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Removing the fear of lung biopsies

The BMJ Awards stories of impact

After the Awards

"The BMJ Awards are an important and productive partnership for Macmillan. The recognition and esteem they give to the shortlisted and winning medical teams empower them to continue to share the best practices that create better outcomes.”

Nicole Dobbin
Senior Marketing Manager
Macmillan Cancer Support

Dr Sam Hare is a leading consultant chest radiologist within the UK, based at the Royal Free London NHS Trust. He has introduced an innovative lung biopsy technique leading to improved patient experience and earlier lung cancer diagnosis. This has made a 73% improvement in curative surgical resection rates over three years.

Sam and his team were awarded Cancer Care Team of the Year for measurably improved care in cancer through innovation and commitment at The BMJ Awards.


“Treatments for lung cancer are improving however too many patients are failing to benefit due to delays in diagnosis or the reluctance of hospitals to do lung biopsies for fear of a common complication, a collapsed lung (pneumothorax).” Sam explains.


“We are dealing with an extremely difficult system that presents huge challenges with waiting lists, funding and limited resources. The only way to overcome these challenges is to have innovative work that keeps patients out of hospital and gives them access to an early diagnosis.

A key step in this innovative technique is removing the fears surrounding biopsies through the use of a small portable device, the Heimlich valve chest drain (right), which in the event of a collapsed lung can be inserted before allowing patients to go home. The traditional bulky drain typically requires a one to two-day hospital stay, which meant that many frail patients were denied biopsies because of fears over prolonged admission. 

“The BMJ Awards recognises and promotes this work, and that is very important for the necessary cultural and behavioural shifts by all NHS workers. It also helps to set a benchmark for the rest of the department and our sub-specialties.”

“Most importantly, it helps to create those shifts in behaviours that ultimately lead to better patient outcomes.” 

Sam and his team have streamlined a service that has led to more and better lung biopsies for patients as well as taking up a leadership role nationally by setting up a course to train other centres. They are set on helping make the technique standard practice for lung biopsy throughout the NHS.

“Change in the NHS is difficult because it takes cultural bravery to overhaul outdated techniques. Providing a service with the good of the patient at the centre of it is where you start to see evidence for change.” 

“For our work to become recognised boosts the morale of the entire department and encourages us to continue to deliver the highest standard of patient care. We’ve been on the BBC News and in the Times, but this award takes us to a new level because The BMJ is so widely read by clinicians all over the world.”

“Since the Awards, we’ve had contact from all around the country from Clinical Commissioning Groups, hospitals, individual clinicians and patients asking more about the technique. They’ve requested to visit and asked about ways of sharing this practice.”

“We have also been approached by the award sponsor Macmillan, Cancer Research UK and UCLPartners about collaborating. Due to this win, we are now working with Cancer Research UK to develop a best practice tariff to encourage buy-in from other institutions”

“I would encourage other teams to apply for the Awards. Even being shortlisted for The BMJ Awards gives innovative practices exposure that only The BMJ can provide. It creates so many opportunities due to it being so widely read by clinicians all over the world.”

“Winning Cancer Care Team of the Year award has been inspiring for the entire team. It is so rewarding to know what we are doing is making a difference and receiving that recognition. It makes us want to continue to innovate, share best practices. Finally, it empowers us to be brave about pushing for what we believe in so we can create better patient outcomes.”



Dr Sam Hare, consultant thoracic radiologist (left) with Dr Ashish Saini, consultant interventional radiologist and lead for diagnostic imaging.


The winning team: Barnet Ambulatory Lung Biopsy Service, Royal Free London Foundation Trust.

Sam’s NHS blog


Twitter handle 




The Prevention Team of the Year 2016 was category proudly sponsored by: