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November 2013

The Royal Liverpool and Broadgreen University Hospitals

insight www.rlbuht.nhs.uk

@RoyalLpoolHosps Facebook.com/royalliverpoolhospitals RoyalLPoolHosps

New Royal: approval from city council

NHS Trust

We say ‘NO’ to smoking

Ready for Winter


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Patient experience - to deliver a high quality patient experiance

How are we performing? We, along with all other NHS Trusts, continuously monitor our progress against a series of targets that are set both nationally and locally.

%

100

This allows us to monitor the delivery of

our key corporate objectives of patient experience and quality of care, patient safety, productivity, people and financial health. Below is an overview summary of some of our key performance indicators.

Overview to August 2013 (except where stated)

The PLACE

results are in! The results for the ‘Patient-led assessments of the care environment’ (PLACE) are in and both of our hospitals have managed excellent results in all categories. The PLACE assessment is used to give local people the opportunity to go into hospitals as a team and assess how the environment supports patients’ privacy, dignity and wellbeing; food; cleanliness and general building maintenance. The results are then used to help improve patient care within hospitals. In all four categories, both the Royal and Broadgreen scored over 90%, with Broadgreen receiving an impressive 100% for cleanliness and the Royal receiving a fantastic 99.86% also for cleanliness. A big thank you to all staff for your continuing effort and care!

Patient Experience and Quality All Cancers: 31-day wait Diagnosis to first treatment A Cancers: 31-day Surgery wait for second or Anti cancer drug treatments subsequent treatment All Cancers: 62-day wait Urgent GP referral to treatment for first treatment Screening service referral Referral to treatment Admitted waiting times Non-admitted Incomplete Cancer: two week waits Urgent suspected cancer referrals Breast symptomatic (not suspected cancer) Accident & Emergency % patients waited over 4 hours Patient Surveys To increase by 5% the number of patients who rate their experience as good or excellent Patient Safety MRSA and Clostridium Clostridium Difficile Difficile MRSA Venous Thromboembolism (VTE) Venous Thromboembolism (VTE) Assessments Mortality Hospital Standardised Mortality Ratio (HSMR) Risk adjusted mortality - all diagnoses Falls 30% reduction in falls by year end Pressure ulcers Grade 2 or above pressure ulcers rate Grade 3 or above pressure ulcers rate Productivity Productivity indicators Daycase Rate Average Length of Spell (Elective Average Length of Spell (Non Elective) New to Follow Up Ratio Did Not Attend Rates People Sickness absence (July) Sickness absence rate (in month) Finance Financial Performance Financial Risk Rating

Employee of the Month The latest winners presented with their certificate are:

Our monthly award scheme recognises dedicated members of staff who have gone the extra mile to help patients during their stay or visit to our hospitals.

June: Jane Tinsley, Haemotology/Oncology trials nurse

July: Salihu Samas, Urology specialist nurse

If you would like to nominate someone for this award, please contact the Quality Department on extension 2293.

August: Carol Edgar, healthcare assistant, Urology

September: Christine King, staff nurse


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Patient experience - to deliver a high quality patient experiance

Full capacity protocol To ensure our patients receive the best possible care and treatment when we are at our busiest, we have developed a full capacity protocol to help manage capacity in our emergency department. The protocol is activated (for at least 12 hours) when: 1. The Trust escalation status is red

Ready for winter Last winter was exceptionally busy across the NHS, with an increase in the number of elderly, frail patients needing hospital care. However, the main challenge for our hospitals was that we found it harder to discharge patients to social or community care when those patients no longer needed to be in hospital. This means we find it hard to admit patients because beds are taken up with people who should be being treated elsewhere. That leads to a build-up of patients in Emergency Departments.

•W  e have opened up to 23 intermediate care beds at the Royal to look after patients who no longer need acute care

There are a number of measures we have put in place to help us manage this pressure and to improve the discharge process. These include:

• We are recruiting additional nurses

•A  consultant is now available in the Emergency Department 24/7 •A  ll patients bought in by ambulance are being seen straightaway by a consultant – this is so they can receive the right treatment quickly and so senior doctors can assess whether patients need emergency care •W  e are recruiting additional consultants in acute medicine, the Emergency Department, surgery and radiology • T wo GPs will be on site to see patients in the evenings and weekends – this is a transfer of the Everton Road walk-in centre to be on our site so patients who don’t need emergency care can be seen by these GPs

•W  e are focusing on there being more consultant-led care across our hospitals, including ward rounds seven days a week and having specialist doctors (such as respiratory doctors) available to give expert opinion to the emergency doctors •W  e open additional beds when needed during peak periods

•W  e are working closely with the Local Authority and Liverpool Community Health – including a pilot project to train our senior nurses to refer patients directly to social care services Busy emergency departments are not just the responsibility of hospitals. Everyone is responsible for ensuring that hospitals are able to focus on people who really need our care. The whole of the NHS and social care systems need to work together to ensure this happens and we are working with partners locally. Patients and the public can also help by using services appropriately and by focusing on their own health. There is lots of information available to assist people in where they can go to get advice, care and treatment and we ask people to use the NHS responsibly.

2. The emergency department escalation status is red 3. There are seven or more patients in Emergency Triage for a period of more than 15 minutes 4. The executive on-call has approved escalation to the full capacity protocol. (It may be instigated at lower levels of escalation if deemed necessary). A senior manager coordinates actions, both in and out of hours.

Main changes Transfer of patients to wards whilst awaiting a bed In extreme circumstances patients are transferred to wards if we expect a bed to become available for them within four hours. These patients should only be transferred if they are stable and ‘well enough’ to wait in an armchair. They must be cared for on bays. These are called ‘red transfers’. Wards must nominate where and how these patients will be nursed. Specialty in-reach to emergency Specialties must send a nominated individual (ideally a consultant/registrar) to attend the emergency floor at least three times a day to review patients, triage and help avoid unnecessary admissions. This is coordinated by the emergency floor case manager. Resident junior medical teams must provide assistance to specialty teams. Clinical nurse specialists are expected to assist in association with medical staff. The emergency department consultant acts as clinical arbiter. The capacity protocol is available on the intranet. Please ensure you are aware of what it says and what your responsibilities are. It includes a checklist and criteria for ‘red transfers’.


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Patient experience - to deliver a high quality patient experiance

New Royal Update: Council planners back the new Royal In September, the Council’s planning committee voted unanimously to grant planning permission for the new Royal. This was a massive step forward for our future plans to have a world class hospital, designed to meet the needs of a growing city and dealing with our very specific and acute health challenges in the region. The new Royal will provide both the most advanced treatment and the highest standards of comfort, privacy and dignity for patients. The BioCampus that will be built on the current hospital site, will make Liverpool a city that develops and attracts global talent and we will act as a hub for leading international clinicians, pioneering researchers and cutting-edge Life Science businesses.

Royal will provide state of the art facilities that will help make a huge impact on some of the big health problems we face in Liverpool, such as cancer and stroke.” Planning approval for the new Royal was hugely supported by the Mayor and local councillors. Liverpool Mayor Joe Anderson publically voiced his support and that of the city of Liverpool for the plans for the new Royal on youTube. In addition City Central Ward Councillor Nick Small told the Liverpool Echo that he was fully supportive of the plans, highlighting the economic benefits it will bring to the people of Liverpool. Cllr Small said: “Be in no doubt, the new Royal will have a huge impact on the well-being of the people in some of the most deprived parts of Liverpool.”

Aidan Kehoe, chief executive said: “This is an exciting development for the city and for our staff and patients. The new

New Royal funders announced Three major financing organisations are behind the funding for the new Royal, following a competitive process that will bring the Trust’s annual repayments down to around just 5% of annual turnover.

The remaining funding will be provided by Legal and General Investment Management (LGIM) and Lloyds TSB with £90.5m. In addition, over £30m will be provided through an equity arrangement with Carillion and Scottish Widows Investment Group.

The new hospital scheme, costing a total of £429m, is part publicly funded with £118m from the Trust and £94m from the Department of Health. It can now be revealed that the European Investment Bank (EIB) will provide £90.5m, meaning almost three quarters of the project will be publicly funded.

In the funding structure, which is expected to be finalised and signed off by the end of the year, LGIM together with the EIB, will provide long-term finance for the project and Lloyds TSB will provide short-term construction period finance. The three funders were approved by the Trust following a competitive

bidding process overseen by HSBC on behalf of Carillion and Scottish Widows Investment Group. Helen Jackson, director of redevelopment and strategy said: “We are delighted with the outcome of the funding competition. The deal we have achieved has further reduced the annual repayment (the Unitary Payment) which will now be over £10m less than the initial projections and will mean our annual repayments will be around just 5% of our income. This is one of the lowest cost public private deals ever.”

What’s next? The project team and Carillion are working hard towards ‘financial close’ when the contracts are signed and hope to achieve

this before Christmas. Once this happens, work will begin on building the new Royal and transforming the gateway to

the city from Edge Lane. We’ll have more information on construction timescales in the February 2014 edition of Insight.


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Patient experience - to deliver a high quality patient experiance

New Royal – new approach to patient care The new Royal will be the largest hospital with all single rooms in the country. All inpatients will be cared for in a single room.

park on the hospital site, walk straight into hospital and will be able to find the ward they want to visit much easier due to a much simpler layout.”

Each of the rooms will have windows from ceiling to bed level and they will be equipped with the latest technology such as motion sensors to detect sudden movements such as a patient getting out of bed, as well as intercom systems and call alarms for patients to contact staff. As well as ensuite facilities, each room will be fitted with freeview TV and internet facilities to provide patients with greater home comforts. There will also be day rooms on each of the wards so that patients are able to mix with each other if they wish to and reduce any sense of isolation.

“With the measures we will put into place for the new hospital,’ Aidan said, ‘we expect that most people will have short stays in the new Royal of up to five days, except on some specialist wards. After which they should be fit enough to be discharged home or to a community care provider, or if they require a longer hospital stay they can be transferred to Broadgreen Hospital, which will be the centre for rehabilitation and planned treatment.”

A question many people have asked is will having single rooms require more staff? Aidan says, “We need to ensure that we have the right skill mix for the type of patients being cared for on the ward and good ward management. We will look at patient dependencies for specific areas and if we need to increase nursing staff for some areas then we will do.” Carillion have built full scale mock ups of the single rooms on Ward 4X to give staff the opportunity to see what they will look like and how patients would be cared for and also give their feedback.

For staff caring for patients, rather than being based at a single nurse station, there will various nurse bases along the corridor so that staff can keep a closer watch on their patients. Aidan Kehoe said: “The new Royal will provide patients and visitors with a completely different environment to the current hospital. Patients will come to the new Royal with serious conditions and will be cared for on wards with all single rooms and ensuite facilities. Visitors will be able to

There are nurse bases along corridors for close monitoring of patients

Why have all single rooms? The decision to have all single rooms was based on patient feedback. Patients said they wanted: • More single rooms with en-suite facilities • Peace and quiet at night

• It allows more efficient bed management, particularly around ensuring same sex accommodation • It provides greater privacy and dignity for patients, ensuring more effective communication between staff, patients and their families and a

much better experience of care • It reduces noise and disturbance for patients, improving their experience and helping them rest and recover better • It reduces the risk for medicines errors and therefore improves patient safety

• P rivacy so that they can have confidential conversations with the team that are caring for them and with their visitors • Security, cleanliness and hygiene •A  ll patients emphasised the importance of privacy and dignity with no mixing of sexes. With this in mind, the decision to have all single rooms was based on these clinical reasons: • Improved patient safety by enhancing the management of infection and reducing hospital acquired infections. Last year 175 bed days were lost due to infectious outbreaks and single bedrooms will mean that this is avoided

Artist’s impression of the single rooms in the new Royal


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Patient experience - to deliver a high quality patient experiance

Cancer care rated as excellent or very good In a survey of our patients receiving treatment for cancer, 93% rated the care they received as excellent or very good. The survey gathered feedback from nearly 400 day case and inpatients between September and November 2012 who were being treated for cancers related to haematology, breast, prostate, eye, upper GI, colorectal, urological, sarcoma, head & neck and lung. We scored within the top 20% nationally for responses in 27 of the 63 questions in the survey. These included: • S taff explained completely what would be done during test •G  iven complete explanation of test results in understandable way • P atient definitely involved in decisions about care and treatment • T aking part in cancer research discussed with patient • P atient had confidence and trust in all doctors treating them • P atient had confidence and trust in all ward nurses • P atient’s rating of care ‘excellent’/’very good’ The survey also allowed patients to provide comments about their care. Some of these are below: “My treatment was very good and I was pleased the way they were with me. The ward even rang to see if I got home safely after I was discharged.” “Very efficient pathway involving all relevant investigations before seeing consultant for diagnosis and treatment plan, all on the same day. Booked in for surgery the next day.” “The care was is excellent and prompt, I cannot thank all staff enough.”

Aidan Kehoe, chief executive beside the Stoptober campaign disc – if you can quit for 28 days you are more likely to give up for good.

We say NO to smoking Smoking has a massive impact on public health in Liverpool. The city has the highest number of people with cancer in the UK and the highest death rates from the disease. Liverpool also has some of the highest respiratory death rates. As the main hospital for the city, and one which treats hundreds of cancer patients each year we have to take a stand on smoking.

other members of staff from smoking on our grounds.

We will be launching a campaign to discourage people from smoking outside our entrances involving surveying the views of staff, patients and visitors, more prominent posters outside entrances and working with local media and community partners.

A. Ask the person politely to stop smoking in that area and direct them away from entrances.

Our Smoke Free Policy states that all staff are responsible for politely asking anyone smoking at entrances and exits to cease doing so or to move to the shelters. If every member of staff did this every time they saw someone smoking outside the entrance, this would reinforce the message that We Say ‘No’ to Smoking and people would be much more likely to comply. We’re asking staff to actively get involved in this by discouraging patients, visitors and

What to say… Here is an idea of what we’re asking our staff to say to patients and visitors smoking in unauthorised areas: Q. What should I say to someone smoking in an unauthorised area?

Q. What if someone is aggressive? A. Calmly ask them not to be aggressive, if they persist contact security. We have a zero tolerance policy with any patients or visitors who are aggressive towards our staff. Q. What if someone says they are smoking an electronic cigarette? A. They have similar health risks as cigarettes, so you still need to use the smoking shelters. Q. What if a person says they have been told by another member of staff that they can smoke there? A. Politely direct them away from entrances


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Patient experience - to deliver a high quality patient experiance

Sharing best practice on dementia care Healthcare professionals, dementia care organisations, patients and carers gathered in September to share ideas and experience to improve care for people with dementia, at an event organised by specialists in dementia care at the Royal. Held at the Foresight Centre in the University of Liverpool, ‘Embracing Dementia Care – it’s everyone’s business’, was the second annual summit organised by the Royal. It included speakers from the Trust, Aintree University Hospital Foundation Trust and Mersey Care NHS Trust as well as Alzheimer’s Society ambassador Ann Johnson MBE who gave a passionate speech about her personal experience of living with dementia. Event organiser Shaun Lever, dementia practitioner at the Royal said: “This year’s Embracing Dementia Care highlighted the transformation of services for patients with dementia along with the excellent collaborative work

we have been involved in, working with other trusts and community healthcare providers. It was also a great opportunity for us all to get together and share our experience on what works to ensure patients with dementia received good quality, seemless care wherever they were being looked after.”

Local experts in dementia care gather to share expertise

We provide specialist training to all nursing staff outlining symptoms of dementia, early detection and how to manage challenging behaviour. A ‘This is Me’ document outlines a patient’s likes and dislikes, their family, home life, hobbies and interests. It means staff know more about the patient’s personality so they can care for them in a more personal way. We also have specially trained volunteers who will sit with patients with dementia while they are in hospital and keep them occupied with a range of things such as games or historic items like ration books to help stimulate conversations.

Experiencing dementia Staff, visitors and a Radio Merseyside presenter had a real wake up call when they were given the chance to see through the eyes of someone with dementia at the Royal. Nichola Myers and Annette Mulhall, staff members from ward 5X at the Royal who completed the exercise

September was World Alzheimers Month and to help spread awareness of the symptoms, special kits were used in the hospital’s Education Centre to simulate the devastating affect of dementia on attention and co-ordination.

About 60 people completed the interactive Dementia exercise and many walked away shocked at the daily struggle people with dementia face. They were given glasses that blurred their vision, headphones playing music and sounds to distort hearing and restrictive hand mitts that simulated arthritis – which many dementia patients also have. They were then taken through simple, everyday tasks such as making a sandwich, to demonstrate how difficult it can be for people with dementia before filling in a survey afterwards to reveal what they had learned from the experience. The day was organised by the Trust in conjunction with Person Shaped Support (PSS), an organisation who help people find somewhere to live, meet new people who have been through a similar life experience, improve their health or ensure their family are supported.


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Patient experience - to deliver a high quality patient experiance

Tell us what you think about our services

Patients have more forums than ever to thank staff, or to raise any issues about our service. You can contact the Customer Relations team on 0151 706 4903/2265, type talk: 18001 0151 706 4903/2265 or email complaints@rlbuht.nhs.uk. On wards, the Friends and Family test can be completed and online there are various places patients and their families can turn to, including NHS Choices (www.nhs.uk), Twitter, Facebook and more. The Communications and Marketing team monitor the avenues available to people so that concerns can be addressed and messages of gratitude passed on.

Patients can rate the service they receive at the Royal, Broadgreen and the Dental Hospital out of five and comment on it online at NHS Choices, while comments both positive and negative can be posted on our social media sites Twitter, Facebook and Instagram. The NHS Friends and Family Test is an easy-to-understand question that is asked to patients who have been treated in the Emergency Department or as an inpatient, within 48 hours of them being discharged from hospital. After they have been discharged, patients will receive a text to ask them “how likely are you to recommend our ward/emergency

department to friends and family if they needed similar care or treatment?� Patients are asked to select one of six options ranging from extremely likely to extremely unlikely. They are also invited to tell the hospital the reason for their selection. Responses are anonymous and patients at the Royal can opt out by ignoring the text, or by texting the message STOP. They can opt out before to leaving the hospital. Patient feedback is used to help us build on good performance or make improvements where services could be better. So please take up the opportunities to tell us what you think about our services.

Volunteers at Broadgreen Volunteers are now on hand at Broadgreen Hospital, following feedback from patients who requested more help with finding their way around. A designated volunteers service desk has been established at the entrance to the Alexander Wing, with volunteers available 9am to 4pm, Monday to Friday. The volunteers will be on hand to

meet and greet people coming into the hospital and help them find their way to wards and departments. Whilst applications from volunteers at the Royal are currently on hold, the Volunteers Service is looking for volunteers to help out at Broadgreen, on wards and clinics for dermatology, audiology and urology. In the future we will be looking for more volunteers at Broadgreen to help out in

outpatients and the discharge lounge. Ward volunteers help with answering telephones, transferring case notes, talking to patients, and running errands when required. Audiology volunteers will help out generally, giving out batteries and tubes for hearing aids (training will be provided).Outpatients and discharge lounge volunteers will be helping out with refreshments and chatting to patients.

L-R: Ian Harper, Tracy McDonald, Joan Parry, Roy Molyneux – Volunteers happy to help Broadgreen Hospital


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Clinical excellence: to provide excellent care to all our patients

Trauma and Healthcare Orthopaedics

Transforming

The Royal is the major provider of orthopaedic trauma in Cheshire and Merseyside and is the largest specialist centre for orthopaedic trauma in the North West. The department consists of 30 consultant surgeons with various different sub-

specialty interests, covering the whole of orthopaedics, of these consultants 21 regularly undertake trauma surgery. We offer a regional limb reconstruction service which supplies hospitals throughout Cheshire and Mersey as well as Greater Manchester, Lancashire, The Isle of Man and North Wales.

An x-ray of Irene Purcell’s arm after the prosthetic humerus was implanted

Pioneering role in creation of bionic arm A revolutionary bionic arm has given a patient who faced amputation a new lease of life, thanks to the pioneering work of Professor of Orthopaedics Simon Frostick. Professor Frostick helped to create a device that can give greater mobility to people with rheumatoid arthritis. The device - which has synthetic joints at both ends - can replace the upper arm bone, the humerus, following arthritis, trauma or infection, or when previous shoulder and elbow replacements have reached the end of their natural life. Irene Purcell, 61, had the operation to replace her humerus with the groundbreaking prosthetic limb at Broadgreen Hospital. Just days after the operation, she was starting to move her arm and has physiotherapy on the joints four times a day to regain her strength.

“Since it was replaced it was like switching a light off – the pain has gone,” she said. “I’m looking forward to doing normal every day things without thinking twice. Professor Frostick is the first person outside the US to use the artificial implant created by Biomet in Indiana, USA. The Comprehensive Segmental Revision System, is constructed of cobalt, chrome and polyethelene. With five operations completed using the implant and five more already planned, he is the one of the world leaders in the field. Prof Frostick, who has more than 20 years of experience and performs around 100 shoulder replacements a year, was consulted at various stages of the development of the prosthesis. The design was based on his knowledge and he travelled to Biomet’s design facility as the company put the finishing touches to the implants.

A complete humerus prosthesis identical to that received by Irene Purcell He added: “The level of skill and expertise required to conduct this type of surgery means that it is only provided in two or three places in the UK.” Irene’s operation was filmed with her permission so that junior doctors can learn about the procedure.

TT Rider hails staff at the Royal A rider in the Isle of Man Classic TT praised specialist surgeons at the Royal after sustaining multiple injuries when he came off his bike at 70mph. Peter Richardson, 69, from Blackpool, was left with a broken right shoulder blade and left hip socket and a minor liver laceration after the incident. Peter, a father-of-six said: “They think I might have landed on my knee which pushed my thigh bone into the ball and socket of my hip. They have repaired the top with four screws. Without a doubt, this is my worst biking injury.”

Consultant surgeons Gunasekaran Kumar and Sanjay Kalra, both specialists in complex trauma including hip socket fractures, performed Peter’s hip socket operation. Mr Kumar said: “The complex fracture of his left hip socket was fixed using specialist equipment, which results in minimal scarring and a shorter recovery time for the patient. We are one of the few centres to provide this type of complex hip socket surgery.” Peter added: “All of the staff at the Royal have been absolutely brilliant.”

Local newspaper feature on Peter’s accident and follow up care


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Clinical excellence: to provide excellent care to all our patients

Helping stroke patients get back in the game! The Early Supported Discharge Team (ESDT) is a community based therapy team based at Broadgreen Hospital. The therapists follow stroke patients out from hospital to the community settings once discharged, to continue therapy. One patient who has been cared for by the team is Alan who had a stroke on his way back from holiday in April 2013. Following treatment at Salford Royal, Alan was moved to Broadgreen Hospital where his care continued on the Stroke Rehabilitation Unit. The Early Supported Discharge Team took over once he returned home. The team strongly want people to return to live as independent a life as possible after their stroke. They asked Alan what sort of things he wanted to continue to do and Alan said that he really wanted to continue his visits to Anfield to watch Liverpool FC. His occupational therapist, Rebecca Ashton, contacted LFC and Colin McCall their Disability Officer enabled a visit to Anfield over summer. Alan says, “It was amazing to practice climbing up the steps to my seat and I’m looking forward to returning to Anfield for a match soon. It may seem trivial, but when you have gone from being able to walk and move freely to having to learn to use your body again, this was a tremendous achievement. LFC have been amazing at enabling this visit.”

Nuclear Medicine team lead the way in cancer treatment The Royal is leading the way in the use of a pioneering cancer treatment that can improve and extend the lives of patients.

targeted therapy for inflammatory diseases of the joints and radionuclide therapy for neuroendocrine tumours.

Radionuclide Metabolic Therapy uses molecules that are able to find tumours, latch on to them and kill them, extending the life of the patient and alleviating symptoms and pain.

Dr Chris Mayes said: “The use of Nuclear Medicine techniques to treat disease is developing at a rapid pace and I hope this book will both help to improve the understanding and the use of these invaluable therapies. It is really fantastic that the Royal has been recognised as a leader in this field.”

As a European centre for the treatment of neuroendocrine tumours, the Royal treats patients from across the UK using this method. Now a team from the hospital’s Nuclear Medicine Department has written a guide to the therapy for other medical professionals, which was launched at the European Association of Nuclear Medicine’s annual congress in Lyon, France. The authors - Professor Sobhan Vinjamuri, doctors Ruth Menghis and Brian Lowry and radiographer Dr Chris Mayes contributed three chapters on the alleviation of bone pain in cancer patients,

An electronic version of the book can be downloaded from: http://www.eanm. org/publications/tech_guidelines/docs/ Radionuclide_Metabolic_Therapy.pdf The Nuclear Medicine team have dedicated inpatient ward facilities for therapy as well as a £1.8m PET CT scanner to identify the tumours, allowing them to plan targeted treatment for patients with a variety of cancers as accurately as possible.

Top accreditation for echocardiography Our echocardiography service, part of the Royal’s cardio-respiratory department, has received departmental accreditation from the British Society of Echocardiography (BSE) becoming one of only four departments in the North West to receive this title.

Adrian Chenzbraun, consultant cardiologist and echocardiography lead at the Royal said: “This accreditation is recognition of our collective efforts and an indication of the high standards we try to provide to both patients and staff. We now join a select list of echo labs across the UK.”

BSE accreditation is a benchmark for quality in echocardiography and shows patients, staff and other organisations that our team meets the BSE standard of quality.

Alan with occupational therapist Rebecca Ashton on his trip to Anfield

The service, which performs around 10,000 scans a year, passed rigorous quality assessments in all areas with flying colours and now means the echocardiography is considered to be at standards of some of the best in the UK.

Adrian Chenzbraun with members of the echocardiography team


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Patient safety and outcomes - to ensure the safety and effectiveness of our services

Everton FC support the AAA Team Everton legend Derek Temple and staff at the Royal are encouraging men aged 65 and over across Cheshire and Merseyside to take part in a national screening programme for potentially fatal abdominal aortic aneurysms (AAAs). An abdominal aortic aneurysm is where the wall of the aorta (the main blood vessel that supplies blood to the body) becomes weak in the abdomen. It can then expand causing a weak spot or aneurysm, which if left unchecked can burst causing massive internal bleeding and is fatal in 98% of cases. The condition is most common in men aged 65 and above and the Royal is hosting a

range of screening events across the region, including one held at Goodison Park, that was attended by former Everton footballer and FA Cup winner Derek Temple. Derek Temple said: “I am only too pleased to get involved with this initiative. If a partnership involving Everton in the Community and the Royal can raise awareness and potentially save lives then there more support it receives the better.”

Robert Fisher, consultant vascular surgeon at the Royal and director of the Cheshire and Merseyside AAA screening programme, said: “Large aneurysms are rare but can be very serious and if we find that you have one we may want to book you in for surgery to prevent it from bursting. We perform a quick

and painless ultrasound scan which will determine whether you have an abdominal aortic aneurysm and if so how large it is. You get your result straight away but a copy is also sent to your GP.’

We perform a quick and painless ultrasound scan which will determine whether you have an abdominal aortic aneurysm and if so how large it is

‘I am convinced that this screening programme will save lives across Merseyside and Cheshire and hopefully reassure men against the threat of an aneurysm.” The most common symptom of a ruptured aortic aneurysm is sudden and severe pain in the abdomen. If you suspect that you or someone else has had a ruptured aneurysm, call 999 immediately and ask for an ambulance.

Derek Temple and Robert Fisher with the AAA Team

Screening events are being held in GP practices across the region and invitations are being sent to men aged 65. Those over 65 living in Cheshire and Merseyside can book a screening appointment by calling 0151 706 4767 or emailing aaascreeningprogramme@rlbuht.nhs.uk.

C.diff: Keeping patients safe this winter We have a well earned reputation for sustaining low infection rates at our hospitals and are proud of the hard work of our staff in achieving this. This year our infection control targets for hospital acquired infections are tougher than ever: • MRSA – Zero cases •C  lostridium difficile – no more than 35 cases For every case we have over these targets, the Trust will be penalised by £25,000. These are tough penalties, but more importantly, MRSA or C.diff can have serious consequences for our patients, so we need to do everything

we can to keep our patients safe. Meeting our C.diff targets is particularly tough and staff need to do all they can to reduce the risk of infection. Here are a number of steps staff should take to ensure patients are safe: • Identify patients with a history of C.diff and focus on nutrition, antibiotic prescribing, staff and patient hygiene measures.

• If a patient is suspected to have C.diff, isolate the ward and contact the infection prevention and control team on extension 4415/4416 •M  ake sure patient equipment is effectively cleaned and disinfected •M  ake sure the patient environment is effectively cleaned

•M  ake sure patients receive a CDT risk assessment on admission and at least weekly during their stay

If you need help or advice on antimicrobial prescribing, contact the medical microbiology team on extension 4410/4425.

• S upervised nutritional assessment should be completed on admission and at least weekly during the patient stay.

For more information or training on how to keep your ward safe, contact the infection control team on extension 4415/4416.


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Patient safety and outcomes - to ensure the safety and effectiveness of our services

Keeping yourself and others safe from norovirus Norovirus or the winter vomiting bug is the most common stomach bug in the UK, affecting people of all ages. It is highly contagious, but there are ways of reducing the risk of catching the bug and spreading the bug, helping to keep others who may be more vulnerable, safe. Norovirus causes vomiting and diarrhoea and is a bug that you have to let run its course, which should last no longer than a couple of days. However, from the time when you are infected to when you start showing symptoms, which usually lasts around 12-48 hours, you may be infectious to other people. There are ways of easing your symptoms, as well as reducing the risk of infection for others: •D  RINK plenty of water to avoid dehydration •T  AKE paracetamol for fevers, aches and pains •E  AT easy to digest foods if you feel like eating •D  ON’T go to your GP or accident and emergency, where you risk infecting people more vulnerable than yourself. Stay at home. If you have an hospital appointment call the number on your appointment letter to rearrange •C  ONTACT YOUR GP if symptoms last longer than a few days or if you already have a serious illness Norovirus is easily spread by contact with an infected person, especially through their hands. You can also catch it through contaminated food or drink or by touching contaminated surfaces or objects. To reduce the spread of norovirus: • WASH your hands frequently • DON’T share towels or flannels •D  ISINFECT all surfaces a person with the virus may have touched Help to reduce the spread of norovirus and keep our friends and family safe!

Staff Protocols for norovirus Staff in our hospitals have procedures to follow to stop the spread of Norovirus. Here’s what staff should do to help prevent themselves and others from the virus:

found via the Intranet. For more information contact the infection control team on extension 4415/4416.

• T horoughly wash hands with handwash and water •O  ffer all patients handwash and water after using the toilet • Isolate patients thought to have Norovirus as soon as possible • S end stool and vomit samples for Norovirus via the POD system immediately •M  ake sure visitors are restricted to two per bed and remind visitors of the importance of hand hygiene •D  o NOT let children onto wards where Norovirus is suspected •M  ake sure cleaning of equipment is carried out thoroughly • If a staff member has diarrhoea and vomiting. Do not come into work until symptom free for at least 48 hours Each ward should have a copy of our ‘Norovirus resource pack’, which can also be

Staff flu vaccinations We are offering all staff free flu vaccinations to help protect themselves, their family, their friends and most importantly their patients from the risk of flu. Flu is an unpleasant virus for most people, but for more vulnerable people like some of our patients, it can kill. Last year we were one of the highest performing trusts in the UK, with over 85% of staff getting the jab and we want to beat last year’s amount! The flu vaccination is available to every single member of staff. It’s quick, easy and effective. We’re holding regular vaccination sessions in the Royal and Broadgreen, which are included in the weekly email bulletin In Touch and on the staff Intranet. If you haven’t had your flu vaccine yet, roll your sleeves up and get the jab!

Aidan Kehoe, chief executive getting his flu jab – have you had yours yet?


13

Information Technology

Dr Paul Fitzimmons demonstrating how Lync is supporting the stroke telemedicine service

A time-saver for staff, potential life-saver for patients! Precious time lost travelling by clinical, managerial and admin staff to meetings at the Royal’s outlying sites is now a thing of the past thanks to innovative Lync software installed on every Trust computer. Using familiar techniques found in popular social networking platforms like Skype and FaceTime, it supports remote and flexible working practices by allowing staff to connect securely - anytime and from virtually anywhere. Designed to work with Microsoft Office, SharePoint and Exchange, Lync can facilitate a virtual face-to-face meeting and can include web, video and audio calls, application and desktop sharing and instant messaging (IM). Amanda Penketh, deputy director of information and patient access services, says Lync is already proving extremely effective for streamlining routine communications and saving travelling time. “Our work involves regular meetings with colleagues at Wavertree Science Park and other sites, which previously took up at least 20 minutes each way. Lync’s video conferencing facility allows us to hold ‘virtual’ meetings, which means collectively we’re saving around six hours per week to spend more usefully.” Debbie Bradley, workforce and training information manager in learning and

development, says her staff have also been quick to adopt the new system.

week. This will have hugely beneficial implications on valuable clinician time.”

“As well as saving us time, Lync is really useful for screen sharing and navigating through documents and presentations. It has dramatically increased our productivity by letting us discuss documents on-screen in realtime, enabling decisions to be reached much faster.”

“It’s a surprisingly straightforward solution that will transform our cross-site MDT process by enabling faster clinical decision-making and closer collaboration.”

In addition, Lync is already proving to be particularly beneficial in multidisciplinary (MDT) teamwork. Among the first to use it is Liverpool’s Vascular and Endovascular Service (LiVES), which operates across four trusts in North Merseyside where patients of the service are treated by specialist teams including vascular nurses and doctors from other disciplines. Consultant vascular surgeon and clinical director of LiVES, Professor John Brennan, says: “As a principle, we discuss all cases for major surgery at weekly MDT meetings to ensure we provide the best possible management to patients. “Until now each site has held their own MDT meetings, up to a total of ten across the network each week. By enabling us to host joint MDTs from the Royal for the key aspects of our work, with input from all four sites, Lync will allow us to reduce this to three per

Meanwhile, consultant physician Dr Paul Fitzimmons says Lync is continuing to play a major role in Merseyside’s first telemedicine service introduced earlier this year to improve outcomes for stroke victims. “The voice-and-video capability enables emergency department staff to use a computer on wheels fitted with an HD camera to use lync to connect to the on-call consultant, who can quickly make an assessment and identify next steps. He or she can then supervise a specialist stroke nurse in administering a clot busting injection. Travel, and crucially, lost time is thereby eliminated.” Project manager, Stephen Latimer adds that future plans include adapting the technology to help clinicians obtain a second opinion and make instant referrals. “By connecting people, processes and ideas, it will quickly repay the Trust’s investment in the software through rapid savings in time, travel and phone bills alone,” he concludes. To discover how Lync can help your department call service desk on Service Desk on extension 5499


14 Research and development and innovation - to support high quality research and development for the benefit of patient care

Patient at the Royal first in the world to trial new eczema treatment A patient has become the first person in the world to trial a potentially life changing eczema drug at the Covance-Royal Liverpool University Hospital Clinical Research Unit. The “First in Human”, study hopes to provide sufferers of Atopic Eczema, the most common form of eczema amongst sufferers, with an alternative treatment to ones that use steroids that help relieve sufferers from the irritating redness and dryness of skin often associated with eczema. The new treatment tests a molecule never used to treat eczema and by testing this in a patient at such an early stage, there is the hope that it will reduce the time between development and the doctors’ room, meaning the drug will be available to more sufferers quicker than the current drug testing process which takes around ten years before a drug is available to patients. Speaking about the trial, the patient testing the new drug said, “I’ve had it since I was a child and used a number of treatments, but during the summer my eczema was really bad. I wasn’t sleeping because of it and had to go home from work, so my doctor suggested this trial to me and here I am. I’ve had my first dose of the treatment and it seems to have worked well. Even if it doesn’t work for me, my involvement in the trial might help somebody else.” The trial is being conducted at the Royal Liverpool University Hospital’s Clinical Research Unit, a state of the art research centre purpose built for housing early clinical trials. Dr Richard Fitzgerald, co-director of the Clinical Research Unit said, “After receiving phase 1 accreditation from the MHRA, it’s great to finally start trialling potentially life changing drugs on patients.”

Last year, more than 630,000 patients took part in clinical research studies supported by the NIHR Clinical Research Network

Royal to run North West Coast Clinical Research Network The Royal has been announced as one of just 15 NHS Trusts in England to be appointed to run a local branch of the National Institute for Health Research (NIHR) Clinical Research Network. The NIHR Clinical Research Network is the clinical research delivery arm of the NHS. It provides funding to hospitals and surgeries to pay for research nurses, scans, x-rays and other costs associated with carrying out clinical research in the NHS. Since April, the NIHR Clinical Research Network has been carrying out a rigorous selection process to identify the trusts to run its 15 local branches across England. As the chosen Trust for the North West Coast, the Royal has been awarded a five year contract from the Department of Health through the NIHR, and will take responsibility for distributing £17m of funding per year, to support clinical research across the whole area.

Aidan Kehoe, chief executive said: “We are delighted to be appointed as the Local Clinical Research Network host for the North West Coast. Over recent years there has been significant growth in the clinical research profile of this region from Cumbria and Lancashire to Merseyside and Cheshire. As network host we will be working with NHS Trusts and other partner organisations from across the whole region to raise the profile of clinical research and embed it into core NHS activity throughout the whole North West Coast region, so that local people can benefit from having access to the very latest treatments.” Dr Jonathan Sheffield, chief executive of the NIHR Clinical Research Network, said: “We were extremely impressed with the commitment shown by the Royal during the selection process, and I very much look forward to working with them to increase the opportunities for patients to participate in research, and develop the treatments of the future.”

Want to get involved? We’re always looking for patients and volunteers to take part in clinical trials. Here are some of the conditions we’re currently recruiting for: • Patients with moderate to severe eczema Patient testing the new eczema treatment

• P atients with varying degrees of renal failure • Patients with respiratory problems such

as asthma and Chronic Obstructive Pulmonary Disease (COPD) We’re also always looking to get healthy volunteers to take part in our studies as they play a vital role in the clinical trials process. To get involved call 0151 706 4860 or email c4c@rlbuht.nhs.uk.


15

Service Improvement and Excellence

Every one Matters – Your views really do count! ‘Every one Matters’ is about putting staff at the heart of improving services for patients and their families, and for themselves. Through ‘staff conversations’, staff are listened to, including what gets in the way of you delivering excellent quality care and services, and listening to your ideas to transform services and reduce waste. Ideas are fed back into the ‘Every one Matters’ implementation plan and progress is reported to the Board of Directors.

Staff engagement and empowerment are essential in driving affordable quality and change

During 2013, staff engagement successes included a ‘reward and recognition’ scheme led by one of our wards, leading to a reduction of complaints and incidents, reduced sickness, improved appraisal and mandatory training.

Improved team work in Pharmacy (Aseptics) reduced time for processing medication, and the patient experience has been transformed, as staff from the emergency dept. to the fracture clinic have a greater understanding of the entire patient journey. To embed still further, divisions and corporate teams are implementing our new Trust model for staff engagement, ‘Going Local - Six Steps to the Stars’, by hosting their own local staff engagement sessions to continually listen to staff, setting up ‘Star Teams’ to address local issues, and implementing your ideas which matter to you and your patients. This should be coming to a place near you soon!

National Pioneers for Staff Engagement This year, we completed the National Pioneer Programme for staff engagement along with seven other trusts to share best practice and strengthen our own approach. Part of the pioneer programme included a ‘Pulse Check’ based on the NHS Staff Survey. About 1,500 members of staff completed the survey and all but one question response had improved and all responses were higher than other trusts on the programme. The biggest improvement (up by 35%) was on ‘day to day frustrations that get in the way are quickly identified and resolved’. Also last year, we were in the top 20% of trusts for our 60% response rate to the NHS Staff Survey, up from 51% in 2011.

Care and Concern Workshops

Twelve Care and Concern Workshops have now been delivered in the Orthopaedics Directorate to pilot the first part of a new training programme. Following evaluation these sessions will shortly be made available to directorates.

What next?

These interactive, half day workshops focus on the attitudes and behaviours essential for all staff in every role, clinical and non – clinical, patient facing or office based, to be able to continually deliver the best service and experience for those who use our services.

•M  ore information coming soon about a new course for managers and leads, Every one Matters – Responding to Complaints and Concerns

Wide consultation with mixed focus groups was undertaken in preparation to gather feedback and to test ideas before the sessions began in September. The issues raised by staff fell in to eight broad themes: 1. First impressions 2. Being professional 3. Blame culture 4. Positive attitude 5. Patient care / patient involvement 6. Difficult conversations / breaking bad news 7. How you say it… 8. Treating internal customers (each other) well With the help of Nicky Duirs, Arts for Health lead, a DVD has been produced highlighting these themes based on real scenarios and complaints and was used in the workshops. The Trust values, and the key messages raised in the Francis Report and their impact on patient care were also discussed, with lively debates about how best to deal with some of those difficult situations we all face.

• L ook out for further Care and Concern session dates and information so that you can book your place

For more information about either of these courses, please contact Kirstin Gregson, Service Improvement & Excellence, kirstin.gregson@rlbuht.nhs.uk, ext: 3044

What people learnt from the sessions:•“  Stop and think about the situation before going in feet first!” •“  You always have a choice about how you handle situations” •“  Many barriers are things we can affect starting with self awareness” •“  Patients do not need to know the pressures we face, I would be less inclined now to let them know”

Filming the Care and Concern DVD


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Productivity - to ensure we make the best use of people and our physical and financial resources

Have you completed your 2013 staff survey yet? Most people will have received a reminder by now about the survey, so we’re making one last push to get your view across to us through the 2013 staff survey. Last year we had a response rate of 60% and we’re aiming for 70% this year. The staff survey is your chance to tell us what’s great about our hospitals and what we could improve on. Last year’s survey highlighted that staff

would like to see more of senior managers and executives, so we did more on staff engagement and visits. Executives and other directors have taken part in ‘back to the floor’ programmes, the chief executive has regular ‘walkabouts’ and Questions Time sessions to meet staff, and executive and non-executive directors regularly attend and participate in staff engagement events. Last year’s survey also highlighted that staff felt the appraisal system wasn’t working

well. So we are piloting a new system, and have set targets for completion of appraisal. The survey is completely confidential; no-one from the Trust will ever see your questionnaire. Quality Health is the company we use to administer the survey on our behalf. The closing date for survey submissions is Friday 29 November so take some time out of your day to let us know exactly what you think of us!

NHS Unsung Heroes We have launched a campaign to put some of the lesser known roles in the our hospitals in the spotlight.

and neck cancer, stroke, and the therapists work in rehabilitation at Broadgreen as well as in the community.

While patients and visitors are well aware of the vital role our doctors and nurses play in our hospitals every day, there are members of staff who are critical to their care they may be less aware of.

During our time with Louisa, she visited a patient on a ward to check he was swallowing food and drink properly. Louisa used a stethoscope to listen to the patient’s neck as he ate to check for signs the food was going into his chest.

The Communications and Marketing team has visited several members of staff, shadowing them while they work and updating our Twitter account about the brilliant work they do, using the hashtag #NHSUnsungHeroes.

Louisa Deady, a speech and language therapist There are 15 speech and language therapists working throughout the Trust who respond to inpatient referrals from ward staff for both swallowing and communication problems. They offer assessment, advice and therapy and aim to see people within 24 hours of receiving a referral. There is also an outpatient service for voice difficulties, head

Our Twitter followers were invited to ask questions of Louisa with one tweeting: “What’s the most rewarding aspect of your job Louisa?” Louisa said: “Contact with patients and family and knowing you’ve made that difference. We can help reduce distress that can occur with swallowing and communication difficulties. We can give patients, staff and families the tools to cope and manage.” If you are interested in taking part in our Unsung Heroes campaign, or wish to nominate someone, please contact the Communications and Marketing team at communications@rlbuht.nhs.uk.

Are you interested in Lean? The Service Improvement and Excellence team is offering a course for staff on the philosophy and culture of Lean. The course will refresh or increase skills in some of the improvement tools and techniques associated with Lean.

•H  ave an appreciation of the principles and practices of a Lean philosophy, and its role in supporting improvement within their service

Introduction to Lean is a four module course. At the end of the four sessions, participants should:

•H  ave undertaken an improvement within their workplace. This improvement will be in line with

•U  nderstand some foundation Lean tools and be able to apply them in their work

NHS Unsung Hero - Louisa Deedy, speech and language therapist

the job role of the delegate and may range in complexity and size Further information is available on request. Please contact the Service Improvement and Excellence Team on email: ServiceImprovement&Excellence@rlbuht. nhs.uk or telephone 0151 706 2473 to obtain an application form.


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Other Trust news and updates

Royal multi-storey car park Security

Update

The new multi-storey car park is due to open in February in time for the start of construction of the new Royal, when much of the current staff car parking areas will be closed. All staff wishing to park on the multi-storey or Q-Park will need to apply for a car parking pass via the online application form available on the staff intranet. Each application will be tested against new criteria: 1. How you use your car for Trust business 2. The availability of public transport alternatives to you 3. Your shift patterns 4. Medical conditions you may have that mean you rely on your car

5. Whether you have carer responsibilities

Recent Incidents at the Royal There have been a number of bike thefts within the grounds of the Royal recently. None of these thefts have been from areas where staff can securely store their bikes, so we urge bike users to contact Graham Furniss on extension 3638 about using the secure bike storage facilities available.

This criteria has been established and agreed by the car-parking working group (which includes, staff-side, HR, equality and diversity and management) following feedback from staff.

Security staff apprehended a man in the act of stealing a bike from the Royal in July and with the cooperation of Merseyside Police he was arrested, charged and convicted.

Applications from staff who are blue badge holders will be accepted automatically. Other criteria will be scored to ensure all applications are measured fairly. Your line manager will be required to review and confirm your application and you may need to provide evidence in support of your application.

Help us to help you It is crucial that all security incidents are reported using the Trust’s Incident Reporting System, DATIX. With accurate reporting we can raise awareness of security incidents and ultimately prevent them from re-occurring. Improvements to the way we work will increase if we improve our reporting rates and the quality of our reporting. Without you telling us what’s going on, we are unable to do anything about it, so help us to help you

The closing date for applications is 27 December, passes will be issued in the new year.

Access Control Our sites are fitted with access control systems. Most of these take the form of magnetic locking doors which are accessed via your id card. These systems are there to protect staff and patients so please, if you see any damaged doors, report them to our estates department by phoning extension 2156. Don’t leave it for someone else to do. For access to be added to your card please take a look at the Security department intranet page.

New pricing models for staff car parking The Royal: We currently subsidises car parking for staff but this will not continue. The Trust has a duty to prioritise front line care to patients and to continue subsidising staff car parking is not a reasonable use of public funds. It is also unfair to other staff who choose to get to work by other means such as cycle or public transport, which is not subsidised. The price of staff car parking for the multistorey car park at the Royal will be increased from the current fees. Staff are being

consulted about new pricing models and these along with the fees for staff parking will be confirmed in the new year. More detail is available on the intranet.

Broadgreen Hospital: Parking charges at Broadgreen are set by Vinci Parking. From 1 December 2013, monthly fees for staff parking will be increased to £19.60 from £18.50 following an inflationary increase by Vinci Parking. This will be the first increase for almost two years.

The Trust Local Security Management Specialists (LSMS) can be contacted on extension 3999 or by e mail ian.wright@rlbuht.nhs.uk or keith.hands@rlbuht.nhs.uk.


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Other Trust news and updates

Staff and visitors discussing the plans for the new Royal

Annual General Meeting 2013 The Lord Mayor of Liverpool attended the Trust’s Annual General Meeting (AGM) on 9 September to hear how we performed in the past year and our plans for the future.

Chairman Judith Greensmith welcomed attendees in a packed lecture theatre at the Royal’s Education Centre for the first AGM to be attended by a serving Lord Mayor. She said: “It’s been a really important year for us gaining approval for the new Royal. I can’t tell you how excited we are about that.” For the first time, key points and images from the AGM were tweeted live to the Trust’s many followers on Twitter. Finance director John Graham formally presented the accounts for 2012/2013, hailing the “efforts and hard work of everyone in the Trust”. He added: “We are in an era of reduced growth. How we maintain service delivery is the biggest challenge. But we are in a really good place.”

Aidan Kehoe, chief executive speaking at the AGM

Chief executive Aidan Kehoe followed, telling attendees the Trust hopes to gain Foundation Trust status in the next six-nine months.

2014 Team brief dates announced Next year’s Team Brief sessions will take place on the following dates:

• April 4

• January 3

• July 4

• February 7

• August 8

• March 14

• September 5

• May 2 • June 6

• October 17 • November 7 • December 5 All sessions will take place at 10.15am and in the Royal and Broadgreen education centres.

Mr Kehoe also outlined the benefits the new Royal will bring to both staff and the city as a whole. He said: “We can’t underestimate the impact the new Royal will have on the city - 750 jobs during construction including at least 60% for local people; up to 5,000 jobs to be created by BioCampus. The new hospital will create a catalyst for change across the city to make it a much healthier city.” A fly-through of the new Royal was shown before Kate Clarke, our emergency medicine clinical director, gave a presentation on our performance as a major trauma centre. She said: “We are part of a major trauma collaborative with Aintree Hospital and The Walton Centre that has helped Merseyside and Cheshire become the second best place in country for trauma care.” Dr Clark reported that from April, Emergency Department consultants are available within five minutes, 24 hours a day, seven days a week. She added: “There’s been significant investment in additional staff to make sure we have a robust team. We have recently appointed the first rehabilitation consultant in Broadgreen. “Thank you to all of my colleagues for the work that is done in making trauma so successful.” A question and answer session followed before Judith Greensmith thanked everyone for attending before visitors gathered at stalls set up by departments in the foyer of the Education Centre.


19

Other Trust news and updates

Diane Wake, outgoing chief operating officer and executive nurse

Sue Redfern, outgoing deputy director of nursing

Trish ArmstrongChild, outgoing deputy director of operations

Donna McLaughlin, director of operations

Lisa Grant, chief nurse

Jill Byrne, interim director of nursing

Colin Hont, deputy director of nursing

You say goodbye, I say hello… In recent months, there have been significant changes in senior nursing. Diane Wake, chief operating officer and executive nurse left in October to take up the position of Chief Executive at Barnsley Hospital NHS Foundation Trust. Diane’s departure was preceded by that of Sue Redfern, deputy director of nursing, who took up the post of nursing director at St Helens and Knowsley Teaching Hospitals NHS Trust and Trish Armstrong-Child, who joined Royal Bolton Hospital NHS Foundation Trust as director of nursing. These were great opportunities for Diane, Sue and Trish and we wish them all every success in the future. Diane, Sue and Trish will all be remembered for the major contributions they made on improving standards of care, reducing infection and patient harm.

We have amended our current executive structure that will see Diane’s former role changing as we appoint a chief nurse and a director of operations. We have appointed Donna McLaughlin, as director of operations. Donna joins us from St Helens and Knowsley Teaching Hospitals NHS Trust, where she was director of operations and performance. Donna has been in that role since 2008 and has experience in primary care, commissioning and acute hospitals. We have also appointed a new director of nursing - Lisa Grant will join us in early 2014. Lisa is currently the director of nursing and modernisation at the Walton Centre, she has been director of nursing since 2011 and has worked in various roles, gaining extensive experience, including at Aintree, Arrowe Park and the Christie Hospital. She started her

nursing career as a staff nurse at the Royal after qualifying as a nurse in 1998. Before Lisa starts with us, we have appointed an interim director of nursing to ensure a smooth handover. Jill Byrne, currently director of nursing and patient safety at Aintree, will join us from October 21 until February 2014. Jill brings a wealth of experience with her. Jill and Lisa are supported by the appointment of Colin Hont as deputy director of nursing. Colin joins us from Lancashire Care NHS Foundation Trust, where he was deputy director of nursing. Colin had previously worked at Aintree Hospital for over ten years and had been assistant director of nursing there. A big welcome to Donna, Lisa, Jill and Colin.

Liverpool UTC students on work experience Students enrolling on healthcare courses at the new University Technical College (UTC) are getting first-hand experience of the skills needed to care for patients thanks to a unique partnership with the Royal. Around 200 work experience placements a year will be available for UTC students aged 16 and above in clinical and non-clinical areas at the Royal Liverpool University Hospital, Broadgreen Hospital and the Liverpool University Dental Hospital. Jo Marinas clinical skills training manager at the Trust said: “This is a great experience for these students who will be shadowing and observing staff in their roles. Not only

will they see how clinical staff care for patients, they will also get a real insight into the wide range of career opportunities available in healthcare both in clinical and non-clinical roles. They each receive induction training beforehand so that they understand our values and practices and are trained in cores skills such as compassionate care, infection control and patient confidentiality.”

College as a gateway to a career in nursing. I’m looking forward to starting my work experience and learning about all the different roles there are in hospitals.” Hannah Johnston, 17 said: “I want to work as a Clinical

Bio-Chemist. At the UTC we have carried out a number of experiments that university students do. I’m looking forward to seeing the work that is undertaken in the pathology laboratories at the hospital, as this is what I want to do in the future.”

Around 20 students recently had their core skills induction training ahead of starting their placements in the coming weeks. 18 year old Polly Rooke said: “I’ve always wanted to look after people and see the University Technical

UTC Students in induction at Broadgreen Hospital


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Other Trust news and updates

Our surgical team giving hope to children in Gaza A team of four clinicians from the Royal’s transplant unit, led by Abdul Hammad has carried out the first ever kidney transplants on children in Gaza, Palestine. Doctors at Shifa Hospital had never carried out kidney transplants and didn’t have the necessary drugs and equipment, so called upon Abdul’s expertise. He has now travelled to Shifa hospital in the Gaza Strip three times. Along with Adham Al Bakri, Sanjay Mehra and Professor Derek Middleton, Abdul now intends to bring hope to Gaza’s 500 dialysis patients, 60 of whom are children. One of those children, nine year old Fatma Othman was on dialysis for two months before the team from the Royal arrived, enabling her mother Marwa to donate a kidney for her transplant. Before the surgery, Abdul assured Fatma she can look forward to having a new kidney when she wakes up. Another patient, Abdel Motalib Awad, 9, has Bartter Syndrome, a defect that has caused profound deafness and kidney failure almost from birth. Without surgery, Abdel could have died within six months. But his mother, Sharifah, was able to donate her kidney. Mr Hammad said: “This little boy is a fighter. His arm was swollen from the dialysis and

Proud nursing traditions commemorated Liverpool has a proud history in nursing care – Liverpool was the first city to have district nurses, established in 1859 by William Rathbone and Liverpool was also where the first school of nursing outside London, established 150 years ago. The Royal has been instrumental in both of these services and on the 20 September, descendant of William Rathbone, Julian Rathbone, unveiled a new plaque to commemorate the first District Nursing Service as well as the first Nurse Training school to be established outside London. The event, organised by Alderman Roger Johnston (former council member) the event was attended by Lord Mayor of Liverpool Cllr Gary Millar, the Lord Lieutenant of Merseyside Dame Lorna Muirhead, the President of the Royal College of Nursing Andrea Spyropoulos, Chair of the Trust Judith Greensmith.

I was worried about the outcome. In fact, I barely slept before the operation, but it went very well. This is what we’re in the profession for, and this is why we’re in Gaza. A transplant was this child’s only chance of survival.” Abdel’s father said his son had suffered terribly with his veins from the dialysis, adding: “His whole arm had swollen up as one of his last veins had started to collapse. We’re so happy – and my wife is so proud that she’s been able to give a kidney to him.” The team from the Royal are also keen to make it possible for people to donate kidneys after they have died – something that doesn’t happen in Gaza at present. Abdul addressed the Palestinian Legislative Council, the government of the Gaza Strip, and they agreed there was no reason why organs should not be donated after death.

The life saving team from the Royal – Abdul Hammad, Sanjay Mehra and Adham Al Bakri

Abdul said: “The best treatment for kidney failure is kidney transplant. It immeasurably improves and extends the life of a patient. And the important thing is we’re helping the staff here to establish a permanent renal transplantation centre.” A team from the Shifa is due to visit the Royal soon to learn the necessary skills to carry out transplant surgery themselves.

“Highly commended” Alma recognised at national awards WRVS manager Alma Edwards was recently recognised at The National Skills Academy’s Rising Stars Award ceremony in September. Alma was “Highly commended” in the category of ‘Retail Learner of the Year’ at the awards, which celebrates and recognises talent in retail, after completing a year-long NVQ level three course in retail management. Alma has worked for the Royal voluntary service as a service manager for 15 years and has supported both paid and unpaid workers during her time with us as manager. Alma Edwards, second right, with Jane Rexworthy, Sam Malvern and Theo Paphitis

Nine year old Fatma, smiling with joy following her kidney transplant


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Fundraising

Lord Mayor hosts pink day for Linda McCartney Centre The Lord Mayor of Liverpool painted the Town Hall pink to raise money for breast cancer services at the Royal’s Linda McCartney Centre.

The Community Health Ambassador Team (CHATS) and Liverpool Community Health’s iVan were also on hand to offer advice and support to members of the public.

Lord Mayor, Councillor Gary Millar teamed up with Judith Greensmith, trust chairman and fundraisers from R Charity to organise a day of cakes, crafts and song to promote breast cancer awareness. Over £1,100 was raised for the work of the Royal’s Linda McCartney Centre.

Businesses in the city accepted a challenge to Go Pink on the same day, hosting their own fundraising events to raise money for the life-saving work done in the Linda McCartney Centre, and Liverpool Housing Trust held a dress down day and bake sale.

A ‘pink’ carpet was even rolled out to welcome guests including Merseyside Fire and Rescue Service and their pink breast cancer awareness engine for the Pink Lady: Breast Cancer Awareness Day on Monday 28 October. Lord Mayor Gary Millar said: “I’ve always kept very close to the Linda McCartney Centre at the Royal and when I was becoming Lord Mayor, I felt I had to choose the centre as one of my nominated charities.” Live singing from local choirs and comedienne Pauline Daniels kept visitors entertained while the R Charity’s fundraising team were on hand with information on the work done at the Linda McCartney Centre.

Liverpool FC legends help at cancer survivor’s fundraiser The first person in the North West to benefit from the state-of-the-art cancer fighting da Vinci Robot has raised more than £5,000 for prostate cancer research. Alan Ingham, 59, spent four-and-a-half hours in the operating theatre at the Royal in 2011 after being diagnosed with prostate cancer. Surgeons removed the prostate with the pioneering robot and he has been cancer free ever since.

Margaret Shields, a former patient and volunteer for the Linda McCartney Centre, Pauline Daniels and Radio Merseyside presenter and former patient at the centre Maureen Walsh offer cupcakes baked especially for the event

The £1.6m machine, which has since been moved to Broadgreen Hospital and been involved in about 275 operations, is used to perform complex, minimally invasive surgery on patients with prostate, bladder, kidney and colon cancers, and is controlled by a surgeon from a console. Liverpool FC legends Ian St John, George Scott, Liverpool’s first European goalscorer Gordon Wallace and Ian Ross, formed one of the teams who battled it out on the fairways of West Derby Golf Club last month. Alan said organising the golf day is his way of saying thank you to the hospital that saved his life while also raising awareness so that other men can spot the signs of prostate cancer. Alan said, “It’s 30 seconds of inconvenience to have the examination and then you’ve got the rest of your life to look forward to.” Robin Weston, consultant cancer urologist at the Trust, has conducted about 225 operations with the daVinci robot.

The Lord Mayor Gary Millar and Judith Greensmith, chairman with the Fire Services’ Pink Lady

He said: “The success of surgery using the daVinci Si robot has had a dramatic impact on the recovery for patients. 90% of patients will go home after just one day in hospital.


22 Fundraising

Rugby ace’s leap of gratitude for Royal A former rugby international was one of three daredevils who leapt from a plane to raise money for the Royal. Ex-Wales full back and current under 20s head coach Byron Hayward, who was diagnosed with eye cancer in January, kicked off a series of personal challenges by leaping from 14,000 feet at the Black Knights parachute centre in Cockerham, Lancashire in September. Byron, said: “I came up with the idea for the challenges after coming for my appointment in July. I spotted the leaflet for the skydive in the Royal. I recovered from the radiotherapy and decided I didn’t want to sit around and do nothing until my next appointment. I wanted to do something positive while I can.” Byron, who is now back working full time as head coach of Wales under 20s rugby team, paid tribute to the staff who have looked after him throughout his illness. “The care at the Royal was absolutely unbelievable, both for me and my wife,” he added. “This is just my way of giving something back. The quality and professionalism of the nurses and doctors was unbelievable. They are very, very caring people – I could never speak highly enough of them. They’re the best people in the world. I don’t call them nurses – I call them my angels.”

Loren Slade, fundraiser on her safe return

Fundraiser practiced what she preached Loren Slade from our fundraising team is used to persuading other people to do weird and wacky things to raise money for R Charity. But Loren practiced what she preached in October when she rode nearly 300 miles from Glasgow to Liverpool in just three days with eight brave men and women. Liverpool boxer Derry Matthews also got in the saddle for the R Charity. The riders were also raising money for Fazakerley 9, a charity set up by the father of James McVey - an 18-year-old apprentice electrician who died following an assault. The ‘R 9 Riders’ team set off on 18 October and made it back in time for tea on 21 October, raising more than £3,000 for the charities.

Byron Hayward skydiving for R Charity

Loren said: “It was much more difficult than I expected and the weather wasn’t kind – it was pouring with rain most of the time. There were a few occasions in the hills when it was a real struggle – but it was so satisfying to complete.

“The hardest part was the first two days, coming out of Scotland and going through the Lake District. Shap Hill was definitely the toughest – there was thunder, lightning and hailstones! “It was a great personal challenge and looking back, I thoroughly enjoyed it. It was great to see our family and friends waiting for us at the end, with the realisation that we’d completed it. It is such a worthwhile cause so knowing what good the money would do for the new hospital really spurred us on. “I’m so glad we made our £3,000 target – it will make a real difference to the new Royal Hospital appeal.” If you want to sponsor the team, please visit: http://www.sponsorme.co.uk/lorenslade/ glasgow-to-liverpool-charity-cycle.aspx or www.justgiving.com/teams/R9Riders, or if you would like to embark on a challenge of your own for the Royal’s R Charity, call Loren Slade on 0151 7063150 or email loren.slade@rlbuht.nhs.uk


23

Patient experience - to deliver a high quality patient experiance

Thank you to our staff Many of our patients and their relatives provide feedback on our services, either by writing to us, commenting on Facebook or Twitter or reviewing our services on NHS Choices. Almost all of the feedback we get is positive and here’s a selection of some of these comments from the last few months. Dental Hospital “Thank you so much to all the staff at the Liverpool University Dental Hospital for treating me with an LR7 extraction. As a very nervous patient with a background of bad experiences with various dentists I came to the Dental Hospital as a walk in patient who was in pain. The doctor gave me a consultation and had my teeth x-rayed, another doctor explained very clearly to me what treatment would need to be carried out and exactly how they would perform the surgery. The doctor managed to get me an appointment for urgent dental treatment the next week. Seven days later I had my LR7 extracted and as nervous and scared as I was, I didn’t feel a thing! The doctor and Dental nurse who carried out the procedure were highly skilled, very professional and reassured me throughout the procedure. I would recommend the Dental Hospital to anybody. All the staff and students at the hospital are a credit to the University and teaching staff.”

Broadgreen Hospital

red “I was very apprehensive as I ente ent. Ward 3 for a total knee replacem and The first nurse I met put me at ease full me give to ed tinu con f all the staf have support and the best care I could nd to seco had anywhere. This hospital is at stay my none and I can honestly say cted xpe une Broadgreen Hospital was an pleasant experience. I laughed from our morning until night with the hum staff. of ber mem y and banter from ever f! itsel They were kindness Ward My favourite member of staff was e yon ever 3’s Tea Lady, she cheered the up from the moment she entered d war the on us of room. Everyone laughed through the pain. ber of Thank you so much to every mem !” best the ly staff, you are simp

Here’s a few comments posted on Twitter and Facebook: “I was in the A&E with my father who was admitted by emergency ambulance, I would like to thank the staff of both NWAS and the Royal’s A&E staff for everything they did to care for him. The department was very busy throughout the day but we were never forgotten about and even as relatives we were looked after by the staff.” “Thank you to the Pain Team for

responding quickly to my dad! Excellent care 5b. This is what the Care Quality Commission wants to see!” “Having a lovely time at the Royal catching up with lots of people who made my treatment as good as it could be.” “My sister has had treatment with you over the past 18 months. She is so much better and looks amazing. Thank you.”

The Royal - St Paul’s Eye Research Centre “I have been fortunate in attending St Paul’s Eye Unit for a total of 19 years. I suffer from a rare eye condition which was diagnosed as a potential cancer 19 years ago and kept under observation until an operation became necessary seven years ago. Since then I have had exemplary treatment in a clinic, categorised by international specialists as within the top five in the world. Without exception, every member of the team gives 100% to their patients. At initial diagnosis each patient receives a CD with their individual diagnosis and prognosis. This is unique in my experience and invaluable in trying to understand this rare and complex disease. Some four years ago I developed complications which another centre could not diagnose, a doctor at St Paul’s instantly determined the problem and three days later I received the necessary treatment which continues today. Speed is of the essence and this clinic never fails.”


August 2012 | Issue 10

News for the members and communities of Liverpool Women’s

Inside

OCTAGON DESIGN & M A RKE T I NG LT D

Our staff are stars at Merseyside Women of the Year awards p02

Jeanette and Arthur celebrating their amazing family

And now we have five! Joyful parents pay tribute to the Hewitt Centre for IVF dream come true

• FT members’ magazines and literature • Mailing service and socio economic profiling • Annual reports, quality reports and summaries – print runs from as low as 10 copies • Advertising funded social care directories and information • Advertising funded staff magazines • Promotional items e.g. lanyards, pens, balloons, mugs etc • Ebooks

But after years of thinking they might be childless, in the last SIX years, they have had FIVE beautiful children - thanks to fertility treatment at Liverpool Women’s Hewitt Centre for Reproduction, the latest arrivals being the twins who were born on June 28, 2012. The new arrivals, Isaac and Lulu, are siblings to Millie, six, Adam, four and Matthew, two. The five are effectively “quintuplets” as all are the result of the same highly successful IVF cycle which Jeanette and Arthur had in 2005 after which Jeanette became pregnant with Millie. The remaining embryos were frozen and stored at the Hewitt Centre. Prior to that, the couple had had two

IVF treatment, the first of which was unsuccessful and the second ending in tragedy when their daughter, Hattie was stillborn in 2003 at 38 weeks, leaving them devastated and fearing they might never have a family. “We had been so thrilled. We

❛❛

“In essence the five children are quintuplets born six years apart because they were conceived on the same day” - Fertility expert Professor Charles Kingsland

❛❛

Working in partnership with the NHS

Jeanette Fardelin recently went shopping for school uniforms for the new autumn term. Seven years ago that might have seemed “the impossible dream” for Jeanette and husband Arthur who had been hoping without success for children since they were married 18 years ago.

almost got there and then it was snatched away. We just felt it wasn’t going to happen for us after Hattie,” admits Jeanette. To help them move on with life after losing Hattie, Jeanette and Arthur, who met at Liverpool’s Billy Martin’s Dance

School in 1991, went back to dancing to lift their spirits. That gave them the courage to try a third IVF which was unsuccessful - but with their fourth in 2005 they unknowingly hit the jackpot, starting off with the birth of Millie in February, 2006, 12 years after they were married.

You’re welcome! Annual Members’ Meeting, September 8th – Learn about our future plans Plus all the fun of our Open Day p03

With their remaining embryos frozen, the couple decided in 2007 to try for a sibling for Millie - and Adam was born in January, 2008. He should have been a twin but sadly his twin was lost 17 weeks into pregnancy. In February, 2010, Matthew was born to make it three. Then, last year, using their final stored embryos, Jeannette, now 42, became pregnant again with Isaac and Lulu, who were born on June 28, 2012, making theirs one of the most successful IVF treatments ever at the Hewitt Centre, the largest of its kind in Europe.

A “legend” in the care of our neonatal babies says ‘goodbye’ p04

(continued on page 2)

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

December 2013 WE CARE FOR YOU

New rehab centre ‘Blessed’ bY lOCAl VIP

GoveRnoR elections due

G5

gets its Family Room

Choose Well

this winter

News for staff, volunteers and members of Doncaster and Bassetlaw Hospitals NHS Foundation Trust

staff magazine | Autumn 2013

Hannah helps spread the word

May 2013

RD&E news

NHS Foundation Trust

NHS Trust

ISSUE 19 SUMMER 2013

Find out

what our Portering Manager has invented … See Page 11 Staff newsletter

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Every possible care has been taken to ensure that the information given in this publication is accurate. Whilst the publisher would be grateful to learn of any errors, it cannot accept any liability over and above the cost of the advertisement for loss there by caused. No reproduction by any method whatsoever of any part of this publication is permitted without written consent of the copyright owners. Octagon Design & Marketing Ltd. ©2013. Britannic Chambers, 8a Carlton Road, Worksop, Notts. S80 1PH. Tel: 01909 478822

Royal Liverpool and Broadgreen University Hospitals NHS Trust, has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does Royal Liverpool and Broadgreen University Hospitals NHS Trust endorse any of the products or services.

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p l e h d n a y a d o t Join us … e r u t u f r u o e p sha becoming a We are on our way to ! e want YOU to join us w d an t us Tr n tio da Foun mbers to help us

staff as me al people, patients and We want to recruit loc ns. develop our future pla s about how blic and staff in decision pu the , nts tie pa ed olv cial surpluses Foundation Trusts inv FTs can also retain finan . ure fut the in ed vid services should be pro hy don’t you become a direct into patient care.W est nv rei can y the ich wh ke a difference. member and help to ma

, embership or to join us m t ou ab e or m t ou d To fin bership Office. please contact our Mem Tel: 0800 694 0180 .office@rlbuht.nhs.uk Email: foundationtrust more about You can also find out ebsite: membership on our w www.rlbuht.nhs.uk

What’s at the Royal?

What’s at Broadgreen?

Shopping The mezzanine floor (1st floor, RLUH) is open 8am – 7.30pm, Monday to Friday and 10am – 6pm at weekends.

Shopping The WRVS general store is on the main corridor. It is open 8am – 5pm, Monday to Friday and 10am – 2pm at the weekend.

Shops include Delifresh, the Stock Shop, Costa Coffee (open until 4pm on weekends) and WH Smiths (open until 5pm on weekends).

Dining room Breakfast and lunch served: 7.30am - 11am and 12pm to 2pm. Hot drinks/cold food available 12pm - 5pm.

WRVS Tea and coffee bars Royal Hospital, ground floor: open 8.30am - 5pm, Monday to Thursday and 8.30am - 4pm on Fridays. Near to Outpatient Clinics.

Chapel and multi-faith prayer room Both are situated on the mezzanine floor and are open for private prayer. Church of England services are held every Sunday at 10.30am and Roman Catholic Mass every Sunday at 4pm and at 12pm on holy days.

Dental Hospital: Open 8.30am - 4pm, Monday to Friday. Linda McCartney Centre: Open Monday to Thursday, 8am - 5pm and 8am - 4pm on Fridays

Finding your way ‘Lend a hand volunteers’ will help you find your way. Contact the volunteers on ext 3170 if you need assistance.

Dining room Open 8am – 4pm for breakfast, lunch and supper: 8am-11am; 12pm-2.30pm. Hot drinks and snacks available 2.30pm-5pm

and every Wednesday at 12.30pm. Roman Catholic Mass takes place every Sunday at 11am and at 11.30am Monday to Friday aswell as at 11.30am on Holy Days. Radio Broadgreen Radio Broadgreen broadcasts to all bedsides. Requests can be made on 252 0919 or ext 6588.

Chapel Located off the surgical corridor, the Chapel is open for private prayer. Church of England services are every Sunday at 4.15pm

Got something for the next InSight? Got something for the next Insight? The next edition is out in February. If you have something to share or some news you want to tell people please email communications@rlbuht.nhs.uk or call 0151 706 5489 by 24 Janurary.

Designed & Published by Octagon Design & Marketing Ltd, Britannic Chambers, 8a Carlton Road, Worksop, Notts. S80 1PH Tel: 01909 478822


Insight Liverpool November 2013