New Ambulatory Surgical Centre opening

A new service set on easing pressure in Leeds Teaching hospitals

One of the positives from 2020 was the opening of a pioneering new consultant-led outpatient surgical facility at St James’s in Leeds in October, the Ambulatory Surgical Centre (ASC).

Two years in development, the unit was created to reduce high pressure impact on other key units of LTHT, providing innovative and streamlined new pathways for same day emergency surgical care, GP advice and guidance, and straight to test diagnostics, primarily for general surgery patients. The Acute General Surgical unit at LTHT is the busiest in the UK (NELA Data) and the unit is one of only a few centres in the country, with its own dedicated team of Emergency General Surgeons. The centre has been designed to improve patient experience for those well enough to walk into the unit, with a triage facility providing rapid senior assessment of cases, leading to a higher percentage of sameday discharges and fewer overnight stays. When fully up and running, the ambitious unit will have a dedicated 12-person team of Emergency General Surgeons, efficiently working to deliver ambulatory assessment and surgery preventing patients needing hospital admission. Says Dr Phil Wood, “We fully believe that this service places Leeds at the forefront of acute general surgery both clinically and academically.” In the first two months since opening, the team took 465 triage calls from various primary care operators, of which 51% were seen in ASC and 17% were either given advice or re-directed based on the triage process. Pathways continue to be developed but of those patients referred from primary care, 73% have been managed on an ambulatory pathway with only 128 patients requiring inpatient treatment. The new service has had a significantly positive effect on the surgical assessment unit, with reduced numbers attending this care stream each day. Similar work in other centre models has demonstrated a reduction in waiting time to see a senior decision maker from just over four hours to 22 minutes, and similarly for access to acute theatres the project has demonstrated an improvement from an average waiting time of 29 hours to same day surgery and discharge for day cases.

Stress less – your best ways of unwinding, recharging and coping during uncertain times

Never before has the word ‘wellbeing’ been so widely used as it has this past year, as the global pandemic has spread adding to pressures on jobs, family, friends and our general mental health. Many have taken inspiration to focus on making time for their own wellbeing, so we asked colleagues what they do to decompress and recharge. Got a top tip you want to share? Let us know at communications.lth@nhs.net

Sarah Dodsworth, Assistant Patient Services CoOrdinator in Pre-assessment at Wharfedale Hospital – Slow down, pay attention:

“To help me cope, I have continued to have lots of walks outdoors and I take the time – real time – to slow down and really look at, listen and smell things around me, whether it’s a frosty leaf with the blinding sun shining on it, children playing and laughing, or a beautiful smelling flower garden. I absorb my surroundings. “My four-year-old cat, Gordy, plays an important role in keeping me calm, he is so fluffy and cuddly like a teddy bear. I sit with him and really look at him and take note of his features and yes, I talk to him – I’m sure he has no idea what I’m saying and he does seem to look disapprovingly at me most of the time!

“I think what has helped, is to stop or slow down and breathe. I have also found that if you wait a while, sometimes the worrisome things don’t need as much of your precious time as you might previously have given them.”

Mike Adlam, Consultant in Intensive Care Medicine and Anaesthesia, and health and wellbeing consultant lead – Team exercise challenges:

immediate success was several staff accessing their phone health app at the end of the day and seeing they had covered several km just from being at work, one Consultant managing 10Km in a day! Another success was teams across the CSU bringing colleagues on board with up to 40 staff members submitting from across the city for each challenge. As Christmas approached and we had some torrential rain, we did slow up a little, and fear grew we would be stuck in Humberside. However, ACC pulled together and with the final submissions on Boxing Day we happily rolled into Robins Hood’s Bay.” “After wave one we organised a summer health and wellbeing fortnight across the Adult Critical Care CSU. There were sessions across the city on mindfulness, dignity at work, chair yoga, and Mike Adlam more besides. Over the fortnight we asked staff to submit their stairs climbed from health apps to see if we could collectively climb the equivalent height of Mount Everest. It proved extremely popular and we managed to summit Everest three times. “In the run-up to Christmas we wanted to set a challenge that would give a good guide of our progress each time we updated. I also thought a calming picture would help. So, we settled on walking the coast of Great Britain – all 10,600km – in just over four weeks. We set off on 25th November from Robin Hood’s bay and headed North. One

Ester Jamera, Senior Project Nurse for Diversity and Inclusion – Spectator sports for the whole family:

“I have been Ester Jamera watching a lot of sports, in particular football, darts, golf and snooker. Football is a family favourite, however, we all support different teams. You can imagine how heated things get when these teams are playing. I am a big fan of Leeds United. I am very happy they are in the Premier League after 16 years of hard work! “We like watching sports because anything can happen and it engages your emotions especially when the score-line is tight and everything is at stake. The Darts World Championships were particularly inspiring. “We are also really impressed by Marcus Rashford’s courageous End Child Food Poverty Campaign where he called on the government to support vulnerable children with meals and activities during holidays. I respect that a lot because sometimes, as we live in a developed country like ours, it is difficult to imagine families going to bed hungry.”

Nicola Nicholson, General Manager, Medicines Management and Pharmacy Services – Real crime podcasts and soft toy sewing:

“I enjoy spending my free time listening to podcasts and audiobooks whilst sewing. During lockdown, I have started to learn how to make soft toys whilst listening to real crime podcasts. It’s quite a contrast of interests I realise, but it makes me calm and gives me satisfaction - I am quite proud of my monkey.”

Sam Bacha

Nick Clark

Fiona Dickie, Operating Department Practitioner - Dogwalking:

“I love my dog Brodie, not only does he give us unconditional love, he provides us with a need to get out in the fresh air and move. He’s a 3 ½ year old German Shepherd dog and when I’m not working my shifts, we walk around ten miles a day, once in the morning and once in the evening. Standing for ten hours doing my job can be hard and stressful, I find getting outside and walking in nature a great stress relief.”

Sam Bacha, Senior Oncology Occupational Therapist - Family, food, and French:

“I relax and switch off by choosing to park my car a lot further than I need to so that work is further behind me by the time I get to driving home. I have also enjoyed getting into various different TV shows on Netflix and relaxing with my family instead of rushing around trying to fit outdoor activities in on an evening. I have done more yoga practice during the pandemic than ever before, and have re-joined Duo-Lingo language app to progress my French. And I have also now perfected my maltester cheesecake without needing the instructions”

Nick Clark, Senior Communications Officer – Creative writing:

“I’ve always found creative writing cathartic but the pandemic was the first time I really relied on my writing to get to grips with the disruptions and anxieties of everyday life. “I poured a lot of what had built up into a short story I wrote over about four months. The first draft had a lot going on, but in the second draft I was able to take a step back and craft what was there into something more effective on the page. It’s now out for initial feedback from my writing group, so it will be interesting to see whether it resonates with others. “Doing something creative is a really effective coping mechanism, but it’s important to realise that you don’t have to be good at what you do to get something out of it – just let yourself go and see what comes out. You never know, you might even surprise yourself!”

Anna Winfield, Associate Specialist in Elderly Medicine – Running and hiking:

“In the summer months I found running really helped me relax and blow off steam – I was running daily off road in my local area. Over the colder months I re-discovered a love of hiking; I found you can more-or-less forget about everything when you are in the middle of nowhere in beautiful surroundings! Pictured is one of my favourite places that I can run or walk to from my house – Almscliffe Crag.”