Insight Royal Liverpool Winter 2017

Winter 2017

Exclusive:

R Charity reveal the appeal total so far

www.rlbuht.nhs.uk

Royal artwork Creative designs begin to transform new hospital

Digital healthcare Awarded for innovative digital work Opt-out organ donation Prime Minister visits our Transplant Unit

2 World class workforce

Thank you for your support

Our fabulous staff We love to recognise our staff and the amazing work they do around our hospitals, so each month we celebrate a nominated team, employee or volunteer.

Here are our latest award-winners that have gone ‘above and beyond’ and provided our patients with an excellent level of care.

Employee of the Month

In November, we revealed that we’ve raised a fantastic £6.8million of our £10million Appeal.

Thank you to everyone who has swam, ran, walked, baked or jumped for R Charity in recent years; your unbelievable support will enable our patients to have access to some of the best healthcare facilities in the country.

Areas to benefit from the appeal include breast cancer services, with funds being used to purchase a state of the art 3D mammography machine so that patients can begin treatment earlier and ultimately increase their chance of survival.

While the money raised so far is impressive, there is still work to be done.

Please get in touch with our fundraisers to find out what you can do to support R Charity and give Liverpool a hospital to be proud of.

April: Gerry Gervan, nurse practitioner

May: Susan Hessey, health care assistant

June: Jenna Bardsley, physiotherapist

July: Sheryl Henry, nurse practitioner

Team of the Month

April: Acute Cardiac Unit

May: St Paul’s Theatres

June: High Dependency Unit

July: Ward 2 Broadgreen

August: Outpatient Parenteral Antimicrobial Therapy

September: Ward 8Y

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Fundraising

R Charity’s appeal reveal What’s On In November, R Charity celebrated a significant milestone in the journey to raising £10 million for the new Royal.

R Charity’s aim is to raise enough money to purchase equipment which is not currently provided as standard by the NHS.

A grand total of £6.8millon has been reached with the help of fundraisers including staff, patients, volunteers and dedicated supporters.

Some of the areas set to benefit from the £10m appeal include breast cancer services; the funds raised will allow the Trust to purchase a state of the art 3D mammography machine. This will help diagnose cancers earlier so that patients can begin treatment quicker and ultimately increase their chance of survival.

The funds will enable the new Royal to provide services beyond the NHS promise of care to create an outstanding patient experience in a world class hospital.

To mark this momentous achievement, staff throughout the hospital joined in by wearing purple, and took part in fundraising activities.

We had performances from three local school choirs, the Royal Liverpool and Broadgreen staff choir and soloist Rhian-Carys Jones.

Lauren Davies, interim head of fundraising for R Charity said: “I am delighted to announce that we have raised a staggering £6.8milllion for the new Royal as part of the £10m appeal. What an incredible achievement! We couldn’t have done it without all our supporters. Staff, patients and local people have all taken part in various activities since the appeal began.

“A huge thank you to our cyclists, swimmers, marathon runners and those businesses that come to our events and select us as their charity of the year.”

The critical care unit in the new hospital has the latest digital technology enabling staff to monitor and respond to patient needs.

The £10m appeal will help provide reclining furniture to improve comfort for relatives and visitors while they are visiting loved ones in the critical care unit, often for long periods of time.

Lauren added: “We have just over £3million still to raise, your support will enable us to provide equipment, services and diagnostic facilities which go beyond the NHS promise of care. By enhancing the services we currently provide we can ensure that our new hospital will provide world class health care for generations to come.”

To get involved or for more information you can contact the team on 0151 706 3153, email fundraising@rlbuht.nhs.uk or visit www.rlbuht.nhs.uk/r-charity

Christmas carol concert Join us on Tuesday 12 December for our annual Christmas carol concert at Liverpool Anglican Cathedral.

The event, hosted by Roger Phillips, starts at 7.30pm and will be a magical evening of carols and special performances.

Tickets start from £8.

For event details call 0151 706 3150, email fundraising@rlbuht.nhs.uk or visit the fundraising office in the Royal’s foyer.

Charity Ball a huge success In September we hosted our fabulous R Charity Ball at Liverpool Football Club which raised a staggering £62,000 towards the £10m R Charity appeal for the new Royal!

The prestigious event, sponsored by ITS Technology group, proved to be a huge success with the 260 guests that enjoyed an evening of food and entertainment, as well as a raffle and a charity auction that alone raised a remarkable £9,000.

Weekly lottery Play our weekly lottery for a chance to win an amazing £25,000 while also raising money for R Charity.

For every £1 you play 50p will go towards our £10 million appeal for the new Royal.

These funds will help us improve the experience of our patients and visitors while at our new hospital.

Visit www.unitylottery.co.uk/charity/ display/r-charity or call R Charity on 0151 706 3150 for details.

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Improving the quality of life for our patients

Irene Jones, Sylvia Roby, John Roby, Christina Darling and William Swindlehurst are part of our Pancreatic Cancer Buddy Service.

Buddies give pancreatic cancer patients support This year we have set up an important new befriending programme called the Pancreatic Cancer Buddy Service, which aims to support our patients.

It was organised by Macmillan clinical nurse specialist Phil Whelan along with patients that have been through the same type of surgery.

Phil said: “This is the first time this service has been offered in the UK for pancreatic cancer patients, so it’s great for the hospital and our patients to have this buddy system available. It started in September 2017 and it’s a befriending service for patients who are going to have surgery for pancreatic or bile duct cancer.”

As part of the project we now have five Trust volunteers that have all been through similar surgery and come into the hospital to meet pre-operative and post-operative pancreatic cancer patients.

Phil added: “The idea stemmed from pancreas cancer support groups that occur every few months in the Trust, but some of our patients wanted to offer support to other patients in a more friendly, personal way.

“The surgery our pancreatic cancer patients go through can be six to 12 hours long and then chemotherapy in the months after, so having someone that has been through that experience is a unique way of supporting our patients.

“It gives them hope speaking to someone in a similar situation. Hearing about what it will feel like, what the chemo is like and what dietary changes are needed is much easier to understand coming from a patient rather than a doctor.”

After being seen by an anaesthetist and a dietician, the patients meet ‘buddies’ in a pre-operative clinic, facilitated by Phil, they then have time to chat together before a feedback and support session.

They can also meet with pre-chemo patients.

The service has had really good feedback from our patients with them saying “they answered questions that I didn’t even know I wanted to ask, it was great and put my mind at rest” and “the pre-op package is great, adding the buddy into that is such a positive initiative. The team have been great but meeting someone who has been though what I am going to have, really makes me feel positive.”

Bishop of Liverpool gets checked for HIV Testing Week The Bishop of Liverpool is encouraging more people to “know their HIV status” after taking an HIV test to raise awareness of National HIV Testing Week.

Bishop Paul Bayes took the quick fingerprick test to raise awareness of HIV and to encourage more people to take part in regular HIV testing.

Figures show the number of people with HIV across Merseyside has increased during the last 12 years. In 2004, there were approximately 250 cases in Merseyside but by 2016 this figure had raised to more than 1,041 patients.

Bishop Paul took the HIV test at Liverpool-based charity Sahir House, which provides care, support and practical assistance to people with HIV. Bishop Paul Bayes said: “When I was asked to take part in this campaign, I was very glad to do so. I took the test because I believe that it will help our health as a nation if millions more people knew their HIV status for sure. Given the history of fear and stigma around HIV, I understand that people may be reluctant to be tested - but knowledge is the best way to destroy fear.

“Taking the test is easy and free, with the results back in minutes. It should become normal for all of us. The staff who dealt with me were lovely and completely put me at my ease. So if you have been putting this off I say: Don’t

worry. Go, take the test, become sure of your HIV status, and face the future with confidence.”

HIV tests take just a few minutes to complete and can be done at the Royal Liverpool University Hospital’s Sexual Health clinic and other centres across Merseyside.

Mark Lawton, consultant in sexual health and HIV said: “Knowing your HIV status helps you and others remain healthy. Testing is free and completely confidential. Rapid testing is also available which gives a result in just 20 minutes.

“Of the 6,095 people diagnosed with HIV in 2015, 39% were diagnosed at a late stage of the infection. People who are undiagnosed or diagnosed late have poorer health outcomes and are more likely to die prematurely, they are also more likely to pass on the infection to others.”

Tommy McILravey, chief executive officer of Sahir House, said: “Dozens of people still die each year of HIV related illness.

These deaths are preventable as there is treatment available to keep HIV in check. The sad thing is that the stigma associated with the virus stops people from finding out early enough. When high profile people like the Bishop take an HIV test it sends a powerful message.

Knowing your HIV status should be one more thing you get checked regularly.”

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Improving the quality of life for our patients

Prime Minister visits our Transplant Unit Prime Minister Theresa May said she was “humbled by the bravery of those who have had their lives transformed through organ donation”, after visiting the Royal’s Renal Transplant Unit.

The Prime Minister and Health Secretary Jeremey Hunt visited the Royal to hear more about organ donation after announcing plans to move to an opt-out donation system.

They met patients who have benefited from organ donation, including Holly Shaw who received her second transplant one year ago.

Holly, 30, from Warrington, said: “Theresa May and Jeremy Hunt were very interested in hearing how transplants had changed our lives.

“If the opt-out system means there are more organs available that’s got to be a good thing and right now the fact people are talking about it is great – it’s not an easy subject. Even with a change in the law relatives can still over-ride the decision, so it’s important people talk to their families and make sure they know what their wishes are.”

Over the last year, 93 people in Merseyside have received lifesaving or life changing

Theresa May and Jeremy Hunt hear how transplants have changed the lives of former Royal patients transplants. There are currently 322 patients on the Liverpool transplant waiting list.

transformed their lives and therefore how important it is for people to be willing to donate organs.”

Speaking to reporters, the Prime Minister said: “It’s great to be here at the Royal and actually meet people who have benefited from kidney transplants and what they have told me about is how that has actually

During the visit, Jeremy Hunt met staff to talk about patient safety and praised the Trust for our ‘Good’ CQC rating and the number of staff protecting their patients and families by getting the flu jab.

It’s time to talk about organ donation Volunteer Paul Dixon has now signed up more than 9,000 people to the organ donation register in just two years.

Some of the people who have been affected by organ donation took to the Trust’s social media channels to explain what organ donation means to them.

The former Jaguar Land Rover worker, who now uses his time to raise awareness of the organ donation register, recruited more than 250 people during Organ Donation Week to take him to the impressive figure.

Paul spent Organ Donation Week in the Royal’s foyer, talking to staff, patients, and visitors about the impact organ donation can have.

He said: “It was a very positive week where I was able to talk to a lot of people about the importance of organ donation, the need to tell your family your decision and the difference it can make.”

The message from Organ Donation Week this year focussed on the importance of discussing your decision to donate your organs with your loved ones.

NHS Blood and Transplant surveys show more than 80% of people support organ donation but only around 49% of people have ever talked about it.

Peter Hampshire, the Royal’s organ donation lead, said: “That chat might be the next time you sit down for a meal, when you are shopping or working, or when you are just driving in the car.

“If you want to be a donor, your family’s support is still needed for donation to go ahead, even if you are on the NHS Organ Donor Register.”

Over the last year, 93 people in Merseyside have received lifesaving or life changing transplants. However hundreds of transplants are being missed around the country every year because families don’t know what their relative wanted.

To sign up to the register or to find out more, visit www.organdonation.nhs.uk

Holly Shaw, who received a kidney from her mum, said: “Receiving a kidney meant I could marry my fiancé, Aidan, and get back to work.”

Peter Brown, a charge nurse at the Royal, said: “To me, organ donation means life. It means being around to provide for my family and see my children grow up. It means everything to me.”

Helen Crowther, from Runcorn, who donated a kidney to her best friend, said: “I was able to help my best friend. I think everyone would want an opportunity to do something for someone they care about.”

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World class workforce

The Roald Dahl Centre’s TTP team took home the Patients’ Choice Award

Our winners for the 2017 Make a Difference Awards More than 500 members of staff came to this year’s Make a Difference Awards, making it a special night at the ACC Liverpool.

In his welcome speech Aidan Kehoe, chief executive, said: “As you know, across the NHS, we are currently working in particularly challenging circumstances. It makes me extremely proud that, despite these challenges, you continue to deliver and improve the services we provide to our patients. I’m incredibly proud of you all.

Divisional Star Award for unscheduled care: New Starter Dialysis team Divisional Star Award for Liverpool Clinical Laboratories: Cytology and Virology teams Divisional Star Award for corporate teams: E-Sepsis project team

involved with the event and entered their colleagues into the awards this year.

“Seeing and hearing the work you do is always extremely humbling. Each year I really look forward to reading the nominations for these awards as they only confirm the care, compassion and innovation that I see right across our hospitals on a daily basis. I would like to thank you all for the work you do.”

The 12 award winners were:

Well done to all the winners, those who were shortlisted and everyone who got

Divisional Star Award for scheduled care: Virtual Fracture Clinic

Patients’ Choice Award: Roald Dahl Centre’s TTP team R Staff Unsung Hero Award: Alex McCrudden, lean practitioner

QEP and Innovation Award: New Starter Dialysis team Research and Development Award: AME Oncology team Education and Wellbeing Award: Diabetes team Volunteer of the Year: Tony Bentley Employee of the Year: Jenny Hughes, house keeper Team of the Year: Acute Medical Unit

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World class workforce

Unsung heroes: CFS therapy team Chronic fatigue syndrome (CFS) is a long-term illness with a wide range of symptoms. The most common symptom is extreme tiredness and, while it is a condition that is being more widely recognised, those that live with it can often struggle to be diagnosed due to a lack of visible symptoms.

The CFS Therapy Service at Broadgreen provide specialist care of the diagnosis and treatment of CFS, taking referrals from all over the North West, North Wales and the Isle of Man. The service provides an innovative group rehabilitation programme and, due to the unique nature of each patient’s condition, one-to-one individualised therapy.

The therapy service is made up of a specialist nurse and nurse researcher, specialist occupational therapists and a clinical psychologist along with their wonderful administration team.

The therapy and administrative team are particularly resourceful dealing with over 800 referrals each year.

Deb Roberts (second from left) and the CFS team with patient representatives and The South Sefton Support ME Group.

They run a successful patient engagement forum, relaxation and mindful drawing workshops and are currently displaying their second patient-led art project to capture the experience of the condition from the patient perspective.

The regular coffee club all provide support

that patients report is so valuable when living with such an uncertain and misunderstood long term health condition.

Patients describe how the team have worked on the department has produced a calm, welcoming and safe environment in which they feel safe, physically and emotionally.

Life-saving action at 30,000ft A Royal nurse called upon her training to save a man’s life as she was flying home from her holiday.

Emma Channing was mid-way over the Atlantic Ocean when the pilot announced a fellow passenger was seriously ill and called for any qualified doctors or nurses to help.

When 23-year-old Emma stepped forward, she realised the man was showing all the signs of sepsis.

Emma told the Liverpool Echo: “I was dozing off and watching a movie when an announcement came over the tannoy.

“A voice said ‘we have a medical situation are there any qualified doctors or nurses on board?’

“Well they put out the announcement and it turned out I was the only one, so they took me to this man who was having breathing difficulties.

“You could tell immediately that it was serious. Even though he had breathing equipment on his lips his face had turned blue.”

Emma then advised the pilots to land at the nearest possible airport to give the passenger the best chances of survival.

“I said to him that if this happened in a hospital we would begin treatment within 60 minutes and that every hour we delayed would increase the chance that the patient would die,” said Emma.

Sepsis is organ failure caused by the body’s response to infection Dr Emmanuel Nsutebu, consultant in infectious diseases and clinical lead for sepsis at the Trust, said: “It’s fantastic that Emma was able to use

her sepsis training to help this man. We have done a great deal of work throughout the Trust to improve recognition and treatment of the illness.

“Sepsis is an extremely serious illness which is caused by your body’s response to an infection. It’s extremely common and results in more than 37,000 deaths every year in the UK. It’s vital that antibiotics are administered for sepsis within one hour.”

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World class workforce

Double awardwinners The Trust picked up two awards at the recent Responsible Business Awards 2017 for the local chambers of commerce.

In front of 320 local business leaders at the Liverpool and Sefton Chamber Responsible Business Awards, the Trust collected awards for Empowering People and the Local Hero Award.

This was a remarkable achievement, as only five awards were given out at the event.

The Empowering People Award was collected by Karen Mattson and Annette Pollitt, for the work that they have undertaken on a number of projects.

These projects included supporting widening participation through work with LCL, a traineeship that prepares applicants from less advantaged backgrounds for entry into healthcare scientist support roles. It consists of a 13-week course delivered in-house at the Liverpool Clinical Laboratories and five weeks of sessions delivered

by Wirral Metropolitan College.

Participants also undertake eight weeks of lab work experience.

We also run a work exposure programme for young people from the Liverpool Life Sciences UTC that over 300 young people have attended.

Plus we offer other work experience placements and apprenticeships to local people.

The Local Hero Award went to Paul Dixon, a volunteer in the Trust, who has tirelessly worked to encourage more than 9,000 people to sign the Organ Donor Register and who has even donated his own kidney.

One-stop health check for the homeless Dr Tici Criddle and staff at the Liverpool Diabetic Eye Screening Programme are working with the Brownlow Group Practice to reach local homeless people with diabetes.

Homeless people often have poorly controlled diabetes which puts them at a higher risk of developing diabetic retinopathy and vision loss. Plus, due to their circumstances they’re often hard to contact and so very few homeless people turn up for health screening sessions.

It was felt that visiting a GP surgery, rather than a hospital, would be less intimidating for potential patients, especially if that surgery already had a track record of working with homeless people.

The St Paul’s Eye Unit team is now working with Ian Harrison, who looks after local homeless people at the Brownlow Practice, and Juliette Palmer, the diabetic specialist nurse at the surgery. The intention is to create a one-stop shop where people can have their eyes screened by an ophthalmologist, their feet checked by a podiatrist and their diabetes monitored by a nurse, all in one visit.

A screening clinic would usually involve a patient being screened and then recalled if a problem was revealed, but as homeless people would be unlikely to return for their

results St Paul’s team made sure that their retinas could be analysed straight away at the clinic.

The clinic had great results with 66% of homeless people attending, which was a lot higher than expected and really encouraging for the team. Those who attended included people who had repeatedly failed to attend appointments and those who had never even made an appointment, which is also considered a real success. The intention is to roll-out this model to other surgeries in the group practice.

Dr Tici said: “The success of the clinic was really down to team work, working with a surgery that has experience of reaching homeless people, and the joined up service we were able to provide. This model can definitely work in other surgeries.

“It was also really useful to be able to show patients the photos of the back of their eyes. It always has a big impact on people as they can see the changes that have already occurred, and often persuades them to take screening more seriously.”

This isn’t the only work Tici and her staff are doing with local hard to reach groups.

They’ve also been visiting prisoners in HM Prison Liverpool and HMP Altcourse for several years offering the same service with similarly impressive results.

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World class workforce

Improved diabetes service for young adults In October the Royal’s diabetes team won a prestigious Quality in Care Diabetes 2017 national award thanks to innovative ideas that improved the young adult diabetes clinic.

The team were awarded in the ‘Diabetes Team Initiative of the Year’ category, for their project entitled ‘Engaging to Improve: Outcomes of the Young Adult Clinic Restructure’.

The project, which was started in 2015 by our Young Adult Diabetes Team, included innovative ideas and getting young people to give us feedback through social media.

Changes to the services included a clinic restructure and structured care pathway, flexible drop-in sessions and pre-clinic questionnaires. We also helped establish the first peer-support group for Type 1 diabetes in Liverpool (LIVT1D), with a view to engage, support and empower young adults in managing their diabetes.

At the end of 2016 we had a significantly

lower non-attendance rate, quadrupled rates of patients achieving NICE recommended targets, a reduction in diabetes related admissions, very positive user satisfaction as well as financial gains and savings.

Additionally, the new peer-support group brought together a significant number of people with Type-1 diabetes in Liverpool together for encouragement and empowerment. Educational meetings that we set up resulted in excellent feedback and engagement with the clinical team.

Dr Reza Zaidi, consultant diabetologist and clinical lead for the Young Adult and Transitional Diabetes Service, who led the project, said: “We are absolutely honoured to have won this prestigious award, which is a testament to the hard work and innovative

thinking by every member of the team.

“Most importantly, we made sure we listened and implemented everything that was asked by young people with diabetes. We are grateful for their support and innovative ideas, more than anything else.”

The Quality in Care Diabetes 2017 Award is endorsed by every diabetes organisation in the UK, including Diabetes UK. The judges highlighted the brilliant use of social media in bringing young people with diabetes closer and were also impressed by the fantastic feedback and outcomes.

The project is also being showcased at the International Diabetes Federation Congress 2017 in Abu-Dhabi, UAE, in December 2017.

Setting the pace Our Pacemaker Team have been awarded ‘Showcasing Best Practice in AF’ award for their project that looks at a patient’s use of anticoagulant medicines to reduce their risk of stroke.

AF or atrial fibrillation is the most common heart rhythm disorder affecting more than 16 million people around the world. Every 15 seconds someone suffers an AF-related stroke, yet most can be prevented using appropriate anticoagulation therapy.

Discussing the project that led to the team winning at the AF Association Healthcare Pioneers 2018 Awards, Christopher Stanton, Pacing Services Lead at the Royal, said: “We developed this proforma in order to create a relationship between the hospital and community healthcare professionals to ensure our patients are appropriately assessed and informed when reaching a decision about the use of anticoagulant medicines to reduce their risk of stroke.

“Each proforma asks the community

healthcare professional, usually the GP, to calculate the patient stroke risk vs bleeding risk in order to confirm clinical indication for anticoagulation.

“This supports NICE guidance and aids healthcare professionals’ support the person with AF weigh up the possible benefits, risks, advantages and disadvantages of the treatment options available to them. It also is able to support patients in a specialised clinic in order to streamline their care and tailor the treatment to suit their specific need.”

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World class workforce

Life-threatening infection from a fly bite A Wirral man is thanking the staff who saved him after nearly dying from a fly bite while on holiday.

Mark Russell was on holiday in Spain in 2014 when he contracted a life-threatening infection from a sand-fly bite.

Although he didn’t realise he’d been bitten, Mark had been infected by a rare parasitic disease which doctors were initially unable to diagnose.

After doctors were able to work out what Mark was suffering from, the 46-year-old from Bromborough was transferred to Liverpool where a team of specialists from the Royal and Liverpool School of Tropical Medicine were waiting for him.

Thanking the doctors that saved him, Mark told ITV News: “It has been a horrible road; I thought I was going to die at one stage because nobody knew what was wrong with me. My family were worried to death.

“It hasn’t put me off travelling, but I would say if you do feel unwell while you’re away, like I did, get it check out quickly by the professionals. If I didn’t do that, then I wouldn’t be here today.”

The disease, which is rare in Spain, is more common in South East Asia and Brazil, but researchers at LSTM are finding ways to control and prevent it.

Nick Beeching, consultant in tropical and infectious diseases, said: “Mark was not well. He had lost several stone and was very pale. This is a life-threatening condition but, thankfully, it’s a treatable condition so we knew what we had to do.

If it had been left untreated then he would have slowly declined.”

£4.7M award for Zika virus vaccine trial The Royal’s Clinical Research Unit is part of a major new collaborative project to develop a Zika virus vaccine that is suitable for use in pregnancy.

Supported by a £4.7million grant from Innovate UK and led by the University of Liverpool, the new project aims to take two new vaccine candidates through to a clinical trial in humans within the next three years.

Pregnant women continue to be the population at highest risk of a Zika virus infection as the virus can cause severe foetal birth defects. However, no approved vaccine or treatment is currently available.

Alongside collaborators from the University of Manchester, Liverpool School of Tropical Medicine, Public Health England and industry, the researchers plan to confirm the safety of two new vaccine candidates,

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infectious diseases around the globe.

Copyright of McCoy Wynne based on a safe derivative of a pre-existing smallpox vaccine, before moving into Phase 1 first-in-human studies.

Project lead Professor Neil French, director of the centre for global vaccine research at the University of Liverpool and honorary consultant in infectious diseases at the Trust, said: “Infection research in Liverpool is world leading and we are focused on delivering life changing vaccines and treatments for the most important

“Although the current outbreak has slowed, there remains a significant risk of foetal abnormality when pregnant mothers become infected, and the changing climate raises the possibility of major epidemics occurring in previously unaffected parts of the world. A ready to use vaccine would dramatically reduce the threat that we face from Zika.”

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Developing a sustainable health system

A digital revolution in health care Coming to hundreds Combining the medical expertise of screens near you of our clinical teams with the latest digital innovations is essential so we can provide world-class healthcare to our patients.

Across the new Royal and Broadgreen there will be hundreds of new screens with rolling updates allowing for clear presentation of information both to patients and healthcare professionals.

The Digital Liverpool programme has seen our IT teams, while working alongside clinicians, develop a range of initiatives that are making a significant differences to the front line care our patients experience. observations of patients.

Key technology in our hospitals include: • E-sepsis programme: We’ve had successful results by screening patients using our e-sepsis programme. We have seen patients with sepsis getting antibiotics within one hour increase to 66% in the Emergency Department and 56% on the wards, and cardiac arrests reduced by 46%.

• Whiteboard system: Our ‘admission, discharge and transfer’ Whiteboard is used on every ward including our emergency floor and it allows our staff to have a real time view of where patients are as well as clinical information.

• Patient Electronic Notes System (PENS): An in-house developed electronic clinical record that brings together medical, nursing and Allied Health Professional clinical notes in the one place for the first time, reducing duplication and improving communication.

• Bedside e-observations: A jointly designed clinical and digital innovation to actively monitor bedside

In addition to this, we are planning to introduce an exciting joint project between the Royal Liverpool and Broadgreen, Aintree University Hospital and Liverpool Women’s Hospital for a Liverpool Electronic Patient Record (EPR) system that will allow patient information to be shared between the three trusts.

Dan Milman, the Liverpool EPR programme lead says: “This EPR project will comprise one of the largest single patient record acute systems in the country, with clinical service staff having the ability to share and collaborate through a single record for the benefit of patient care in this city.

“It will transform the way we collate and use patient information, success is based on our engagement with staff and the understanding and adopting the necessary change in the way they work.”

To find out more about the Digital Liverpool programme and the way it is helping transform our city’s healthcare, go online and visit bit.ly/DigiLpool

The screens will include health messages, such as who should get the flu jab, as well as practical advice and information about the hospital and services available.

Currently there are large numbers of posters meaning key information can be hard to find, so we’ve already started to introduce digital signage in Broadgreen, the Dental hospital and in the canteen at the Royal.

The Trust’s aim is to become a paper-free, digital-first hospital when we move into the new Royal so we won’t be using paper posters, everything will be clear, up-todate information on easy-to-view screens.

They will also be able to support targeted information depending on the screen location and potential demographic of the service users in any area, for example in the dental hospital there will be messages about mouth care and oral hygiene.

In the new Royal alone there will be 1,589 display screens including patient information screens and TVs within the single bedrooms. The display screens within the patient bedrooms will enable clinicians to share diagnostic results, personalised health information and aftercare advice for patients.

Anyone who wants their messages put across in the Trust can pass the information onto the digital signage team who can not only relay that information but can digitally display it in the areas where it is the most effective.

Contact communications@rlbuht.nhs.uk for details.

Trust scoops top healthcare IT award The Trust was awarded ‘Best Global Digital Exemplar’ by the e-Health Insider (ehi) Awards, for our innovative digital work in health care that improves patient care.

We were also finalists in other categories including ‘Best System or Initiative Adoption’ for e-sepsis, which was recently praised by the Secretary of State for Health at the NHS Health and Care Innovation Expo.

In addition our chief information officer, David Walliker was also a finalist for ‘Chief Information Officer of the Year’.

The Digital Liverpool programme aims to transform digital care for staff and patients, building significant digital investment and

capability across the city. The initiatives will also enable the new Royal to become a ‘digital first’ hospital.

David said: “Winning best Global Digital Exemplar is a fantastic achievement, for all three trusts and for Liverpool. I am proud that our staff are being recognised for the fantastic digital work that is taking shape in Liverpool.

“The achievements are a testament to the hard work and commitment of our staff and the creative ideas being shared within the organisations to improve patient care.

A brilliant example of this is the innovative work around e-sepsis, which is helping us to keep our patients safe. E-Sepsis uses electronic systems and advanced technology to alert teams of the dangerous symptoms

of sepsis, which when identified early can save lives.”

The annual awards ceremony is the UK’s only event dedicated to recognising innovation and achievements in the healthcare IT industry.

Representatives for Digital Liverpool collect their ehi award for Best Global Digital Exemplar in October 2017

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Developing a sustainable health system

Colour and culture in the new Royal The installation of unique artwork into the new Royal has now begun and while it looks impressive it also brings a range of health benefits for patients, visitors and staff.

Research from the All-Party Parliamentary Group on Arts, Health and Wellbeing suggests art can help people recover faster, experience a better quality of life and improve wellbeing, plus it can also help reduce anxiety and stress for staff.

The Creative Health report suggests access to green space and natural light also improves our wellbeing and speeds our recovery from illness, and in the new Royal there are garden areas as well as natural light flooding into the bedrooms and main foyer.

The most recent art installation is the Tribute sculpture from Luke Jerram. People can enter this tower-like piece and read quotes from patients and staff about the personal impact of organ and tissue donation. The mirrored floor creates a sense of infinity and pays tribute to the gift of life.

It was funded through a partnership between the Donor Committee and The Renal Dialysis Charity. Luke Jerram’s work highlights the importance of organ and tissue donation and the role of dialysis for patients with kidney failure.

The West Courtyard of the new Royal has seen mosaic seating installed by international renowned mosaic artist Emma Biggs.

She has based the specially created designs for the mosaics on Liverpool’s long trade links with China and the fabric designs that were influenced by Chinese art and a love of nature. The seating adds a beautiful series of coloured areas within the planting in the West Courtyard that our patients and visitors can enjoy.

Additionally, glass artist Alex Beleschenko is providing a distinctive visual link between both the north and south main entrances to the hospital with bold and memorable glass installations.

Before starting his bespoke pieces Alex visited the area for inspiration and looked at the vibrancy of Liverpool, its music history and diverse cultures.

Alex Beleschenko’s glass art work at the new Royal entrance.

Taking influences from the modern design of the hospital and Liverpool’s rich culture, Alex’s art is full of colour to provide an uplifting welcome to the hospital, and create an interest when seen from all angles within the building.

13

Developing a sustainable health system

How would you say goodbye?

The Royal has served us, and you, well for the last 39 years but it’ll soon be time to say goodbye to this wonderful hospital.

Above and bottom-right, Luke Jerram’s Tribute sculpture and below-left Emma Biggs’ mosaic work.

It’s a hospital that carries so many memories for hundreds of people in the city, and beyond, so we want you to share with us the special times you’ve had at the Royal.

Whether you’ve been a patient and had treatment with us or you visited a friend or family member, you’ve worked here or you’re a member of staff, get in touch and send us your photos, stories and maybe even a quick ‘selfie’ video and tell us what you love about the Royal.

We also want to know how you would like us to say goodbye to the Royal, let us know your ideas!

Although it will be sad to see the Royal go, remember our amazing nurses, doctors and teams of staff will be moving into the new hospital too. So, there will be excellent health care in world-class state-of-the-art clinical surroundings!

Something our city should be proud of!

Email your memories to: communications@rlbuht.nhs.uk with Goodbye Royal in the subject box.

An essential staff guide to the new Royal Staff across the Trust will be able to find out everything they need to know about moving into the new Royal in a new interactive guide.

The staff handbook will launch before Christmas, giving staff the opportunity to find out what they need to do during the move, how things will work once they’re in the new hospital and get an exclusive look at departments across the new hospital.

As well as reading about the new Royal, staff will be able to watch a series of videos about their new work environment by clicking on the video icon.

The handbook will include detailed information on a whole range of both new innovations, such as digital signage, Self-Check-in and flow management technology, and improvements to existing facilities such as staff rest and change areas on every floor, patient and visitor information centres and external courtyard gardens.

Karen Green-Wilson, development manager, said: “We wanted the handbook to be as interactive as possible so our staff can get vital information in a number of ways.

“As well as giving our staff the information they’ll need for moving into the new hospital, staff will also have a first-look at many areas of the hospital by clicking on the video links as they read through the online guide.”

When the new Royal opens in 2018 it will be the largest all single-bedroom hospital in England.

The state-of-the-art hospital will offer the very latest treatments and technologies, while providing patients with the highest standards of comfort, privacy and dignity.

14

Exceptional patient experience

Would you like to make a difference?

We are looking to recruit a further 250 ward volunteers to complement and enhance the compassionate patient-centred care delivered by our clinical teams.

Our volunteers provide a wide range of valuable services across the Royal and Broadgreen. Spending time talking to patients, making them laugh, listening to their stories, helping them find their way or supporting them through difficult times can all make a real difference to our patients and their families.

Requirements; • Aged over 18 years • Can spare a minimum of three hours a week?

• Can you volunteer for at least six months?

If you would like to volunteer then call 0151 706 3170, email volunteer1@rlbuht. nhs.uk or apply online, the first week of every month at jobs.rlbuht.nhs.uk.

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.

This allows us to monitor the delivery of ouor 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.

Patient Experience and Quality All Cancers: 31-day wait Diagnosis to first treatment All Cancers: 31-day wait for second Surgery or subsequent treatment Anti cancer drug treatments All Cancers: 62-day wait for first treatment Referral to treatment waiting times

Cancer: two week waits Accident & Emergency Patient Surveys

MRSA and Clostridium Difficile

Reds at the Royal Patients on Ward 7Y and 10Z had a couple of special visitors brighten up their day in November.

LFC chaplain Bill Bygrove and the wonderful Margaret Aspinall spent time talking to each patient on the ward and brought a smile to so many with their visit.

Bill got everyone clapping and singing along as he played guitar and serenaded patients with classic songs. There was plenty of football talk and even some blues banter with Everton supporters. Staff joined in a little song or two which really gave a boost to the ward.

They brought gifts along and handed out football shirts and signed photos. Plus, Bill and Margaret took the time offer lovely words of hope and moments of support to our patients.

● ●

Falls

MRSA VTE Assessments Hospital Standardised Mortality Ratio (HSMR) Risk adjusted mortality - all diagnoses Reduction in falls

● ● ● ● ●

Pressure ulcers

Grade 2 or above pressure ulcers rate

●

Grade 3 or above pressure ulcers rate Productivity 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 rate Finance Financial Risk Rating

●

Venous Thromboembolism (VTE) Mortality

Productivity indicators

May Martin receiving a volunteer of the month award for her contribution to the Trust.

Urgent GP referral to treatment Screening service referral Admitted Non-admitted Incomplete Urgent suspected cancer referrals Breast symptomatic (not suspected cancer) % patients waited over 4 hours To increase the number of patients who rate their experience as good or excellent Patient Safety Clostridium Difficile

● ● ● ● ● ● ● ● ● ● ●

Sickness absence Financial Performance

● ● ● ● ● ● ●

15

Fundraising

Thanks to R supporters We have some amazing fundraisers we would like to say a huge thank you to…

Thank you to our Scouse 5k runners that completed a fantastic challenge around the city for R Charity!

Paul McMillan, from our IT team, ran 13.1 miles in the Great Scottish Run and raised £528 for the breast unit!

Congratulations to Hilary, Melissa and Kate on completing the Royal Parks half marathon and raising an amazing £1,739.74!

Businessman gives back after life-saving treatment After writing his company’s business plan during a five-month stay in hospital, Roy Shelton has since raised over £10,000 to give back to the hospital that saved his life.

It was in 2010 that Roy collapsed and was rushed to the Countess of Chester Hospital. He was then transferred to the Royal for emergency treatment where he was diagnosed with acute pancreatitis.

Roy spent five months recovering, and had to miss the birth of his son Charlie, but it was during this time Roy decided he wanted to try and start his own company.

So, it was on Ward 5B of the Royal that Roy used his time to work on a business project that would change his life and that of his family.

Roy, who is now the chief executive of ITS Technology Group based in Chester, said: “I decided to start writing a business plan while in the Royal as I didn’t have much else to do!

“I told my wife and she said it was a good idea, but I think she thought it was good to have something to occupy me rather than there being a chance that I’d

actually go through with it.”

ITS Technology Group, which offers broadband solutions, is now thriving in its sixth year of business. Roy said: “The company is doing well, but it might not have even existed had I not made it through my illness.”

Roy now uses this success to help him say thanks to the Royal and the staff that saved his life. By completing a range of challenges such as abseiling down the Royal, doing the Liverpool-Chester bike ride, the Three Peaks challenge and many other fundraising events, Roy and his team have raised more than £10,000 for R Charity.

The money raised will go towards helping families of Critical Care patients giving them a quiet space to relax during what can be a difficult time for loved ones.

Roy said: “We’ve taken part in many activities for R Charity in the past. When I left hospital I couldn’t walk so it shows how far I’ve come.

“R Charity is a cause that is very close to me. I can’t thank the hospital staff enough for what they did to save and change my life.

Everyone from the catering team to the nurses, surgeons and medical staff are a credit to the hospital.”

16

Improving the quality of life for our patients

Your local Walk-in Centre can help Your local NHS Walk-in Centre provides consultations, advice and treatment for minor injuries and illnesses, such as minor infections and rashes, stomach upsets, superficial cuts and bruises, strains and sprains, coughs, colds and flu-like symptoms.

You can also call NHS 111 which is available 24 hours a day, 365 days a year for any medical help which is needed fast, but is not an emergency.

Log on to www.examineyouroptions.info for more details. Please call your local walk-in centre to confirm opening times.

Liverpool City Centre NHS Walk-in Centre

6 David Lewis Street, Liverpool L1 4AP 0151 247 6500 Opening Times: 7am-10pm; Monday to Friday 9am-10pm; Saturdays, Sundays Closed Christmas Day 9am-6pm: Christmas Bank Holidays

Old Swan NHS Walk-in Centre Crystal Close St Oswald St L13 2GA 0151 247 6700

Opening Times: 7am-10pm; every day

Smithdown Children’s Walk-in Centre For 0-15 years only Smithdown Road L15 2LF 0151 285 4820

Opening times: 8am-8pm; Monday to Friday 10am-4pm; Saturday, Sunday and Bank Holidays Closed Christmas Day

South Liverpool NHS Walk-in Centre Church Road Garston L19 2LW 0151 295 9010

Opening Times: 9am-9pm; Monday to Friday 9am-5pm; Saturday, Sunday and Bank Holidays

Our staff get their #JabDone We started our staff flu campaign in September and had a fantastic response with around 2,000 being vaccinated in the first two weeks.

With vaccination stations in the Royal’s foyer and an area in Broadgreen it was quick and easy for staff to stop and get their flu jab. Additionally, we also vaccinated our clinical teams on their individual wards to ensure it was convenient for everyone to get their jab.

Some of the first members of staff to be vaccinated were our chief nurse Lisa Grant and our chief executive Aidan Kehoe (pictured).

By mid-November we had seen 70% of our front line workforce vaccinated on site, which made us the ninth best provider in the UK at getting our staff vaccinated.

This is an excellent achievement and benefits our patients and staff.

By getting the flu jab it reduces the chance of our staff passing on the virus to our vulnerable patients or family members, which is all part of our infection control policy.

Plus it also aims to see that our teams don’t become ill, which would not only be bad for the employee, but also their colleagues who would have to pick up additional work.

Flu is a much more serious illness than a heavy cold. In older and more vulnerable people the flu can lead to more serious illnesses like bronchitis and pneumonia, which may need hospital treatment.

Should I get the flu jab?

If you’re over 65, pregnant or suffer from an underlying medical condition such as asthma, emphysema or other health conditions speak to your GP now about getting your flu vaccination.

It’s also recommended that young children get the flu spray. If they’re in school it should be offered there, alternatively contact your GP.

Will the jab give me flu?

The vaccine cannot cause flu because it doesn’t contain live virus, and around 10 days after getting your flu shot you will be vaccinated against that strain and similar variations. You will be vaccinated for about a year.

17

Developing a sustainable health system

Mersey Care provides community health services with our support After a successful bid Mersey Care will now be running the services for Liverpool Community Health NHS Trust (LCH).

quality joined up services and to make a real difference to the lives of local people.

A spokesperson for NHS Improvement, said: “The NHSI evaluation panel that considered the bids felt that Mersey Care’s plan most closely met the needs of local health care for the future. We are confident that the Trust will work well with partners in the city to develop community services that improve people’s health and lives.”

NHS Improvement (NHSI) made the decision after close analysis of the proposals from two local NHS organisations, the second bidder being Alder Hey Children’s NHS Foundation Trust.

In April, Mersey Care had already taken on responsibility for the community services in South Sefton following a decision by LCH two years ago not to pursue a future as a stand-alone organisation.

The management agreement transferred to Mersey Care on November 1, and the transaction is expected to be complete by 1 April 2018.

Both the Royal and Aintree Hospitals supported Mersey Care’s bid to deliver

Joe Rafferty, Mersey Care’s chief executive, said: “We’re delighted that Mersey Care has been chosen as the preferred provider to deliver community services across Liverpool.

Joe Rafferty, Mersey Care’s chief executive community services and welcome the opportunity to work together with our partners across Merseyside to deliver high

“This is an exciting opportunity to bring together community physical and mental health services and ensure more care is available in communities, closer to people’s homes, where possible, along with more appropriate stays in hospital.

Nutritious food and drink for all The care we provide in our hospitals isn’t just medical, ensuring our patients, staff and visitors all have nutritious food and drink choices is essential too.

Our Learning Disability team also keep key staff informed about who is on each ward and visit the patients to ensure their requirements are being met.

As part of the strategy we are also making continuous changes around our hospital to support staff and visitors to make healthier choices.

In our latest Food and Drink Strategy 2017 we have three key aims: • To provide nutritious food for patients

Ian said: “Our on-site retailers are working with us to help people make a healthier choice, many are only selling reduced-sugar beverages and ensuring there are healthy food options that are affordable.

• Healthier food for staff and visitors • To offer sustainable food for all Ian Stenton, head of sustainability, said: “Due to an illness a patient may have difficulty swallowing or need to increase their calorie intake due to malnutrition.

Each patient is different so the food and drink they require also changes.

“Our staff work together to assess patient’s needs, from the quality matron for nutrition, ward managers and healthcare staff to ISS supervisors, dietetics team and the speech and language therapy department.”

Our hospitals also have a visual menu that is bespoke to the Trust and is designed to help patients with learning disabilities, visual impairments and

language barriers when they are ordering their meals.

Ian said: “The menu has black writing on a yellow background, which makes it easier to read, plus pictures to help with understanding, such as a cow to represent the meal contains beef. We also plan to introduce blue crockery, where appropriate, that helps people with visual impairments.”

“By 2018/19 our aim is that 80% of sugar sweetened drinks stocked must have less than 5 grams of added sugar per 100ml. Plus, 75% of prepacked sandwiches or meals (wraps and salads) contain 400kcal or less per serving and do not exceed 5g of saturated fat per 100g.”

The new strategy also includes an NHS Declaration on Healthy Weight which is a commitment to reduce unhealthy weight in our Trust and protect the health and wellbeing of staff, patients and visitors.

18

Exceptional patient experience

Patient thanks

JA gave Orthopae dics at Broadgree n Hospital a rating of 5 stars Broadgreen Hosp ital Ward 3 - Lim b Reconstruction I have stayed at Br oadgreen on Ward 3 on three occasio past 10 months aft ns over the er having surgery (10 days in total). team really are pr The whole etty amazing. I fel t thoroughly looke arrival all the way d after from through to being discharged. Even ring the ward for at home I can advice post surgery . Brilliant nursing physiotherapists, staff and clean wards and my surgeon is ab I feel like I can to solutely first class. tally trust their de cisions and care pla big step for me as ns which is a I have had poor me dical care in a dif I hope this review ferent trust. helps someone els e who will be ha the unit to make ving surgery in them feel a little less worried abou t their stay.

Visited in Octobe r 2017. Posted on 16 October 2017 ty

reen Universi erpool and Broadg

ed Royal Liv Paul Stubbs review st – 5H Hospitals NHS Tru

Dodie gave Gene ral Medicine at Th e Royal Liverpool Universi ty Hospital a rating of 5 stars Good care at th e Physiotherapy Dept (Spines) I would like to th ank all the staff at the Physio Dept I be very kind and found them to helpful. After two spinal fractures wi was in a lot of pa thin a year I in and wasn’t too mobile. My Physi fantastic very kin otherapist was d and very know ledgeable in spine the correct exercise s, they gave me s to do along with very useful informa posture core stren tion on gthening, I am co ming on well and grateful to them. will always be Visited in Octobe r 2017. Posted on 20 October 2017

adgreen Royal Liverpool and Bro Kate Wheeler reviewed S Trust – 5H University Hospitals NH my doctor last week. ay after being referred by tod n ree adg Bro to nt We thorough inspection by g staff, professional and Fantastic and welcomin vice.

40 minutes. What a ser the doctor. In and out in

fault the recently, could not ent at the hospital atm the good work tre up d ha ep d ke an ll, sb my hu treated very we th bo re we we ff, facilities or the sta

Excellent care

Sarah osman gave Acc ident and emergency ser vices at The Royal Liverpool Un iversity Hospital a rating of 5 sta

rs

I was brought in on 1st September from a cut on my arm. I didn’t wa too long and the nurse it who seen to me stitche d my arm up, around 30 stitches, had a great con versation and provided excellent care for me.

Such a fab nurse and I’m glad this nurse is the one who seen to me big massive thank you, plu s I’m all healed now and my stitches are all out.

Visited in September 201 7. Posted on 15 Septem ber 2017

y at The ocrine and thyroid surger Pauline Parker gave End rs sta 5 of ing y Hospital a rat Royal Liverpool Universit Ward 9y Superb

Lisa and Joe gave Royal Liverpool Un iversity Dental Hospital a rating of 5 stars Paediatric Orthod ontics - outstan ding long-term treatment My son has been treated here for a nu mb climbing frame ac er of years followi cident. His treatm ng a ent has been outst some time now he anding. For has been looked aft er by the same Or and I can honestl y say that he enjoy thodontist s his trips to Liverp surprising given th ool (which is e length and natu re of some dental pr His treatment has ocedures!) been made much easier by the cons and the friendline istency of care, ss and efficiency of all staff (admin/rec as well as dental eption team staff).

From the outset, our son’s Orthod ontist has treated and respect and him with honesty he has appreciated being spoken to adult. The Orthod as a young ontist knows which bits of treatment difficult - he’s neve he has found r going to enjoy having impressions tips/techniques us taken but the ed and the sense of humour with wh delivered, have ma ich they are de it as relaxed an experience as possi ble!

Many thanks to all concerned - it’s an understatement to you are a credit to say that the National Healt h Service.

Visited in Septem ber 2017. Posted on 30 September 2017

roidectomy. On 2nd October for para thy g I was admitted to 9y on ndly, a real team workin ff organised, happy, frie eI car The ts. admission I noticed sta tan sul con to board from cleaners atmosphere across the e asked for more care. none and could not hav to ond sec received was port especially the sup staff for their help and all nk tha to like uld I wo life and I am only on day rally given me back my consultant who has lite . You are all very much l so much better already fee and ion rat ope t 3 pos xxx appreciated. Thank you er 2017 7. Posted on 04 Octob Visited in October 201

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