For staff, patients, GPs, volunteers and all local people
United Lincolnshire Hospitals NHS Trust
autumn 2014
Staff really are working their socks off – Exclusive interview with Pauleen Pratt, Acting Chief Nurse page 8
Beyond Good
Be Proud. Make a Difference
Contents
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Listening into Action: supporting our quality improvement journey
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Lincolnshire Health and Care – making our services more sustainable
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Listening into Action: supporting our quality improvement journey
Men’s health awareness
Message from Jane Lewington Jane Lewington,
Welcome to our new look Chief Executive magazine for the Trust. It’s been rebranded with a fresh new style and a new name – the Lincolnshire Wire. I hope you like the new design and content, which focuses much more on the big issues that matter to our staff and patients. As we approach our reinspection by the Care Quality Commission (CQC), I am constantly blown away by the continued hard work, enthusiasm and shared learning of our staff. Our quality improvement plan highlights our Trust’s overall ambition to be “beyond good”. It outlines the improvements ULHT is making and also includes all of the recommendations that we must achieve ahead of our reinspection by the CQC. Some of the key areas that we have to get right are around our appraisals and core learning, medicines management, infection control and the way we share best practice and learning across our hospitals. At the time of going to press only half of staff have had an appraisal. It is incredibly important that as a member of staff we comply with the core learning requirements for our job. Our targets as a Trust are that 95% of staff have had an appraisal and 95% of staff have completed their core training by the end of March 2015. Based on feedback from staff we have simplified core learning to make it easier for staff to book onto training and have reduced the amount of core learning staff have to undertake. We are also making progress with our clinical strategy, looking at transforming and improving services for our patients and treating them in the most appropriate care setting. We are currently involving our staff in discussions around the different options for our women’s and children’s and emergency care services, making sure they are sustainable, affordable and accessible for our patients in Lincolnshire. Read more about this on page seven. Listening into Action is also supporting our quality improvement plan with the introduction of LiA Rapid. The 15 LiA teams have identified their objectives, held their listening events and are working towards delivering the outcomes of their schemes, which relate directly to the things that our staff told the CQC got in the way of them delivering good care. The preparations for our second annual staff awards are also underway and is a great opportunity to celebrate the fantastic work that our staff do. This year’s awards were a fantastic success, let’s try and make next year’s ceremony even better! Jane Lewington Chief Executive 2
autumn 2014
Listening into Action (LiA) is supporting the delivery of the Trust’s quality improvement plan, including some of our CQC priorities. At the LiA little conversations, staff contributed to discussions about what they felt gets in their way of providing the best quality care to our patients, and what can be done to make changes to put that right. The message from Jane Lewington to teams was simple – Be Big, Be Bold, Be Brave. Staff and public members of the Trust were asked to think about what good quality care and services would look like, what big impact changes need to be made to deliver these services and who will take responsibility to ensure this happens. Discussions on the day, objectives for each of the teams and ways to deliver positive change included: Customer care: positivity and respect ■ Encouraging everyone to respect patients, staff, members of the public and the environment around them ■ Making customer care a key part of appraisals, core learning and the Trust induction Cleanliness is everyone’s responsibility ■ Ensuring that housekeepers and cleaning staff feel respected and a valued part of the organisation ■ Ensuring that equipment is fit for use and readily available Adherence to care bundles ■ Educating staff on the importance of using care bundles and when they should be used ■ Using the sepsis care bundle as a pilot and monitoring its use Outpatients transformation: cancellations, delays for review, clinic start times ■ Improving the environment, including better signage and patient facilities in the department ■ Review and promote the text reminder service to help reduce the number of patients that do not attend appointments Availability and quality of medical/ patient case notes ■ Ensuring that all notes are readily
available, fit for purpose and in good physical condition ■ Ensuring that staff are aware of their responsibilities – pass on notes in the condition that you would wish to receive them Improving medical management of the surgical patient ■ Reduce medication errors across clinical areas by introducing electronic prescribing ■ Dispensing medication so it is available when the patient is ready to be discharged Timely discharges before 10am ■ Discharge lounges that are fit for purpose, open longer and provide a good environment for patients who are ready to go home ■ Establishing greater working partnerships with healthcare providers in the community to discharge patients who are medically fit to go home Reducing bureaucracy with in-patient documentation: integrated care record ■ Reducing unnecessary paperwork – removing duplication, forms to complete should be simple and easy to fill out Equipment availability ■ Equipment needs to be fit for use and available in the right place at the right time ■ Review systems that are already in place in other organisations and see what could be adopted at the Trust. ■ Decontamination and cleaning of equipment Pan-Trust model for special observations for patients with complex needs ■ Patient centred care delivered by specialist staff ■ Ensure we communicate with the patient’s family from the outset to explain what is happening to their relative The teams have eight weeks to implement their ideas to benefit our patients and staff. For more information about the 15 teams, their objectives and how you can get involved in making a difference through LiA e-mail lia@ulh.nhs.uk.
Beyond Good
Be Proud. Make a Difference
Cleanliness is everyone’s responsibility What are the best kept secrets of infection control? It isn’t a secret! We all know what to do. Most healthcare associated infections are preventable through good hand hygiene such as cleaning our hands at the right times and in the right way. Do you ask your kids to clean their hands before eating? Why not apply the same thinking at work? Who do you think is responsible for keeping wards clean and free from infection? Ward sisters? Matrons? Doctors? Housekeepers? Admin staff? Actually, it’s everyone’s responsibility. Housekeepers have a crucial role in cleaning but we don’t have the staff to do this 24 hours, 7 days a week. All staff need to do their bit. At the time of going to press (early November), we don’t know the date of the next CQC inspection but we think it will be early in the New Year. What we do know is that infection prevention and control is something that we must improve upon, and sustain it long-term for the benefit of the patients we provide care for, before the inspection. The NHS Trust Development Agency (TDA) has provided funding for the Trust to employ an Infection Prevention and Control Consultant Nurse for six months. Suzanne Morris, a nurse with more than 30 years’ experience in healthcare joined the Trust from Sherwood Forest Hospitals NHS Trust, where she was instrumental in leading the infection prevention and control agenda, and developing a planned
system for outbreak management, which reduced the spread of infections within the inpatient setting. Suzanne, who commenced her role on 29 September, said: “I’m really excited to be part of the dedicated team of specialists at the Trust, my role is to provide leadership to nurses and other clinical staff to ensure we improve on providing high-quality infection prevention and control in our hospitals.” Our rates of C. diff are higher than they should be, and higher then we were this time last year. We need to sort this out. On wards and notice boards you’ll start to see reminders on what to do as part of “My 5 movements for hand hygiene”. Please read them and encourage your colleagues to. The My 5 Moments for Hand Hygiene approach defines the key moments when health-care workers should perform hand hygiene. This World Health Organisation (WHO) evidence-based, tested approach is designed to be easy to learn, logical and applicable in a wide range of settings. WHO recommends health-care workers to clean their hands 1. before touching a patient, 2. before clean/aseptic procedures, 3. after body fluid exposure/risk, 4. after touching a patient, and 5. after touching patient surroundings. Save lives. Wash your hands!
What is Beyond Good is trying to do Since the CQC inspection reports were published in July, staff from across the Trust have been working hard writing and delivering our long-term quality improvement plan. This plan builds on all our work over the last year – its focus is the next phase of our quality improvement journey, a phase we are calling “Beyond Good”. This plan, available on the intranet, is about making positive long-term changes in key areas. We have big challenges to overcome, and obviously we can’t do everything by New Year when the CQC will re-inspect us but by then we need to demonstrate we have made improvements. The plan covers 19 projects. In a nutshell, here are a few things we will do. 1. Appraise 95% of staff. This supports staff and helps develop their skills and career. 2. Ensure 95% of all staff to have completed their core learning. 3. Transform outpatients department at Lincoln County – patient environment, booking systems, and availability of notes. And then roll out to other departments at Pilgrim and Grantham. 4. Repair at least 9,000 medical records starting in orthopaedics and ophthalmology. 5. Clear the backlog of complaints and fully roll out See it My Way our patientcentred new complaints system.
What can you do to help us get there? 1. Complete all your core learning 2. Appraise your staff and report you’ve done it 3. Always report incidents and near-misses 4. Complete all clinical documentation properly 5. Pass on health records in the condition you’d like to receive them 6. Reduce patient harm 7. Save lives – wash your hands. autumn 2014
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Our hospitals highlights
Be Proud. Make a Difference
Man’s best friend makes ward visits at Pilgrim A new therapy to provide comfort and support to patients has been introduced at Pilgrim Hospital. A Pets As Therapy (PAT) dog has started visiting the patients and their relatives on the elderly care ward and stroke unit at the hospital. Ellie, a five year old St Bernard, has been registered as a PAT dog for three years. Her owner Mr Langford has been involved in this voluntary service for a number of years and Ellie is the second dog he has trained. Maxine Skinner, Matron for medicine at Pilgrim said: “The reaction of our patients and staff has been incredible. Ellie’s visits have brightened everyone’s day and those with dogs of their own have found it a real comfort. “One of our stroke patients who has not been able to talk tried to speak to Ellie when he first met her. Staff have commented that they have seen a really positive improvement in our patients because of the visits.” “We set up tea and coffee in the day room and use it as a social event for patients and their relatives. We then tour the wards to visit those patients that cannot get out of bed. “We recognise that hospitals can be a daunting place for many of our patients, often because they are in unfamiliar surroundings and feel isolated. By making the environment more pleasant and providing patients with reminders of home comforts we can help to speed up their recovery.” Pets As Therapy is a national charity founded in 1983 to provide therapeutic visits to hospitals, hospices, nursing and care homes, special needs schools and a variety of other establishments from volunteers with their pet dogs and cats. All animals that come into the Trust must have full current vaccination records and the PAT dogs are tested for behaviour and temperament. PAT dog at Pilgrim
Paul Tesha and team
Lincoln County Hospital eye specialists win national award The Trust’s eye clinic at Lincoln County Hospital has won a national award after outstanding praise from patients.
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he hospital’s Macular Service team has been named ‘Clinical service of the year’ as part of the Macular Society’s Awards for Excellence. The award recognises their exceptionally good practice in the care of people with macular degeneration. The team was among dozens nominated from across the country, but managed to win the award after judges recognised the exemplary patient care throughout the clinic and passion to deliver a high quality service. Age-related macular degeneration (AMD) affects the central vision and is the most common cause of sight loss in the UK. More people are affected as our population ages. Paul Tesha, Consultant Ophthalmic Surgeon and Head of Service at ULHT, said: “The Macular Service team are extremely grateful to all the patients who nominated us for this prestigious award which recognises all the hard work that has been done to develop the service.” Dorothy Ward, from North Hykeham, is a patient who nominated the team. She said: “After many visits for injections, photographs and consultations I have always found the staff including nurses and technicians to be efficient, kind, understanding and committed to their work. Every effort is made to see patients at their allotted time.” Agnes Barstow, from Lincoln, is another patient who nominated the team. She said: “Mr Tesha has built a strong outstanding, caring team which has expanded in the past 5 years to help the growing aging population in Lincolnshire with AMD and
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many other eye problems. “Since I started, the clinic has become very busy but the care and attention given is constant and excellent by the consultants, nursing team and the receptionist. “One again I cannot emphasis enough the dedication of the team. Their friendliness, care and smiles are consistent with a happy team.” Tony Rucinski, Chief Executive of the Macular Society, said: “Congratulations to the Lincoln County Hospital team on winning this award. The judging panel agreed unanimously that they were worthy winners. “The judges felt the nominations reflected the exemplary patient care and communication provided by the team, as well as a desire to provide a high quality service. “It’s amazing to hear how people have made such a difference to the lives of others. There are some fantastic people working within the sector, so it’s great to be able to celebrate their hard work in this way.” Representatives from the team were presented with their award at the Macular Society’s annual London conference on 27 September. ‘Clinical service of the year’ is one of four awards presented by the charity. There are also honours for ‘Support or rehabilitation professional of the year’, ‘Optometrist or optician of the year’ and the ‘Chairman’s award for volunteering.’ For information, advice or support concerning macular disease, contact the Macular Society’s helpline on 0300 3030 111 or email help@macularsociety.org
Our hospitals highlights
Be Proud. Make a Difference
United Lincolnshire Hospitals helps restore sight in Pakistan and Uganda Two machines used in cataract surgery have made the journey from Grantham and District Hospital to Pakistan, and from Lincoln County Hospital to Uganda to help provide free quality eye surgery to people in some of the poorest areas of the world.
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treatments. This new machine will improve the quality and quantity of operations to people with a big need for healthcare.
The machine will do around 600 cataracts in a year whilst also conducting other eye operations and
Consultant in ophthalmology, Mr Sohail Ahmed said, This new machine “It was my mother’s desire will improve that I establish the quality something and quantity permanent for people over of operations there after I to people with decided to stay in the UK. The a big need for hospital was healthcare. established
he machines had recently been replaced by newer models and would normally have been returned to the manufacturer Bausch and Lomb for destruction. The Trust gained permission from Bausch and Lomb to send the machines overseas to help provide free quality eye surgery to people in some of the poorest areas of the world.
Operating Department Practioner Jenny Milner handing over a ‘phaco’ machine to Hilditch logistics driver
with my own money about 18 years ago but I was helped with some of the equipment by my colleagues and a grateful patient. It was my mother’s idea and desire so I named it after her.”
“Me and my other colleagues from the UK can’t go over there because of the security situation at present. I hope once the situation improves then we will go across again,” said Mr Ahmed. Mr Ahmed uses his own money to help those patients in need. Two local doctors have now been trained on the machines and they go to the hospital every weekend to operate and provide consultation for patients at a minimal cost to them. For those patients who may not be able to afford the consultation, there is a waiting list for the free eye camp which happens twice every year. This wouldn’t be possible without the donation of the machines.
What’s on in Lincolnshire 16 November – Big Craft Event at Lincoln Showground www.bigcraftevent.com 29 – 30 November – Food and Gift Fair – Lincoln Showground www.lincolnshireshowground.co.uk/ whats-on/lincolnshire-food-and-gift-fair/ 4 – 7 December – Lincoln Christmas Market lincoln-christmasmarket.co.uk/ 6 December onwards – Santa Special Railway from Cleethorpes Kingsway www.cleethorpescoastlightrailway.co.uk/ 18 December - Healthcare carol concert at Lincoln Cathedral, 7.30pm
Farmers’ markets Lincoln - third Saturday of the month at Castle Square Boston – third Wednesday of the month at Wide Bargate, Boston Grantham - every 2nd Saturday on Welby Street Louth – 4th Wednesday of the month, Cornmarket. www.visitlincoln.com/markets
Trust Board: Tuesday 2 December 2014 in the Boardroom, Robey House, Lincoln.
Health Awareness campaigns There are various health awareness events every week and month. Why don’t you help promote among teams, patients and friends and family. Here’s what’s coming up: November Lung Cancer Awareness month Pancreatic Cancer Awareness Month Mouth Cancer Action Month Movember 14 November – World Diabetes Day December 1 December – Worlds AIDS Day January Love your liver autumn 2014
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Changing our NHS
Be Proud. Make a Difference
Changing our NHS Four new community health care teams caring for the county
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eams of health and care “champions” dedicated to creating individual plans for hundreds of patients have been launched this summer.
The innovative project will see the most at risk patients given a personal care plan and their own care co-ordinator to ensure they get the services they need when they need them. These champions will form a key part of the first wave of neighbourhood teams set up as part of the Lincolnshire Health and Care programme’s review of health and care across the county. We spoke to the man heading up the neighbourhood team project Dr Brynnen Massey, chair of East Lincolnshire Clinical Commissioning Group (CCG) and practicing GP, about the new teams and how they will benefit patients. 1. Where are the early implementer sites? The early implementer sites are in Skegness, Stamford, Sleaford and Lincoln City South. 2. What will neighbourhood teams do? on areas of the county which already had Each team will include professionals from a enthusiasm and experience of some aspects wide range of services – from social care and of integrated working. community nurses to GPs and therapists. 4. When will other areas be rolled out? The aim is to bring together professionals The plan for Neighbourhood Teams is to roll from different bodies to create a single team out another wave in the autumn and CCGs working together who will identify patients are already working most at risk of health to identify the next and social care The Neighbourhood Team sites. The second problems and decide should deliver more proactive wave will build on how best to manage the experiences of their needs. They care and reduce patients’ the early implementer will ensure the right likelihood of having to be sites and enable the services are delivered model for Lincolnshire at the right time admitted to hospital. to be improved as we and ensure patients go along. The aim is who have to go into for the whole county to have Neighbourhood hospital have the right support in place when Teams within a year. they are discharged, as well as trying to avoid each patient having to see different people, and fill out different forms, from different health and care providers. Once the most at risk patients have been assessed the teams will begin the process of identifying and meeting hundreds more who will benefit from the process. Eventually the teams will develop into seven-days a week services available for any patient. 3. How were they chosen? The clinical commissioning groups (groups of GPs who decide on local health services) were asked to nominate one area each and were given a set of criteria to apply based on population sizes of between 20-50,000, the need to test out Neighbourhood Teams in a range of diverse communities such as rural, urban, deprived, coastal and on the borders and the opportunity to build 6
autumn 2014
5. Where is the evidence that Neighbourhood Teams will work? And are we building on what works already in Lincolnshire (ie integrated teams)? Neighbourhood Teams are well established and various models have been trialled and implemented successfully both within the UK and internationally (in Spain, New Zealand and elsewhere). Evidence shows joined-up proactive care is proven to improve health and wellbeing and reduce the likelihood of admittance to hospital. LHAC has looked extensively at our health profile in Lincolnshire and believes neighbourhood teams can deliver the improvements we need, ensuring we avoid admissions wherever possible and treat people closer to home. 6. How will it be different for patients – will they need to access the service in
a different way? Some patients and service users should start to see an improvement in the coordination of support and the way they are managed very soon. This should be a more personalised approach that looks at the person’s needs as a whole. In time we expect services will be available seven days a week. Information will be given to patients about any changes in the way they will access services as the NT is rolled out. Most importantly the Neighbourhood Team should deliver more proactive care and reduce patients’ likelihood of having to be admitted to hospital. 7. What does this mean for other patients who use services (not high risk)? Other patients will still see the benefit of a Neighbourhood Team approach as they develop, particularly when they begin to work on a seven-day basis. It should mean all patients have access to neighbourhood teams and the inter-connected services throughout the week – avoiding the need for people to go to A&E because there is no other option available. 8. How are Neighbourhood Teams linking in with wider services like council services, voluntary sector etc. NTs will have links to a wealth of local services such as wellbeing service, district council services, community and voluntary sector services. A local directory will ensure that knowledge of and access to these services is coordinated and well publicised so that patients and service users can get the most appropriate support they need in their local area.
Changing our NHS
Be Proud. Make a Difference
Two vital services you can help change!
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he Trust can’t afford to stand still and do nothing. We need to transform our services so they are clinically and financially sustainable. The way we provide services needs to change for the benefit of patients and our staff. Where do we start? A Clinical Strategy Implementation Group (CSIG) was set up to answer that question. It is chaired by Dr Suneil Kapadia, our medical director.
Women and children’s group The women and children’s group is chaired by Dr Boardman, consultant physician at Grantham. She is supported by clinicians and managers from across the trust. The group is looking at the pros and cons of two possible models for Lincolnshire. 1. One obstetric site with co-located midwifery led unit and paediatrics, and 1 paediatric assessment unit on a second site.
CSIG is a Trust wide group made up of medical staff, senior nurses, Executive team, finance, HR and corporate support.
2. Two obstetric sites with co-located midwifery led unit and paediatrics on each site.
CSIG set up two clinical project groups to develop options on emergency medicine, and women’s and children’s services. The groups will be taking into account national best practice guidance, travel times, clinical viability, patient experiences and staffing levels when options develop.
So far, over 50 staff have had the chance to share their views and ideas. Staff engagement discussion forums will continue.
During the summer, clinical strategy leads spoke to staff to help shape their ideas. And we still need your ideas and contributions.
No decisions have been made. The group will present the review of their options to CSIG in November, which will include a detailed nonfinancial work up. The preferred option will then be developed in more detail, including finance by the end of December. Emergency care group Dr Hepburn, consultant dermatologist, chairs the emergency medicine group. He is supported by clinicians and managers from across the Trust.
Emergency Centre (EC) Urgent care centre (UCC) They key point is that this is a whole hospital designation – it does not simply refer to the ‘A&E’ or emergency department. Discussion forums were held with staff groups providing emergency care services across the Trust during October, to share the initial work of the group, the emerging options and to listen to their thoughts and suggestions for inclusion in the project team work. No decisions have been made. The group will present the review of their options to CSIG in December which will include a detailed nonfinancial work up. The preferred option will then be developed in more detail, including finance early in the New Year. What happens next? No decisions have been made on future of any services including options or locations. CSIG has a key role to confirm and challenge the work groups and will scrutinise all steps of the process.
The group has looked at two possible models for the county: 1. 1 Specialist emergency centre, 1 emergency centre and 1 hybrid or augmented service 2. 1 Specialist emergency centre, 2 emergency centres The emergency care group work is being informed by the national standards which are currently being developed by NHS England. The draft guidance states there will be 3 types of ‘emergency care’ designation. Neill Hepburn
Shirine Boardman
Specialist emergency centre (SEC)
Dates for the diaries – staff clinical strategy forums As well as the speciality discussion forums being held and hosted by project teams, clinical strategy discussion forums are being set up on the three main hospital sites. These are intended to become a forum that will be held monthly with clinical staff from across the Trust.
on the agenda, and all clinicians on the sites will be invited to attend.
The clinical discussion forums for Trust staff will not be limited to the development and progress of the clinical strategy, they will also include other items
Monday 3 November 5:30pm to 7:30pm – Lincoln Hospital
We want as much engagement as possible for all staff to develop the solutions for services. This is your opportunity to get involved and shape the future of our hospitals. The first forums were held on:
Tuesday 4 November 4pm to 5:30pm – Grantham Hospital
Pilgrim Hospital – TBC Look out for further dates in the Weekly Round-up Contact: Dr Suneil Kapadia suneil.kapadia@ulh.nhs.uk, executive lead Julie Pipes julie.pipes@ulh.nhs.uk, clinical strategy lead Sue Rogerson sue.rogerson@ulh.nhs.uk, performance improvement directorate autumn 2014
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In the spotlight
Be Proud. Make a Difference
Staff really are working their socks off Interview with Pauleen Pratt, Acting Chief Nurse We spoke with the newest recruit to the Trust executive board, Pauleen Pratt, to find out why she joined us, her plans to support staff and what drives her to do better. 1. What is your background / how did you get to where you are? I trained as a nurse at the Peterborough and Stamford School of Nursing at a time when you were also employed by the organisation you trained with. I qualified in November 1987 and worked in acute medicine for a couple of years and then transferred to critical care, working in the intensive care unit and undertaking intensive care training. I then went on to commission the coronary care unit, which was a new unit at the old district hospital in Peterborough. It was after this that I decided I needed to get some different experience so I went and worked at Harefield Hospital in Middlesex as lead nurse for cardiothoracic surgery. I worked there for a couple of years before deciding to move back up to the Midlands. I decided I wasn’t really a London girl so I got a job at Leicester Royal Infirmary as the critical care, coronary care and high dependency unit lead nurse. That role evolved and I then took on the responsibility of managing the day surgery unit central recovery and the pain service before becoming the consultant nurse for critical care across all three of the Leicester hospitals, implementing the critical care outreach service. I then developed an interest in chronic ventilator weaning and
domiciliary ventilation so worked very closely with the ICU department and our colleagues the community. This work focused around the opportunity for patients who could go home on ventilation and did a lot of work around tracheostomy care.
I took the job at Basildon. I came to ULHT because I wanted to work somewhere where I could make a difference. I enjoy a challenge and a problem to solve and I felt that working at ULHT would be a really positive career opportunity that also wasn’t far from home.
Then decided it was time to go home, I’m from Norfolk originally and I took on the role of associate chief nurse at the Queen Elizabeth at Kings Lynn. I then transferred to Basildon in Essex as the Associate Chief Nurse leading on corporate projects around dementia and pressure ulcer reduction. I came to ULHT as deputy chief nurse in January 2014 before being offered the opportunity to act as Chief Nurse in May 2014.
3. What are your objectives over the next 12 months? My number one objective is to support the clinical teams to deliver good, safe care and to get us out of special measures.
Equally there are some things that we need to adopt across the organisation but there are also some innovations that I want to look at implementing. For example how can we use technology to free up nurses time? How can we develop the nursing, allied health 2. Why did you choose to work at ULHT? professional and My ambition has always support staff workforce been to become a chief “I want to be part of an to deliver care in the nurse. In fact, I still future rather than just organisation that has proved have the newspaper what we’ve article from Harefield to its patients, its public and doing always done? There are where I said that I issues that we need to the media that we can do a wanted to become a address now, but we chief nurse so at least really good job here. That our need to start thinking I’m consistent. But to patients are safe and they about how we can become a Chief Nurse be a bit different and I needed a corporate can trust us to deliver top a bit visionary. An deputy role which is quality care.” example of this is how one of the reasons can we develop the band 4 practitioner, there’s a hugely motivated workforce there so how do we support them. How do we make sure that nurses are nursing and that we use innovation to support them to free up their time and enhance care for our patients. 4. What do you think you can bring to the role? I think my experience of working in a number of different organisations, having to deal with similar challenges and how I have supported staff in the past helps me to deal with the issues faced by ULHT. I am quite resilient and I don’t give up easily so I think I bring the ability to keep going and can support staff to help them keep going, because ultimately they’re the people that make the difference, not me. 5. Can you describe a typical day? My days tend to start quite early, checking emails to see if anything urgent has come
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In the spotlight
Be Proud. Make a Difference
On the spot... Favourite food I really love a good burger and chips and a glass of champagne. If you we’re having a dinner party which three people would you invite and why? Jeremy Clarkson - because I think he’s feisty and I like a good debate Simon Cowell My dad, he was very special to me and died a few years ago.
in that I need to respond to quickly. Then meeting with key people - be that in a meeting setting or informally. So for example today I had a meeting with one of the deputy chief nurses about the safer staffing review, making sure we’ve got all the information we need to make a good case to the board around the need for increasing staffing levels. I also met with one of the deputy chief nurses to talk about the challenges we have around safeguarding and the need to ensure that key staff have the right education and support to be able to meet the needs of our patients. I’ve also chaired a meeting around how we are delivering quality across all our sites, looking at what we’re doing well and where we need to make improvements. 6. Where do you think the organisation’s strengths lie? I think the resilience of its workforce is key. The huge commitment of staff to always want to do better. I think the caring nature of our staff highlighted in our recent CQC report demonstrates that, against all odds, staff really are working their socks off and are delivering the best they can with the resources they have. 7. What drives you? The desire and commitment to be part of something better. I want to be part of an organisation that has proved to its patients, its public and the media that we can do a really good job here. That our patients are safe and they can trust us to deliver top quality care. 8. What is the best thing about your job? I like the responsibility and autonomy that being the chief nurse brings. That I can stop the nurses having to do things that don’t have a direct impact on improving patient care. I think it’s being given the responsibility to make those decisions which probably seem very small but make a big difference to our frontline staff. 9. What do you think the organisation’s biggest challenge is? I think the amount we need to do in the time that we have. We have huge challenges around our finances but equally we also need to improve quality and safety. We need to think about how we achieve that by being more efficient, by not duplicating things and
by making sure that we don’t cut corners in our desire to cut costs. I wouldn’t compromise care to save money, I’d have to find another way to save money and that is a huge challenge for us as an organisation. 10. What would you say to staff at ULHT? Don’t give up. Most of you are doing a really good job so let’s keep doing what we’re doing and equally let’s challenge each other when we see behaviours or practice that isn’t up to standard. If something doesn’t seem right, it probably isn’t right so speak up. We can’t allow poor standards to be delivered, regardless of the excuse. We have to escalate that and I want to know where things aren’t right. Ideally you should go to your line manager in the first instance but if you don’t feel that they are responding and listening then I want to know about it. 11. What would you say to anyone considering working for ULHT? ULHT has a huge amount to offer. Yes we’re in special measures, yes we’re challenged financially but the delivery of our clinical strategy, the changes across Lincolnshire and the opportunity to really deliver good services means that if you want a challenge, if you want to be part of a different model of care, come to ULHT because there are some fantastic opportunities here. Equally for our existing workforce, it’s important that we support and develop you. I’m aware some of our staff have been here for many years and have helped keep the organisation going when it’s been really tough. We as employers need to make sure we support our staff – have they had their appraisal and has that been useful. It’s not about ticking a box with the appraisal but how do we develop our workforce to be able to deliver the challenges and work that needs to be done. It’s about making sure our staff are better clinicians to be able to deliver better care for our patients. I am very happy here at ULHT. It’s definitely where I want to spend the next part of my career and I think that is largely due to the commitment of the staff that work here. It really is a fantastic place to work.
Who inspires you? Florence Nightingale – not just because she was a nurse but also because she didn’t give up – she spoke up and challenged things. I also admired the work of Diana, Princess of Wales around raising awareness of HIV/AIDS. She stepped out of the box and created a huge political shift around just caring for people and addressed the stigma that went alongside these diseases. Where is your favourite place in the world? I think it has to be Rome. There’s just something about the city, its history and all the old wrecks and ruins! If you were stranded on a desert island what three things would you take? Vaseline, because I can’t be doing with chapped lips, a poetry book or a dictionary – something you could read again and again and a box of matches, because there’s no way I could start a fire with two stones! At least I’d be warm, I’d have something to read and my lips wouldn’t be chapped! What do you like to do with your spare time? I like spending time with my two dogs Archie and Winston. My guilty pleasure is watching Home and Away. When I’m at ULHT in the week I don’t get to watch it so I have to watch all five episodes on a weekend when I’m home. What three things would your friends or colleagues say about you? I’m a chatterbox, I’m ambitious but I think most of them would say they are proud of me. I’m not an academic, I was middle of the class at school so in a way I’ve out-achieved myself. I have a real resilience around bouncing back, I’ve had some tough issues to deal with but I’m not down for long! autumn 2014
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About our members
Be Proud. Make a Difference
Me and You
Audrey, a Trust member, and Helen in OD talk about their shared experiences of working together observing care on Stow Ward at Lincoln County Hospital. someone to help Helen with her leadership programme. I have personal experience of studying while working full-time and I hoped I could give some help and assurance. It takes a great deal of courage and hard work to try to improve one’s skills and knowledge when you are in a working situation. Helen and I visited a ward and as I have no clinical skills I looked at everything from a patient’s point of view and put the patient’s perspective into the answers to her questions. I would like to see more opportunity for members to be involved on a one to one basis.
Helen Nicholson – Assistant Director of Organisational Development Audrey Pestell – Trust member Since retiring from education I have been involved with the NHS in many ways. I want to speak for the patients who don’t have a voice and being involved with ULHT helps me to do this. As a Trust member, I provide a patient’s view on the Trust’s services. There are regular meetings to keep us informed and I have been involved in ward visits and inspections, checking areas for cleanliness and safety. I became involved in helping Helen Nicholson by responding to a request looking for
patients, showing dignity and respect. I felt that this visit gave me a direct insight into patient care as this is not a usual aspect of my job. It was also a good opportunity for the ward as both Audrey and I brought fresh eyes, were open minded and saw things from a lay person’s point of view. It was great working with Audrey because we both saw the same examples but interpreted them differently. Together we were able to support each other and give positive feedback to the ward staff. Visits like this would be good for other areas and provide a very positive experience for both the patient representative and the staff member.
I am responsible for the development of leadership skills, cultural change and staff behaviours at the Trust. I have worked here for a year. I am currently completing the Elizabeth Garrett Anderson masters in healthcare leadership course. As part of my course I had to observe linked to patient care, working with a patient representative, so I asked the membership office to find me a willing buddy. With the permission of senior nurses, we did our observation on Stow Ward at Lincoln. Audrey and I observed the ward for an hour and then fed back our findings to the sister. We had a really good view of the ward and found that staff from all disciplines communicated well together and showed great teamwork. We saw good examples of reassurance to
Join us today Become a member of our Trust and learn more about what we do, have your say and a direct influence on the decisions we make. You can be as involved as little or as much as you like. We have over 1,130 members. We are currently working with our staff members to create a really great package for those who sign up to our membership scheme. So if there is something you’d like to see included and you’re not already a member, sign up today and get involved. At the last round of forums in 10
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September, we made some changes to the format because we want to spend more time listening to our members’ views on our plans for the future. We focussed on our quality strategy and the Trust’s clinical strategy for women and children’s services and emergency care and came away with some very interesting and useful feedback. If you would like to come along to our next round of meetings in December, please contact the membership office for more information. Previous papers are available to view on the website.
December Wednesday 10 December - Lincoln Monday 15 December - Grantham Tuesday 16 December - Louth Thursday 18 December - Boston Contact the Membership Office at: Robey House Lincoln County Hospital Lincoln, LN2 4AX 01522 572301 foundationtrustoffice@ULH.nhs.uk www.ulh.nhs.uk/foundation_trust/
Living well
Be Proud. Make a Difference
Men’s health month Don’t be a cancer statistic!
A
t this time of year, you may begin to see a rise in the number of men growing moustaches in a variety of shapes and styles. This is because the month of November has now be christened ‘Movember’ to raise funds and awareness of men’s health.
■ Do more exercise ■ Eat a healthy, balanced diet ■ Keep to a healthy weight
Did you know that the Macmillan Cancer Information and Support Service has three centres in Boston, Grantham and Lincoln? People can go to get information on the signs The whole month focuses on men’s health and symptoms of cancer and also healthy including cancer and mental health through lifestyle literature. The centres are staffed by the growing of hundreds of moustaches trained health professionals and supported whilst being sponsored to do so. by trained volunteers. No matter what age If you would like any Tip – it’s sensible to get any you are, it is good to information about symptoms you are unsure about be aware of the signs cancer, or support for checked out by your GP. For more and symptoms as well anyone affected by information visit www.cruk.org or as knowing how to cancer please contact www.macmillan.org.uk keep healthy. one of our centres. The national Cancer Boston is open Plan 2000 states that one third of cancers Tuesday – Friday, 9am - 4pm and can be are due to smoking and up to one third are found in the Main Reception of Pilgrim due to diet. According to Cancer Research Hospital. Tel: 01205 446392 UK, prostate cancer is the most common cancer in men with more than 100 men being Grantham is open Tuesday – Thursday, 9am - 4pm and can be found in outpatients at diagnosed every day. In England, every hour Grantham Hospital. Tel: 01476 464978 one man dies from prostate cancer. There are other cancers to be aware of too, such as testicular and bowel, but there are a number of things you can do to reduce the risk of cancer and improve mental wellbeing:
Lincoln is open Monday – Thursday, 9am – 4pm and can be found in outpatients main entrance at Lincoln County Hospital. Tel: 01522 573799
■ Give up smoking
Alternatively we have a service email which is macmillan.infosupport@ulh.nhs.uk
■ Drink less alcohol
Healthy recipe This quick and easy recipe is perfect for the autumn months but is also packed with nutrients to help promote prostate health, a healthy heart and healthy skin.
Tomato and butter bean soup Ingredients olive oil 1 large red onion 2 cloves of garlic, finely chopped 1 400g tin of chopped tomatoes 200ml vegetable stock 1 400g tin of butter beans, drained sea salt and black pepper Method
Space age technology saves Lincoln man’s hip Mr Timothy Coltman is in mid-seventies and enjoyed a self-sufficient active life. Following a horse-riding accident in 1984, he had a hip-replacement but that had never stopped Mr Coltman from enjoying his lengthy walks in the country side.
tantalum and is also used by NASA to build space shuttles. Its porous nature ensures that it mimics the characteristics of human bone. In fact it is hailed as the ‘next best thing’ to natural bone. Mr Antapur is the only surgeon in Lincolnshire to use this new technique.
However, over the years the plastic component in his hip replacement had worn away requiring a redo surgery in 2010. Ever since, he has had a number of admissions to A&E and orthopaedic wards with ongoing hip problems.
Within a week of being referred to Mr Antapur, Mr Coltman underwent a five hour complex redo hip surgery. The aim was to naturally fuse the bone and metal over time to give Mr Coltman as natural a hip as possible.
In April 2014, Mr Coltman was referred to Mr Antapur, an orthopaedic consultant who has trained extensively in the UK and Canada in hip surgeries. By the time Mr Antapur saw him he was quite disabled by his unstable hip. Based on his extensive experience Mr Antapur decided to redo Mr Coltman’s hip with a plan to use trabecular metal. Trabecular metal is made out of pure
It has now been over three months and Mr Coltman is back on his feet and feels like a new man. “I found the care I received excellent; the ITU were caring both of me and my visiting family and the Neustadt Welton ward was comfortable and the staff were responsive, kind and attentive. Perhaps as important, put up with my incapacities without a single complaint and greatly helped my recovery,” said Mr Coltman.
Heat olive oil in a pan and add the onion and garlic. Cook on a low heat for 4-5 minutes until soft. Add the tomatoes and bring to the boil. Reduce the heat and leave to simmer for 8 minutes. Add the stock and transfer to a blender and process until smooth (if you prefer a chunky soup, skip this stage). Season with the salt and pepper. Return the soup to the pan and add the butter beans. Simmer for a further 4 minutes and serve.
Do you have a healthy recipe which you would like to share? Send it to communications@ulh.nhs.uk
If you’re taking part in Movember, send your pictures to communications@ulh.nhs.uk autumn 2014
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5 minutes with...
Be Proud. Make a Difference
Get to know…
Staff and board members tell us a bit about their lives, careers and a few secrets. Ron Buchanan, Trust Chairman
Kate Sayles, Acting Matron
Sarah Otter, LiA administrator
What do you like best about your job? Meeting colleagues on the frontline. What was the first record you ever bought? Moody Blues – Nights in White Satin. What makes you proud to work at ULHT? Being part of an organisation committed to doing its best for its patients. Who or what inspires you? Nelson Mandela. Which three people, living or dead, would you invite to a dinner party and why? Alex Salmond – to gloat over the referendum result! Anita Roddick – the late founder of the Body Shop, to understand how she challenged the establishment and succeeded as one of the most notable women in business. Billy Connolly – to have a bit of a laugh and to remind him that I booked one of his first gigs when he played with Gerry Rafferty and called themselves The Humblebums.
How would you like to be remembered? To have had a positive influence on people’s lives.
What do you like best about your job? Being creative – Putting together events for staff and members. Creating the posters, invites, displays. I also like to see when an event I have put together with the LiA team has gone well, that is a good feeling!
What’s your favourite sport? To play – squash. To watch – football. If you could have any superpower what would it be? To blitz bureaucracy from the NHS. What was the last thing that made you smile? Listening to the Chief Nurse’s accent! (sorry Pauleen realise I am in trouble now). What talent do you wish you had? To play the guitar. Who’s your favourite band? Cream. What is your greatest achievement? Moving from the big bad world of banking to a more meaningful life in the NHS. Where is your favourite place in the world? The Galapagos Islands. What’s your favourite book? Birdsong by Sebastian Faulks. If you were stranded on a desert island, what three things would you take with you? A guitar, a long book and a case of vintage claret. 12
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What do you like best about your job? Working with the most amazing people. What makes you proud to work at ULHT? Because we put our patients first. Who or what inspires you? Everyone who I come across that goes that extra mile. Name one thing you couldn’t live without? My iPad. How would your friends and colleagues describe you? Fun and fair. Which three people, living or dead, would you invite to a dinner party and why? Dawn French – she is so funny. Jamie Oliver – he could cook. Daniel Craig- obviously my date. Who had the greatest influence on your career? A third year student nurse when I began my training, her name was Paula and she taught me to treat every patient as a family member. What talent do you wish you had? Would love to be able to sing. Who’s your favourite band? Counting Crows. What is your greatest achievement? Winning the leadership award at the first ever ULHT Staff Awards last year. What’s your favourite book? Anything by Jodi Picoult. If you were stranded on a desert island, what three things would you take with you? My best friend, iPad and a bottle of wine. How would you like to be remembered? For just being me.
What makes you proud to work at ULHT? The staff I work with are very kind, supportive and helpful and on a personal note the staff at Lincoln hospital have treated several members of my immediate family over the years and have saved their lives. Who or what inspires you? My mum – she has been through so much and is still so supportive to everyone else around her no matter what and she seems to know EVERYTHING. Who had the greatest influence on your career? My mum probably for kicking me out of bed every morning to go to college and study! Also David Furley for setting me a new challenge every week! If you could have any superpower what would it be? I’d like to be able to fly, because I wouldn’t get stuck in Lincoln traffic and I’d also get to see some beautiful sights and places. What was the last thing that made you smile? Jenny Creasey dancing on the stage and playing the drums at the New Life centre. Who’s your favourite singer? Elvis Presley. Where is your favourite place in the world? Las Vegas – it’s amazing! If you could change one thing about where you work what would it be? Staff would have more of an open mind around improvements. If you were stranded on a desert island, what three things would you take with you? Music, photos and drawing materials – this is all stuff that would keep me entertained, I love to draw, while listening to music and I take a lot of inspiration for my drawings from photos. How would you like to be remembered? I guess everyone wants to be remembered as kind, loving etc. but to quote J.K Rowling ‘As someone who did the best she could with the talent she had’.
News round-up
Be Proud. Make a Difference
Innovative project to improve hospital environment for dementia patients Featured in the Lincolnite Burton ward at Lincoln County Hospital has undergone a £180,000 redevelopment to reduce patients anxiety and encourage better independence for people with dementia. The number of beds per bay have been reduced from six to four to provide patients who are prone to wandering with
more space to walk around independently. Hand rails and bay doors are brightly coloured to help patients to find their way around the ward and relocate their bed easily. All bays have dementia friendly clocks, which not only tell the time but tell the patient whether it is morning, afternoon or night.
Find out about the latest developments in the Trust or where we have been featured in the local and regional news. For more information on the latest press releases, visit the news section on the ULH website homepage www.ulh.nhs.uk Do you have a story to tell about the care you received? Then send your story to communications@ulh.nhs.uk
Staff successes Featured in the Lincolnshire Echo and Boston Target
Acting Chief Nurse, Pauleen Pratt
The Trust recently won two patient safety and care awards for the fractured neck a femur service at Pilgrim Hospital, Boston. Pilgrim is now one of the best performing #NoF services in the country with 20% improvement in achieving the 36 hour target from admission to theatre. We now achieve 96%. Jane Lewington has praised the work being done to get the trust out of special measures.
Photograph courtesy of Jane Lewington
Chief Executive and Chief Nurse take on the ‘hot seat’ Chief Executive, Jane Lewington and Acting Chief Nurse, Pauleen Pratt took part on BBC Radio Lincolnshire’s hot seat feature. Members of the public were invited to ask questions about their local hospital Trust. They were asked questions such as if they had any tips on improving big organisations, whether the organisation found the NHS systems confusing and complicated, particularly around finance, and what is next for the old maternity building at Grantham.
Top Tweets @suneilkapadia Excellent feedback from EM Deanery on the quality of medical training at Pilgrim Hospital, Boston. Well done to all. @ULHTNews @pmjp97 Good visit #grantham League Of Friends @ULHTNews today. Looking at projects they are considering supporting. Thanks to them for all they have done already. @ULHTNews New heart monitoring service introduced at Grantham Hospital @StBarnabasLinc @ULHTNews @SWLincs_NHS @ehospicenews All systems go as we prepare for the opening of the Hospice within a Hospital
Follow us on Twitter @ULHTNews @croftpod @ULHTNews thank you to staff on Welton Ward for looking after my mum so well. @LizBall13 Really impressed by the service improvement projects by the leadership in practice candidates @mccarthy_ph Our new nurses enjoying their start @ULHTNews ‘the induction into ULHT has been fantastic so far with everyone very friendly and welcoming’ @MacularSociety @ULHTNews Congratulations to the team! We are so grateful for all they do for people with macular conditions.
Jane said following the Trust board meeting at Pilgrim: “Since the publication of the CQC inspection reports in July, staff from across the trust have been working hard delivering our quality improvement plan. “I am proud of the commitment the staff have shown to get the trust out of special measures.”
Grantham Hospice in a hospital Featured in the Lincolnshire Echo The St Barnabas Hospice at Grantham Hospital has opened its doors as the first of its kind in the UK. The six-bed inpatient unit will welcome an estimated 160 people from south west Lincolnshire each year who will benefit from the homely environment that has been created on their doorstep. It will save them and their family and friends a 60-mile round journey to what is currently the charity’s only existing inpatient unit at Nettleham Road, Lincoln. Its opening comes as latest figures reveal that south west Lincolnshire has one of the fastest-growing populations the UK, with GPs reporting an increase in the number of their patients suffering from cancer, heart and lung disease and dementia. autumn 2014
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