Optimising Tracheostomy Outcomes

Ema Swingwood

Consultant Physiotherapist, UK

Ema is a Consultant Therapist (Physiotherapist by background) in Critical Care at University Hospitals Bristol and Weston NHS Foundation Trust. Her area of clinical expertise and interest is ventilation, weaning and complex airway clearance. 

Having completed the Advanced Cardiorespiratory Physiotherapy Msc programme at University College London (UCL) in 2012, Ema has continued her research focusing on the use of Mechanical Insufflation-Exsufflation (MI-E) and other cough augmentation strategies. Her current PhD work focuses on the use of MI-E in the intubated population which is funded through the NIHR Clinical Academic Research Fellowship pathway. 

Extra-curricular activities include contributions to the Undergraduate Physiotherapy programme at the University of the West of England, and post-graduate teachings at University College London and Brunel University. She sits on the Intensive Care Society Physiotherapy Professional Advisory Group and Education Committee, the Equity, Diversity and Belonging Committee of the CSP, and ICUsteps support group network. She has been part of the multi-professional authorship for BTS/ICS documents related to Respiratory Support Units and Weaning Centres. Most recently, she is part of the NHSElect working group for the development of a Critical Care Capability Framework.

: @emaroids1

Brendan McGrath

Consultant Intensivist and Anaesthetist

Brendan qualified from the University of Sheffield and trained initially in general medicine in Yorkshire, the North East and then Australia. He returned to specialise in Anaesthesia & Intensive Care Medicine, appointed as a consultant at Manchester University NHS Foundation Trust, at Wythenshawe Hospital in 2009. He was appointed Manchester Academic Health Sciences Centre (MAHSC) Honorary Professor in 2022.

Brendan’s research interests in patient safety and airway management led to the initiation of the UK National Tracheostomy Safety Project, collaborating widely in developing educational resources to guide the multidisciplinary response to airway emergencies. Realising that the real work was in prevention of airway emergencies, Brendan helped to develop the Global Tracheostomy Collaborative in 2012, bringing together international expertise from Harvard to Melbourne with the goal of improving tracheostomy care ‘everywhere’ through quality improvement initiatives. Brendan has worked on and led a number of domestic and international quality improvement projects and research studies, securing significant grant funding. 

Brendan and his team have won a number of awards for their work, including:

• Association of Anaesthetists Innovation Award 2023 (Bubble PAPR)
• British Medical Journal Award for Anaesthesia & Perioperative Medicine Team of the Year 2020
• Intensive Care Society Improvement Project Award 2020
• National Institute of Academic Anaesthesia Research Award 2019 

Outside of medicine, Brendan is entertained by a young(ish) family, plays guitar in the family rock band, "Death Metal Children of Rock," attempts to support Liverpool FC whilst living near Old Trafford, and tries to ride his road bike when it isn’t raining (too hard).

: @BrendanAMcGrath

Anna-Liisa Sutt

Speech and Language Therapist

Anna-Liisa Sutt is a Speech and Language Therapist whose work involves communication and dysphagia management of adult intensive care patients. Most of Anna-Liisa’s career to date has been in Brisbane, Australia. She has recently moved back to the UK to continue in a clinical post at The Royal London Hospital, alongside continued teaching commitments and research nationally and internationally. Her passion is improving the management of patients with tracheostomies, from insertion to decannulation and longer-term outcomes.  She is devoted to advancing SLT input and its evidence base in the critical care environment.  In her PhD Anna-Liisa assessed the effect of one-way valves on regional ventilation and communication success of ventilated ICU patients with a tracheostomy.

: @MsAnnaLiisaSutt

Ashwin Bhat

Clinical Specialist Physiotherapist - Critical Care, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent

Ashwin graduated from Rajiv Gandhi University of Health Sciences in 2006 with a Bachelor’s degree in Physiotherapy. After 2 years of working across various intensive care units at Bombay Hospital, he moved to the states and completed a Masters in Health Sciences at University of Indianapolis, USA in 2010. He has extensive experience working in respiratory medicine and critical care across 4 different healthcare models including India, USA, New Zealand, and UK. He moved to the UK in 2016 and has worked as a respiratory physiotherapist in both private and public sectors. In addition, he undertook further post graduate training and has completed a PG Diploma in Advanced Clinical Practice - Critical Care at Brunel University London. Ashwin is currently working as a Clinical Specialist Physiotherapist in Critical Care at Royal Stoke University Hospital. He has a special interest in tracheostomy weaning, rehabilitation after critical care illness and NIV. He currently sits on the Association of Chartered Physiotherapists in Respiratory Care (ACPRC) committee.

Gemma Jones

Speech and Language Therapist, UK

Gemma has 20 years’ experience as an SLT, with over 15 years’ experience of working in Intensive Care.  She is a specialist advisor to the RCSLT for Critical Care.  Gemma is the SLT lead for Tracheostomy services within her Health board and Chair of the UK National Specialist interest Group for SLTs working in Intensive Care.  She has helped develop a number of national policies and guidelines, including ICS SLT Pillar, RCSLT Tracheostomy Competencies for SLT

Helen Newman

Speech and Language Therapist

Helen has over 20 years experience working as a speech and language therapist (SLT) in the UK and New Zealand. She has worked extensively with patients with a tracheostomy in intensive care, H&N cancer and brain injury rehabilitation. She is a member of the International Group of SLTs Working in Ultrasound, whose pioneering work explores clinical applications of ultrasound in voice, speech, swallowing and tracheostomy. She is committee member and Treasurer of the Royal College of Speech and Language Therapists’ Tracheostomy Clinical Expert Network. Helen currently holds an NIHR Clinical Doctoral Research Fellowship, jointly hosted by Barnet Hospital (Royal Free London NHS FT), and the UCL Division of Surgery and Interventional Science. Her PhD focuses on how to choose the best size tracheostomy tube for adults in ICU, inspired by seeing first hand the effects of tube size on patient experience and recovery. She is passionate about humanising care in the ICU through person-centred, ‘whole-picture’ approaches to management.

: @HelenNewmanSLT

Jason Nunn

Jason graduated from King's College London in 2009 and is currently working towards the Advanced Cardiorespiratory Physiotherapy MSc at UCL. He has specialised in Critical Care physiotherapy and since moving to University Hospital of Wales in Cardiff has taken a key role within their Tracheostomy Team. Jason's clinical interests are focused around supporting the recovery of Critical Care patients to optimise their outcomes alongside the art of mechanical ventilation weaning. Within his tracheostomy role Jason's drive is to ensure each patient living with a tracheostomy gets the best possible care and opportunities at weaning from that tracheostomy where possible. Alongside his colleagues within the Cardiff Tracheostomy Team Jason leads on local education, procedures and policy as well as supporting colleagues working with patients living with tracheostomies across South Wales.

Paul Twose

Physiotherapist, UK

Paul Twose is a consultant therapist working with critical care at Cardiff and Vale UHB. He is also an honorary lecturer at the School of Healthcare Science within Cardiff University, the current ACPRC critical care champion and deputy chair of the National Rehabilitation Collaborative.

Having graduated in 2005, and completed his MSc in 2013, Paul’s main interests are in workforce development across all therapies. This focuses on the roles and responsibilities undertaken by therapists but also trying to prepare the workforce of the future. This follows on from his work exploring the minimum standards of clinical practice by physiotherapists in critical care, and ongoing work exploring existing services including both qualitative and quantitative studies. His future research will explore how therapy workforce impacts on patient outcomes, and to make more specific assessments of required workforce. His other major interest is within tracheostomy care. He recently received a £400,000 grant from the Cardiff Capital Region to explore innovative ways of delivering education including the use of virtual and augmented reality. This will include tracheostomy care but also consider other potential uses including bronchoscopy and intercostal chest drain insertion.

Professor Sarah Wallace

Consultant Speech and Language Therapist

Sarah Wallace OBE FRCSLT is a Consultant Speech and Language Therapist (SLT) at Wythenshawe Hospital in Manchester and honorary senior lecturer at the University of Manchester. She specialises in Critical Care and has over 30 years of clinical experience as an SLT. After training in Manchester, Sarah has worked in hospitals and Non-Government Organisations in the UK, Singapore, Grenada (WI) and Cambodia. Whilst working clinically in cardiothoracic, ECMO and general critical care in Manchester, she also teaches and conducts research internationally, focussing on laryngeal injury, dysphagia and communication issues post intubation and tracheostomy. She has over 60 publications, several top cited articles winning awards from the BMJ and the ICS. She holds expert advisor roles with the Intensive Care Society (ICS), the National Tracheostomy Safety Project and the Royal College of Speech and Language Therapists (RCSLT) and has contributed to many policies, guidelines and initiatives including GPICS, FEES, NCEPOD and the ICS National Rehabilitation Collaborative. Sarah is also an Associate Editor for JICS. She has pioneered new treatments for laryngeal recovery in ICU, setting up the first FEES service in Asia and the UK and supports SLT service development in the UK, Sweden and Chile. 

Tim Felton

Consultant in Intensivist and Respiratory Medicine, Manchester University NHS Foundation Trust

Tim Felton is a Consultant in Intensive Care and Respiratory Medicine at Manchester University NHS Foundation Trust and Senior Lecture in the Division of Infection, Immunity and Respiratory Medicine at the University of Manchester.  He qualified in medicine in 1999 at the University of Nottingham.  Dr Felton undertook his training in Respiratory and Intensive Care Medicine in the North West of England and in Sydney, Australia.  He completed an MRC Clinical Research Training Fellowship and was awarded his PhD in anti-infective pharmacology by The University of Manchester in 2014.  His research interests are in the diagnosis and optimal treatment of sepsis and other infections in critically ill patients. He has particular expertise related to optimising antimicrobial drug regimens to suppress emergence of anti-microbial resistance.  Dr Felton has received £2.5M of external grant funding over the last 5 years. He is involved in a number of academic and commercial clinical trials in critically ill patients with severe infections.  

: @timwfelton

Holly Mackenzie

Principal Pharmacist - Critical Care, King's College Hospital NHS Foundation Trust

Holly MacKenzie is the Principal Pharmacist in Critical Care at King’s College Hospital NHS Foundation Trust, London. She started out in critical care in 2017, and has gained diverse experience working across leading teaching hospitals, including Newcastle upon Tyne NHS Trust and Leeds Teaching Hospitals, before taking on her current leadership role at King’s.

Holly has clinical and research interests in drug management in Extracorporeal Membrane Oxygenation (ECMO) therapy, unlicensed drug use and ethical decision-making. She supports operational implementation of drug related NIHR portfolio studies in her organisation ensuring safety and governance aspects are being adhered to.

Passionate about education, leadership, and service innovation, Holly has delivered local training programs, supervised quality improvement projects, and contributed to the development of critical care guidelines and business cases.

Regionally, Holly is a member of the South East London Adult Critical Care Operational Delivery Network where she has actively participated in peer reviews at other Trusts.

Her commitment to multidisciplinary collaboration, research, and evidence-based practice underpins her vision for fostering inclusive and sustainable critical care pharmacy services, always striving to improve patient safety and outcomes.