Spring 2019
www.rlbuht.nhs.uk
BBC Two’s Hospital Staff shine on television series R Charity Our fundraising aims for 2019 New Royal Work restarts on new hospital
Exclusive:
Saying farewell to our CEO, Aidan Kehoe, this March
2 Creating a great place to work for the benefit of staff and patients
Staff recognition awards We love to recognise our staff and the amazing work they do around our hospitals, so each month we celebrate a nominated team and employee.
The award is open to all staff including those working behind the scenes - either in support functions or non-clinical roles - or to those who work in the front line.
Staff, patients, carers, and visitors can nominate someone who they think deserves to be recognised for the excellent care and service they provide and the difference it has made.
Here are our latest award-winners that have gone above and beyond and provided our patients with an excellent level of care.
Employee of the month
Thanks to our staff Work has now resumed on the new Royal and we expect the hospital to be handed over to us by the end of 2020. This year the Trust continues to work toward the proposed merger with Aintree University Hospital, a move which will bring the best of both trusts together. Working together will enable us to deliver safer and better care for patients. In January and February we had a visit from the CQC, who carried out an inspection of our services. As we await the results, I thank staff once again for their continued hard work.
June 2018 – Geoff Loyden, Health care assistant
August 2018 – Susamma Joesph, nurse
July 2018 – Linda Mullen, nurse consultant
September 2018 – Michelle Mullen, housekeeper
Team of the month
My time at the Trust has now come to an end, and I will be leaving in March to take up my new post as chief executive at Hamad General Hospital in Doha, Qatar. It has been a privilege and an honour to be chief executive at this Trust. Every day I have seen your dedication to our patients and the care, compassion and commitment you provide. The proudest moments in my career have been working with you all and playing a part in the transformation of these hospitals. I wish you all a successful future. Aidan Kehoe, chief executive
July 2018 – Ward 5B
September 2018 – Ward 3X
August 2018 – Ward 6X
October 2018 – Ward 4, BGH
Creating a great place to work for the benefit of staff and patients
Goodbye, Aidan! Since becoming the chief executive of the Trust in 2012, Aidan has become a familiar, friendly face around our wards and departments. It was often joked that it would take double the length of time do to a ward round as Aidan would want to stop and have a chat with everyone. If he wasn’t talking about Liverpool Football Club, he would be passionately talking about patient care and his amazing employees here at the Trust. During his six years here, Aidan proudly led the Trust to a good rating from the Care Quality Commission, and has overseen a number of incredible advancements in patient care, including championing digital innovations through the Global Digital Exemplar programme, such as e-sepsis and working toward our proposed merger with Aintree University Hospital. Of course there have been some challenging times, in particular the journey of the new Royal, but Aidan has worked tirelessly with the Department of Health and Social Care, Treasury, funders and local politicians to get back on the right track to our new hospital – and there will certainly be an invitation in the post to Qatar when we throw our grand opening party. He’s also never been afraid to get involved in our fundraising work for R Charity, whether that was abseiling from the top of the Royal and fire-walking, to trekking through the Borneo rainforest and climbing Mount Kinabalu. Everyone here at the Trust wishes Aidan the best of luck for his new role as chief executive at Hamad General Hospital in Doha, Qatar, and we thank him for all of his hard work here in Liverpool. We will miss you, Aidan!
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4 Creating a great place to work for the benefit of staff and patients
BBC Two’s Hospital The Trust recently took part in filming for BBC Two docu-series, Hospital. The six-part programme took a behindthe-scenes look of the six NHS Trusts that Liverpool has: The Royal Liverpool University Hospital and Broadgreen Hospital, Aintree University Hospital, Liverpool Women’s Hospital, The Walton Centre, Alder Hey Children’s Hospital and the Liverpool Heart and Chest Hospital. We were featured heavily in both the first episode on 10th January and fifth episode on 7th February. The episodes showed the contrast of how despite being in a building past its prime, we are still providing exceptional care. Our renowned vascular team showcased their skills, as did our estates team who unfortunately had to deal with a flood. The new Royal was also featured, where work has now once again resumed. The latter episode focused on our renal transplant team, who carried out the slightly unusual occurrence of three kidney transplants in
one day. The services of Liverpool Clinical Laboratories were also featured in multiple episodes throughout the series. “I think we can all agree that it was an emotional experience watching Hospital on BBC Two. The programme showcased the amazing work our staff do every day – we already knew how hard they work but now the rest of the country does as well,” said Aidan Kehoe, chief executive. “I just want to thank all staff for the continued passion that goes in to providing the first class care they give to patients
and the people of Liverpool around the clock. I know that we are often faced with many challenges; but their dedication and understanding does not go unnoticed. “Thank you also to all of the staff who took part in the recording of the programme, and letting Label1 film you in some really tough circumstances. The broadcast was a tribute to all of the staff working in the Trust, and judging from some of the fantastic responses and messages of support on social media – thousands of other people think you’re amazing too.”
Change the way we work to ensure we are ready for a successful move into the new Royal
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New Royal: update on building work Since their appointment in November, Laing O’Rourke and external advisors have been working with the Trust to assess all the works needed to complete the new Royal. This work is required for Laing O’Rourke’s construction programme, which we expect to receive by the end of March. In the meantime, Laing O’Rourke and their contractors are working to prepare areas of the building for repair works to fix the structural issues that have already been identified. Keith McGreavy, project director for redevelopment said: “This is highly complex work and requires significant interventions to the concrete frame, the internal finishes and outside of the building. Once complete, it will ensure that all the structural issues have been resolved.
Our redevelopment team is working closely with the design team on the solutions, to ensure that not only do they fix the issues, but also that they don’t adversely impact on clinical space.” The final costings and the additional funding required to complete the new Royal, will be set out in our business case. This will be submitted for approval
to the Department of Health and Social Care, who have committed to supporting the completion of the hospital.
Maintaining the current Royal In the meantime, additional funds have been provided by the Department of Health and Social Care, in order to maintain patient safety and ensure we can
Aidan Kehoe with Louise Ellman MP and Metro Mayor, Steve Rotherham, on a recent tour of the new Royal.
continue to provide services in the existing Royal. Eamon Fairclough, head of estates and facilities, said: “We are spending over a million pounds this year on the current hospital. Some of this money is being spent on modernising the lifts we use to transport patients, on ensuring we have vital spare parts on-site for systems such as heating and ventilation and increasing maintenance for important equipment and systems. We also ensure our teams are ready to respond quickly to any issues to make sure that disruption to patients is kept to a minimum. Whilst we remain in the current Royal, we are doing all that we can to keep vital systems and equipment operational and our patients and staff safe.”
6 Creating a great place to work for the benefit of staff and patients
Award-winning staff Award-winning health and wellbeing The Royal’s health and wellbeing team were awarded the ‘Workplace Health and Wellbeing’ award for 2018 at the Liverpool and Sefton Chambers of Commerce 2018 annual awards ceremony.
Prestigious pharmacy accolade The Royal’s clinical director of pharmacy has been awarded with a prestigious accolade. Professor Alison Ewing was presented with the Lifetime Achievement Award for 2018 from the UK Clinical Pharmacy Association (UKCPA). “It’s the biggest honour I’ve ever received,” said Alison on accepting the award. The professor was described by the judging panel as ‘dedicated to improving patient care’ and an outstanding contributor to the pharmacy profession. “I am living the dream. I love my job and am passionate about pharmacy and developing things for the future. I am very honoured that my peers and colleagues have given me this award.” Here at the Trust she has made many positive changes in the pharmacy department, notably as an early adopter of technology such as dispensing robots, and promoting and supporting the early deployment of an electronic prescribing system.
Exceptional impact Specialist registrar in the Royal’s tropical and infectious diseases unit (TIDU), Sylviane Defres, received an Exceptional Contribution award at the Encephalitis 2018 conference. Hosted by the Encephalitis Society, the conference presented some of the key results from a National Institute for Health Research programme grant on ‘Understanding and Improving the Outcome of Encephalitis’. Sylviane is a research fellow on the programme, which has been running since 2010 and is having a major impact on management of UK patients with this devastating disease.
Health and wellbeing manager, Mark Caffrey, said: “Over a number of years we have initiated a wide range of programmes to improve the physical and mental wellbeing of our staff, recognising that health and wellbeing is about changing culture. Winning this category has given all the team a real boost as we focus on improving our health and wellbeing in our organisation in the coming years.”
Outstanding contribution The Trust’s head of professional and practice development, Jo Marinas, was recognised with an award for ‘Outstanding Contribution to Equality, Diversity and Inclusion’ in health and social care from the Royal College of Nursing North West. The team attended the RCN’s North West Black History Month celebrations in Manchester where the award-giving also took place.
Celebration upon accreditation The British Society of Echocardiography has accredited the Royal’s Cardio Respiratory Department for the next five years. The BSE departmental accreditation is a recognised benchmark of quality within the profession. It indicates to patients and health professionals that the department meets standards set by the national body in the following areas: transthoracic echo, trans oesophageal echo, stress echocardiography and training to BSE proficiency standard. “This is a massive credit to the whole team,” said Christopher Stanton, principal physiologist and department manager. “Congratulations and thank you everyone for your extremely hard work.”
Work recognised Infectious diseases consultant, Dr Tim O’Dempsey, alongside nurse Pauline Cafferkey, was awarded the Duncan medal for outstanding work during the recent Ebola outbreak in Sierra Leone. Professor Tunde Zack-Williams, chair of the Duncan Society, presented the accolade at a meeting of the Duncan Society in the Athenaeum, Liverpool city centre. The Duncan medal is awarded to those who have made an outstanding contribution to public health and wellbeing of the community.
Complete proposed merger with Aintree Hospital and continue to work with partners to improve care
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Propsed merger: an update This is the latest update to keep you informed about how our Trust and Aintree University Hospital NHS Foundation Trust are planning to merge.
Reviewing service models In December, all our corporate services and deep dive service areas: trauma and orthopaedics, general and emergency surgery, ENT, gastro and endoscopy, nephrology, radiology and dermatology, presented to a panel of executives an outline of their recommendations for how their service could be delivered in the new organisation. This was called a confirm and challenge process. The purpose was to review, challenge and confirm the visions and operating models developed for the new organisation. “This included gaining assurance that our merger plans improved or maintained the quality of service delivery and outcomes for patients, maximised any opportunities for efficiencies as well as identifying and mitigating risks, and ensured that the plans are deliverable,” said Kelly Jones, partnership engagement programme manager. “Work will follow to progress more detailed discussions about staffing plans for delivering the outlined models. This will be individualised to each service, taking into account their needs alongside the expertise and the skills required to deliver the models of care.”
Considering clinical and nonclinical services “It takes a great team to provide a great patient journey – and everyone plays their part, from the consultants and nurses, to the secretaries and administrators that keep the hospital running efficiently,” said Kelly. “If we gain approval to bring the organisations together, we will need the best clinical and non-clinical services to deliver the improvements we want for our patients. This means our merger planning must consider clinical and non-clinical services.” There are nine corporate Programme Working Groups who will develop plans to support the reconfiguration of clinical services, and also develop plans for the transition of corporate services into the new organisation. “Integration plans for how teams will come
together will be considered pre-merger. This will include what will need to happen on day one of the new organisation and what the longer term integration looks like for individual service areas,” said Kelly. “The timeline for bringing services together will depend on what makes sense for each individual service.” Once we have a clearer picture, proposals will be discussed with teams. A key priority will be that we remain flexible enough to ensure our phased integration is deliverable and that all services remain safe. It is likely some corporate services, where there is an operational need, will require teams to come together on merger. “However, for the majority of services we will focus on making sure services continue to deliver operationally and in the
short term, we will focus on standardising policies and procedures, and identifying areas where benefits could be realised in the future.”
Patient Benefit Case nears completion “Over the past months we have been developing our case for why we want to create a new, city-wide hospital Trust and defining why merger will enable us to deliver better, safer, more consistent hospital care that’s fit for the future,” said Kelly. The patient benefits of the merger have been outlined in the Patient Benefit Case, which we have been working with NHS Improvement (NHSI) to develop. The final draft was submitted to NHSI at the end of December and they are in the progress of speaking with clinical leads regarding the benefits they have identified. The next step is to start the Competition and Markets Authority (CMA) process. “We thank everybody who has contributed to pulling this case together.”
Transaction and integration staff roadshows The first set of roadshow sessions for staff were held in February to explain the reasoning behind the proposed merger, where the process is up to and to give staff the opportunity for questions and feedback. Each session was well attended and this feedback will be used to understand common themes so that the Board’s can gauge the views of staff and respond accordingly.
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Deliver high quality care to all patients by improving the way we admit and discharge
Multi-million pound boost for CSSD The Trust celebrated the development of its new Central Sterile Services Department (CSSD) with a VIP tour of the premises in November. The CSSD sterilises reusable surgical instruments in readiness for further procedures, processing approximately 157,000 trays of instruments, including power tools and rigid endoscopes, and 199,000 single instruments, including 50,000 dental instruments. The original CSSD was located on the lower ground floor of the Royal and was becoming increasingly unfit for purpose. This is a stark contrast to the new CSSD at Broadgreen, a state-of-the-art facility valued at approximately £6.3 million, which has been funded by Liverpool City Council and built by contractors, Willmott Dixon. The Trust has also procured £1.5 million worth of equipment, much of which has been tailor-made for the building due to its size. The development started in January 2018 and was handed over in December, with staff moving to work in the facility in February 2019.
Trust chief executive, Aidan Kehoe, said: “I want to thank Liverpool City Council for their support in funding this new multi-million pound facility. We are the only Liverpool Trust that continues to have its own in-house sterile services department, as opposed to outsourcing the service externally.
“With this backing from the council, we are able to continue to provide an excellent service which greatly benefits our patients. I also want to thank Willmott Dixon and all the sub-contractors who have worked on this project to make sure it is completed on time. You have delivered a fantastic facility.”
Therapies garden at Broadgreen This spring, patients at the Phoenix Rehabilitation Centre on Ward 5 at Broadgreen Hospital will be able to use a brand new therapies garden. The idea behind the garden was the promotion of health and well-being to complex rehabilitation patients. Research suggests even a basic level of viewing nature and green spaces can have positive health benefits. “Many of our patients remain in hospital for long periods (up to 16 weeks), which can have a negative impact on mood and overall mental health,” said Jessica Hopkins, team lead occupational therapist on ward 5. “Having an outside therapeutic space enables patients to have a ‘break away’ from the ward while continuing to engage in their rehabilitation programme, and allows space/ time for active relaxation. The gardening activities can be graded to meet patients’
different physical and cognitive levels, ensuring all can make use of the space.” Activities will reintroduce a sense of normality into a daily routine, and patients will have an active role in maintaining the flowers/ fruit trees - providing an additional focus outside of day to day therapy with a sense of purpose, responsibility and accomplishment. The project has been in the pipeline for a while, but in late 2018 a cabin and garden space was finally able to be built. It was awarded £4,000 of funding from Tesco Bags of Help, along with a sum from the Trust’s charitable funds. Ian Stenton, head of sustainability at the
Trust, said: “It’s taken quite a long time to get organised, but we now have the funds and we can get going. We don’t currently have any outside therapies space at Broadgreen, even though there’s green space here, so this will be the focal point of project that we can develop further into the future with additional funds.” The cabin, which was constructed by volunteers from Veolia, who manage the energy centre at the hospital, has now been painted and tables with chairs added. We are also awaiting delivery of a number of large planters that patients can plant flowers in, and future plans for fruit trees to be planted as a border around the garden space.
Deliver high quality care to all patients by improving the way we admit and discharge
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Tiny implant transforms lives A new stent to treat glaucoma is now being used at St Paul’s Eye Unit, where nearly 100 eyes have been treated with this device. The tiny titanium stents, known as iStent Inject, are the smallest implant used in any speciality of medicine. Glaucoma is the leading cause of irreversible blindness in the world. Until now, treatment would involve topical eye drops, laser surgery or even more serious filtering surgery to the eye to try and prevent sight loss if the disease was still progressing.
Erika’s road to success Commonwealth Games and England international athlete, Erika Kelly, has been a patient at St Paul’s Eye Unit at the Royal since she was a teenager. She has received two corneal transplants and is sharing her story to encourage more people to sign up as organ, eye and tissue donors. “Growing up, I was regularly in and out of hospital experiencing corneal abrasions. My siblings were the same and my mum would joke that we were born with season tickets to A&E,” said Erika. “However, it was when I was around 14 and experienced erosion of the eye and subsequent ulceration that I was referred to St Paul’s and placed under the care of Mr Batterbury.” Consultant ophthalmologist and corneal specialist, Mark Batterbury, discovered that there was history of ‘lattice corneal dystrophy’ within the family and Erika was diagnosed, helping to explain the recurrent abrasions, poor vision, photophobia and discomfort. “There was never a sudden loss in sight – it’s been quite a gradual decline. It became more significant while studying A-levels, but I’d pull on my glasses and get on with the work, thinking everything was normal. I sat my exams, applied to university and didn’t stop to comprehend the impairment occurring before me.” Unfortunately Erika’s vision worsened and in June 2011, she underwent her first corneal transplant surgery to the right eye and plans for university were placed on hold. Months then passed and it appeared that the transplant wasn’t having the desired effect.
She has since undergone two lots of refractive surgery, before becoming the recipient of a second corneal transplant - this time to the left eye. “In terms of how sight loss has affected me, it has and it hasn’t. I admittedly struggle on a daily basis, especially if I’m out and about in unfamiliar locations,” said Erika. “As a competitive athlete, I recently spent 3 months living and training at an endurance centre in Leeds. Within the first 10 days, I tripped and had to take a ride in an ambulance. I hadn’t seen some speed bumps and a slight dip in the road. In failing to use my hands to break my fall, I went flying down on to my forehead.” However for Erika, a good sense of humour prevails and despite sometimes being embarrassed, she laughs it off. “With continually varying sight and symptoms that I can’t control, I try to take each day as it comes. It’s only a barrier if others make it one. A visual impairment doesn’t define me, and it hasn’t slowed me down or stopped me pursuing anything.” Erika is now studying for a psychology and counselling degree, playing harp professionally and competing internationally as an endurance athlete. She recently represented the Isle of Man in the 20km race walk at the 2018 Commonwealth Games in Australia. “It was an incredible experience of which I will never forget. To finish in the top ten was a complete bonus! I can’t wait for more experiences like that and will continue to strive to make the Great Britain team. To end on a cliché statement, you can truly achieve anything you put your mind to. Never give up.”
But now a new intervention using the iStent Inject, known as a ‘trabecular micro bypass’, is available on the NHS and approved by the National Institute of Clinical Excellence (NICE). This minimally invasive glaucoma surgical technique is normally done at the same time the patient has their elective cataract procedure. A small titanium stent is inserted into the eye, measuring 0.3mm x 0.3mm, and can only be implanted by a surgeon using a very powerful ophthalmic microscope. The recovery time is typically hours, and most patients would be able to stop taking their glaucoma medication after the procedure. In many cases it would avoid the need for a more complex procedure. Rob Cheeseman, consultant ophthalmologist at St Paul’s, said: “The reality is that for various reasons, eye drops are not a suitable long-term treatment option for all patients with glaucoma. Previously, their only real alternative was a major eye operation, but the iStent inject bridges that gap. Our experience reflects the published research in that the insertion procedure, which takes approximately 5 minutes, is helping to reduce the burden of eye drops in suitable patients. “Miniature implants have been developed to treat a number of health conditions and it’s likely that this area will only increase, improving the acceptability and tolerability of treatment for chronic diseases.”
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Fundraising
Thanks to R Supporters Thank you to all our Royal Santa’s who took part in the 5k Santa Dash. So far over £2,500 has been raised. If you haven’t already done so, please bring in your sponsorship to the fundraising office in the main reception of the Royal.
Thank you to everyone one who joined us for our annual Christmas concert which helped to raise over £3,500. Special thanks to Roger Phillips, Rainford Band, Mersey Wave Choir, Booker Avenue Junior School and Kathryn Rudge, who all donated their time to deliver a wonderful concert.
A big thank you to Tadie Abeki who has raised over £250 by running for the Royal in 2018.
The Trust’s volunteer manager, Alison Germain, married her husband Tim Martin (right) last October and instead of a gift they asked their guests to make a donation to The Linda McCartney Centre. The couple raised an amazing £1,957.90! The R Charity team wish you health, wealth and happiness on this new chapter in your lives.
What’s on
Skydive
Fancy taking the plunge? Sign up for this 10,000 feet free-fall parachute jump to raise money for R Charity. Registration fee £50 and minimum sponsorship £450. Various date available all year. Text SKYDIVE to 07825864197 or email events@rlbuht.nhs.uk for details.
Sync That Song Based on the American musical TV competition - Lip Sync Battle, 10 acts will take to the stage on 15th March to try and win your vote. 7pm – late at Garlands, Liverpool. For tickets visit search ‘Sync That Song’ on Eventbrite. To take part email events@rlbuht.nhs.uk or call 0151 706 3150.
Sportsman’s lunch Enjoy a delicious meal at Marco Pierre
A huge thank you to our ‘Penny Pot Fundraisers’ who to date have raised a staggering £69,354.76. This has been achieved by donating their loose change - an easy and affordable way to support R Charity. To get involved in the R Penny Appeal call into the fundraising office and collect a penny pot to fill and bring back to us.
White Wheeler’s of St James’s Liverpool restaurant on 29th March with Liverpool FC legend, ‘Great Dane’ Jan Molby. LFC TV presenter, Peter McDowall, will also be there as guest interview/host. All funds raised will go toward the purchase of a £100,000 vital piece of diagnostic equipment for our Urology department. For tickets contact aimee.clare@rlbuht.nhs. uk or call 0151 706 3153.
The Casino Royale Charity Ball On 3rd May at Double Tree Hilton, Liverpool, enjoy an evening of fun, fine food and frivolity all in the name of raising much needed funds. £39 per person. For more information email events@rlbuht.nhs.uk or call 0151 706 3150.
Snowdon Starlight Challenge Climb at dusk, enjoy the sunset on
the summit and then descend in the moonlight while raising money for R Charity on 8th – 9th June. Registration £30 (minimum sponsorship £150). Optional return transport and accommodation available. Places are limited so book early to secure your place. Text SNOWDON to 07917598692 to register or email events@rlbuht.nhs.uk.
Everest Base Camp trek The ultimate bucket list adventure, why not challenge yourself and trek to Everest Base Camp on 23rd October to 6th November? Stand in the shadows of the world’s highest mountain and raise money for charity; you will also sample Sherpa hospitality and explore Nepal’s mystical capital, Kathmandu. For more information text EVEREST to 07904818766 or email events@rlbuht.nhs.uk.
Fundraising 11
R fundraising plans Thank you to everyone that supported R Charity throughout our 2018 fundraising appeal. We are working extremely hard to continuously contribute to the improvement of treatment and care of our patients, and it is our aim to provide our hospital and our clinicians with the best possible equipment to do this.
• A TRUB machine for our urology team
This year we are hoping to continue this amazing fundraising and throughout 2019 we are looking to raise money to purchase:
• RemPods for patients with dementia
•A n ultrasound scanner for our breast cancer patients
•G ym equipment for the physiotherapy team •A FEES machine for our speech and language therapists • Equipment for a shared dialysis room • A specialist mammography chair
None of the above will be possible without your support. Every bit of support we receive, large or small, makes a huge difference, so thank you.
Get involved Do you want to organise a fundraising event for R Charity? It could be anything from a lunch or afternoon tea to a golf day or bake sale. If you are part of a community group or are thankful for the care received while in hospital and want to give something back, contact community fundraiser, Angela McShane, on 01517063172 to help make your idea a reality.
Harriet’s fundraising story One person who decided to get involved and raise money for R Charity was Liverpool personal trainer, Harriet McGuffie. She raised £2,000 through hosting free classes at her studio on Woolton Road in exchange for donations to raise funds to support breast cancer patients here at the Trust. Harriet was inspired to raise money after supporting one of her clients, Sarah, who was diagnosed with breast cancer three years ago. Sarah underwent a mastectomy, reconstruction surgery, bone grafts and six rounds of chemotherapy. She is still receiving treatment today.
“There’s plenty of evidence that fitness benefits the mind as well as the body. Sarah is one of the bravest, strongest members of our family. The war against cancer will eventually be won by medical professionals who will come up with ways to beat the terrible disease,” said Harriet. “The fight however is won right here with us, in gyms like ours, at coffee mornings, fun runs, sponsored dancing or whatever you choose to do. By coming together as a community and raising funds to support those on the front line we all contribute to the effort. To those that attended, donated, or simply dropped some money in the
bucket - thank you from the bottom of my heart.” We would like to say thank you to Harriet, her amazing team, friends and clients who all took part. The money raised will go a long way towards supporting more breast cancer patients in the future.
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Creating a great place to work for the benefit of staff and patients
Visit to Africa Two nurses from the Trust recently embarked on a visit to Cape Town in South Africa and Kampala in Uganda as part of the Global Health Research Group, funded by the National Institute for Health Research.
Clare Prince, pharmacology research nurse at the Royal, and Samantha Riccio, clinical nurse specialist at the Royal’s Roald Dahl Centre, visited Africa to share their expertise in anticoagulation and research relating to warfarin to local nurses and doctors. The visit addressed gaps in the understanding of prescribing anticoagulation and misconceptions held by healthcare providers locally.
The Global Health Research Group has been leading on a 3-year research study, ‘Warfarin anticoagulation in patients with cardiovascular disease in Sub-Saharan Africa’, in collaboration with the University of Liverpool, Infectious Diseases Institute, Makerere University in Uganda and University of Cape Town in South Africa. This study aims to improve anticoagulation in non-communicable diseases (which are not infectious directly from one person to another) by developing clinical dosing algorithms, and further improve anticoagulation quality by using novel technological advances. Anticoagulation represents an unmet clinical need in sub-Saharan Africa, as patients either do not receive anticoagulation (because of difficulties in monitoring) or are inadequately anticoagulated because of poor dosing guidelines. “We both felt it was an amazing experience and privilege to visit both South Africa and Uganda to share our knowledge and experience in our individual specialities. We received such a warm welcome from the teams in both countries who embraced the training opportunity,” said Clare, who is also a research nurse at Liverpool University’s Wolfson Centre for Personalised Medicine.
The research is accompanied by education and training of clinical staff in the local communities as part of their continuing medical education, allowing the project to reach a greater audience in the Low and Middle Income Countries (LMIC) setting. Further visits from UK nurses are due to take place this year and in 2020 to share best practice in anticoagulation research and patient management.
“It was humbling to see how both countries delivered their care with the limited resources and funding available,” added Samantha.
For more information on the study, visit www.warpath.info or on Twitter: @WarPATH_GHR
Award-winning volunteers Each month we celebrate a nominated volunteer and present them with a certificate to show how much we appreciate their hard work and dedication around the Royal and Broadgreen.
June 2018 - Patricia Croker
July 2018 – Chris Bootman
September 2018 – Tony Bailey
Creating a great place to work for the benefit of staff and patients 13
Your time at the Trust It’s only natural to sometimes want a career refresh. Whether you’ve been in your post for a long time, or just fancy trying something new – change is something we can help you with.
We are committed to helping our employees grow and reach their full potential, whether that be via learning and development or joining a new team. As the largest trust in Merseyside and Cheshire, our three hospitals are often at the forefront of medical breakthroughs and exceptional care – and that’s down to you, our fantastic staff. So of course we want you to be the best you can be. We love having you work for us, and we don’t really want to say goodbye. If you’re starting to feel unsettled in your role or aren’t sure about something in your career, there are numerous things we can do to help. What we can offer will depend on your role and the needs of your service, but it’s always worth speaking to your line manager or Human Resources to see what could be offered.
• Development We have a variety of opportunities to help you grow in your career. From our in-house programmes available to various staff groups, such as the RLB programme, to external courses for professional development. Have a chat to your line manager to see what could suit you. You can also take a look on the Staff Hub, Learning and Development page, via the intranet to see what courses are available within the Trust.
• Career break or change Sometimes you just need to have a break from work. We know that working in a healthcare environment can be stressful, so if you need to take a step back or reduce your hours, we want to try and help. Speak to your line manager about how you are feeling. Secondments are also often available, meaning you can stay employed by the Trust but work in a different role for a period of time. Keep an eye on the Trust’s job vacancies for any available roles that could suit you.
• Health and wellbeing If you’re looking to boost your wellbeing, both mentally and physically, there are a range of on-site activities to improve activity levels including yoga, pilates and interval (circuit) training. There are also a number
of passes available to attend the University of Liverpool gym and pool, and a 20% staff discount is offered on memberships to all Merseyside local authority gyms. If you fancy something different, you can also join the staff choir who host a weekly practice and a full programme of events.
Want to talk about it? We want to hear from you no matter what your experience is here whether you love working here, you’re thinking of leaving or you’re just not sure. Angie Carroll, Marie Dewhurst and Jo Marinas all know the Trust inside out. You can give them a ring on extension 4890 for Marie, 3276 for Angie, or 4697 for Jo, or drop them an email: Marie.Dewhurst@rlbuht.nhs.uk, Angie.Carroll@rlbuht.nhs.uk and Joselito.Marinas@rlbuht.nhs.uk. You can also email itchyfeet@rlbuht.nhs.uk. Counselling is also available. If you’re worried about something in work, or even at home, that’s making you question your role within the Trust, you can always speak to someone confidential. The independent Staff Support Service (supplied by Merseycare NHS Trust) provides a fully comprehensive service to all Trust staff via a 24 hour helpline number: 0151 330 8103.
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Deliver high quality care to all patients by improving the way we admit and discharge
CQC inspection In January and February the Care Quality Commission (CQC) carried out an inspection at the Trust. Their inspection of our services occurred during what had been one of our busiest periods this winter. Lisa Grant, chief nurse and chief operating officer at the Trust, said: “The CQC fed back to us that they saw no immediate safety concerns. They highlighted how fantastic the staff are, and how positive and proud they are about their place of work. They said the staff they met were very welcoming toward inspectors, especially under pressure, and it was clear how committed, caring and patient centered we are. “They commented that there is a lot of good work on supporting individual needs such as dementia, mental health and learning disabilities, alongside good multi-disciplinary team working. Good feedback was also reported across all core services.” Now that these inspections are complete, we can expect a final report containing the CQC’s inspections and ratings of our services later in the year. Thank you to all staff for their continued hard work.
Pete’s thank you to staff Pete Bailey became a patient on ward 5 at Broadgreen after his wife found him unconscious in their garden; he had experienced a hypoglycaemic attack due to his diabetes and suffered a brain injury. He has since been discharged but wanted to return with a presentation that collated all of his experiences on the ward and to give staff some great feedback on how well he has progressed throughout his journey as part of the rehab network. “My admittance has been a real struggle but I found ways to deal with that. With my rehabilitation here it’s been daily steps of trying to improve on my physical health and cognition, as well as my general disposition such as speech,” said Pete. Due to Pete working in data analytics, the team on ward 5 decided that part of his intensive rehab treatment would be designed to include analytical tasks the brain does normally every day, such as going shopping. Pete would carefully plan his trips out of the ward, accompanied by our occupational therapists and go shopping, making purchases before negotiating his way back to the hospital using public transport. All actions were designed to stimulate precise brain actions.
“Pete made sure all of his work on the ward was around his personal goals, he wanted to get back to work and that involved a whole cohort of different staff involved,” said occupational therapist, Jessica Hopkins. “This was around his physical abilities, processing skills, memory, confidence and his language. It’s been quite long and challenging.” For Pete, to some extent he was sorry to leave the ward as he had built up a lot of friendships: “But I’ve got a life that is waiting for me and I need to move on now. That’s what progression means, I get to go home.”
Deliver excellent digital services to improve patient care 15
Helping to improve flow The Trust is one of eight accident and emergency departments in the UK participating in a project to help the flow of patients in hospitals, using self-directing kiosks. Both the Royal Liverpool University Hospital and Southport and Ormskirk Hospitals were selected as part of the project, led by NHS Improvement to receive funding to install the new kiosks. The kiosks have been available since December in the reception area of the emergency department at the Royal 24 hours a day, 7 days a week. Anyone who attends our A&E department can use the kiosks to help direct them to the most appropriate service within the Trust. Patients will be required to answer questions about their condition, with on screen to help direct them to where they need to be in the hospital for their treatment. The main aim of the kiosks is to help reduce the numbers of patients waiting to be seen in the emergency department.
So far, this facility has proven most popular with patients aged 18-24, which could be due to our large student population here in Liverpool. Paul Evans, deputy general manager for urgent and emergency care at the Trust, said: “The kiosks are a really good initiative. We all know how frustrating it can be waiting in a busy emergency department, so with the help of the kiosks patients using the service will be able to find the service they need and avoid waiting in A&E unnecessarily. “Our team in the emergency department work incredibly hard to provide high quality care for our patients. We want to deliver the best possible experience and I think this is something that will help us achieve that.”
Some of the services that patients can expect to be directed to include the acute medical unit (AMU), the emergency assessment unit (ESAU), orthopaedics, the dental hospital, St Paul’s Eye Unit or the Axess sexual health clinic.
IT Service Improvement Project update The IT Service Improvement Project (SIP) began in December and is currently being rolled throughout Trust. It aims to improve the IT experience for staff based on feedback provided by staff. A part of the project is delivering new IT hardware such as laptops on wheels within clinical areas across the Trust; which will enable clinical staff to complete TTOs and update medical records at the patients beside and improve ward rounds. In addition, new desktops are being delivered reducing the time loading applications - allowing staff to care for patients more efficiently. IT will also be providing one-to-one general IT support which includes resolving any further issues where possible, support with IT systems and listening to feedback from staff regarding how IT can be further improved. Staff will also be circulating after the roll out of the hardware refresh to gather feedback on how well these changes have worked, and if there is any further support from IT that clinical areas require.
In the first two weeks of the kiosks being installed, 62 people used the kiosks, with 38 being signposted to alternative services available on site rather than waiting to use the accident and emergency department.
If you wish to find out more please visit our digital hub team dashboard on the intranet for further information.
Trust included in GDE blueprints As a Global Digital Exemplar (GDE) Trust, our screening and early recognition of sepsis has been included as part of the NHS Long Term Plan. The scheme is one of a series that is being rolled out across the country through the adoption of toolkits, known as blueprints, which allow any NHS hospital to implement improvements quicker and more easily to transform care and improve services for patients and staff. The blueprints are a guide for hospitals that explain how a particular system or innovation was developed and introduced, and the benefits it has had. They detail all the components needed for sustainable digital transformation such as: organisational leadership and culture, technical and configuration guidance, clinical and staff engagement, as well as the people and processes
required to successfully deliver the benefits of new technology. At the Trust, our e-sepsis clinical decision support tool is saving up to 200 lives a year. Since its introduction, screening is now at 100% in the emergency department and on its wards, antibiotic administration for patients with sepsis within an hour has increased to 90% in ED and 60% on wards, and septic shock mortality in the under 45s has dropped from 60% to 7.69%. Dr Paul Fitzsimmons, deputy medical director said: “With e-sepsis, we have seen a major impact on sepsis care with lives saved. These are patients with confirmed sepsis where the clinician may not have considered sepsis as a diagnosis. In some cases, it would have been impossible to make a diagnosis of sepsis without the help of e-sepsis.
“By producing automated sepsis alerts from collated clinical information from multiple sources we are treating septic patients both faster and more effectively - helping our clinicians prioritise doing the right things first and reducing mortality rates in severe sepsis.”
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Deliver our financial plan and ensure we are as efficient as possible
Working while off sick In a nutshell, ‘fraud’ means theft by way of deception. Although the vast majority of NHS staff are honest, dedicated and hardworking, NHS Counter Fraud Authority (NHSCFA) figures show that concerns relating to sickness issues are consistently the most common fraud reported area in relation to NHS staff – costing the NHS millions of pounds every year. One significant area is when NHS staff undertake other paid or unpaid work (including study or training) while they are off sick. This could result in gross misconduct dismissal under the Managing Sickness Absence at Work policy and Disciplinary policy, criminal conviction under the Fraud Act 2006, an order to pay back sick pay, loss of NHS pension and professional body sanctions. Last year, a nurse at a London
trust was sentenced to 16 months imprisonment on two counts of fraud for registering and working shifts via two recruitment agencies while she was off sick. She was dismissed for gross misconduct and referred to the Nursing and Midwifery Council. Staff who are off sick from the Trust must refrain from all paid or unpaid work (including study or training) unless such is expressly advised and documented by their GP (or other health professional providing the fit-note) and with prior discussion and written agreement with the Trust. In any self-certification sickness period, staff must contact and discuss with their line manager or human resources (HR) before considering undertaking any paid or unpaid work. The Trust may be able to support and facilitate an earlier return to work, such as temporary redeployment
and adjusted duties. If you have any questions please do not hesitate to contact HR. Staff are required to declare any other employment and conflicts of interest. The form can be accessed via the Staff Hub ‘Standards of Personal and Business Conduct’ section. If you are aware of someone who is currently, or has been, working while off sick from the Trust, for example you may have seen them working or seen it identified on their social media, you can report reasonable suspicions of NHS fraud in confidence, at www. cfa.nhs.uk/reportfraud or 0800 028 40 60. Staff can also report to the Trust’s Anti-Fraud Specialist (refer to Anti-Fraud, Bribery and Corruption policy and the Whistleblowing policy on the intranet).
Trust chosen in exciting Sprint project The Royal has been selected to be part of a project helping to identify, diagnose and treat rare diseases in the UK. We will be one of five NHS trusts working as part of the ‘Rare Diseases Sprint Exemplar Innovation Project’, with an aim to develop a secure cloud research platform with the potential to transform the understanding of rare genetic disorders, drive improvements in diagnosis and provide proof of principle for use in other diseases. “Our team at the Roald Dahl Centre are delighted to be one of the five hospitals chosen to collaborate on this ground breaking project,” said consultant haematologist, Professor Cheng Hock Toh, who will be helping to steer the project
and genomic technologies have made in understanding rare diseases by creating a secure, anonymised platform to draw together and integrate data from the NHS with research data.
with his team at the Royal. “We are the top recruiter into the national BioResource for rare bleeding disorders and this project makes it much more likely that our patients from across the north west benefit from how big data could improve their care.” The project’s objective is to build on the advances which clinical imaging, pathology
It will initially involve patients with rare diseases recruited to the National Institute for Health Research’s BioResource - a national resource of volunteers who have already provided consent that information retrieved from their health records can be used for medical research. The project is one of ten funded initiatives and will show how technology and data solutions can improve lives and speed up innovation in the NHS and UK life sciences. Each project is set to receive a share of £3 million of government funding.
Creating a great place to work for the benefit of staff and patients 17
Beating HIV together Liverpool has joined a network of cities around the world committed to beating HIV by promoting early diagnosis. Mayor Joe Anderson announced that the city was to become part of the ‘Fast-Track Cities’ network, joining London, Manchester and Brighton in the UK, and 250 others around the world, who are aiming to eradicate AIDS as a public health threat by 2030. Professor Saye Khoo, honorary consultant physician in infectious diseases at the Trust said: “Liverpool has played a global role in research into HIV testing and treatment, with demonstrable benefit to people living with infection. “This new initiative will link the excellent care offered within health facilities and in the community, our academic expertise and our many partnerships with all the support and resources that a ‘fast track city’ offers. We care about the marginalised, the vulnerable and the persisting stigma, and together we will work to overcome these barriers.” There are currently 650 people in Liverpool with HIV, a level comparable
As part of the network, the city is committing to: •W orking with its partners to make sure 90 percent of people with HIV know their status • I ncreasing the percentage of all people with diagnosed HIV infection who are on treatment
with other big core cities. However, it is estimated there are up to 115 people that are infected but unaware and over half of people in Liverpool are diagnosed late, meaning they don’t start treatment as early as they could, which can lead to them becoming unnecessarily ill. Dr Mark Lawton, clinical lead and consultant in sexual health and HIV, added: “Treatment for HIV is so effective it leads to a completely normal life expectancy and renders individuals un-infectious. The remaining challenge is diagnosing everyone so they can access this treatment. HIV testing is free and completely confidential. Know your status. Get tested.”
Knife Angel’s powerful message
• I ncreasing the percentage of people already on treatment who stay on medication long-term thus reducing the likelihood of transmission •R educe the negative impact of stigma and discrimination Plans are being formulated in Liverpool to: •D evelop a city-wide governance group to drive improvements •R eview services to make sure the most vulnerable and at risk groups are tested • P roduce a city-wide action plan to reduce the spread of HIV and encourage more routine testing • I mplement best practice from around the world
Thanks to the support of Merseyside Police, Everton in the Community and Liverpool Cathedral, the Knife Angel made the journey from its home in the British Iron Works Museum, in Oswestry, Shropshire, to the cathedral for Christmas. “I was delighted to welcome the Knife Angel to Liverpool. My role at the Royal means that unfortunately I do see incidents of this sort of violence, coupled with the impact this has on the victims’ families and loved ones. I hope that its presence helped to open up a conversation in our community about the impact of knife crime on both victims and their families.”
The Knife Angel has now spread its wings after being situated outside of Liverpool Cathedral for two months. The striking sculpture, crafted by artist Alfie Bradley from 100,000 blunted blades collected from 43 different police forces in the UK, was brought to the city by Trust nurse clinician, Rob Jackson.
Rob has worked for over ten years in the emergency department at the Royal and during that time has treated countless victims of knife crime. He also visits schools and youth clubs to speak about the dangers of knife - so far he has reached over 95,000 children and young people with his powerful talks.
Aidan Kehoe, chief executive, said, “I am extremely grateful and proud that one of our nurse clinicians, Rob Jackson has been such a leading force in bringing the Knife Angel to Liverpool. “Both Rob and the amazing team in our emergency department work tirelessly to provide care and support to those who sustain such life threatening injuries or in more serious situations support loved ones who lose a relative under such tragic circumstances.”
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Exceptional patient experience
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