Dr Tom Hughes - Ordinary Member Representing Wales

Dr Tom Hughes MBBS FRCP MD, President, Welsh Association of Stroke Physicians (WASP)Council Member, BASP

I am a Consultant Neurologist and Clinical Director of Medical Neurosciences in the University Hospital of Wales, Cardiff.  I also chair the Specialist Advisory Committee (SAC) for Neurology in the Joint Royal College of Physicians Training Board (JRCPTB) in which role I have led – for Neurology –  the negotiations and planning involved in the Shape of Training reforms, the first trainees in which started their Internal Medicine in August 2019.

As a junior doctor I remember well being the person pushing the notes trolley past the patients who had been labelled “ordinary stroke” – by which my consultant meant it was not a result of infective endocarditis or an atrial myxoma – even though the underlying pathologies were susceptible to rational explanation and secondary preventative strategies, and their disabilities were profound and life changing.  This therapeutic nihilism has now been superseded by exciting developments in treatment and understanding.  The pace of change, the beneficial – and detrimental – effect of the interventions, and the repertoire of skills required to be a good stroke physician, makes the subject of stroke medicine exciting and very worthwhile.  For these reasons, and to promote closer cooperation between stroke medicine and neurosciences – locally and nationally – I resigned from my neurology post in 2017 to work full time as an acute stroke physician.

Trials of treatment have been an important part of my engagement in stroke, as a PI, starting with the IST3 trial, then RESTART, and now SOSTART.  Clinical trials allow uncertainties to be shared and help NHS clinicians maintain their engagement with important research. The subject of my MD thesis with Professor Mark Wiles in Cardiff was the measurement of swallowing in health and in motor neurone disease which informs directly my approach to the assessment and management of the disability we see in stroke patients.

I am pleased to be on the executive of BASP to try and contribute to the raising of standards of stroke medicine in the UK.