Dr Laura Gastaldi

The work she does now

Dr Gastaldi is Lead of Cancer and Palliative Care at Bath Road Surgery, Hounslow in Hounslow, where she has clinical lead responsibility for cancer and palliative care across the practice population. For three years she has run a dedicated weekly cancer clinic there — the same patients, week after week, through diagnosis, treatment, discharge, and in some cases recurrence.

That clinic is where Thread came from. Seeing the same people every week over a long period makes something visible that a single consultation does not: the problems that matter most to patients in cancer treatment are rarely the ones the treatment plan is designed to answer. They are the nausea that will not settle on day four. The letter from the hospital that nobody has explained. The partner who has stopped sleeping. The blood test that needs doing before Thursday and cannot be arranged. None of these belong to the oncologist, and all of them are clinical.

What she treats, and what she does not

Dr Gastaldi is a general practitioner. She is not an oncologist, and Thread does not provide chemotherapy, radiotherapy, immunotherapy, or surgical oncology. Those belong to your treating consultant and the centre delivering your regimen — typically HCA London, The London Clinic, Cromwell Hospital, Royal Marsden Private, or GenesisCare.

What she does is the general-practice layer around that treatment: symptom management between cycles, side effects assessed and escalated when escalation is warranted, bloodwork and pathology coordinated, letters read and translated, second opinions arranged properly rather than awkwardly, families briefed, and — after discharge — late effects screened for and surveillance held to a schedule.

She also declines a great deal of work. No cosmetic practice. No weight-management prescribing. No medico-legal reports. No paediatrics. No end-of-life care in the community, which is a distinct discipline with its own teams. Psychology and psychotherapy are referred to specialists with an explicit cancer background rather than delivered in-house. A practice that does one thing can be held to a standard; a practice that does everything cannot.

Palliative care, and what the phrase actually means

Her NHS lead role covers cancer and palliative care, and the two are routinely confused. Palliative care is the management of symptoms and quality of life alongside treatment that is still going on — pain, nausea, breathlessness, fatigue, appetite, sleep. It can begin on the day of diagnosis and run for years in parallel with curative treatment. It is not a synonym for end-of-life care. Much of what Thread does during active treatment is, in the strict clinical sense, supportive and palliative work; it is delivered to people who are expected to recover.

Training and registration

Dr Gastaldi qualified in medicine at Vita-Salute San Raffaele University, Milan in 2011, and has been registered with the General Medical Council since 2017. She holds Membership of the Royal College of General Practitioners (MRCGP), and is indemnified by the Medical Protection Society (MPS) for the scope of practice described on this site.

She continues in NHS general practice at Bath Road Surgery, Hounslow alongside this practice, and intends to. Private work that severs a doctor from an unselected NHS population tends, over time, to narrow their clinical range. Continuing in both keeps the range.

Languages

Consultations are in English. Dr Gastaldi is a native Italian speaker and has limited working German; if a patient or a family member would rather have a difficult conversation in Italian, she will switch. This is an operational capability, not a specialism — Thread is a London practice serving a London catchment.

In her own words

Almost every patient I have looked after through cancer treatment has said a version of the same thing. Not that the treatment was wrong, or that the oncologist was unkind, but that nobody was holding all of it at once — and that they had become the person doing that, at the exact point in their life when they had least capacity for it.

Thread is a small answer to that. One doctor, a defined scope, a stated response time, and a written care plan that says who is doing what. It is not a new model of medicine. It is ordinary general practice, given enough time to be done properly, in the place where it is currently missing.