Future Developments
Cardiovascular disease in Pregnancy
Cardiovascular disease in pregnancy is increasingly important as a cause of maternal morbidity and mortality. Our well established and developing links with the Royal Brompton hospital and the NHLI mean that we are very well placed to take advantage of any grant money is available in this area, in relation both to hypertension and preeclampsia, and structural heart disease. We plan to develop an "Institute of Cardiovascular Medicine In Pregnancy" as a major opportunity to bring substantial grant funding into obstetric research. Such funding is likely to be promoted by recent reports emphasising the importance of cardiovascular disease in pregnancy, and by our established track record in investigating and publishing on cardiovascular adaptation to pregnancy and fetal and neonatal outcome.
Perinatal Medicine
The Women’s and Children’s Directorate is the largest within the Trust and offers a high quality, family focused service, with a seamless approach from fetus to adolescence. Of the three such services within Imperial (the others being at the Hammersmith and St Mary's), it is the only one that offers a complete range of women's and children's services, and overall has the largest volume of work available for research and teaching. It is one of only two recognised Perinatal Centres within the North West Thames neonatal network and the only one with both paediatric surgery and major paediatric services following on from neonatology. The North West Thames neonatal network is the largest such network in London, and the continuing development of the Chelsea and Westminster unit is essential to its future service. It has been stated by the pan-London neonatal network steering board that it is a requirement that such a centre should have a viable and productive research infrastructure. Moreover, it is our experience that many of the most important clinical developments are academic and research led.
Fetal and neonatal growth
The "Barker hypothesis" of fetal programming as is increasingly appreciated as a potentially modifiable major cause of later adult disease. Our track record of research in fetal growth and neonatal development, and our strong links with the London School of Hygiene And Tropical Medicine, mean that we are well placed to obtain grant funding in this area of research.
Reproductive endocrinology, including assisted reproduction
In Gynaecology, we have both the infrastructure and track record to continue to research strongly in reproductive endocrinology and assisted reproduction. Much of this work is already commercially funded and there is substantial potential for this funding to be increased.
Undergraduate Education
The Chelsea & Westminster Hospital is an acute general hospital with a large A&E Department seeing over 80,000 patients a year and a total capacity of 480 beds. It is one of Imperial College’s main undergraduate teaching facilities. Of the major Imperial campuses, it is closest to the centre of Imperial in South Kensington. Together with St Mary's, the Chelsea and Westminster has always provided a major focus for the development of teaching within obstetrics and gynaecology and paediatrics. As the numbers of undergraduates continue to rise, and the standards of training and education expected are also augmented, a centre for the development of new approaches to undergraduate education, especially in the craft specialties, will be increasingly valuable.
Postgraduate Education
The Chelsea and Westminster Hospital has an enviable reputation in North West Thames for the teaching and training of postgraduate, especially in high-risk pregnancy. The growing recognition of maternal medicine means this is an area of postgraduate education we are keen and well placed to develop, and in October 2005 we have two trainees commencing special skills modules in Maternal Medicine and Labour Ward Care.
