More than a hospital
We take an inside look at the founding principles of the new Cambridge Children's Hospital, with the help of Clinical Lead and Clare Fellow, Professor David Rowitch
In December 2018, £100m of funding was pledged by the government to begin developing Cambridge Children’s, a unique collaboration combining paediatrics (Cambridge University Hospitals NHS Foundation Trust - Addenbrooke's), children’s mental health (the Cambridge and Peterborough NHS Foundation Trust) and embedded University of Cambridge research.
Clare Fellow, Professor David Rowitch (1984), Head of Paediatrics at Cambridge University, holds a key clinical leadership role in the project.
After falling from a trampoline and injuring her knee, Jasmine Hunt, a formerly bright, cheerful and athletic young girl, began to experience severe pain and other complex symptoms
which left her confined to a wheelchair.
As her condition meant she was no longer able to play and socialise with other children, Jasmine began to withdraw. Attempts to treat her pain were proving unsuccessful. Jasmine grew increasingly anxious and eventually stopped eating.
This led to her referral at the age of 12 to a specialist intensive team at the Cambridgeshire and Peterborough NHS Foundation Trust, and a twelve-week inpatient stay at The Croft, a centre for children with mental health difficulties, and their families.
At The Croft, psychiatric specialists used play therapy to begin sensitively working with Jasmine on her issues, and it was there that a diagnosis of Conversion Disorder was made. The illness made Jasmine extremely sensitive to pain, to the point where merely thinking or talking about it made things worse.
With a renewed understanding of her condition, and after weeks of therapy sessions, Jasmine’s mental state improved, and she once again found herself becoming more mobile. Her pain reduced, and she was eventually able to leave her wheelchair behind. Within weeks, she was back at school, on the way to a full recovery.
It is this combined approach of treating both physical and mental health which will underpin the philosophy of Cambridge Children’s.
This brand new hospital will bring together in collaboration Cambridge University Hospitals, the University of Cambridge, and the Cambridge and Peterborough NHS Foundation Trust, to provide world-class paediatric healthcare to the region.
Professor Paul Fletcher is the Bernard Wolfe Professor of Health Neuroscience and a Fellow of Clare College. He welcomes the innovative approach being taken by the hospital: “While it has long been known that mental and physical health are intimately related, somehow they have become separated from each other, with psychological and physical medicine frequently losing contact with each other. Against a growing realisation, in both clinical and research fields, that this separation is highly detrimental to overall care, it is wonderful to see that they will be closely integrated in the context of the new children's hospital.”
£100m of public funding has so far been pledged to build the new hospital on the Addenbrookes/Royal Papworth site, and a further £100m of philanthropic support will be sought regionally, nationally and internationally to make Cambridge Children’s a reality. Phase 1 of the project is forecasted to open in 2024.
Cambridge Children’s will be established around a series of founding principles, including the aforementioned holistic approach of treating mental and physical illnesses. The hospital will focus on treating the whole child, rather than the individual conditions, bringing together resources from across the region. This is intended to create a more joined-up, seamless experience for children navigating the system.
Cambridge Children’s will take advantage of the tremendous track record in Cambridge around DNA technology, to which Clare in particular has made significant contributions. It will take a leadership role in genomic medicine with a purpose-built institute embedded within the hospital to explore further the huge potential of this area.
Professor David Rowitch (1984) is the Head of Paediatrics at University of Cambridge, Wellcome Trust Senior Investigator, and a Fellow and alumnus of Clare College. As one of the project’s clinical leads, he is responsible for building a research strategy that aligns with NHS priorities and also draws in expertise from across the University, Sanger Institute and other aligned research groups. He says that the aim of Cambridge Children’s is “to bring about a paradigm shift away from reactive approaches to one based on prevention, early detection and precision intervention, that is fully capable of tackling even the rarest of childhood conditions.”
For two-year-old Millie-Mae Daly, genomic medicine played a critical role in improving her treatment and quality of care. Millie-Mae, who suffers from severe epilepsy, took part in an Addenbrookes-based study, the Next Generation Children’s Project, in which 300 babies with critical illnesses had their whole genome sequenced. As a result of the study, her doctors were able to pinpoint the gene responsible for her condition, and adjust her treatment in order to better manage it.
As Millie-Mae’s mother, Claire, said: “As well as improving her care we now know that Millie’s illness was caused by a glitch in one of her genes during the very early stage of foetal development. It was not something that [her dad] and I carried, which in many ways is a relief as this may have had implications for our other three children.” By prioritising the further study of genomic medicine, Cambridge Children’s aims to trial new interventions in order to help children build up resistance to illness. This knowledge will be shared globally, in the hopes of improving the care of children like Millie-Mae all over the world.
Genomic research is also a key factor in furthering our understanding of so-called ‘rare’ conditions. 3.5 million people in the UK suffer from the more than 7,000 complex rare conditions which require multiple interventions, and these account for 30% of paediatric admissions to hospital. Over 200 million people are affected worldwide.
David Rowitch looks forward to how prioritising research into this area might benefit future patients of Cambridge Children’s. “For children and their families, the diagnosis of a rare genetic condition often takes months or years, with multiple tests and visits to specialists. The benefit of genome testing is that it can achieve early detection of such conditions avoiding the so-called ‘diagnostic odyssey.’ Moreover, we think that this information will help us match clinical interventions most appropriate for that child.”
Clare alumna, Professor Rosalind Smyth (1977) is Director of the UCL Great Ormond Street Institute of Child Health. “In early life,” she says, “the foundations of health and disease are laid which will influence the length and quality of each person’s life. Three-quarters of rare diseases affect children and, sadly, around 30% of children with a rare disease will die before their fifth birthday. Cambridge Children’s will enable the Cambridge Biomedical Campus to prioritise and focus on health and well-being of children, this vulnerable and critically important age-group.”
Finally, Cambridge Children's will support outstanding paediatric healthcare provision throughout the East of England region. This is the only region in the UK which is currently without its own dedicated paediatric hospital. The current infrastructure at Addenbrooke’s, and other regional facilities, are becoming unfit for purpose as they age, and services are under increasing pressure across the NHS.
The new hospital will be able to take advantage of the cutting-edge medical research being carried out by the University and other institutions on the Cambridge Biomedical Campus. A new website has recently launched, which provides information and updates on the hospital’s development, and invites members of the community to get involved and give feedback. What will Cambridge Children’s mean locally? “The East of England is one of the country’s fastest growing regions,” says Professor David Rowitch. “We can help families and primary care givers by providing specialist care in area. For the University of Cambridge, the embedded research institute represents a major commitment to supporting the future of child health research.”
And what will it mean for David himself? “Sleepless nights, and lots of papers to write, but all worth it because we could inspire more Clare medics to go into paediatrics!”
