Beatson staff help spread the word on dementia

Dementia is a fact of life for thousands of Scots and their families – but what does it actually feel like to suffer from the disease?

 That’s what some staff at the Beatson West of Scotland Cancer Centre tried to discover, as part of Dementia Awareness Week.

The aim of Dementia Awareness week (3-9th June 2019) is to encourage people and organisations to help in raising awareness of the disease and the impact it has on people and those around them.

At the Beatson, staff have been doing their bit too.

Nicky Donnelly, Cancer Clinical Educator said: “ To mark Dementia Awareness Week myself and a colleague wore the Dementia simulation suits and went on a walk round of the building to engage with staff about how it felt to be wearing this resource.

The Dementia Simulation suit helps to simulate ageing and impairs the movement of those wearing it, simulating some of the typical difficulties that people experience in older age, showing you how tiring it is not to be able to move fully, stopping you being able to freely move your joints, making it difficult to feel and move your hands and fingers and grip things.

Nicky added: “It also has a back piece that gives you a curvature of the spine so you can’t stand up and googles that give you a yellowing vision to replicate loss of sight and peripheral vision, typically associated with cataracts, while ear plugs can impair your hearing and awareness of your surroundings.”

“Our experience of wearing the suit was quite revealing as you truly appreciate the cognitive changes that people with Dementia experience; it really highlights the impact on people with this condition that without the suit you wouldn’t be able to understand.

“The wider staff enjoyed the experience of seeing us in the suits they were very engaged in asking vital questions of the Care of the Older Person Nurse who has been instrumental in raising awareness of the issues people with Dementia face.”

Study of UK dental professionals reveals extent of occupational risk of SARS-CoV-2 infection

A University of Birmingham-led study of over a thousand dental professionals has shown their increased occupational risk of SARS-CoV-2 infection during the first wave of the pandemic in the UK.

The observational cohort study, published today (3 June 2021), in the Journal of Dental Research, involved 1,507 Midland dental care practitioners.  Blood samples were taken from the cohort at the start of the study in June 2020 to measure their levels of antibodies against SARS-CoV-2, the virus that causes COVID-19.

The team found 16.3% of study participants – which included dentists, dental nurses and dental hygienists – had SARS-CoV-2 antibodies, compared to just 6% of the general population at the time.  Meanwhile, the percentage of dental practice receptionists, who have no direct patient contact, with SARS-CoV-2 antibodies was comparable to the general population, supporting the hypothesis that occupational risk arose from close exposure to patients.

The study also found ethnicity was also a significant risk factor for infection, with 35% of Black participants and 18.8% of Asian participants having SARS-CoV-2 antibodies, compared to 14.3% of white participants.

Blood samples were taken from participants three months later, in September 2020, when dental practices in England had re-opened with enhanced PPE and infection control measures in place, and once again in January 2021, six months after the start of the study, during the second wave of the pandemic when healthcare workers were being vaccinated.

The results showed that of those who had previous COVID-19 infection, over 70% continued to have SARS-CoV-2 antibodies both at three months and six months later, and they were at a 75% reduced risk of re-infection with the virus.

The study also demonstrated the immunological impact of COVID-19 vaccination, with 97.7% of those without previous infection developing an antibody response at least 12 days after their first Pfizer vaccine.  In those with evidence of previous infection, the antibody response was more rapid and higher in magnitude after a single dose of the Pfizer vaccine.

Furthermore, none of the cohort with a level of SARS-CoV-2 antibodies greater than 147.6 IU/ml in their blood tested positive for COVID-19 throughout the six-month period from the first to the final blood tests.   

First author Dr Adrian Shields, of the University of Birmingham’s Institute of Immunology and Immunotherapy, said: “Understanding what an antibody test result means to an individual with respect to their risk of infection is essential to controlling the pandemic.

“Our study has taken the first steps in defining the level of antibody in a persons’ blood necessary to protect them from infection for six months. Furthermore, by comparing the antibody levels we have found in dentists to those contained in widely available reference material produced by the World Health Organization, we hope the protective level we found can be easily confirmed and compared by other laboratories.”

Corresponding author Professor Thomas Dietrich, of the University of Birmingham’s School of Dentistry, adds: “Critically, only 5.3% of the cohort developed an antibody response that exceeded this threshold of 147.6 IU/ml following the first wave of the UK pandemic.

“This suggests that natural infection alone is unlikely to generate meaningful, durable herd immunity.”

Co-corresponding author Iain Chapple, Professor of Periodontology at the University of Birmingham and Consultant in Restorative Dentistry at Birmingham Community Healthcare Trust, adds: “Dental professionals are thought to be at high risk of exposure to SARS-CoV-2 because they routinely operate within patients’ aerodigestive tract and regularly carry out aerosol-generating procedures that result in the production of airborne particles.

“Through our research, we have clearly shown that dental professionals were at increased occupational risk of exposure to SARS-CoV-2 prior to the new PHE guidance on PPE. The occupational health measures that have been put in place in general dental practice as a consequence of COVID-19 appear to remove that increased risk, however, this will need to be thoroughly investigated to see if they have successfully interrupted transmission of SARS-CoV-2 and other respiratory viruses.”

Co-corresponding author Professor Alex Richter, also of the University of Birmingham, said: “This is the first time the occupational risk of exposure to a potentially fatal respiratory virus has been studied in a large dental cohort.

“It is important that we now progress our research to ensure we have an understanding of how people are protected from re-infection with COVID-19 following natural infection and vaccination.

“The nature and duration of immunity in these cohorts will be critical to understand as the COVID-19 pandemic progresses, particularly with respect to the efficacy of vaccination strategies -single-dose, multiple-doses, vaccine combinations – and in relation to novel viral variants of concern.”

New partnership offers learning opportunities for Ambulance service Mobile Testing Unit staff

The Scottish Ambulance Service has teamed up with West Lothian College to promote a new Scottish Vocational Qualification (SVQ) in health and social care for staff working at our Mobile Testing Units (MTUs).

The Gateway to Health and Social Care SVQ is a nine-week course developed by West Lothian College in collaboration with the Service.

It provides MTU operatives with the opportunity to formally demonstrate their current skills and knowledge which they have developed in their work at the testing centres. The course, starting in June 2021, is a stepping stone for those who are interested in pursuing a career in Health and Social Care, as successful completion of this short course can be used towards the full SVQ award.  

This opportunity for staff working within the MTU has been made possible by a £200 grant for each staff member from Skills Development Scotland. It will provide MTU operatives with a transferable qualification to apply for further opportunities within health and social care.

Our 39 MTUs across Scotland support the ongoing response to the COVID-19 pandemic by ensuring patients in urban, rural and remote areas have easy access to a coronavirus test. The location of the units is planned by National Services Scotland and local resilience partnerships.   

John Alexander, General Manager for the Mobile Testing Units (MTUs) said: “So far over 300 staff members have looked into applying for this great opportunity, which allow them to receive a formal qualification following the practical skills they have developed in their roles.

“We’ve seen the dedication of our staff who have signed up to work at Mobile Testing Units, many of whom were working in very different roles before the pandemic, and this qualification will equip our staff with further skills to develop their careers.”

Jackie Galbraith, Principal of West Lothian College said: “We are delighted to be working in partnership with Scottish Ambulance Service on this opportunity for their staff and to support the development of the Health and Social Care workforce. 

“This is a really valuable qualification, allowing MTU operatives to transfer their skills to other areas within health and social care. I have no doubt that our excellent team of work-based assessors will enable Mobile Testing Unit staff to succeed in this new qualification.”  

Forget Me Not Box aims to comfort those affected by dementia

Edinburgh Napier student Christy Orr develops tool in memory of her Gran

A sensory box that aims to comfort those affected by dementia through helping recall memories has been created by an Edinburgh Napier student.

Forget Me Not Box has been created by final year graphic design student Christy Orr.

The box contains a set of tools that help trigger the five senses – sight, smell, touch, taste and sound – helping those with dementia recall memories and retain identity. It gives the user the opportunity to completely personalise its items and is split into four main sections.

The lid can be used to showcase photographs. The inclusion of scent bottles provide opportunities for the user to include certain smells such as their favourite perfume. A built-in sound module can provide favourite music or even voice notes from loved ones with another compartment available to store treasured items such as marbles, medals and more.

The box also includes taste cards that can be used as a reminiscence tool. They feature photos and descriptions of food and drink that may trigger memories.

The aim of the box is to allow those affected by dementia to undertake reminiscence therapy sessions with a loved one or carer, with the playful items acting as conversation starters.

Christy, 22, has designed the box as part of her final year graphic design project at Edinburgh Napier, and will this week exhibit her work at the annual Edinburgh Napier Degree Show which takes place online from 2 June.

The toolkit has already been user-tested by individuals at various stages of their dementia diagnosis through a link-up with Yorkshire-based charity Dementia Forward. Christy has also received support from CogniHealth with the project.

Christy, who is from Cumbernauld originally, has created the toolkit in memory of her late-Gran after seeing first-hand her own experiences with Alzheimer’s.

She said: “I was quite young when I lost my Gran to Alzheimer’s but I remember finding it quite difficult to find things to initially talk to her about when I visited her. That’s really where the idea for Forget Me Not Box stemmed from. I wanted to create something that helped start those conversations.

“As I looked more into this area, and learnt more about reminiscence therapy and how it can help, it was important that my box had the ability to be completely personalised to an individual person.

“Everyone has different triggers that invoke memories – whether it be a certain smell, a sound, a photograph, the thought of eating fish and chips or the sight of something like a souvenir from a past holiday. It was essential that the toolkit could help include as many of these things as possible.

“Working with CogniHealth and Dementia Forward has been fantastic, and it’s great to have seen the box out there and being used by people who it was designed for. I’m still awaiting feedback from the user-testing but early indications show that it has been warmly received by those who have used it.

“Although this has been designed as part of my final year project at Edinburgh Napier, I’m very keen to continue with the idea as my time at the University comes to an end. I’m really looking forward to developing the box further in the coming months and if it can help some more people find comfort through a dementia diagnosis, then it’ll have been completely worthwhile.”

The Edinburgh Napier Degree Show runs from today – 2 June. More information and to view this year’s work, visit here.

New Clinical Nurse Specialist appointed to support asbestos-related cancer patients

Funded by Action on Asbestos, Lynne Hunter joins national charity, Mesothelioma UK and will be based at the Western General Hospital

Lynne Hunter has been appointed as a Mesothelioma UK Clinical Nurse Specialist and will be based at the Western General Hospital. Lynne will provide nursing care and support for mesothelioma (asbestos-related cancer) patients in South East Scotland.

The post has been made possible thanks to funding from Scotland’s asbestos, industrial disease and injury charity, Action on Asbestos.

Lynne will work with Mesothelioma UK Team Leader for Scotland, Carolyn MacRae, and will link with colleagues across the region to promote equitable access to mesothelioma-specific support and treatment throughout the region.

Mesothelioma is a cancer related to exposure to asbestos and predominantly affects the lining of the lungs. The UK has the highest incidence of the disease in the world with around 2,700 people diagnosed each year. Between 50 and 60 cases of mesothelioma are diagnosed each year in the South East Scotland region.

In her new role, Lynne will focus on caring for patients with mesothelioma at every part of their treatment journey, helping to make their journey as smooth as possible. She will provide specialist support and advice to patients, families, healthcare professionals, and link in with local patient support groups.

Most recently, Lynne has worked as a pleural nurse at St John’s Hospital in Livingston. Prior to this, she worked in general respiratory in St John’s Hospital.

Lynne qualified as Registered Nurse in 2012 and has also completed her clinical decision-making course at Napier University.

Commenting on her new role, Lynne said: “I am really excited to be taking on this new role and bringing my previous experience in respiratory nursing practice.

“I have always had a strong interest in this area of nursing and have described the role as my dream job and it’s finally great to get started.”

Lorraine Creech, Head of Nursing for Mesothelioma UK, added: “Mesothelioma UK is extremely grateful to Action on Asbestos who have provided the funding for this post and are now working closely with Mesothelioma UK to support and complement the work of the Scottish National Mesothelioma Network.

“Lynne is a very valuable addition to the Mesothelioma Nursing Service for South East Scotland and the Scottish Mesothelioma Network as a whole.

“Lynne’s appointment sees Mesothelioma UK reach 33 Clinical Nurse Specialists and seven within Scotland, providing dedicated care, support and treatment for mesothelioma patients throughout the UK.”

Edinburgh student helps start cancer cures in mum’s memory

An Edinburgh student has raised over £3,900 to help Worldwide Cancer Research start cancer cures, in memory of her beloved mother who passed away three years ago following a breast cancer diagnosis.

Alex Burns, 21, joined by best friend Tara Haworth, 22, completed a 100km walking challenge along the Union Canal at the beginning of May, inspired by her mum Anne’s desire to raise money for life-saving research, and to bring together those who loved her to do something positive.

Anne Burns, who passed away in 2018, was initially diagnosed with breast cancer in 2008.  The mum of two went into remission but was told the cancer had returned in 2014.

Speaking about coping with losing her mum, Alex, originally from Helensburgh, said: “Four years after her second diagnosis in 2014, my mum passed away on 25th March 2018, which was also her birthday. It’s been really difficult since then, and I’ve not really talked about it much.

“Although cancer is a part of her story, she is better remembered for the love and laughter she brought to everyone in her life. People didn’t really know what to say to me and my sister when mum passed away, but being able to celebrate her memory three years on has brought together all the people that loved her and helped us do something positive to remember her.”

Since it was established in 1979, Edinburgh-based UK charity Worldwide Cancer Research has funded over £200million of research in over 30 countries to start new cancer cures.

This year, 16 institutes, in 15 cities across eight countries have now received £3.2m of funding – three of which are UK-based – to fund research into 11 different cancer types, as well as fundamental research. 

Alex added: “Supporting a local charity like Worldwide Cancer Research, and particularly supporting the funding of research into new cancer cures, was something that my mum would have loved.

“When my mum was at the end of her journey, she wanted to make sure there were new avenues to explore and bring hope to others who might find themselves in the same position as her.

“There’s nothing you can say to make losing your mum easier, but doing something like this walk to, not only bring together everyone who loved my mum, but to also raise funds so that this doesn’t happen to others in the future.

“My mum loved raising money for cancer research, and I wanted to honour that by doing something I think she’d be proud of.”

Alex completed the walk with best friend Tara Haworth.

“We’ve been friends since our first year at the University of Edinburgh, where we were in rooms next door to each other in halls. Tara is my only friend from Edinburgh who actually met my mum as she passed away early in my first year.

“I wasn’t really ready to be massively social during this time, but Tara has just been so empathetic and understanding throughout this whole journey. She’s been by my side every step of the way, and now quite literally as we take on this 100km walk!

“We started walking at 4am and finished around midnight, walking from the Edinburgh Quay to the Falkirk Wheel and back, with five breaks to meet friends and family en route and celebrate my mum’s memory.

“We’ve already raised almost £4,000 which is just amazing, and we’re so thankful to everyone who has sponsored us and hopefully this money helps bring hope to more people in the future.”

Dr Helen Rippon, Chief Executive at Worldwide Cancer Research said: “Breast cancer affects a huge number of people right across the world. By funding more discovery research, we can continue to start cancer cures and save more lives in the future.

“We are so grateful to Alex and Tara for their amazing fundraising efforts and for helping us continue to make our ground-breaking research possible. Together, with the help of Curestarters like them, we can end cancer.”

For more information about Worldwide Cancer Research or to find out how you can help us start new cancer cures, please visit: 

https://www.worldwidecancerresearch.org/support-us/donate/

To support Alex’s fundraising, go to: 

https://www.justgiving.com/fundraising/alexandra-burns42

Henry Duncan Grants to provide £1m to support mental health and wellbeing

 Corra Foundation announces £1m Henry Duncan Grant funding for community-based mental health and wellbeing support

This year’s Henry Duncan Grants programme  opened on May 25 and the fund totalling £1m will have three strands:

  • Organisation Grants – open to charities with an annual income up to £500,000 and a core focus on supporting people of any age who experience mental ill health. A maximum of £8,000 per year granted up to five years.
  • Black, Asian and Minority Ethnic Project Grants – open to Black, Asian and Minority Ethnic led charities with annual income up to £500,000, delivering projects that support people of any age who experience mental ill health. A maximum £8,000 per year up to three years.
  • Micro grants – open to small charities and voluntary groups with an annual income up to £50,000, supporting communities experiencing disadvantage to improve mental health and wellbeing by reducing isolation and loneliness. This includes Black, Asian, Minority Ethnic and rural communities. One-off grants of a maximum £1,000.

It is estimated that around one in three people in Scotland experience mental ill health in any year. The health, economic and social impacts of the coronavirus pandemic are likely to increase people’s need for mental health support.

The impacts aren’t spread equally across the population, with adults living in areas of poverty approximately twice as likely to have common mental health problems.

Black, Asian and Minority Ethnic communities have been among those most impacted by the coronavirus pandemic. This is likely to affect people’s mental health, for example through fear and anxiety, experience of illness or loss of loved ones.

Corra also acknowledges the impact that racial injustice has on mental health and well-being. Research has shown that Black, Asian and Minority Ethnic communities are disadvantaged when accessing mental health and well-being services, including the quality of care they receive. This is due to racism, structural and institutional inequalities, fear, stigma and discrimination.

For these reasons, Henry Duncan Grants 2021 includes a strand focused on Black, Asian and Minority Ethnic communities.

These are project grants, rather than core, reflecting the fact that much of the work done to support mental health among Black, Asian and Minority Ethnic communities is delivered by organisations that do not have mental health as their primary focus. Corra believes diversity, equity and inclusion (DEI) is fundamental to its ten-year strategy. As a result, the team are working proactively to reach, and be accessible to diverse communities.

Henry Duncan Grants opened on 25 May – please keep an eye on the Corra Foundation website, or follow Corra on Twitter @CorraScot or Facebook for more information.

Spring into summer with an offer from Edinburgh Leisure

With Edinburgh Leisure’s gyms, pools, fitness classes and climbing arena open, they are encouraging you to spring into summer with an enticing no-joining-fee offer. At a time when health has never been so important, their latest offer could be just what you need to kick start your fitness regime.

The no-joining-fee offer is available on new memberships and can be bought online on the Edinburgh Leisure website from Tuesday, 1 June to Wednesday, 30 June and is applicable to all fitness, swim, gym, class and climb memberships.

The Edinburgh Leisure experience may be different from before Covid-19 with new customers needing to join online rather than in venue and pre-booking required for all activities, but customers will still receive the warm, Edinburgh Leisure welcome.

Edinburgh Leisure continues to operate in a cashless environment, accepting contactless payments; and safety remains important with enhanced cleaning taking place and additional sanitisation stations available throughout the venue for use before and after each visit; and timetabled activities with staggered start times to reduce congestion.

With 50+ venues across the city, including a world class climbing centre, 6 golf courses, 9 swimming pools, 10 state of the art gyms and 800+ fitness classes per week across the various centres, Edinburgh Leisure is the biggest club in town, with something for everyone to enjoy moving and getting fitter.

For further information visit www.edinburghleisure.co.uk

New treatment standards for drug users announced

New standards for treatment for drug users will ensure everyone has access to the support which works best for them.

The 10 new standards, published today by the Drug Deaths Taskforce, will reinforce a rights-based approach for people who use drugs and the treatment they should expect, regardless of where they live.

Funding from the additional £50 million for drugs services announced by the First Minister in January will ensure that all Alcohol and Drug Partnerships (ADPs) are supported by the Scottish Government to embed the standards by April 2022. They make clear that people must be able to start receiving support on the day that they ask for it and emphasise the importance of allowing people to make informed choices about the type of medication and help available to them.

These 10 standards apply to Medication-Assisted Treatment (MAT) which is the term used to refer to the use of medication, such as opioids, together with any psychological and social support, in the treatment and care of people who experience problems with drug use.

Minister for Drug Policy Angela Constance said: “I want to thank the Drug Deaths Taskforce for their work on developing these standards and all those who gave their views following the interim report.

“We now have a set of standards which are safe, accessible and person-centred. These will help ensure consistency of treatment across the country. Making help available and giving people an informed choice is an essential part of respecting a person’s rights and dignity. It is also an approach which is more likely to be effective and provide people with the support and treatment they need.

“We have said a national mission is needed to tackle the drug deaths emergency and that is why we allocated an additional £250 million over the next five years to improve and increase services for people affected by drug addiction.

“These MAT standards will mean everyone with problematic drug use can access the right support for them regardless of their situation or location.”

Chair of the Drug Deaths Taskforce Professor Catriona Matheson said: “The publication of the MAT Standards and the start of their implementation represents a major achievement for the Taskforce and the beginning of a new phase of our work.

The Standards constitute the most significant intervention in the strategy to reduce the unacceptable level of drug related deaths. The Standards will form a critical element of the longer term, sustainable actions that will save lives, complimenting the emergency actions taken to date.

“The evidence is clear that using street drugs and not being in treatment is dangerous and life-threatening. The Taskforce wants more people at risk to be in treatment programmes.

“I would like to thank everyone who contributed to the rapid development of the Standards and who are now involved in their roll-out and adoption. Commitment like this will help save lives.”

Scottish Drugs Forum CEO David Liddell said: “Scotland’s MAT Standards are the most significant landmark in improving Scotland’s response to problem drug use in over a decade. Implementing the standards will be the most significant development in addressing the on-going public health emergency of drug-related deaths.

“People who enter treatment are amongst the most vulnerable people in our society and often find engaging with services difficult. Services need to be more attractive, more approachable and more accessible; and reach out to people who have been in treatment but no longer are. 

“These standards are the basis for  making services truly person-centred. Implementing them will help services develop empowering relationships with people in treatment. Full implementation of the standards will save lives, reduce harm and transform people’s quality of life.”

Medication-Assisted Treatment (MAT) standards:

  • all people accessing services have the option to start MAT from the same day of presentation
  • all people are supported to make an informed choice on what medication to use for MAT, and the appropriate dose
  • all people at high risk of drug-related harm are proactively identified and offered support to commence, re-commence or continue MAT
  • all people are offered evidence based harm reduction at the point of MAT delivery
  • all people will receive support to remain in treatment for as long as requested
  • the system that provides MAT is psychologically and trauma informed (Tier 1); routinely delivers evidence based low intensity psychosocial interventions (Tier 2); and supports the development of social networks
  • all people have the option of MAT shared with Primary Care
  • all people have access to advocacy and support for housing, welfare and income needs
  • all people with co-occurring drug use and mental health difficulties can receive mental health care at the point of MAT delivery
  • all people receive trauma informed care.

Scottish Government launches lung cancer detection campaign

A new Detect Cancer Early (DCE) campaign is encouraging people to contact their GP if they have a new or different persistent cough or unusual breathlessness for three weeks or more in an effort to return to pre-pandemic cancer detection levels.  

These could be the early signs of lung cancer – and it’s important to get checked, especially if you’re over 40. While lung cancer is the most common cancer in Scotland, with around 5,500 new cases diagnosed every year, more people than ever are surviving the disease. This is down to improved treatments and more people being diagnosed earlier.

The campaign has been developed in response to Public Health Scotland’s data that show around 25% fewer lung cancers are being diagnosed now compared to pre-COVID-19. This, coupled with the fear of a potential cancer diagnosis continues to stop people acting early, when there are more treatment options available and the chance of survival is higher. The campaign, entitled ‘Settling In’, aims to empower people to take responsibility for getting any potential symptoms checked.

Since the launch of our £43m Detect Cancer Early Programme the proportion of lung cancer diagnoses at the earliest stage have increased by 43%, and by 57% in the most deprived areas of Scotland.

Launching the campaign, Health Secretary Humza Yousaf said: “More people are surviving cancer than ever before, but we know that fear of cancer is putting people off getting checked or attending screening, when invited.

“Don’t ignore early cancer signs and symptoms, and certainly don’t delay getting checked. NHS Scotland remains open during COVID-19 and your GP practice is still there for you – getting checked early is a hugely important step in finding out if you, or your loved one, needs urgent medical help.

“While it’s probably nothing to worry about, a quicker diagnosis can mean less worry. If cancer is confirmed, more treatment options are available if it’s found early.”

Co-chair of Scottish Primary Care Cancer Group Lorna Porteous said: “If you have a sign or symptom that might be due to lung cancer, please don’t delay contacting your GP practice.

“During the pandemic appointments may be done by either telephone or video so when you do get in touch, please give as much information as you can. You will be asked to come in for a face-to-face appointment if we need to examine you or do some tests – measures are in place to ensure your safety.”

Top professional snooker referee, Leo Scullion, today backed the call for people worried about potential lung cancer symptoms to get checked without delay, as someone who survived the disease after seeing his GP about a persistent cough. 

Leo, 63, originally from Glasgow but treated in Ayrshire, was diagnosed in July 2014 and started treatment in September 2014 which involved chemotherapy and radiotherapy. Following a period of recovery, Leo returned to the snooker circuit in 2017. 

He was told his cancer was in remission in December 2019, five years after diagnosis –  the same year he reached the pinnacle of his career, officiating his first World Championship final.

Leo said: “I was aware I was coughing, but it became noticeable to those around me.  I was in China for a tournament and put it down to the smog at that time, and the fact I was a smoker. 

“I did have other symptoms which I now know were warning signs.  I was waking up in the middle of the night with terrible sweats, and by the time I came back home, I was feeling pretty horrible. Looking back, I think I knew there was something more going on, your body just tells you.

“As soon as the results came back, I just remember saying ‘is it terminal?’ At that point my GP reassured me that there was plenty they could do.

“When I was at the sharp end and I needed help, the NHS was there for me.  If you’re worried about any unusual changes to your health, or worried about someone close to you, go and get checked.  It really is that simple.  The sooner they can find out what is wrong, the better.  I’m very grateful I went when I did.  There were times when I wondered whether I’d be back refereeing.  To be back working at a professional level, and to have my health, is tremendous. 

There is life after a diagnosis, and I intend to cause havoc for the rest of it!”