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Issue 19, November 2011

FuTureAt approximately 11.45 each day a group of dedicated volunteers don their trendy red tabard aprons and begin their lunchtime feeding rounds! They are the volunteer group who go by the name of Feeding Buddies. For all sorts of reasons, and for all ages, some patients are unable to feed themselves, or need encouragement to eat. Nutrition is an essential part of recovery and these sterling volunteers help the nursing staff to ensure that vulnerable patients have help to eat. Those who are at risk of not eating have their meals served on red trays which can easily be seen and there is also a symbol on the white board above their beds to alert volunteers that these patients need help. It is still the responsibility of the nursing staff to encourage patients to eat but with buzzers going off, the telephone ringing and 101 other tasks, the volunteers are invaluable extra pairs of hands. Sometimes all that is needed is help with yoghurt pot lids, cutting up food, etc. but the buddies' friendly smiles and the time to sit and chat while a patient eats really help make mealtimes enjoyable. All the Feeding Buddies work to strict guidelines and are given appropriate training. They also help complete food charts so that the nutrition and dietetics team can see

where supplements may be needed.

I was able to shadow Kathleen and Rose who are part of the team of volunteer feeding buddies on Bedwell Ward. It was not simply a case of feeding a patient. I watched as they walked around the ward to say hello,

ask 'how are you' and find out which patients are going to need help. Kathleen says that after her mother was ill and needed help feeding she thought it would be one way of helping others. She thoroughly enjoys the two lunchtime sessions that she contributes.

There is a great need for others to join the buddies, both men and women, especially at teatime (4pm-6pm). Their help on the ward is greatly valued by the nursing staff. If you, or maybe a friend or relative would be interested in

volunteering to join the Feeding Buddies team please contact Jane O'Connell/Christine Miller on 01702 435555 ext 6135

Patient Governor - Rochford

Hey Buddy - what's for dinner?

For our Members - from the Governors

Valerie Powell

Two of volunteer feeding buddies

2 A day in the life of...

Pathology - part 2 and its team of biomedical scientists..........

Microbiology

In the microbiology department the quest is finding bacteria, viruses and fungi either in urine or faeces, sputum or other body fluids, in skin and nail samples or in swabs of leg ulcers, post operative wounds, cuts, or other body sites. etc. All samples are sterilised beforehand to prevent harm to the team. Microbiology receives over 1500 swabs each day – including those

sent via Accident & Emergency. Unlike biochemistry – bacteria take time to grow – and need to be incubated at the correct temperature. Some will only grow where there is no oxygen. Sample dishes are set up during the day and incubated overnight. If a positive result for infections - which could pose a risk to Public Health such as E.coli 0157 or salmonella is discovered – then Environmental Health are notified. Where organisms such as MRSA, C.difficile or norovirus are identified

in an in-patient, Infection Control are immediately informed to protect both patients and staff alike. Detection of bacteria and viruses take a varying amount of

time depending on sample type and infectious agent. For example, in the case of septicaemia it may take from 6 hours to 48 hours to grow. Detection of viruses

is usually quicker,for example testing for HIV virus takes 90 minutes.

Resistance to treatment has increased because of the past heavy use of anti-biotics. As a result your GP's take more care when prescribing antibiotics.

If you have ever sent a urine sample for analysis this is where it ends up! When an infection is identified the challenge for the scientists is to find the best antibiotic treatment. A culture of the bacteria is spread on to an agar plate and paper discs containing various antibiotics are put onto the sample dish and the bacteria either grow up to the drugs or avoid it leaving a clearly defined circle where no bacteria are present! And so, the right medication is readily identified!

Again this department has a role to play in preventative medicine and all ante-natal patients are routinely screened for HIV, hepatitis, syphilis and rubella.

Haematology

In the Haematology & Transfusion department there are approximately 25,000 requests each month for full blood counts and 5000 blood clotting tests (for patients on warfarin). Other tests include haemophilia, VTEs (a

Testing for the correct antibiotic (Agar Plate)

Cultures being worked

Overnight reaction

A very busy department

A day in the life of... 3blood clot), diabetic monitoring, typing of white cells to identify types of leukaemia and for HIV monitoring, haemoglobinopathies for antenatal screening and sickle

cell anaemia. Whenever an abnormal full blood result is found through the instrumentation it is physically reviewed under the microscope by the specially trained staff before the result is telephoned through to the requester.

The department also runs anticoagulant outpatient clinics four mornings a week where patients receive a finger prick and the result is tested by the side of the patient. Their anticoagulant treatment is then adjusted depending on the result. In this instance the biomedical scientists work alongside a team of pharmacists.

Transfusion

Our last port of call was the hospital transfusion department. This area undertakes the tests necessary

to provide blood to support routine transfusion requirements for planned surgery, top up transfusions to treat anaemia and in emergency cases to save life in the event of a road traffic accident or major bleed. The demands on this work area are very unpredictable as one major case could need 30 units of red cells, plus platelets and fresh frozen plasma as soon as the department can provide them.

In excess of 10,000 units of red blood cells are selected, matched and issued each year. Each precious blood pack costs £140 and there are strict controlling guidelines governing the storage and use of the products and what cases require transfusion cover. Red cells have a 'shelf life' so great care is taken in the storage and handling of blood to minimise waste. The department has one of the lowest wastage rates in the country.

In all disciplines within Pathology are a team of medical laboratory assistants, clerical officers and medical secretaries supporting the biomedical scientists. Each department has a clinical consultant lead. Almost 300 people are employed in Pathology.

Finally, one of the medical scientists said to us – “Pathology hides behind the test tube” - and today we were able to see just how true that is. We would like to say a huge thank you to the team for showing us round Pathology. They have every reason to be proud of the service they give and as patients and public alike we have every reason to be grateful to them!

Valerie Powell - Patient Governor, Rochford

Tony Guinness - Public Governor, Rochford

One unit of blood

Transfusion blood is kept refrigerated

A trained eye looks for abnormalities

The Southend Research and Development (R&D) department is a very busy and proactive part of the work of the hospital aiming to:

• Promote the attractiveness of Southend for research in both capacity and capability by achieving targets with researchers and communicate achievements widely.

• Develop the brand in terms of: safety; reliability; patient experience; research as part of patient care; it is the patient who is the customer

• Organisational values to develop the vision• Describe the mission statement to provide greater patient

access to research• Define our core values

The Clinical Director of Research and Audit is Professor Bhaskar Dasgupta, a Consultant Rheumatologist and an internationally recognised expert in his field.

The Research and Development manager is Dr. Craig Mackerness whose vision is to make Southend Hospital NHS Trust to be the leading research trust in the East England by 2013.

R&D department supports Clinical Trials in a vast number of areas in Southend Hospital NHS Trust.

Sexual Health Department

The PIVOT study is a multi-centre trial with over 40 sites participating across the UK and Ireland. PIVOT stands for 'Protease Inhibitor monotherapy Versus Ongoing Triple-therapy in the long term management of HIV infection'. I bet you didn’t know that!

The Southend HIV team have recruited 10 patients to the study, all of whom are in their second or third year of follow-up. The research team consists of Infectious disease consultant Dr John Day and Clinical Nurse Specialists Cortina Penn and Laura Hilton.

The benefits for the HIV team are that we are able to broaden and deepen our understanding of research methodology and be part of a potentially groundbreaking research project. The patients who are part of the trial may be a small part of changing future HIV treatment strategies, and most of them seem to enjoy being part of the study. They have the added bonus of a free sandwich and drink at each visit!

Ophthalmology Department

Mr. Karia says: "Our AMD (Age Related Macular Degeneration) patients are growing in numbers as the population's life expectancy extends. The ‘Quality of Life’ is vital for these patients as many of them live alone, possibly are full time carers or help with childcare for their grandchildren. The inability to go shopping, locate their shopping on the shelf, see the price or sell by date, at the same time wearing co-ordinating clothes and being able to actually get to the shop and home again safely, is just a snap shot of the many problems associated with AMD.

The patients on both the AMD trials at the Ophthalmic Unit attend

monthly. They have made friends with each other and I book the same patients on each visit as their visit has now become a social event. They discuss their problems and are very supportive to each other. I invite their partner/carer to attend each appointment as AMD is a family problem and all the family need support with someone who has visual loss.

As their appointment lasts approximately five hours, I am continually ensuring that they have sufficient refreshments and are accommodated out of the general clinic traffic. The patients are more than happy to be taking part in a trial that will hopefully benefit themselves and unselfishly benefit patients in the future."

Vicky Goater Paediatric Research Nurse standing next to the Sculpture for the special care baby unit at Southend Hospital which reflects the dedication of all the staff in the unit particularly to commemorate Hugo Liebeschuetz the founder.

The Paediatric Research Nurse

As a paediatric research nurse I am responsible for the delivery and co-ordination of neonatal and paediatric trials. I am here because I believe children are not just mini adults, their bodies and minds work in different ways and they should be treated as individuals in their own rights. Discussing clinical trials with parents can be extremely challenging, especially if the trial only allows 48 hours from admission to recruitment. Having a child in hospital is a distressing time for all involved and a rich mix of emotions often surround child illness such as panic, anxiety, anger, powerlessness, and guilt. However, to continue to provide the best possible care for our patients it is fundamental that we strive to improve our knowledge and understanding of all aspects of patient care through high quality, patient centred research. It is imperative that parents and children are made aware of clinical trials relating to them, have the choice to participate and both are kept fully informed with what we are doing and how they are helping us. It is also important to note that at any point during any trial, people are allowed to withdraw without giving a reason and their hospital care will not be affected in any way. I am lucky as the majority of parents and children attending this hospital make my job easier by sharing the

4 Research and Development

Nurse Specialists Laura Hilton and Dr. Day & Cortina Penn

LSG leader (Mr. Karia & Geraldine Smith Research Nurse)

Vicky Goater Paediatric Research Nurse

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5Research and Developmentsame opinions on research as myself. Generally people enter into trials for altruistic reasons as the trials are sometimes of no direct benefit to them or their child. I feel very privileged and humbled to be able to work with these people as they make my job enjoyable and fulfilling. Lastly, I would like to mention the nurses on the Special Care Baby Unit for their contribution towards the Probiotic in Preterm Study. Without them the trial would not be possible at Southend and our recruitment would not be over target, so a big thank you to them!

Oncology Department

Anne McPherson says "As a Breast Cancer Research Nurse, I was approached to write a piece entitled ‘A Day in the Life of a Research Patient’.

I often wondered how patients really felt when they consented to enter into a clinical trial and the reasons why they consented to participate. My dilemma was how was I going to capture a true reflection of how a patient feels or what being in a clinical trial meant to them and their family.

After seeing one of the breast trial patients, I just mentioned that I had been

asked to write a short piece in A Day in the Life of etc. I was so pleased that Elaine volunteered after receiving the support and encouragement of her husband. Elaine also has four children".

I asked Elaine to tell me in her own words how she felt and here are some of the points important to her.

“Because I have gotten through my surgery, chemo, radiotherapy and twelve months of Herceptin, being told I would now be seen every six months came as a bit of a shock. I knew I had to accept this as standard practice but I was still very scared that the cancer would come back or, even if it had gone. Were there any other treatments available to me, I asked myself.

When I was approached by my Oncology Consultant and was told about a clinical trial I was eligible for, I had no hesitation in wanting to take part. My main reasons were, although I had almost two years’ of cancer treatment, I felt reassured that if I was on a trial the possibility of receiving another form of medication was very reassuring.

I was introduced to my Research Nurse Anne McPherson, who explained the trial in great depth and allowed plenty of time for us to ask questions. I felt very well informed about the trial and very confident on how to handle any side effects. I was fully aware that I may not be randomised to receive the active drug so I have no idea whether I am taking the active drug treatment or placebo.

Taking the tablets does not interfere with my daily life and my children feel very reassured that because Mummy is taking tablets they are making me better. I also feel very reassured when I see Anne that all the investigations required are carried out every six weeks and it gives me the opportunity to ask any questions I may have. I also know that I can contact Anne by telephone should I have any worries or concerns.

I would advise everyone that is offered a clinical trial to participate, as I believe the benefits to be very positive”.

Clinical trials and Pathology

The role of pathology within the clinical trials team is highly varied. Patients are recruited to a specific clinical trial based upon their clinical condition. To the patient, the outcome of these trials is often measured in how they feel but as a scientist this is done more specifically through the measurement of parameters within both blood and urine samples. Clinical trials nurses and research fellows liaise with us in Pathology in both the set up of new clinical trials and when patients are coming to the research clinic.

Samples are brought to pathology where they are processed and prepared for sending off to the clinical trial centre by specialised couriers, often frozen on ice. The trial centre receives samples from all sites participating in the clinical trials and analyses specific parameters for the condition within the blood and urine samples.

Team work is vital for clinical trials to work smoothly and this is most certainly in place within pathology and clinical trials. Working within clinical trials is highly rewarding as we feel we are contributing to new and exciting therapies which will ultimately improve patient care.

The Data Manager

Data Management is essential to all research studies. The Clinical Local Research Network (CLRN) Data Manager is responsible for maintaining and developing a system to monitor recruitment into research trials at Southend University Hospital NHS Foundation Trust.

Currently at Southend Hospital we have 124 studies active in 24 different research areas. Collecting and analysing recruitment data on a vast amount of studies is both challenging and rewarding. Research and development within the NHS aims to improve the service provided to our community, having a role to play in this agenda is extremely fulfilling and provides a true sense of purpose.

Clinical Site Trials Co-ordinator

Acknowledgment to the following departments:

Accident Emergency, Rheumatology, Renal, Spinal, Paediatric Outpatient, Cardiovascular, Gynaecology.

On the left, Anne McPherson, Research Nurse & her patients

Sarah Mapplebeck (Principal Biochemist) Lisa Wilson & Emma

Donnelly

Maryam Zare

6 Calling all members...

Future Members' MeetingsDetails of Members' Meetings are now available on our web site at:http://www.southend.nhs.uk/Membership/Member+Meetings/

Date Venue Doors Open

24th November 2011 St Edmunds Community Hall, Pantile Avenue, Southend SS2 4LB 1 pm Speakers: Clinical presentation by Mr M D Dooldeniya (Consultant Ureological Surgeon) on Bladder and Prostate cancer Jacqueline Totterdell (Chief Executive)5th December 2011 Macmurdo Hall, Edwards Hall Primary School, Macmurdo Road, Leigh-on-Sea SS9 5AQ 7 pm Speakers: Mr Rajesh Aggarwal (Business Unit Director) on the Ophthalmology Department Jacqueline Totterdell (Chief Executive)16th February 2012 Main Hall, Belfairs High School, Highlands Boulevard, Leigh-on-Sea SS9 3TG 7 pm Speakers: Clinical presentation - Heart Pacemakers Jacqueline Totterdell (Chief Executive)22nd March 2012 Community Hall, St Augustine's Church, 86 Tyrone Road, Thorpe Bay SS1 3HB 1 pm Speakers: Clinical presentation - Children's Services Jacqueline Totterdell (Chief Executive)

All welcome but please confirm attendance so we can cater for refreshments on arrival

Telephone: Freephone 0800 0185202 email: foundation.members@southend.nhs.uk

It amazes me how today so many of our youth believe they are aware of what takes place in our hospitals.

The many varied films, videos and television programmes that have hospitals/medicine in their storylines do not relate to real life.

As a member of a much older generation I would like to think that their parents/grandparents, family and friends could encourage them to become Foundation Members to realise the true nature of hospital life.

When a family member, or even a young person, is admitted to hospital, often they may visit us for a short time only.

How can we understand their views? If everyone who reads “The FuTure” were to try and encourage one young person to become a Foundation Member we would be able to learn how they feel about the hospital and the various departments within it. Please join me in my campaign.

If you are a young person reading this article perhaps you would like to attend one of our Member Meetings below to find out for yourself what it’s all about.

Heather Glynn

Carer Governor

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WANTED – young members...

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7From Our Expert...

Newsletter eMail AppealThe present economic situation means that the Hospital needs to reduce costs in all areas. The FuTure editorial team faces a choice of reducing the number of issues per annum from 4 to 3 or reducing the cost of postage and printing. If we could significantly increase the number of copies sent by e-mail we can continue to issue quarterly.

You can help us by sending your name and e-mail address to newsletteremailappeal@southend.nhs.uk. Each quarter we will send you an e-mail with a direct link to the latest issue enabling us to save on printing and postage.

An introduction to arthritis and its treatment. With grateful thanks to Dr W M Wong, Consultant Rheumatologist at Southend Hospital for this summary of his talk at a Foundation member meeting on 21st June 2011.

Arthritis is a Greek word meaning ‘inflammation of joints’. However, in everyday conversation, ‘arthritis’ tends to be used to mean ‘any condition that causes pain in the joints or bones’. There are many different conditions that can cause pain in joints – possibly 200 – 300 altogether. Some of the more well known conditions affecting the joints are Osteoarthritis, Rheumatoid Arthritis, Gout, Spondylosis – cervical or lumbar, Ankylosing Spondylitis, Psoriatic Arthritis and Juvenile Inflammatory Arthritis.

Other conditions thought of as ‘arthritis’ affect the bones, muscles, blood vessels or tendons and ligaments more than the actual joints including Osteoporosis, Paget’s Disease, Tennis Elbow, Polymyalgia Rheumatica (PMR) and Fibromyalgia.

The typical symptoms of arthritis are pain, stiffness, swelling and weakness or loss of function in the joints or limbs. However, other associated symptoms are important; these can include general weakness, tiredness, depression and anxiety. People who develop joint symptoms often have concerns about the future, for example about their ability to look after children or continue working. Symptoms vary between different conditions and between different people – even if they have the same condition. Over time symptoms can get better, worse or fluctuate and this is part of the frustration.

Treatment has two aims – to give immediate relief of symptoms such as pain and swelling and secondly to improve the long-term outcome. The more people

know about their condition the more they can be in control of what happens to them. Two good sources of information are the charities Arthritis Research UK at www.arthritisresearchuk.org., and www.arthritiscare.org.uk People should not be afraid to ask their doctor or nurse if they are worried or have doubts about medication. Exercise is very important and patients should ask about physiotherapy referral if unsure as to how to exercise.

We hope this article will give you a taste of how our Consultants support our Members by speaking at meetings. Members are able to ask our consultants any questions. For example on this talk Dr Wong was asked:Q Is there any research on cartilege regeneration? A Yes - with stem cells etc. This is in its early stages. At

the moment the regenerated cartilage is very soft and not able to cope with the mechanical stresses inside joints. There is a lot more research still to be done.

Q Is rheumatoid arthritis hereditary?

A Some genes make a person more likely to get the condition – about 1% of the population have RA. If you have a close relative with rheumatoid your chance of developing it is about 4%.

If you would like to attend a member meeting please see Page 6 for dates, venues and topics.

Dr Wong

Member meeting June 2011 with Dr Wong

Governors8

Contact Southend Hospita

l Governors via:

The Foundation Trust Se

cretary

Trust Corporate Office

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ital NHS Foun-

dation Trust

FREEPOST ANG1863

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2

email: foundation.membe

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Hospital switchboard01702 435555then add extension if known

Editorial Team:

Valerie Powell

Tony Guinness

Heather Glynn

Hilary Seago

Geraldine Alward

John Bruce

David Fairweather

EEd

H

On 5th October, along with my fellow governor Ron Kennedy and Membership Manager, David Fairweather, I spent the morning at the Freshers’ Fair in the new South Essex College building in Southend, and as you can see, I enjoyed the experience very much, and I am sure my colleagues enjoyed it too. Our purpose was to recruit new young members. A whole range of student services and potential activities were on display and I was amazed at how interested in the hospital a lot of the young first and second year students were.

We were able to get 27 students to sign up to become members of the Foundation Trust, which was a great achievement.

It was good to see young people from a wide variety of backgrounds enjoying themselves and showing interest in all sorts of things that were going on that day.

Governor Geraldine Alward at the Freshers' Fair

Freshers' Fair at South Essex College

Geraldine Alward - Public governor for Rochford