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Sep 28 - Ayling-Buttigieg Chemotherapy Unit Opens At St Bernard's Hospital

The GHA’s Chemotherapy Day Unit at St Bernard’s Hospital was officially opened today by the Chief Minister Fabian Picardo, and is now open for cancer patients needing Chemotherapy.

As from this week, all newly diagnosed cancer patients with solid tumours can be referred to the Unit to receive Chemotherapy on an out-patient basis from Tuesdays to Thursdays, 9am to 5pm.

The new Chemotherapy Unit contains five clinical couches, a Consultation room, a Drugs preparation room with a gowning area and a waiting and reception area. Additionally, the commissioned clinical oncology team from Xanit, who was successful in the tender and will be running the service, will see patients in Consultation and follow-up clinics; the team includes a Medical Oncologist, a Chemotherapy Nurse, and a Cytotoxic Pharmacist.

Following Government approval of the project, Margaret Ayling, who had long been wanting to assist in creating a chemotherapy facility in Gibraltar, contacted the Minister for Health and kindly offered to provide funding for the capital works and equipment. This has been provided in loving memory of her late husband, Leslie Ayling, and her parents Anthony and Lucia Buttigieg. The Unit will therefore carry the name of The Ayling-Buttigieg Chemotherapy Unit and has been open 11 years after the death of her husband. 

Speaking on behalf of Mrs Ayling, a friend of the family's, James Vinales, said: "Leslie realised how debilitating the whole experience was, and how painful it was for the patient to be taken away from their normal environment and the comfort and support from family and friends. 

"He then vowed to Margaret that one day he would do something to alleviate the pressure on patients sent abroad by the health authority. Fast forward to 2005, Leslie died rather unexpected, leaving Margaret to carry out his unrealised wishes."

Minister for Health, Dr John Cortes, said he was delighted that Gibraltar was able, for the first time ever, to deliver this kind of treatment, adding: “There is no doubt of the benefits to Gibraltar patients for the repatriation of Chemotherapy treatments to St Bernard’s Hospital. Patients presenting with solid malignant tumours no longer need travel to another country such as Spain or the UK in order to receive their Chemotherapy treatment. This removes the stress of travel and dependence on others for transport. The new Unit also means local, in-house support for cancer patients and family members. I would particularly like to thank Mrs Margaret Ayling, a long-time friend and most caring person, for her kindness and community spirit in providing such a kind gift to Gibraltar. ”

GHA’s Cancer Services Coordinator, Isobel Ellul, said: “The clearly added benefit to having our own Chemotherapy Unit means that weekly Oncology Multi-Disciplinary Team meetings will take place at St Bernard’s Hospital. This means that Radiology, Pathology, Oncology, Medical & Surgical Consultants and specialist nurses will discuss patients together and make holistic recommendations on treatment pathways. The Radiotherapy Oncologist from Clinica Radon will also be part of the team. This has its obvious advantages to patient care, especially from a communication point of view.”

Mr Picardo said: “This is a red letter day for Gibraltar. For all those who need Chemotherapy, having the opportunity to have that treatment provided in Gibraltar is a huge step forward toward better care and better service. When we are ill, having to travel to receive much needed treatment is always an additional burden. In the case of Chemo, even if the distance has for some patients not been far, involving travel to the other side of the Bay, the notoriously unreliable frontier has caused stress to many when they least need it. So delivering on this manifesto commitment is a source not just of huge pride but also of massive satisfaction for the benefits that will attach to patients in need of this treatment.

"My thanks, of course, to Mrs Margaret Ayling who has been a friend for many years. I have very fond memories, as everyone who knew him will, of Mr Leslie Ayling who was an absolute gentleman with whom I had the pleasure to work. I am therefore delighted that we are able to count with Margaret's generous and selfless support in assisting in the establishment of this groundbreaking service to the Community as a whole. The whole nation will want to thanks Mrs Ayling for her philanthropy and assistance which has been altruistic and which is reflected in the naming of the suite after Leslie and Mrs Ayling's own parents. It is also true that the establishment of this service is further testament to the devotion and dedication of all staff of the GHA and in particular a further achievement of Minister John Cortes who has revolutionised the health service through the delivery of the innovative policies we have committed ourselves to in successive manifestos."

Technical details - St. Bernard’s Hospital: New Chemotherapy Suite

As part of the GHA’s repatriation of services strategy and following an options appraisal, GHA was given ministerial approval on the 16th September 2015, to proceed to the detailed planning phase for a new Chemotherapy facility at St. Bernard’s Hospital.

The design of the unit is based on best practice guidance Health Technical Memoranda M03-01 Aseptic Suites & Health Building Notes 02-01 Cancer Treatment Facilities. Clinical Staff input was incorporated to ensure workflow features were compatible with expected service level parameters.

It was decided that the development would be carried out in building 1 level 2 at SBH. This required internal relocation of other services but provided an ideal area with easy access for patients and importantly linking into the appropriate air management infrastructure.

The project incorporates the following additional features:

1. Specialist Cytotoxic drugs preparation area.

2. Staff Gowning Area.

3. Oncology Clinic.

4. Facilities for 5 Chemotherapy stations including multi-use space for in-patient/out- patient use.

5. Nurse monitoring station.

6. New reception.

7. Dedicated waiting area.

Cytotoxic Room

The Cytotoxic room has been fitted with a dedicated CDC F Cytotoxic Dispensing Isolator. This negative pressure isolator allows for safe aseptic reconstitution and dispensing of cytotoxic drugs complying with the highest applicable safety standards.

EU GMP Grade A (unidirectional airflow) work area.

High air change rate D type transfer chambers with electromagnetic timed interlocks.

PLC controls for easy set-up, operation and maintenance.

User friendly automatic pressure decay leak testing

Treatment Bays

The five treatment bays have been designed incorporating Patient Call and staff alert systems, specialist IV/Transfusion couches, IV infusion Systems & patient entertainment (TV Systems). Everything possible has been done to ensure our patients are treated in a modern and well equipped facility.