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In conversation with Devesh who lead the transformation of care for our stroke patients

In Conversation With...

Here’s the next instalment of our new series: In Conversation With…introducing Devesh Sinha, our clinical lead for stroke.

Age: 45

Lives: Brentwood

Personal life: Wife, Garima and 10-year-old daughter Devanshi

What’s your role at our Trust and how long have you been with us?

I’m a consultant and the clinical lead for stroke. I joined in May 2016 from Southend Hospital, which was my first consultant post. I’m also the north east London operational lead for stroke.

Had you always wanted to be a doctor?

I wanted to be a doctor for a very long time. I was inspired by my older sister, Deepti. She’s five years older than me and has always been my role model. She still lives in India, where I grew up, and is a gynaecologist.

Tell us about your career path

I trained to post-grad level in India and worked in the government healthcare system, then in private healthcare. I went from one extreme to the other; private healthcare was so expensive I felt like I was mugging people when charging them. I kept hearing about the NHS from colleagues, an equal system where people could get the healthcare they needed. It was a lightbulb moment and I moved to the UK in 2003.  The NHS got into my blood. My wife is also a consultant, in fertility, and I encouraged her to come over too.

It was a struggle when I first came, I started as a senior house officer in Newcastle and have worked my way up in hospitals across the country, training in Cardiff then across north east London, including King George Hospital, so coming back to our Trust is like coming full circle. I’ve been a consultant for five years.

What are some of your proudest achievements?

Most recently our team has turned around stroke services for our patients. The score card for stroke from the Sentinel Stroke National Audit Programme goes from A-E with E being the worst. This time last year, we were D, so we gave ourselves the challenge of getting to B within a year. I’m so proud that we got to A within six months. It was a lot of work across the whole team, and we didn’t expect to do it that soon. We changed our structure and how we co-ordinated our team. We’ve given people the power to make changes, putting the challenge back to them to find their own solutions.

Across our whole division we looked at where there were issues, one example was getting patients to the right services more quickly, to do this, we needed to work better with our colleagues in Radiology. It’s been a real team effort and everyone is rightly proud of their hard work.

During my time at Southend Hospital we had a piece of software, a HOT-TIA, which helps identify patients at risk of a stroke. It worked so well that I thought it should be used more widely, within a year five other trusts and seven CCGs were using it. I then thought, why can’t it go country-wide? So I secured a £100,000 innovation challenge award grant from NHS England in 2015 to roll out the software to every trust in the country. I’m working with NHS Digital to improve the software and launch it across London.

Why did you decide to specialise in stroke care?

Previously stroke was not thought to be too exciting as patients were often paralysed and you could only really think about rehabilitation. But it’s become one of the fastest growing branches of medicine in the last ten years. We started giving patients injections for blood clots in 2007, and then in 2015 science evolved and mechanical thrombectomy was introduced. This involves going in through a patient’s groin and removing a clot from the brain using wire and a basket.

It’s something I can tell my grandchildren about, I can say so much was changing, and I was there.

We offer mechanical thrombectomy here and it makes a huge difference to our patients, 90 per cent of patients who’ve had a stroke walk out of our hospital within three-four days. The procedure can only be delivered by neuroscience centres and it was one of the reasons I wanted to work here.

Tell us about some of your most memorable patients

I have lots of memorable patients. Many touch your human side in different ways, sometimes because their treatment was such as success and sometimes because you wish you could have done more.

One family I’m still in touch with is of a young man, Joseph, who was just 22 when he had a stroke. He was given a mechanical thrombectomy and is now back at work, back playing rugby and doing all the things he did before. Joseph has also become a champion in helping us to raise awareness about stroke and his treatment, he’s spoken at lots of events. He’s a very emotional speaker. It’s all well and good for consultants and professors to speak but it has very little impact – it makes a huge difference to have a patient telling their story, Joseph tends to have half the hall in tears!

Another patient that stays in my mind is a man who was largely disabled by his stroke and cannot eat or breathe for himself. I think his case stays with me as he had his stroke just before we started giving the new mechanical thrombectomy procedure.

I also remember a woman who had a stroke just after her husband died and it was widely accepted that she wouldn’t be able to attend his funeral. But the whole team wanted to do everything we could to get her there, doctors were on call if needed, nurses were happy to go with her, hospital transport got involved and we got her there. It was a real team effort and I was so pleased we did it.

What else are you passionate about?

I’m a mentor. It’s really important for me to help colleagues learn and develop and it’s my way to give back, it also helps me to keep learning too.

With both her parents (and aunt!) in medicine, do you think your daughter will follow in your footsteps?

Devanshi is very intelligent. She’s sharper than her dad and has won achievement awards at school for the last two years running. She’s a bit young to have decided what she wants to do, and I don’t necessarily want her to follow in our footsteps. She’s quite artistic and loves music and art. If she does want to be a doctor, she’s got to really want it. Without that, you’ll never be successful in this field.

Any other hobbies or interests?

I love to play the tabla – Indian drums. From a child I was mesmerised by people playing them so I learned and I never lost it. I play at events, and it really helps with stress. I also love to play cricket and am on the BHR consultant team. We played just last weekend, beating Basildon Hospital’s team. It was a really exciting game and we won with 198 runs to 197, with just the last ball to spare!