000 portable echocardiography scanner to detect heart problems at the bedside.

“There are still occasions when the patient has to be brought to us to use fixed machines – however we can improve the whole experience for patients and staff with a portable version,” he said.

Mr Kyereme hopes to raise £2,620 – reflecting the 26.2 miles he will run. St George’s Hospital Charity hopes to fund the remainder, and already has two £5,000 pledges. An additional machine is required to help St George’s, a specialist cardiology and cardiothoracic centre, cope with an increase in demand.

“An extra portable Echo machine would mean that around 75 more people a week can be seen in the wards rather than being moved across the hospital, reducing stress and giving quicker diagnoses.

“It’s fun to think that running fast could also help with speeding up treatment for patients – it’s a win/win.”

Mr Kyereme has run eight marathons – London three times, plus Stockholm, New York, Toronto, Boston & Berlin.

 

He added: “My job is split between administration and clinical duties. I manage a team of 15 highly specialised echocardiographers across 3 sites.

“We deliver routine and urgent scans of the heart to various cohorts of patients across the trust.

“Echocardiography is a useful diagnostic tool; using ultrasound to visualise the heart’s structure (chambers, valves and vessels) and to detect various heart conditions or abnormalities.”

* https://www.justgiving.com/fundraising/kojo-kyereme

Nurse with cancer vows to defy doctors and complete three marathons

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Marika and running partner William Anderson

Marika and running partner William Anderson

A nurse with breast cancer is to defy doctors’ orders and run three marathons to raise money for life-saving research.

Marika Wiebe-Williams, 49, will run London, Milton Keynes and Edinburgh in little over a month despite being on palliative chemotherapy after the disease spread to her lungs.

The mother of two was given between two and five years to live last September when doctors discovered her breast cancer had returned. A secondary lung tumour was discovered in January.

She was told to take a break from running – undertaking brisk 17-mile walks at the weekend instead – and has only recently restarted.

“Running is what keeps me sane. I will keep on going for as long as I can,” she said. “Cancer might take everything else from me – but it won’t take this.”

She and running partner William Anderson will run the three marathons in aid of the Institute of Cancer Research. The Chelsea-based organisation undertakes pioneering studies, including on recurring breast cancer.

Marika and son Ben

Marika with her younger son, Ben

Ms Wiebe-Williams, who lives in Faversham and works at Kent and Canterbury Hospital, in Canterbury, was diagnosed in November 2016 with breast cancer after spotting the symptoms herself.

Six rounds of chemotherapy and surgery were not as effective as hoped, and then a small mass was found on her left lung.

“I remain cheerful,” she said. “I will never give up. I was told shortly after the diagnosis of secondary cancer that I should give up running. Never.”

She added: “I can’t think of a worthier thing to run for. And, for as long as I am able to, I will run. I will not wait to die. I will fight this all the way.”

Mr Anderson said: “Marika and I have been running partners for years so when she said she wanted to run three marathons in a month I thought she was mad. I will be with her every step of the way.

“Marika is on continual chemotherapy, which comes with its side-effects and makes this an enormous task. Marika has a limited life expectancy and her dream is to complete these races before she is unable to run anymore.”

* https://uk.virginmoneygiving.com/WilliamAnderson11

BBC, SKY News and ITN in unprecedented complaint after being barred from City Hall meetings on knife and gun crime

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Sadiq Khan was today at the centre of row over two City Hall meetings about knife crime that were held in “secret”.

Editors at BBC, Sky News and ITN jointly made an unprecedented complaint to the Greater London Authority after press and public were barred from an emergency meeting of the London Assembly’s police and crime committee yesterday.

It had been called to quiz the Mayor and Met chiefs on the 50 murders so far this year in the capital.

The Mayor’s knife crime summit on Tuesday, with Met commissioner Cressida Dick and Home Secretary Amber Rudd, was also held in secret.

For the full story, click here.

Below are the letters between the broadcasters and City Hall.

Mr Jeff Jacobs

Chief Officer of the GLA

Dear Mr Jacobs

We are writing to you jointly on behalf of the BBC, Sky, and ITN to express our concern over the decision to deny the press access to the PCC committee meeting tomorrow and to delay releasing the recording of proceedings until after the local elections on May 3rd.  We can think of no precedent whereby access is denied in this manner;  there are no GLA elections and those members of the Assembly who also happen to be candidates in the borough elections still hold their responsibilities as elected members during the election period.   Public access to a meeting of the PCC, where the Mayor is being held to account on an important issue is not “publicity” but proper scrutiny.  It is quite astonishing that you should come to the conclusion that such a meeting should be kept out of the public domain for more than three weeks.

Our understanding is that the only limitation in this regard would be that GLA press officers should not assist candidates in arranging interviews with the media.  There is absolutely nothing in any relevant guidance which suggests an elected body should not be fully accessible to the public, through the broadcasters and press, during an election period.  Indeed, if that were the case, the same restriction – presumably – would apply to the House of Commons.

Given the pressing nature of events we would be grateful for a swift reply, before we decide what further options are open to us ensuring that there is a proper – and prompt – opportunity for appropriate public scrutiny of proceedings of the London Assembly.

Best wishes

Michael MacFarlane BBC

Hannah Emerson-Thomas ITN

Peter Lowe SKY News

Dear Mr MacFarlane, Ms Emerson-Thomas and Mr Lowe,

Thank you for your email last night.

The meeting today is not a meeting of the PCC.  It has been arranged in order for the Assembly Members , both PCC members and other Assembly Members , to have a discussion with the Mayor about an important and topical issue. The meeting today is an informal one and a decision was taken to advise via press release that it is happening in order to demonstrate that the matter was being considered with the highest importance.

The rules in the pre-election period as set out in the GLA’s Use of Resources Guidance  are a mirror of the Code of Recommended Practice on Local Authority Publicity March 2011 issued under section 4 of the Local Government Act 1986. This Code applies to all local authorities in England specified in section 6 of the Local Government Act 1986 and to other authorities in England which have that provision applied to them by other legislation. The GLA is deemed to be subject to the same legal rules that control local government publicity, including a statutory Code on Local Government Publicity. I should also note that these rules do not apply to central Government.

Both the Local Authority Publicity Code and GLA Use of Resources Guidance  make clear provision for pre-election periods:

“33. Local authorities should pay particular regard to the legislation governing publicity during the period of heightened sensitivity before elections and referendums ….. It may be necessary to suspend the hosting of material produced by third parties, or to close public forums during this period to avoid breaching any legal restrictions.

 

  1. During the period between the notice of an election and the election itself, local authorities should not publish any publicity on controversial issues or report views or proposals in such a way that identifies them with any individual members or groups of members. Publicity relating to individuals involved directly in the election should not be published by local authorities during this period unless expressly authorised by or under statute. It is permissible for local authorities to publish factual information which identifies the names, wards and parties of candidates at elections.”

 

While discussions will be conducted in private, individuals who are not politically restricted (like the Mayor and Assembly members) are free to give interviews to the media. As you are aware the Mayor spoke to LBC, BBC radio London, BBCLDN TV, Bauer radio, Sky, the Evening Standard and London Live TV yesterday. I am also aware that a number of other individuals gave statements including Amber Rudd, Justine Greening, Jo Johnson, Teresa Villiers, Sian Berry, and Ravi Govinda. 

While this may not be the preferred approach for you, there is clearly access for the media to key individuals and this kind of engagement  is consistent with the rules under which the GLA is governed.

Yours sincerely

Jeff Jacobs

GLA Head of Paid Service

Dear Mr Jacobs

We refer to your email dated 11 April 2018. We are writing to you jointly on behalf of the BBC, Sky, and ITN.

We note that you have stated that today’s meeting is not a meeting of the Police and Crime Committee (“PCC”), but rather a meeting at which Assembly Members, including members of the PCC, can discuss with the Mayor “an important and topical issue”. Irrespective of whether it is a PCC Meeting, it is clear that it is a meeting which would have typically been open to the public and press. This is clear from the fact that you intend to broadcast the meeting after the 3 May 2018 elections.

The sole basis upon which you have refused public and press access is that you consider that the rules pertaining to the pre-election period prohibit this. We do not accept that. The applicable guidance, “The Code of Recommended Practice on Local Authority Publicity” (“the Code”), does not contain any prohibition on Committee meetings (formal or informal) being held in public during the pre-election period. You have failed to identify any precedent whereby access has been denied in this manner. At §33 of the Code there is a suggestion that it may be necessary to close public forums to avoid breaching any legal restrictions, but the relevant legal restrictions (at §§7-9) concern referendums, and therefore do not apply. At §34, there is a prohibition on “publicity”, and particularly “publicity” relating to individuals involved directly in the election. Allowing public and press admission to a Committee meeting does not, on any view, constitute “publicity”, and is certainly not publicity which relates to individuals involved directly in the 3 May 2018 election. The GLA is not proposing to publish or report on anything: this is about proper scrutiny and accountability, which is not prohibited under the Code. As you are aware, public bodies must continue to discharge their core functions at all time, regardless of whether an election is coming up.

In these circumstances, we ask you to reconsider your decision to refuse public and press admission to today’s meeting. We would be grateful for a response as a matter of urgency.

Best wishes

Michael MacFarlane BBC

Hannah Emerson-Thomas ITN

Peter Lowe Sky News

Hospital with specialist burns unit that treated Grenfell victims is rated ‘good’

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ChelWest CQC

A hospital trust that treated burns victims from the Grenfell Tower fire has been ranked “good” in all key areas.

Chelsea and Westminster Hospital NHS Trust was praised by the Care Quality Commission for staying out of debt and hitting targets on A&E treatment and waiting times for cancer and non-emergency operations.

It was “good” (the second highest of four possible ratings) in the CQC’s five key domains – safe, effective, caring, responsive and well-led – after widespread improvements in the wake of the 2015 acquisition of West Middlesex hospital. Previously both hospitals were classed as “requires improvement”.

Both hospitals benefit from having some of the most modern buildings in the NHS but the CQC inspectors praised the trust for a systematic approach to allowing excellence in clinical care to flourish, and on learning from mistakes in a “no blame” culture.

Chelsea and Westminster hospital, in Fulham Road, is the capital’s main burns centre, and treated 25 victims of the Grenfell disaster last June.

The burns unit was among many areas praised for outstanding practice, with staff showing an “outstanding contribution” to developing new ways of wound healing, with their learning spread across the NHS.

The trust also runs the pioneering HIV and sexual health clinic, 56 Dean Street, in Soho. It is judged one of the 10 best-performing trusts in the country but does have higher than average staff vacancy rates and suffers from one of the worst rates of patients failing to attend appointments.

Trust chief executive Lesley Watts said: “This is an incredible result and achieved by the amazing dedication, commitment to patient care, and loyalty to each other.
“We are all committed to continuing our improvement journey and ensuring we give the very highest quality of care to our patients day in day out.”

Professor Ted Baker, England’s Chief Inspector of Hospitals, said: “This is a fine achievement and I congratulate the trust and its staff on the improvements that have been made since our last inspection.”

  • A version of this article appears in tonight’s Evening Standard.

Great Ormond St Hospital: outstanding for care but misses top rank due to concerns over senior management

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COSH CQC report

Great Ormond Street hospital missed out on an “outstanding” rating because of concerns with the way it was being led, NHS inspectors said today.

The children’s hospital was judged outstanding for the effectiveness of treatment and the care provided to patients and remained “good” overall.

But, despite its international reputation, it could not achieve the Care Quality Commission’s top overall ranking because of problems with its top tier of management.

The CQC report today said it “requires improvement” – the second bottom rating – in the “well-led” category.

Bosses were criticised for a “defensive attitude” and appearing to be unaware of “wide concerns” raised by nurses about leadership and morale.

This comes in the wake of the Charlie Gard case, the terminally ill baby whose care sparked a legal battle between the hospital and his parents last year and resulted in violent threats and abuse being directed from the public towards hospital staff.

The report said: “The trust does not demonstrate open and positive relationships with key stakeholders.

“It was not sharing information promptly and was often defensive when challenged on performance and safety.”

The report did not mention the Charlie Gard case directly but said: “High-profile cases often impacted on day-to-day service oversight and the trust’s leaders did not always fully plan for additional operational pressures nor implement prevention mechanisms to minimise this impact.”

Inspectors ordered the hospital to tackle a problem with patient records that occasionally resulted in surgeons operating without having seen a child’s full medical history.

The 482-bed hospital is the largest in the UK for children with heart or brain problems and the largest in Europe in treating paediatric cancer patients. The report said staff shortages had forced the closure of some beds.

Professor Ted Baker, England’s chief inspector of hospitals, said: “It is impressive that only positive comments were received from patients or their parents and carers about GOSH staff.

“However, the trust must improve on well-led. This was highlighted at the last inspection and the necessary improvements have not yet been made. I hope that with a more settled senior management team in place, better results can be achieved in the future.”

GOSH chief executive Dr Peter Steer said: “Our mission ‘the child first and always’ is at the heart of everything we do and our staff should be very proud that the CQC received only positive comments from patients or their carers about our people throughout this inspection.

“We remain proud to be judged as outstanding for the effectiveness and caring nature of our services and are pleased that our services are rated as good for being responsive and safe.

“We acknowledge, when looking at leadership throughout the organisation and how we manage the governance of our services, we require further improvement. However, we have made progress in addressing some of our biggest challenges. This includes turning around the way we manage our waiting time data so it is transparent and reliable and ensures we are meeting all national targets and treating patients on time. This is demonstrated by the fact that in the month of the CQC inspection we had the most improved performance for referral to treatment times in the country. We have also conducted a lengthy and complex review into our gastroenterology service which is now driving through improvements in care and patient experience.

“Additionally, we have appointed a highly experienced and talented Chair in Sir Mike Rake to succeed our previous Chair.

“One area of particular importance, and where we know we have work to do, is around improving nurse morale. We recognise the issues raised in the CQC report and our new Chief Nurse Alison Robertson is fully aware that the development of a strong nurse voice is a priority.”

  • An edited version of this story appears in tonight’s Evening Standard.

 

Fall in collisions since traffic ban at Bank junction – but authorities withhold data on number of drivers fined

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Ying Tao lorry collision

The moment before Ying Tao was crushed at Bank by a left-turning lorry

A ban on lorries, cars and taxis driving through Bank junction on weekdays has resulted in a big reduction in road injuries.

The 7am-7pm restrictions, introduced last May in response to the death of cyclist Ying Tao, 26, who was crushed to death by a left-turning HGV in 2015, also improved the air quality.

Ying Tao

Ying Tao: killed cycling to work in 2015

Now cyclists are calling for the ban to be extended 24/7 – but cab drivers want to regain access throughout the day.

Drivers who flout the ban are sent £130 fines – generating an estimated £15 million to £30 million for the City of London Corporation.

The ban has been backed overwhelmingly in a consultation, and has the support of 150 City property firms.

However The Ned hotel has complained about the difficulty of hailing taxis for its customers and of problems with deliveries.

The six-lane junction beside the Bank of England was the worst location in the City for road casualties.

Between 2012-16 there were 107 casualties, including two fatalities – an average of 21 incidents a year.

Since the scheme’s introduction, six crashes were recorded in its first six months – four between cyclists and pedestrians, one involving two cyclists and one when a car turned right into a cyclist.

All resulted in slight injury except the incident last September when a pedestrian was seriously injured in collision with a cyclist in Poultry.

Bank junction collisions

Collisions since the weekday traffic ban at Bank have all involved cyclists

The number of road casualties in the wider area around Bank fell from 51 to 34, and from 97 to 75 across the entire Square Mile.

Bus journeys across Bank were quicker but most diverted taxi journeys took longer – meaning higher passenger fares.

The findings emerged in reports (including exerpt above) by the City of London Corporation, which will decide in July whether to make the 18-month trial permanent, retain it with modifications or scrap it.

About 75 per cent of the 4,300 people who responded to a consultation supported it or wanted it to remain with changes.

The London Cycling Campaign said all motor vehicles should eventually be banned and the junction turned into a public square or plaza.

One in eight responents – mostly taxi drivers – wanted cabs allowed. The City Property Association, which represents leading developers and landowners, said: “For the vast majority of City workers this is not a primary issue.”

The City Corporation press office refused to reveal how many fines it had issued – telling the Standard the information would only be released if a request was made under freedom of information laws.

A FoI response last year revealed that 106,357 tickets were issued in the first four months of the scheme, bringing in at least £6.9 million for the corporation.

  • An edited version of this article appears in tonight’s Evening Standard.

Transcript of shocking evidence from London trauma surgeon Martin Griffiths on young victims of knife and gun crime

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Martin Griffiths at the Royal London hospital

Martin Griffiths, (above) lead trauma surgeon at the Royal London hospital, was interviewed on Radio 4’s Today programme this morning in response to the London death toll from stabbings and shootings reaching 50 victims this year.

He said that in the 1980s, knife and gun injuries were a “relatively uncommon, niche injury”.

He said: “Now it’s our core work. About a quarter of what we see in our practice is knife and gun injury. Now we are doing major life-saving cases on a daily basis.

“Some of my military colleagues have described their practice here as being similar to being at [Camp] Bastion, [The UK base during the Afghanistan war] which is a very worrying thing to hear.

“As a clinician, we are now doing major interventions on younger and younger people who require operations which we only used to describe in years gone by.

“We routinely have children under our care – 13, 14, 15-year-olds are daily occurrences [coming in with] knife and gun wounds.

“The thing to understand about our practice now is that we used to look after people in their 20s. Now people are often in their mid to late teens, and children in school uniforms are being admitted under our care with knife and gun wounds.”

Figures provided by Barts Heath NHS Trust reveal that the Royal London, one of the capital’s four major trauma centres, treated 163 stabbing victims between January 1 and April 2 and 23 victims of shotgun wounds. Over the same period the previous year, it treated 165 stabbings and 10 gunshot wounds.

Mr Griffiths, who earlier this year spoke of his concerns with fellow trama surgeon Duncan Bew at the Royal Society of Medicine, said: “We are very fortunate to work in partnership with the St Giles Trust, which we developed a violence reduction service with. We provide a wrap-around care to these young victims of injury.

“They have tremendous skills in digging into the detail of these young persons and the circumstances of what is driving their injury.

“We found that there are obviously some kids who are gang-involved, involved in the drug trade, but more often than not it’s just young people… who have been caught in difficult situations and they don’t respond well to conflict.

“I think lots of young people are easily swayed. The lack of positive role models, lack of mentorship, lack of support of youth, keys into young people being led down the wrong path.

“I think we have seen a normalisation in attitudes towards violence globally and also a willingness for people in general to take offence at pretty much everything. Things escalates on social media over literally nothing, things that used to be ignored.

“People now, when faced with conflict, react in a much more expressive manner. If people who run countries react in this manner it gives a signal to everybody to be responsive in that manner.

“What we are seeing is people’s attitudes towards violence are changing. Whereas a young boy being stabbed five or six years ago was a horror story, now it’s normal. People expect to hear about people being killed on a daily basis.

“Members of the public who are not involved in gangs or violence let this thing pass without comment.

“You get the society you deserve. If you ignore violence, if you ignore offending as a member of the public, your society will change. We are all responsible for what is happening in our society right now.”

  • An edited version of this article appears in tonight’s Evening Standard.
  • Mr Griffiths first spoke to me in 2013 about the dangers of knife crime and his work to teach teenagers about the dangers of carrying a knife. Click here to read the article.