TEACHING
PATIENT CARE KNOWLEDGE
For staff. By staff. About staff.
ISSUE 6, SUMMER 2014
UNIVERSITY
QUALITY
RECRUITMENT
RESEARCH
LEARNING INNOVATION
MORE THAN
>A NAME WHAT DOES UNIVERSITY HEALTH BOARD STATUS MEAN?
@CwmTaf @CwmTafCymraeg
CONTENT TEACHING
PATIENT CARE KNOWLEDGE
UNIVERSITY
QUALITY
3
RECRUITMENT
RESEARCH
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LEARNING INNOVATION
A day in the life of a dietitian
University status - more than just a name
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Bike skills for life skills
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Cwm Taf staff recognised for achievments
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NHS Wales study tour to Uganda
Pontypridd a’r Anthem Genedlaethol
17 Cwm Taf University Health Board Catering Services
Patient Menu Thumbs up for new menu
Diabetics If you have diabetes, you should choose the ‘Healthier Option’ puddings indicated with the green apple symbol. If you choose any of the other hot puddings, your blood glucose (sugar) levels will rise as these are high in sugar. These should only be chosen when advised to by your dietitian. Other puddings such as ice cream or cheese and biscuits can also be chosen as these are less likely to increase your blood glucose levels.
Delivering nutritional excellence with outstanding variety using where possible, locally sourced, seasonal products to deliver the highest quality of food & beverages. = Healthier Options
These items are lower in total fat and saturated fat than other options. Desserts are lower in fat, saturated fats and sugar.
H = High Energy
S = Softer Options
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These choices are softer and easier to manage if you have a problem with your teeth or chewing foods. (These may not be suitable for patients with swallowing problems unless advised by your Speech & Language Therapist, if you have a swallow problem please ask your nurse for advice).
EDITOR’S LETTER
As the new Head of Communications I am delighted to welcome you to the Summer 2014 edition of the Courier! I was lucky to start the job just in time for the staff recognition awards which was an introduction not only to some of the great work going on across Cwm Taf, but a glimpse of the passion for wanting to make people’s lives better. As well as a good spread in all of the local newspapers we have dedicated six pages to the staff recognition awards in this edition as a tribute to the all the winners. I hope even more people will enter the awards next year because it’s so important that we celebrate and share what we are doing well. As a former journalist you would expect me to be interested in stories and I’m especially interested in your stories. I may have only been here a month but I know for certain that with around 8,000 staff across Cwm Taf there will be a wealth of positive news stories that deserve to be told. One of the first things I have implemented is a positive news programme which aims to highlight more of the good work that is being done day in day out across the Health Board, but we need your help to tell us about them. The Courier is just one way we can highlight some of our achievements but I want us to build on that so we start communicating our good news stories to more people. So whether it’s about an award, a new innovation in your department, or just something that you’re proud of, please keep sharing your stories with us. You can email the communications team paul.edmonds@wales.nhs.uk; Debbie.owen2@wales.nhs.uk; or Sharon.draper@wales.nhs.uk or message us on Twitter @CwmTaf and @CwmTafCymraeg I look forward to meeting some of you very soon but in the meantime enjoy the summer edition!
Paul Edmonds Assistant editor and designer
MORE THAN
>A NAME WHAT DOES UNIVERSITY HEALTH BOARD STATUS MEAN...
“THIS ALSO HELPS US TO ATTRACT THE HIGH CALIBRE CLINICIANS WITH THE AMBITION TO BE THE BEST”
...FOR PATIENT CARE? LYNDA WILLIAMS
CWM TAF UNIVERSITY BOARD’S DIRECTOR OF NURSING, MIDWIFERY AND PATIENT SERVICES
It also helps us to build a research and development infrastructure to accelerate the learning which can contribute to improving the health of people in Cwm Taf. Working alongside our academic partners – Cardiff University and the University of South Wales University health board status – means that we can access will enable us to develop, fine- different levels of research to ly-tune and implement new support our health improvemodels of multi-disciplinary ment work. and multi-agency services, which extend beyond the This also helps us to attract traditional medical model to the high calibre clinicians with meet the unique health and the ambition to be the best social care needs of our pa- and who want to pioneer new tients and local communities. services for our patients. Having skilled and enthusiastic staff who are committed to treating people living throughout Merthyr Tydfil and Rhondda Cynon Taf is vital for improving the health of the population of the Cwm Taf area in the longer term.
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...FOR RESEARCH? PROFESSOR JOHN GEEN
ASSISTANT DIRECTOR FOR RESEARCH AND DEVELOPMENT IN CWM TAF UNIVERSITY HEALTH BOARD
Demonstrating the quality, quantity and collaborative nature of the research being undertaken across Cwm Taf University Health Board is one of the prime factors integral to acquiring and maintaining university health board status. Establishing our position as a university health board with the ambition to increase our research activity is also critical to becoming a recognised centre of excellence for the training and education of all healthcare professionals. Building on the existing relationships with the University of South Wales and Cardiff University will serve to further develop the symbiotic collaborations and partnerships with our academic colleagues. page 5
data acquired. This will facilitate the translation of the research into clinical practice through efficient knowledge transfer within the university This will be achieved through health board, via presentation the initiation, design and com- at events such as our annupletion of innovative research al research and development studies that help resolve conference. identified problems and priority areas across healthcare, In addition, knowledge transfor the benefit of the clinical fer will require support from academic partners, management and experience our through the formal education of the patients we serve. of healthcare professionals. Working together and sharing the resources of all stake- There is the opportunity to holders - intellectual, clinical, increase the research infraequipment, facilities or finan- structure, investment and cial - will strengthen the qual- income of all the partners, ity of the research, improve through supporting research the success of research fund- projects on the NISCHR clining applications and ultimate- ical research portfolio, sucly the robustness of the evi- cessful research grant applidence base of any research cations, commercial research This will help to ensure the research agenda, strategies and priorities of all stakeholders will be met.
“CRITICAL TO BECOMING A RECOGNISED CENTRE OF EXCELLENCE FOR THE TRAINING AND EDUCATION OF ALL HEALTHCARE PROFESSIONALS�
port available, research active and ambitious healthcare professionals across the health board - including medical, scientific, nursing, therapies, pharmacy and non-clinical professionals - have the We have demonstrated our chance to build on these pedigree and the quality of strengths and maximise this our research and develop- exciting opportunity by bements by winning the Med- coming involved with and iWales NHS Judges Award undertaking their own and the Partnership with the patient focussed reNHS and Academia Award search. in November 2013. As well as these recent award suc- After gaining cesses, we have a strong and university health developing collaborative re- board status, the search portfolio in anaesthet- time is right for proics, mental health and CAHMS, the importance and public health, ENT, paediatrics file of research, service develand some GP practices within opment and innovation to be primary care. recognised as a responsibility of all healthcare professionals With the considerable sup- to help change how the NHS (pharmaceuticals, medical devices), shared academic posts and commercialisation of products and processes that have registered intellectual property rights.
is delivered to maximise the benefits to the patients and their care.
...FOR TEACHING? PROFESSOR DONNA MEAD
INDEPENDENT MEMBER OF CWM TAF UNIVERSITY HEALTH BOARD AND DEAN OF THE FACULTY OF LIFE SCIENCES AND EDUCATION AT THE UNIVERSITY OF SOUTH WALES
In partnership with the health board, the University of South Wales has strived to ensure there is a qualified nursing and midwifery workforce available to be employed in what are some of the most deprived areas in Wales, where health needs of the population are great. Nursing is an all-graduate profession. Every year approximately, 100 newly-graduated nurses and midwives are employed by Cwm Taf having been educated by the University of South Wales. There is a concerted effort to recruit individuals locally; individuals who may have little in terms of formal qualifications but who may have aspirations to become a nurse. Without compromising degree-level standards, the university and the health board work with such individuals to help them achieve their goal. This is not easy and for many individuals the process can take a long time and much page 7
“THERE IS A CONCERTED EFFORT TO RECRUIT INDIVIDUALS LOCALLY”
support is required. We believe it’s worth the effort because the result is a qualified workforce in areas which would be very difficult to recruit to from outside. Furthermore, it is often the case that the newly-qualified nurse becomes a wage-earner taking the family out of economic dependency. That family’s aspirations are changed forever when one of them becomes a graduate. This is an example of social mission at its best but it is not without risk. At a time when league tables can have a powerful influence over a university’s future, widening access strategies such as this can compromise the university’s position. Our place in the league tables is in part determined by the qualifications students have on entering university.
work in this area; hence our strategy, hence our strategy to invest in a local workforce. In a recent IPSOS Mori poll about student satisfaction, our students rated their experience as 100% satisfied in Cwm Taf University Health Board. The University of South Wales is proud to stand alongside Cwm Taf University Health Board as one of its academic partners. The relationship between our organisations is longstanding and has its basis in shared objectives.
These include working together to provide the highest calibre of trained health professionals who provide care for the Cwm Taf population; undertaking research which informs the way in which clinical services are deliver and bringing to market those innoWe have more than 10 appli- vations arising from research cations for each nursing place which care improve patient and more than 50 for each care. midwifery place – but on qualifying most would not want to page 8
BIKE SKILLS FOR LIFE SKILLS For further information regarding this scheme contact Sarah Lewis-Simms, principal occupational therapist sarah.lewis-simms@wales.nhs.uk
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The paediatric occupational therapy department at the health board are delighted that four years on and the bike scheme they introduced to help children with developmental co-ordination difficulties is still as popular and beneficial with the children. A developmental co-ordination difficulty is a chronic neurological disorder which begins in childhood that can affect co-or-
Many of the goals that are identified with children happen to be leisure based such as cycling or catching a ball. This can be used a motivation for skill-acquisition to gain skills that then can be transferable into the home and classroom. As a result occupational therapy teamed up with the disability officer, schools and leisure centres in the area to offer these children a chance to learn how to ride a bicycle. Four years on and 30 children have developed independent bike riding skills. Sarah Lewis-Simms, principal occupational therapist for children said: “I am so proud of the staff in the department, they have gone over and above what is expected of them to make this scheme a success and help the children with their developmental coordination difficulties which have proved very successful”.
dination and movement. Children referred to occupational therapy for co-ordination difficulties often experience complications in many areas of life; be it educationally, daily living or play. The role of the occupational therapist is to create meaningful activities which enable the child to work towards therapeutic goals, incorporating tasks that develop skills that can be used in everyday life.
Cycling is an excellent way to encourage children to develop these skills and have fun at the same time as well as increase physical activity, develop co-ordination, body awareness, balance, sequencing skills and boost self esteem. A parent of one of the children who attended the sessions said: “I was over the moon that my son was able to ride his bike, the course has been an amazing experience for him”.
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NHS WALES STUDY TOUR TO
UGANDA
A PERSONAL PERSPECTIVE BY ALISON LAGIER
I’ve been a member of the PONT and Cwm Taf governance committee for 18 months, so I was delighted when I got a call from the chairman – Chris Jones asking if I’d represent the health board on a study tour to Uganda. He explained that a group of executives from NHS Wales had been invited to visit initiatives supported by a national grant, including some PONT was leading – some of the ones I’d heard so much about at our meetings. It was an opportunity to join a group of staff from other health boards and trusts and to share some of the work Cwm Taf had been doing with PONT for many years. The First Minister was also going to be there for three days of our experience. On January 4, I met everyone at Cardiff airport at 4am to start our onward journey. I knew from the moment some of the group turned up with three Singer sewing machines as extra luggage how things would progress
– I’d find out later how they’d be used. Day 1 We arrived at Entebbe at around 10pm after a 13-hour trip; interesting hotel in an interesting area but it was straight to bed. I don’t think I got much sleep as the Sunday preaching and singing from the village over a large speaker system started at around 3.30am. Briefing on our tour with the others was after breakfast my first encounter with Ugandan food and the the first of many, many eggs. We had a two-hour trip to Luwero in our luxury school bus. A school bus, yes; luxury, no. There were 15 of us plus the driver and our entire luggage inside the coach, no air-conditioning and no seat belts. The journey was another first - Ugandan roads, dirt track, red dust and wild drivers. But the welcome was amazing at Bbowa with lots of hugs and hand-shaking. We stayed in
a hostel built by Care for Uganda - a non-governmental organisation, based in Neath - high in a village with the most amazing views, especially at sun set and sun rise. I had my first encounter with matoke here, it’s a harder mild banana/plantain that is generally served with most things. While having our evening briefing we met our night guard - a large gentleman who had made his own bow and arrows, who proceeded to explain how he had made the poison which was on the tips of the arrows. Day 2 Our first official visit was to Lowero district government offices to meet the district health officer and his team. Very official today, the meeting started with a prayer and the national anthem (luckily we Welsh can sing) and then everyone introduced themselves (remember there are 15 of us and probably the same of
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them…) It’s becoming clear that PONT’s work is quite unique – PONT members are very well regarded by the government officers and the partnership approach is highly supported. This isn’t always the case as other organisations don’t always try so hard to engage with the government. It’s important for projects to gain political and financial support wherever possible. I’ve started to notice however that the words don’t always follow in actions – there’s a lot of talk about public health and teaching hygiene but no running water or soap in the toilets of the government offices. We moved on to Nakaseke, which is a hospital equivalent to Royal Glamorgan or Prince Charles in what it provides (or so I thought). It’s probably the most distressing visit of the whole tour. In this country, it would be classed as a derelict buildpage 13
ing - most of the windows were smashed, most doors were off their hinges and leaning against the wall, ceiling tiles non-existent and wires everywhere. Very few staff were around – there was one nurse on the paediatric ward who was working very hard; no mosquito nets on beds; all the beds were broken and everywhere was full to capacity. There’s no transport to get anyone to the hospitals so many people walk for many miles to get there and their families stay in the grounds. At this point all I could focus on was practical issues - how maintenance staff, house keeping, a good middle manager could role their sleeves up and help physically but more importantly work with the staff there to put in systems to alleviate some of the chaos. This place was heart breaking and one we kept coming back to during our nightly briefing sessions.
Our next stop was a village health team, which really lifted the spirits. PONT has trained some amazing people to work as community health practitioners in the remote villages to support their communities with health information, especially hygiene information and initiatives, such as tippy taps, peat latrines and drying racks - things they can make themselves. They also advocate oral health, STIs, immunisation, avoiding malaria and stomach conditions and first aid. A higher level of training is provided for operational level health workers who are often linked to a village health centre. Traditional birth referral attendants focus on supporting pregnant ladies through their pregnancy. This work was amazing, even more so when you realise they don’t get paid! Payment is a T-shirt they wear with pride and the respect of their fellow villag-
ers. The community ethos blew me away and reminded me of the valleys many years ago. It made me think of how much we could learn from these amazingly resilient people. I couldn’t stop thinking about how much more we need to focus on community care at home. Day 3 An early start; an amazing sun rise was followed by a seven-hour trip in our renowned bus to Tororo. We made a few unplanned stops on the way as our poor bus driver was quite sick with malaria - no such thing as going on the sick in Uganda. Gwaragwara Health Centre is a smaller version of a community hospital – clinics, a pharmacy and a few assessment beds. There was a real feel of villagers embracing this centre and a fantastic male nurse there (the only member of staff ). No-one wants to be in a bed in a health centre or a hospital - they wants to be at home, I later understood this was for varying reasons. On a visit to TOCIDA, the headquarters of another NGO, this time linked to the Vale of Glamorgan, we experienced an amazing library filled to capacity inside and out with fantastic young people all eager to learn (even though it was their national holiday). By now the overwhelming joy of all the children that we encountered was heart-warming. Playing football with a ball made from rubbish tied in a plastic bag, no shoes, rolling tyres and shouting “muzungu” - an affectionate name for white-skinned people. There was always a rush forward as soon as you took your camera out; everyone wanted their photo taken but more importantly
they wanted to see themselves on your camera. There was often a friendly fight to see who could get to the front. My Facebook post at the end of day three said: “Amazing villagers, beautiful children. Makes you really wonder what we can learn from those who have no material possessions, little food, poor health but are happier than we are.” Day 4 Started with a visit to a charitable Benedictine eye hospital, again linked to Vale for Africa and Cardiff University. This was an impressive hospital well organised and showed what a little money, good staff and excellent organisation could do. Those who go to page 15
the hospital have to pay but this is subsidised by the charity and therefore cheaper than a purely private facility. We moved onto Tororo government hospital, which despite having significant needs was in a much better shape than Nakeseke. My post home today read: “Another day ahead with amazing communities who have nothing but everything…” My overwhelming experience so far is how thankful the people are for anything that we do. This just makes you want to do more, all the time wondering what next, how can we help and most importantly listening to what they say is needed. Day 5
Optional hike (or, in my case, opt for an hour-long very difficult journey up the mountain in a minibus) to the Mooni community, but wow the scenery, waterfalls, lush plantation and at the top we discovered the infamous motorbike ambulances supported by PONT and the Welsh Ambulance Service. These are literally life saving in this sort of terrain getting women in obstructed labour down the mountain. Ouch, the roads are horrific! Visited Mbale Regional Referral Hospital, the Royal Glamorgan has been twinned with this hospital for many years working to develop an endoscopy unit and supporting the emergency department through its links
everywhere, makeshift stoves and cooking going on in external corridors and you often step over people to get into wards. Families are becoming more deprived because of this system. While caring for a relative at hospital, no one is tending crops at home. This was a real eye opener and I started to understand more clearly why hospital was avoided.
with PONT. The hospital system in Uganda is very different to ours - the only input you get is a clinical intervention. All your other needs are met by your family –you bring your own bedding; all your personal care is undertaken by your family, your washing, your cooking your feeding and drinks. This means all hospitals are very overcrowded, not just with patients but with family. They often stay on the floor by the side of the bed, under the bed or even share the bed with the patient. The grounds of the hospital are full of families who have come with their sick relative; they live in the grounds until the relative goes home, as home can often be many miles away. You see washing hung
Day 6 Our first full day with the First Minister’s party today. When we got to Bubutu we were welcomed by a parade of villagers and dignitaries and a brass band - a little different to the last few days. More examples of a health centre, motorbike ambulance, village health teams but the highlight of today was the new girl’s dormitory at Bubutu High School which was paid for by Pontypridd High School as part of PONT’s wider work. What a fantastic opportunity for the young people who were lucky enough to attend this school, which is every child’s dream in Uganda. All they really want is an education and families try everything to get this for their children. We went on to the PONT engineering workshop where they maintain the motorbike ambulances, make stretchers to attach to bicycles and we discovered the destiny of the Singer sewing machines. They were presented to a group which had set up a consortium to promote work for disabled people as there is no benefits system in the country. We then visited the Ugandan Women’s Concern Ministry where they were making beads from paper. Their patience, resilience and courage, when we heard of
some of their experiences, was totally humbling. The last stop of the day was the PONT office to see where it all happens. A few desks in the grounds of a church shows how little you need to get so much done but the communications hub being developed just down the road will be fantastic for everyone concerned. Day 7 Back to Mbale Regional Referral Hospital today, overwhelmed by the amount of children there who have been triaged and need a bed but none available are on the ward. Some have been waiting for days outside in a semi-covered waiting area. Families are everywhere and the emergency department is full to capacity. It’s a stark reminder of why we are here to determine what more the NHS in Wales can do to help. Our last visit is to Namatala slum before we start our long journey to the airport. Wow, what a place - the most deprived living conditions so far. Children are everywhere; several hanging onto your hands as you walk around, but all are smiling. An amazing charity called Children of Hope looked after us and delighted in showing us their fantastic school which reaches out to the whole community. One child in a family is sponsored to attend school free of charge (all other schools in Uganda have fees attached) that child is then expected to teach the other children in their family. The children acted out a play for us about their aspirations for 50 years’ time - there were more than a few tears shed. page 16
This experience will stay with me forever and has already changed the way I look at everything around me but especially our responsibility to be global citizens. There is so much more that we in Cwm Taf can do with PONT to add value to the work that some of our staff are already doing and have done for many, many years. The staff who return to Mbale year after year, who fund these trips and give up part of their holidays to work in Uganda are
the real heroes – you are amazing. You know who you are, and if your colleagues are reading this please give your friends a big pat on the back from me; I’ve now seen the impact this work has had.
involved. Hospital leads: eryl.hicks@wales. nhs.uk or sean.SRW.watermeyer@wales.nhs.uk Primary care lead: cath.taylor@ pont-mbale.org.uk 07889 076 574
You can be a part of this, we need all types of skills and expertise to help and there are many different ways of helping. If this has inspired you to find out more please contact PONT and get
PONT project management coordinator: jenny.allen@pont-mbale. org.uk 07940 451 424 Website: www.pont-mbale.org. uk
NEW MENU FROM CWM TAF UNIVERSITY HEALTH BOARD GIVEN THUMBS UP BY PATIENTS Going from sunbed to a hospital bed was not something Deborah Roberts from Pontyclun had been looking forward to after an all-inclusive holiday in Cyprus, but she says she was delighted to find the quality of the food at the Royal Glamorgan Hospital was not so different to her meals on holiday! Cwm Taf University Health Board is rolling out a brand new ‘A la carte’ style seasonal menu
please make your choice by 15:00 (Including all salads/jacket potatoes/ sandwiches) Steak & Kidney Pie Beef Lasagne - Garlic Bread Liver & Bacon Casserole Chicken Arabiatta Quorn Chilli & Rice Vegetable Lasagne – Garlic Bread Bean Goulash - Cheese & Chive Scone Cauliflower Cheese Served with a choice of potatoes and selection of vegetables (please ask your catering assistant)
CoLD: Jelly Fruit Trifle Yoghurt Light Yoghurt Mousse Ice Cream Fresh Fruit Cheese & Biscuits HoT: served with custard Chocolate Sponge
monday Corned Beef Pie Sticky Toffee Pudding & Custard tueSday Pork Sausage Casserole Fruit Salad & Cream wedneSday Chicken Curry & Rice (mild) Sultana Sponge & Custard tHuRSday Minced Beef in Yorkshire Pudding Jam Sponge & Custard
Bakewell Tart Sultana Sponge Sticky Toffee Pudding Baked Jam Roll Lemon Sponge Cake Rice Pudding Rhubarb Crumble
fRiday Battered Fillet of Cod Rhubarb Crumble & Custard
which will change every four months to ensure a varied selection of dishes. In good spirits, Deborah who had to spend four days in hospital on her return from holiday said: “Little did I know I was going to be all-inclusive for another few days courtesy of Cwm Taf University Health Board! I found the range of food was very good and the myths of hospital food being awful simply not true.
“There is a good choice of food offered for breakfast, lunch and dinner. I am quite a fussy eater but there was something Cwm Taf U niversity on the Health Boa rd Catering Se menu I rvices liked evPatient Men u ery day.”
SatuRday Beef Burger in a Sesame Seed Bun Cheese Burger in Sesame Seed Bun Chocolate Sponge & Custard
Cwm Taf Health
If you have dia Diabetics puddings ind betes, you should cho ose the ‘He icated with althier Optio any of the other hot pu the green apple symbo n’ dd l. If you cho will rise as Board ose these are hig ings, your blood glucos e h
The new range comes after the Welsh Government decided that all Health Boards will now choose their own dishes for their patient menus from an All Wales Menu Matrix. This ensures that each dish chosen will meet the All Wales Nutritional Standard for hospital in-patients food. Deborah added: “Me and my partner had a lovely time in Cyprus and to swap my sunbed for a hospital bed and my all-inclusive band for a hospital band was something I wasn’t prepared for. The only thing missing is the wine”, joked Deborah. Stephen Barnard, Catering Manager for Cwm Taf University Health Board said: “We try to offer patients a tasty meal made from good quality seasonal ingredients which where possible are locally sourced, all the recipes for the dishes on the seasonal menu are taken from the ‘All Wales Menu Matrix’ ensuring compliance to the nutritional standard which should aid a speedy recovery for our patients.”
vulnerable patients for our specialist input.
A DAY IN THE LIFE OF A
DIETITIAN
Twenty-four year old Fiona Regan lives and works in the Royal Glamorgan Hospital. Fiona who left her home in Devon over a year ago for a five week post as a dietitian with the health board, has now been here over a year. Living in the hospital residences Fiona is enthusiastic about the job she does. She says: “Every day is different, that’s one of the things I love the most about my job.” Fiona gives us a day in her working life as a dietitian at the Royal Glamorgan Hospital in the acute division covering wards, clinics and group education sessions. “In the morning, I review my clinical caseload and prioritise my new referrals alongside my colleagues. This morning my main focus is delivering a weight management group education session. This is a dietetic-led weight management programme, which is based on current evidence and best practice. It consists of two, two hour sessions which aid participants to make and maintain positive dietary changes. The objectives
of today’s session are: to improve patient knowledge of the Eatwell plate and, to provide strategies which will help change behaviour in relation to eating habits/patterns. The session is designed to promote active participation, and today’s group have lots of questions, which is great. I then need to go straight to the wards as one of my patients who is being fed via a feeding tube is well enough to be discharged home. This is great news for the patient and his family, and I explain to them how I can ensure he has all the training he needs to safely feed himself via his tube in his own home. I link with the ward staff, his district nursing team and GP, and the dietetic community support team to arrange the specialist equipment he will need. After lunch it’s straight back to seeing my patients on the ward. The majority of my patients require nutritional support to avoid malnutrition. The nursing staff have a really valuable role, in undertaking MUST nutritional screening of every patient, which enables them to refer the most
My role involves calculating the patient’s nutritional requirements, assessing their current status via interpretation of blood test results, and analysing their nutritional intake. I then devise an action plan, which is explained to the patient and the nurses. Some care plans require me to link with colleagues in catering, whilst others may need me to recommend specialist nutritional products. The aim is to improve nutritional intake because malnutrition has a significant effect on recovery. Most of the patients I review today have shown an improvement in their nutrition since I last saw them. One of my patients has needed a slight change to their initial care plan as they were not meeting their estimated needs and I discuss with the patient, and their family. I also need to contact the medical team to inform them of the changes to the patient’s nutritional status. The last patient I see today is a lady who is newly diagnosed with diabetes. She has already seen the specialist nurses, so understands what diabetes is and why controlling her blood sugar level is important. I’m able to asses her diet and agree with her some targets. She has a few questions, based on what her friends have told her not to eat. I reassure her that there’s definitely no need to avoid bananas and grapes, and that as dietitians we are the only qualified professionals that gives scientific, evidence based nutrition advice. What will tomorrow bring?” page 18
Cwm Taf staff recognised for outstanding achievement in improving patient care Staff from across Cwm Taf University Health Board were recognised for their outstanding contributions to high quality care at the annual staff recognition awards on Friday, May 23rd.
Leadership
CTUHB chairman Chris Jones and chief executive Allison Williams were present for the special ceremony in Nantgarw where award categories included leadership, partnership working, team of the year and patients’ choice.
At the start of the project there were 137 patients with lengths of stay of 40-days plus in community hospitals but in January 2014 only 18 remained in a community hospital setting.
“This event is our chance in Cwm Taf to publicly recognise the outstanding efforts that individual staff members are making to improve patients’ lives and experiences, and to celebrate the great work that is going on across the Health Board,” said Mrs Williams. “Once again this year it was an emotional occasion and I am immensely proud of everyone who was nominated.” page 19
Winner: Kath McGrath, Assistant Director of Operations (Unscheduled Care), Kath McGrath Kath was recognised for her leadership in driving the “Focus on Flow” project which aims to identify blockages and delays in the hospital system and identify ways to speed up the flow of patients.
which aimed to address the specific care needs of those with Parkinson’s. To date 60 care home staff have been trained, with positive changes made to working practice, including effective medicines management.
Sustainability and Improvement
Winner: Lynne Greenhill, clinical nurse specialist
Winners: The Cwm Taf Stroke Implementation group, led by Dr Richard Dewar was recognised for its work on the Stroke Delivery Plan. This includes the award-winning stroke passport and the ring-fencing of stroke beds on district general hospital sites which has seen a marked improvement in performance and the quality of services for patients.
Lynne was recognised for her outstanding work in improving the lives of patients with Parkinson’s Disease. Lynne worked in partnership with the independent sector to plan and deliver a rolling programme of structured education to health care professionals in care home settings
Ruth Friel, senior midwife for her work in helping to reduce caesarean infection rates. Having attended a recent SSI Prevention Master Class as part of the 1000 Lives work, Ruth took up the mantle and led the work required in Cwm Taf, an outlier in Wales for our high Caesarean
Improving Patient Experience
Section Surgical Site Infection (CSSSI) rates. This involved bringing a team together to review the evidence base for the care required for pre-op, intra-op and post- op care. A Standard Operating Procedure has been produced and communicated to all as an eye catching poster, which was presented at the CNO Wales Showcase Conference in May. The Unscheduled Care Team and Joint Emergency Therapy Team (JETT) Unscheduled Care Team: Focusing on patient flow in a complex and dynamic system across five main hospitals is challenging and in previous years concerted efforts achieved improvements in isolated areas. However the situation was unsustainable and during 2013 the Health Board applied a collective focus on patient flow across acute, community and primary care services. The aim of the “Focus on Flow” project was to identify the blockages and delays in the hospital system and identify ways to speed up the flow of patients through the
system by identifying key measures for improvement. Work on patient flow is an ongoing process which will continue to be reviewed and refined as we move forward. JETT: The Joint Emergency Therapy Team (JETT) aims to prevent avoidable admissions to acute beds from Emergency Care Centre (ECC) and Accident and Emergency (A&E) facilitating safe and rapid discharge planning from ECC and A&E. The multidisciplinary JETT is comprised of Occupational Therapists, Physiotherapists and generic support staff and currently operates across both Prince Charles Hospital and the Royal Glamorgan Hospital sites. To date the team has provided input for 803 patients. Two thirds have been discharged with input solely from JETT and not requiring admission to acute wards. The team is required to work closely with community health and local authority colleagues to achieve successful outcomes for patients.
Patients Choice
Winners: Kathryn Doughton and Sarah Morgan-Jones, Patient Experience and Bethan Lewis, senior nurse surgery Recognised for their ongoing support of a 24-year old patient with profound disabilities, and her family. “The work that these ladies have done, has been outstanding,” said the patient’s mum in nominating the three for an award. They have arranged meetings with key staff members so that communication can be improved. They have addressed all of my concerns whilst being professional but also showing great empathy for our situation. “I cannot emphasize the difference they have had on our lives. The positive impact that their care and hard work has accomplished cannot be put into words.”
Partnership
Winners: Housing and Health Working Group (Public Health and Partnership) Brings together the two different sectors across Cwm Taf to improve health and the development of a multi agency pack. Interventions which have had a positive impact on resident’s health and wellbeing include: • the smoke-free homes pilot project to reduce tenants’ exposure to second hand smoke • Community wellbeing coach-
exposure to damp and mould • Dissemination of health messages and information about health services via tenant newsletters Multi-Agency Pack (Partnership) Enables staff from different agencies to confidently roll out a oneday training session to anyone working with children and young people under 25. As a result a robust training pro gramme is now in place which
young people by ensuring those working with them are able to identify warning signs and provide support at an earlier stage, reducing risk and preventing escalation of problems to more severe self harm or potentially suicidal behaviour.
Health and Well Being at Work
Winner: Resolve Mediation Service Conflict in the workplace can have a massively disruptive effect on individuals, their colleagues and the services that they provide to patients. The health board has for the last few years had an established ‘Resolve’ Mediation Service which has 30+ trained mediators. The service has also trained staff side who are invaluable in promoting and supporting the service.
es providing valuable health and wellbeing support to our most vulnerable residents • Development of a housing and health heeds assessment to inform service provision • Integration of housing priorities into the single integrated plans of both Merthyr Tydfil and Rhondda Cynon Taf councils • Asthma and housing leaflet being developed to reduce page 21
has been well received by more than 500 staff trained to date which has been achieved with limited impact on individual services resources. Most importantly, feedback from the training indicates it is positively changing people’s attitudes while improving their knowledge, skills and confidence when working with those who self harm. This positively impacts on outcomes for children and
Employees volunteer to undertake this role without any financial incentive because they enjoy and value the role they plan in helping people resolve their conflict issue. The service has also managed to retain two former employees who have retired but continue to support the service on a voluntary basis. The mediation service would not exist without the dedication and support from the staff who participate in this service.
Most Supportive Colleague
Winner: Roberto Spagna Roberto – or Burt as he is known –always looks to see if he can assist his colleagues. He is the
first person people go to if there is a problem – whether it be a new trainee or the head of department! Burt is often found in the lab well past his normal finishing time as he helps the person who is rostered to work the evening shift; rarely if ever does he take back the time. One of his colleagues has said about Burt: “I’ve worked in NHS Biochemistry labs for 28 years and never worked with anyone as dedicated as Burt. He is unique.”
Team of the Year
Winner: Unscheduled Care – Focus on Flow The aim of the “Focus on Flow” project was to identify the blockages and delays in the hospital system and identify ways to speed up the flow of patients through the system by identifying key measures for improvement. The success very much depended on a whole system approach from pre hospital assessment through to the point of discharge. Numerous initiatives were implemented including work with the WAST, in the acute and community hospital, with the @home services and with our partners. Listening to those who receive the service and work within the process is fundamental if any change is going to be successful and feedback on any intervention ensures staff engagement and long-term success and sustainability. We have received positive feedback from many staff and it is true to say that “Team working allows ordinary people to create extraordinary things”.
CWM TAF ‘STARS’ Occupational Therapy Technician, Zoe Williams has been passionate about developing services to help children with Developmental Co-ordination Disorder (DCD) to learn basic skills in order to access leisure activities within their communities. Zoe initiated the first bike group in August 2010, pursuing partnership working with Disability Officers and successfully bid to Sports Wales for a grant to support ongoing groups. Zoe has enabled 30 children to learn to ride their bike and her efforts and skills have significantly contributed to the children’s lives. Welsh Language officer, Gareth Davies has worked tirelessly promoting the Welsh language in the health board since its establishment and before that as part of the former health board. Michelle Hughes, a member of the ward based catering team in Dewi Sant hospital regularly attracts comments from staff and visitors regarding her manner and style of service. Gwenan Roberts, Head of Organisational Development is extremely committed to delivering the best for the organisation and is a true enabler, motivator and supporter of others, for whom she goes the extra mile. Gwenan has a great communication style and is truly a positive role model for those around her. Doug Proctor and Tina O’Neill (joint award for their work with the mediation service). The ‘Resolve’ Mediation Service has been in place since 2008 and both Doug Proctor and Tina O’Neill have played an active role within the service, not just undertaking the role of a mediator but also promoting and enhancing the service. Alan Pugh, Union Convener started work in Mid Glamorgan Health Authority as a store man in St Tydfil’s Hospital in 1975. Within a few years he moved on to work in Theatres where in 1981 he was elected as a NUPE steward for the department. In all this time he has been a champion for staff ensuring that they are treated equally and with dignity.
SPECIAL ACHIEVEMENT AWARD This special award was presented Major Teresa Levett, Captain Philip Thomas and Corporal Leighton Davies to recognise their contribution to Military Medical Operations worldwide and as members of the Army Reserve. Captain Philip Thomas joined the Territorial Army in 1989 as an infantry soldier with the Royal Regiment of Wales. He progressed to an infantry team medic in 1996. Philip commenced his Operating Department Practitioner (ODP) training at Prince Charles Hospital in 1994 and qualified in 1996. He became the first ODP in Wales and second in UK to become commissioned as a Captain ODP. Captain Thomas has undertaken major exercises in Oman, Cyprus, Germany, Gibraltar, USA, Holland and Jersey. Corporal Leighton Davies joined the Royal Regiment of Wales in 1997 as a bandsman, and played at the Millennium Stadium for the final of the Rugby World Cup in 1999. Leighton then transferred to 203 Welsh Field Hospital in 1999 as a Combat Medical Technician. Deployed to Iraq on Operation Telic 1 in 2003, Leighton was based in the operating theatre, where he met Philip Thomas who then enlightened him regarding the role of the ODP in the peri-operapage 23
tive environment. Following this Leighton applied and successfully commenced his ODP training in 2005 at Prince Charles Hospital.Within the theatre department at Prince Charles Hospital, Leighton is now based at the busy Day Surgery unit and primarily undertakes the role of the scrub practitioner. Major Teresa Levett joined the theatre department in the Royal Glamorgan Hospital in December 2003 as a band 6 staff nurse. Having worked in Llandough theatres previously, she was already an experienced scrub nurse. Teresa progressed to Theatre Team Leader in May 2006.
In 2003, Teresa joined the Territorial Army, and within a year had been promoted to Captain. Teresa has been deployed to Afghanistan on 3 occasions; the first in April 2008 and again in November 2009. During this time Teresa worked in the Operating Theatre department at Camp Bastion. And finally in August 2013 – as part of Operation HERRICK, in her role as Major, which demanded much responsibility. In Teresa’s role as Theatre Team Leader, she manages a very efficient theatre, which she has clearly managed to transfer these skills to her army position.
AT A GLANCE: THE FULL LIST OF WINNERS
LEADERSHIP Kath McGrath, Assistant Director of Operations (Unscheduled Care) IMPROVING THE PATIENT EXPERIENCE Lynne Greenhill, Clinical Nurse Specialist SUSTAINABILITY AND IMPROVEMENT Cwm Taf Stroke Implementation Group Ruth Friel, Senior Midwife Unscheduled Care Team and Joint Emergency Therapy Team (JETT) HEALTH AND WELLBEING AT WORK Resolve Mediation Service PATIENTS’ CHOICE Kathryn Doughton, Sarah Morgan-Jones and Bethan Lewis PARTNERSHIP Housing and Health Working Group Development of a Multi Agency Training Pack SUPPORTIVE COLLEAGUE Roberto Spagna, Biomedical scientist CWM TAF STARS Gareth Davies, Welsh Language Officer Zoe Williams, Occupational Therapy Technician Michelle Hughes, member of the ward-based catering team in Dewi Sant hospital Gwenan Roberts, Head of Organisational Development Doug Proctor and Tina O’Neill (joint award for their work with the mediation service) Alan Pugh – Union Convener TEAM OF THE YEAR Unscheduled Care – Focus on Flow SPECIAL ACHIEVEMENT AWARD Major Teresa Levett, Captain Philip Thomas and Corporal Leighton Davies for their contribution to Military Medical Operations worldwide and as members of the Army Reserve. page 6
PONTYPRIDD A’R ANTHEM GENEDLAETHOL Pan oeddwn yn grwtyn bach uchafbwynt bob rhyw bedwar mis, adeg prynu dillad ysgol, dillad haf, anrhegion Nadolig, oedd trip dydd Sadwrn o Aberdâr i Bontypridd bell ar y trên. Yr un oedd y drefn bob tro rhybuddio’r 3 ohonom, i beidio â mynd ar goll yn y farchnad agored a’r un peth oedd yn digwydd, yn ddi-ffael, oedd bod fy nghyfnither, oedd fel dol fach ac
yn “lico parado”, yn mynd ar goll. Plentyn chwaer Mam oedd hi a dyna le byddai Mam yn sgrechian ei henw lan a lawr y stondinau, er mawr gywilydd i mi, fy modryb yn llefain a’m chwaer a minne fel bwbachs ac yn edrych fel yr extras yn ‘Eastenders’, sefyll, edrych a gwneud a dweud dim. page 24
Ond pan ymddangosai Anne fach, oedd wedi’i hudo gan y dillad lliwgar ym mherfeddion rhyw stondin, a’r llefain a’r cwtshys drosodd, yr hwyl oedd gweld y dynion yn gwerthu, cwpanau o setiau o lestri blodeuog yn cael eu chwyrlio yn yr awyr a’u dal yn ddiogel, ac acen y gwerthwyr hyn yn anghyfarwydd i’r glust. Wedyn, y ffagods a’r pys yn y farchnad dan do, a dal y trên pedwar er mwyn bod adre’n
harad a dechrau darllen yr hanes ar gerflun Goscombe John â’r ddau ffigwr, yn cynrychioli Barddoniaeth a Cherddoriaeth - cofeb addas i Evan James a James James.
gynnar. Roedd y ‘witching hour’ (dewiniol dymp y nos) yn gynt o lawer yn y cymoedd yr adeg honno.
mae angen i rywun fynd i ‘teacher mode’.
Wyddem ni ddim am hanes pont y dref na’r anthem bryd hynny ond wrth dyfu’n hŷn byddem yn cael picnic ym Mharc Ynys Ang-
Peth twp yw cymryd unrhywbeth yn ganiataol, roeddwn i’n meddwl y byddai pawb yn gwybod am gysylltiad Evan a James â’r Anthem Genedlaethol ac â Phontypridd ond, wrth holi,
Un o Gaerffili oedd Evan James yn wreiddiol, un a ddaeth i Bontypridd i agor melin wlân. Bu ei fab James yn gweithio gydag e cyn cadw tafarn yn y dre. Cyfansoddodd James James y dôn i’n
Trwy deimlad gwladgarol, mor swynol yw si Ei nentydd, afonydd, i fi. Gwlad, gwlad ……… Os treisiodd y gelyn fy ngwlad dan ei droed, Mae hen iaith y Cymry mor fyw ag erioed; Ni luddiwyd yr awen gan erchyll law brad, Na thelyn berseiniol fy ngwlad. Gwlad, gwlad ……… (1858) Wrth sôn am yr Anthem yn cael ei chanu mewn gemau rygbi ac ati dywedodd yr awdur Aeres Twigg: “Those who do not know the words have learned to stand in dignified silence for the zoom cameras can be cruel to those who try to bluff us.” ” Ydych chi’n cofio’r gwleidydd enwog ‘na? …….. Ie, dyna chi. Ar ôl 1858 daeth y ‘gân’ yn hynod o boblogaidd ac yn adnabyddus ledled Cymru, cyn troi’n Anthem Genedlaethol ac, erbyn heddi, fe’i cenir dros y byd pan ddaw Cymry at ei gilydd. hanthem pan oedd yn 22 oed ac yn cerdded ar hyd glannau’r afon Rhondda. Yn wir, enw’r dôn yw ‘Glan Rhondda’. Gofynnodd James i’w dad a fyddai’n llunio rhai penillion gwladgarol i ffitio’r dôn. Erbyn diwedd y dydd hwnnw roedd Evan wedi ysgrifennu dau bennill ac erbyn y diwrnod wedyn ymddangosodd y trydydd. Gwyddom fod brawd Evan wedi ymfudo i’r Unol Daleithiau i gael gwaith a’i fod wedi gofyn i’w frawd ei ddilyn. Geiriau’r Anthem yw esboniad Evan, yn ôl pob sôn, pam na allai ei ddilyn:
Mae hen wlad fy nhadau yn annwyl i mi, Gwlad beirdd a chantorion, enwogion o fri; Ei gwrol ryfelwyr, gwladgarwyr tra mad, Tros ryddid collasant eu gwaed. Gwlad, gwlad, pleidiol wyf i’m gwlad; ‘Tra môr yn fur, yn bur i’r bau’, O bydded i’r hen iaith barhau. Hen Gymry fynyddig, paradwys y bardd, Pob dyffryn, pob clogwyn, i’m golwg sy’n hardd;
Aeth James i fyw i Aberaman, Aberdâr, i redeg tafarn ac mae wedi’i gladdu ym mynwent Aberdâr. Symudwyd olion Evan a’i wraig i Barc Ynys Angharad yn y saith degau ac maent wedi’u claddu wrth droed y gofeb. Un troednodyn diddorol i gerddorion, efallai, yw’r ffaith i’r anthem, pan oedd yn ‘gân’, gael ei chanu’n llawer cyflymach. Yr esboniad am y newid tempo yw “mai’r capeli a barodd i’r dôn arafu”. “Grym Capeli’r Gorffennol” – Thesis MA i rywun! page 25