RD&E News Feb 2012

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www.rdehospital.nhs.uk

1Royal Devon and ExeterNHS Foundation Trust

Royal Devon and Exeter NHS Foundation Trust staff newsletter

February 2012


Working to make patient discharge safe, soon & smooth see page 2

RD&Enews

Positiveglobal impact

page 5

safer surgerypage 5

SIGHTS ON

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Improving patient care

Lead nurse for surgery Hayley Peters said: “We recognise that getting the arrangements right for coming out of hospital is a very important part of quality patient care in terms of patient experience and the best possible recovery. Unfortunately, we also recognise from speaking with staff, patients and our Members that we don’t always get this right first time. There’s a lot of great work going on locally to improve post-hospital care but we want to pull it together and organise a really focussed push to get our discharge arrangements right first time, every time. I’m really excited to be working on this but we cannot achieve this

We have set ourselves a challenge – to achieve within 100 days a plan for how we want RD&E hospital discharge to work and a timetable to deliver the actions.

though without the involvement and sign up of colleagues.”

We want our patients and colleagues to be able to set the standards for discharge arrangements for the future, but at the heart of what we want to achieve is a system that:

✓ Has no delays for patients

✓ Gives patients & health and social care professionals the right information at the right time

✓ Provides patients with a ‘seamless’ experience of care between acute services & community services

✓ Enables on going learning from patient experience

✓ Feels as though it works for the professionals involved

✓ Increases the numbers of patients discharged to their own homes

✓ Lowers the rate of unplanned readmissions into hospital

There’s a lot of great work going on locally to improve post-hospital care.

Improving patient care


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RD&E Chief Operating Officer Elaine Hobson has been seconded as the new lead for re-design of health care for frail elderly people in Devon.

As the Joint Agency Director of Delivery and System Re-design Elaine will be the executive acting on behalf of commissioners and providers within the county including acute hospital, mental health, doctors and social services to co-ordinate and improve management of the care pathway for these patients.

Details of the interim management arrangements put in place for Elaine’s three month absence from the RD&E can be found on IaN.

We want to work with a wide group to agree the detailed areas of focus for the 100 day challenge. Key areas already defined include:

n Planning for discharge from day of hospital admission

n Early escalation of potential delays

n Getting communication right with patients, families and other carers

n Referral onto social care (the onward care referral)

n Referral onto community based health care (including community hospitals)

n Getting the right information to primary care professionals (discharge summaries)

n Patients with complex medications

n Assessing those patients most at risk of readmission and having planned contact with them during the first 48 hours after being in hospital

n Nurse /criteria led discharge

n Patients with continuing health care needs

The work will be overseen by a project group, reporting to our Hospital Utilisation Group. They will meet weekly and be tasked with delivering rapid change and innovation within the current system. We want to get it right for patients and staff as soon as possible. Where we don’t know the answer we’ll test new ideas, using the “plan, do, study, act” approach of trying new ways of working and measuring their effectiveness. It’s important that we approach the work with an open mind; we need to recognise the problems we have within our own systems and

processes and take responsibility for improving these.

We really want to get people signed up and involved in this project. We don’t know all the answers but we believe if we can use the expertise of all the professionals involved in working on discharge arrangements and post hospital care, and learn from and work with patients we can improve the current system, and come up with a clear plan within 100 days! There are three main ways of finding out what’s going on:

➤ Come to one of the four project discussion sessions to be held over the 100 days of the project. We’ll use these to update on progress and hear suggestions about the work. Sessions will take place in the PEOC lecture theatre from 12 noon - 2pm on the following dates: 15th February, 14th March and 11th April

➤ Be part of our 10+10+10 group. We want the 10 members of the project group to brief 10 colleagues who will each brief 10 others every week, and for this communication to be two way. That’s communicating with 1,000 people face to face! If you want to be part of that group then e-mail [email protected] with the subject 10+10+10 with your contact details

➤ Look out for weekly e-mail updates sent out and put onto IAN

To get the patient view on discharge we’ll be working closely with our Patient Engagement & Experience team and organising events throughout the project.

This cannot be achieved without the involvement of colleagues

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Innovation

The current postgraduate education centre buildings have now been vacated to make way for preparatory works for the demolition. In its place there will be a leading centre for medical research to improve the quality of life and health of patients here and abroad.

RD&E Joint Medical Director Dr Vaughan Lewis said: “This centre will bring together an abundance of skills, learning and innovation here in Exeter and the South West which will directly translate into real benefits for patients. The modern facilities will make possible pioneering on-site research into the treatment of

Plans for a £19 million world class research centre at the Royal Devon & Exeter Wonford hospital have taken a step closer to becoming reality.

conditions such as diabetes and obesity. It will consolidate a wide range of research already taking place in this city and significantly expand the quantity and variety of research activity we can do.

“The RILD is part of a strategy developed with our partners to have a research and innovation hub physically alongside the healthcare and education environments at the RD&E Wonford. It will enable us to translate work taking place in laboratories into treatments and therapies for patients alongside quality education and training facilities to give skilled professional colleagues access to the very latest

knowledge and technology.”

Essential to the development of the RILD (Research, Innovation, Learning and Development Centre) has been the strong collaborative partnership between the Royal Devon & Exeter NHS Foundation Trust, Peninsula College of Medicine and Dentistry and the University of Exeter. The prestigious Wellcome-Wolfson capital awards scheme injected £4.75 million in to the RILD partnership funding as part of its investment in UK scientific infrastructure.

Updates on the building works will be posted on IaN

This centre will bring together an abundance of skills, learning and innovation

Innovation


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Sights on safer surgeryThe RD&E was a key partner in research which found the performance under stress of novice surgeons could be improved by ‘gaze training’ which teaches them eye

movement patterns used by more

experienced surgeons.

Mr John McGrath, RD&E Consultant Surgeon, said: “The use of simulators has become

increasingly common

during surgical training to ensure that

trainee

surgeons have reached a safe level of competency before performing procedures in the real-life operating theatre. Up to now, there has been fairly limited research to understand how these simulators can be used to their maximum potential.

“This exciting collaboration with the Universities of Exeter and Hong Kong has allowed us to trial a very novel approach to surgical education, applying the team’s international expertise in the field of high performance athletes.

“Focussing on surgeons’ eye movements has resulted in a reduction in the time taken to learn specific procedures and, more importantly, demonstrated that their skills are less likely to break down under pressure. Our current work has now moved into the operating theatre to ensure that patients will benefit from the advances in surgical training and surgical safety.”

n Pictured is new surgeon Tom Dutton wearing the eye tracker technology

used for ‘gaze training’

The specialist work of Professor Sian Ellard (Head of Molecular Genetics) and Consultant Diabetologist Professor Andrew Hattersley at the RD&E has been recognised with the University of Exeter Outstanding International Impact Award.

The award winning team, including Peninsula Medical School colleagues Dr Maggie Shepherd and Dr Sarah Flanagan, studied children diagnosed with diabetes within the first six months of their lives. This is a rare genetic form of diabetes, and by identifying the genes that cause the condition they were able to prove that the two commonest types are better treated with sulphonylurea tablets rather than insulin injections.

Their work has revolutionised the diagnosis and care of these patients, who now have a normal life on tablets when previously they would have expected to be on insulin for the rest of their lives. The tablets also cost the NHS less which has global benefits in countries where insulin affordability is a significant issue.

n RD&E Clinical Biochemist Dr Tim McDonald was nominated for an award in the Student Impact category – see our Praise page 8

Positive global impact

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Fit For The Future

Our fracture Neck of Femur (NoF) pathway already performs well against the national standard, and recent improvement activities have taken place, led by Matthew Hubble, Trauma Consultant.

However that does not mean at the RD&E we rest on our laurels. We want to improve further patient care, recovery and experience.

Recently Mr Andrew

Improving patient care & experience

Fordyce, a consultant from a neighbouring trust, facilitated a patient journey event to the Durbin trauma ward, re-enacted with help from healthcare professionals involved in the care of NoF patients. A patient representative also attended and shared their valuable insight. Clinical staff took away ideas to improve the service and patient outcomes.

Amnesty reaps savingsThe Stationery Amnesty has redistributed £6,500 worth of stock within the Trust. We are still holding a stock of printer cartridges for Trust use and for sale to staff.

There are also supplies of Trust Headed Paper (Black only), suspension files, ring binders, box files, assorted printer labels (not patient labels); and index boxes and cards.

Before placing an order for stationery contact [email protected] / [email protected] or look on IaN on the FFTF pages to check what items are in the amnesty pool.

A patient representative also attended and shared their valuable insight.

Fit For The Future


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Staff Side has met RD&E management to negotiate the new on call proposals for non-medical employees. This has taken into consideration staff feedback.

The outcome of these negotiations has been agreement on the new on call arrangements which collectively Staff Side feels able to commend. The individual Trade Unions were in the process of canvassing the opinions of their members when this newsletter was going to print.

The 13-week consultation period was extended by joint agreement to allow Staff Side time to complete their work and the planned implementation date for the on call arrangements was moved back to 1st February from 1st January 2012.

As all on call arrangements undertaken by non-medical staff are affected by this proposal, in the first instance you should discuss this further with your line manager. Frequently Asked Questions are on IaN along with useful contact numbers.

How often do you walk through your area and see untidy areas or blockages to the flow of movement? What do you see that could be sorted, straightened, swept, standardised, sustained, or made safer?

Use the ‘8 Wastes’ approach in your observations:

n Not using resources properly (eg: not listening, not asking, not empowering)

n Waiting (eg: for authorisation, for patient records, for test results)

n Over-production (eg: too many patient meals delivered, too many opened surgical kits)

n Transport (eg: moving patients unnecessary, moving stock)

n Over-processing (eg: producing notes that aren’t used)

n Rework (eg: reproducing lost notes)

n Inventory (eg: ‘bulk buy’ mentality, hoarding of stock)

n Motion (eg: poor work area design)

If you need help or see opportunities for bigger improvements, contact Service Development on 6953.

Environment Walks – The 8 Wastes

We are delighted to announce a new partnership with Octagon which will design the RD&E News and generate external advertising to offset the production costs.

The printing of hard copies will continue to be done locally. This will enable us to achieve a further 12% financial saving – on top of the 20% from our decision to go bi-monthly last year. The total cost of all the staff newsletters equates to just over a £1 per employee per year.

Read all about it

Non-Medical On Call Review

The deadline for content to be included in the March/April edition of the RD&E News is 13 March 2012. To assist planning, please let the editor Wendy Shaw know in advance of that deadline date to avoid disappointment.

Heading


1Royal Devon and ExeterNHS Foundation Trust

Royal Devon and Exeter NHS Foundation Trust staff newsletter

February 2012


Working to make patient discharge safe, soon & smooth see page 2

RD&Enews

Positiveglobal impact

page 5

safer surgerypage 5

SIGHTS ON

8

Praise pages

RD&E Clinical Biochemist Dr Tim McDonald was nominated in the Student Impact category, which recognises students or alumni who have already demonstrated significant societal or economic impact either through research or entrepreneurial activities. Only three years into his research career, Tim has increased the accuracy of diabetes diagnoses in the UK.

Tim developed a urine test to identify sufferers of monogenic diabetes, who are often misdiagnosed with more common type 1 or type 2 diabetes. His research has already directly improved patient care and the test is now used routinely across this Trust and samples received for testing from 40 others.

RD&E patients take the trouble to thank and acknowledge the excellent care they have received. Here are some examples:

I just wanted to write

to thank a member

of staff at the Exeter

Mobility Centre. I brought in

my knee brace this morning because

a strap had broken. I use it very

regularly for football and other sports

so was concerned I might be without

it for a while. A man called Alan who

is in the workshop there was incredibly

helpful and fixed it within minutes.

I would like to mention how

helpful my Lung Specialist nurse

Sandra Pope, has been. Sandra

has been part of my team since

December 2009, when I was

diagnosed with lung cancer.

She goes way beyond her ‘job

description’. Sandra has a way of

making things happen, and usually

very quickly too! She is always

available for answers to questions

and advice. She ALWAYS returns

calls promptly. If Sandra doesn’t

know the answer to something, she

will ferret it out from somewhere,

and get back to me. She is a great

advocate, and will speak on my

behalf at MDT meetings. She is

always truthful, and won’t soft

soap me when talking about my

cancer. I trust her judgement, and

can’t praise her highly enough. I

know that Dr Gibbons (Respiratory)

and Dr Osborne (Oncology) both

think highly of her too, and it is

almost a standing joke between us

all: “If we want something done,

ask Sandra!”

I came in to your hospital for surgery and whilst in recovery I experienced a few minor problems. I would like to comment on the efficiency, care and friendliness of all the staff in there. I can imagine that the staff in recovery get forgotten by the patients as for the time they are in there they are ‘out of it’ so to speak, but as I said before, I was in there some time so had woken almost properly, so please can you thank them on my behalf. The nursing staff on Wynard ward were also very good.

I would very much like to pass on how incredibly impressed my husband and I have been with the dedication, professionalism and quality of service provided to our daughter by specialised speech therapist Claire McAleer. It is not often that you come across someone who really stands out in terms of their talent in their practice area and in working with children, particularly in this area. Claire was outstanding in her treatment, care and communication skills in treating my daughter… so much so, she was reluctant to stop appointments when she made a full recovery under Claire’s care!

I attended the hospital for an endoscopy. I was very impressed with the whole process and ask you to pass on my appreciation to Dr Shirazi and all the staff (both medical and support) for a job well done.

Positive Global Impact awards

Praise pages


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Twenty Health Records staff have worked hard to achieve their Institute of Health Records & Information Management (IHRIM) Technical Certificates.

The IHRIM Technical Certificate is a certified qualification awarded by a professional body and consists of a work place assessment by a qualified independent IHRIM Assessor with

supporting work-based evidence. The qualification is based on operational experience and practice, demonstrates competence and expertise and provides a greater understanding of how they work within the organisation.

Jane Woods, ASM in Health Records and Theresa Bonner Deputy ASM in Health Records also successfully achieved the IHRIM Foundation

Certificate. The Foundation Certificate is an examination for Health Records Manager and includes a wide range of knowledge in health records, information and human resources.

Deputy Director of IM&T Wendy Ware presented their certificates. External Funding for this training was secured by Vera Byfield, Head of Management and Vocational Training.

Our apprenticeship programme is taking a new approach to giving young people opportunities to start careers in healthcare.

The first cohort of Clinical Healthcare Support Apprentices are trainee healthcare assistants studying the Level 3 Diploma in healthcare support, functional skills and employers rights and responsibilities. They are hoping to complete their ‘fast track’ apprenticeships within a year so they can apply for permanent NHS posts. The in-house programme is being delivered by colleagues in Learning Development and Service Development with placements and support in wards across the Trust, orthopaedic and general surgical theatres, Mardon neuro-rehabilitation centre and endoscopy.

Lead nurse for paediatrics Nigel Lawrence said: “This initiative has provided young people with the opportunity to enter the health care service in a different manner to more traditional routes. Not only does this provide them with the chance to learn about, and understand the NHS, but also gives them a clear career plan to enable them to develop their learning. The apprenticeship can also be a stepping stone to enter more traditional registered nurse training.”

felt they were looked after with respect and dignity during their time in hospital.

RD&E Chief Executive Angela Pedder OBE said: “Our patients and their families put their trust and confidence in us to provide safe quality healthcare. At the RD&E we have taken this responsibility and duty of care seriously.

“None of this progress could have been achieved without the commitment and innovation of our staff to better patient care and experience. The emphasis on team work cannot be overstated; whether that is teams made up of clinicians; doctors, nurses and allied health professionals or managers and clinicians working together, continuously striving to drive up standards of care which results in better outcomes for patients.”

The Royal Devon & Exeter NHS Foundation Trust has been named Trust of the Year 2011 (South) by independent health consumer guide Dr Foster.

The RD&E is one of four excellent hospitals nationally to be given the regional award by Dr Foster, a leading provider of comparative information on health and social care services.

The criteria used for these awards were:

n measures of patient mortality (including deaths following surgery and procedures such as Primary Angioplasty for heart conditions) and:

n patient experience drawn from the national patient survey results about how patients rated their care at the RD&E, their involvement in decisions about their treatment and whether they

Our patients and their families put their trust and confidence in us to provide safe quality healthcare.

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Staff health & wellbeing

The start of a new year is as good a time as any to look at financial fitness – you can carry out an online free unbiased financial healthcheck by logging on to the Money Advice Service website and if you have money worries and need support you can get in touch with the RD&E staff counselling service in confidence.

We have carried out an in-depth look at equality and diversity at the RD&E to assess what this means for our staff and patients.

This work was led by our HR director Lynn Lane and Nursing and Patient Care director Em Wilkinson-Brice. We would like colleagues to share their feedback on a range of equality and diversity issues through simple questionnaires on IaN (look up Diversity on the A-Z ‘let us have your thoughts’ section.

Congratulations to our colleagues on the three RD&E weight loss programmes in 2011 who between them shed an impressive 270 kg (that’s 42.5 stone).

Feedback has been positive from those who have achieved this with a recognition that it has meant more to them than personal weight loss including raised awareness about looking after their health and feeling more valued by the Trust for making the weight loss programme available to staff.

Our dietetic department has set up the 2012 programme starting with New Year New You in February. For an application form contact [email protected] or call her on 2044.

UNISON RD&E BranchAnnual General Meeting

Friday 24 February at 7pm Gladstones Social Club

All members welcomeFree buffet and free prize drawFor more information call x3258

Twenty eight of the modules have been RD&E endorsed on topics like Information Governance, Safeguarding Children and Equality & Diversity training.

A complete list of modules can be downloaded from the e-Learning page on IaN (using the A-Z menu) as well as the trust’s Training Needs Analysis document which sets out the essential training needed for your role (on Learning & Development IaN pages).

Access is now available from outside the Trust to e-Learning via ESR.

For login details or further assistance about using e-Learning email

[email protected] stating your ward / department and contact number or call ext 5265 – voice messages will be returned.

Training at the RD&E couldn’t be easier with over 3,000 completed e-Learning modules available

Financial fitness check

Other news


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RD&E Chairman Angela Ballatti stands down at the end of April after serving on the Trust Board for six years.

She will be succeeded by James Brent who you may recognise as being the new Chairman and investor of Plymouth Argyle football club. He was an investment banker for 25 years and established Akkeron Group LLP which has key business activities in hotels, urban generation and large scale agriculture. Mr Brent also owns a controlling stake in the Devon-based surfwear brand Saltrock. He has combined his commercial ventures with a desire to contribute in a range of public sector settings as well, for example as Chairman of Plymouth City Development Company.

NHSmail – a secure email service for all NHS staff – is going to be available to RD&E staff soon.

It means your email address will change. The service is provided by Connecting for Health and will provide you with an NHS email address for the duration of your NHS career with access anytime from anywhere with internet connection.

Anytime anywhere email service

New Chairman appointed

It’s time to share our best kept secret…We are raising patient awareness about the day case surgery services we provide in community hospitals in Tiverton, Sidmouth and Exmouth.

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Picture stories

Designed & Published by Octagon Design & Marketing Ltd, Britannic Chambers, 8a Carlton Road, Worksop, Notts. S80 1PH Tel: 01909 478822

n It was patient involvement which impressed judges most when they announced Kenn & Bovey wards the winner of our ‘best dressed’ ward competition. Hand-made decorations created by the elderly care ward team and their patients achieved a homely feel without compromising quality. Second place was the Acute Medical Unit and third was Culm East and West wards. All received vouchers from the patient benefits fund.

n Ten year old George Watts (centre) and his mates organised a 20-mile cycle ride to raise money to benefit other West of England Eye Unit patients.

George has been a patient with us since he was diagnosed as a baby with a condition which affects his vision. He donated £450 to WEEU.

She started her career with us as a housekeeper at Honeylands, before moving across the Heavitree maternity unit as a ward orderly.

In 1989 Marg joined the Staff Bank administration office where she has worked for the past 22 years. She was presented with a long service voucher which she intends to spend on holiday clothes for her retirement trips away.

Margaret Shepherd (Marg to those who know her) has retired from the RD&E after clocking up 30 years service

Documents

RD&E News Feb 2012