Royal Surrey County Hospital
Royal Supporter
NHS Foundation Trust
Autumn 2014
Former Patient Opens New Radiotherapy Unit Former patient Rachel Smith opened the St Luke’s radiotherapy unit at East Surrey Hospital on Wednesday September 3. The Crawley resident said this new facility will give people living in east Surrey and West Sussex the chance to have their treatment closer to home. Rachel was treated for breast cancer in 2012, starting her treatment in Guildford three days before her two sons broke up
for their summer holidays.
This unit will make the ordeal so much easier for local patients. Rachel said: “The radiotherapy made me extremely tired. It would have been so much easier to have had my treatment closer to home. I wouldn’t have had to get up so early
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Achieving Excellence
Highlights from this year
Meet Wendy Mitchell
A new appeal for life-saving breast cancer treatment
Pages 4-5
Page 12-13
Page 14-15
Pages 18-19
Message from Nick and Peter
Nick Moberly, Chief Executive
Peter Dunt, Chairman
It’s a very exciting time for us as we prepare our full business case to merge with Ashford and St. Peter’s Hospitals and staff, from both Trusts, taking part in clinical workshops have demonstrated a real passion and determination to work together to achieve the best outcomes for our patients. Read more about the proposed plans on page six.
developing our cancer portfolio. St. Luke’s is a leading cancer centre and we are committed to making the expertise of the staff and the technology it offers available to more patients.
We’re also exploring, with key partners, how we could establish an Integrated Care Organisation (ICO) – that focuses on bringing together health services to the benefit of all. It is very early days for this project, so we’ll give a broader update in the next issue. In July we launched our Surrey Cancer Research Institute which will look to exploit opportunities to make research across a wider network easier, and enhance patient treatment. We opened our outreach services (Radiotherapy at East Surrey Hospital - 3 September, and Chemotherapy at Ashford Hospital - 17 September) further growing and 2
Finally, delivering the best care, anywhere for our patients, through what we do every day, research, development and offering the latest techniques and treatments, would not be possible without our dedicated staff. We’re proud therefore to be included in an annual celebration of the UK’s elite public sector healthcare employers: the Top 100 Best Places to Work list published by the Health Service Journal (HSJ). It was also heart-warming to receive so many nominations from patients for this year’s staff awards ceremony which was held on 8 October. The results are available on our website.
Nick a n d Pete r
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and the travelling would have been less. This unit will make the ordeal so much easier for local patients.” Royal Surrey County Hospital has worked in partnership with Surrey and Sussex Healthcare NHS Trust, which runs East Surrey Hospital, to design, build and open the cutting edge cancer treatment unit. It is
We’re proud to open this new state of the art radiotherapy unit.
This brand new modern facility offers the best range of radiotherapy treatments currently available. staffed by clinicians from St. Luke’s Cancer Centre, a leading specialist tertiary cancer centre run by the Royal Surrey. Nick Moberly, Chief Executive at the Royal Surrey said: “We recognise that many of our patients have been travelling long distances, often on a daily basis, for treatment and are actively looking for ways to deliver these services more locally. Working with our partners at East Surrey Hospital, we’re proud to open this new state of the art radiotherapy unit and will continue to explore opportunities for similar initiatives.” Michael Wilson, SaSH Trust Chief Executive, said: “This is good news for our patients who need radiotherapy as they can now have their treatment much closer to home. This brand new modern facility offers the best range of radiotherapy treatments currently available and means we can give the highest standard of care to people locally.” The unit has two ultra-modern ‘True Beam’ Linear Accelerators (LINACs) which are able to deliver the most accurate and safest care. Radiotherapy patients have free parking at the unit which is staffed by highly specialist and experienced clinicians supported by the St. Luke’s Cancer Centre at the Hospital. They will also have access to a range of the latest clinical trials. 3
Quality Priorities Achieving Exc The Royal Surrey is committed to providing the best care, anywhere, for our patients and one of the ways we look to do this is through our quality priorities: a set of priorities, aligned to our strategy. These are summarised below.
In order to achieve the best outcomes: 1. W e will continue our drive to reduce harm, focusing particularly on the management of deteriorating patient and improving infection control training uptake rates 2. W e continue striving towards achieving full compliance with Sir Bruce Keogh’s (Medical Director, NHS England) standards on seven day sub-specialist consultant-led care
To provide our patients with an excellent experience 3. W e are implementing new emergency processes that will improve clinical care pathways for patients seen in A&E 4. W e are improving communication between patients, relatives and clinicians 5. We are transforming our outpatients
Our skilled, motivated teams will 6. D eliver and embed the Achieving Excellence programme on our wards 7. E nsure that everyone is working to achieve the same overall vision
We will demonstrate top productivity 8. D eveloping and embedding standardised and evidence based pathways of care across all our specialties 9. D esigning and implementing an effective approach to integrated care in the local health system
Our strategy is underpinned by firm foundations 10. That encourage collaboration with colleagues across the health economy 11. That use data to drive quality improvement 4
Here at the Royal Surrey, we are committed to providing patients the best care in a clean, safe and professional environment. To help our ward staff do his, we launched the Achieving Excellence programme, in April 2014, starting on Merrow and Tilford Wards. All wards are assessed against standards set by the Trust, which include infection control, compassionate care, communication between clinical teams and families, and the environment. Wards use their assessment results to work towards becoming an achieving Excellence Accredited ward, being rated as Red, Amber, Green or Blue wards according to their scores. The ward teams, with support from Patients 1st Improvement Team, use their assessment results to direct and implement the new ways of working as highlighted below. All wards are regularly re-assessed to continually maintain and improve standards.
Daily Reviews Merrow and Tilford have introduced new style morning and evening nursing handovers, which begin with a patient focused safety briefing. There is then a review of the ward’s performance in areas such as pressure area care, infection control, staff levels and an opportunity to highlight any issues that may have occurred during the shift. The final element is a handover at the
cellence Update >>>>>>>>>>>> patient’s bedside between the nurse looking after the patient on the previous shift and those coming onto the new shift. Ward teams have also introduced a short “safety huddle” in the middle of the day, where staff are able to raise concerns about any patients and highlight any issues. Staff on the wards have commented that they think that introducing this safety huddle has contributed to an improved patient experience.
Workplace Organisation & Environment We want ward staff to have what they need, when they need it and not have to spend time looking for things. To support this, we have been working with the wards to ensure equipment and resources are well organised, clearly labelled, colour coded, easy to access and stocked to the required levels. All areas of the ward, such as linen cupboards, drugs cupboards, sluice rooms, and store rooms, have been reviewed using this process, ensuring that everything has a correct place and putting together visual standards so all members of staff working on the ward can see where and
how things should be kept. The work on the ward has been supported by our estates team, who have spent time putting up new shelving, hooks, building cupboards and adapting storage areas to safely charge mobile equipment away from patient walkways. This has meant that the ward corridors look clearer and staff have commented the “corridor looks brighter and more welcoming” and gives the team “pride in the ward appearance”. Much of this re-organisation has taken place over a three week period. From a staff perspective items required have become easier to find, releasing time to care for patients. One of our bank Health Care Assistants (HCA) who regularly works on Tilford has commented that the reorganisation has had an impact on her role, allowing her to spend more time with the patients: “All of the care items are now together in a storage area, clearly visible … More time to spend with patients”. She also commented that these “little changes have had a huge effect on the daily work of the HCA.” Another new development has been the installation of new desks in the bays to enable nurses and HCAs to
complete documentation whilst still being visible to patients. On Tilford the entrance to patient bays and cubicles have been repainted. A different colour per room has been used, with improved signage which is particularly helpful for patients who suffer from dementia or visual impairment.
Improving quality, safety and efficiency through standard work Standard work is a method of ensuring that tasks are completed to the same degree of quality, safety and efficiency regardless of who does them. Standard work ranges from detailed Standard Operating Procedures, to checklists and guidelines. All of our current standard operating procedures are undergoing a review by the relevant teams. Standard work also applies to our clinical leaders and managers. One page checklists have been introduced for a range of such staff, from the nurse in charge and sister on a ward, to matrons, senior managers and executive team. These are to ensure that the jobs and tasks that are important to the safe ...Continued on page 6
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>>> Achieving Excellence Update and effective running of our wards are done to the right standard and that managers are visible and accessible to our staff. As one nurse commented “there is a better role definition [for] when I am in charge”.
Although a lot of work has been carried out by both the ward teams and Patients 1st, it is only the start of the journey. Staff have commented on this by saying: “I feel that this is a work in progress” and that “change is a challenge but it
can be done”. The Achieving Excellence programme is now being rolled out across other wards over the coming year. If you are visiting the hospital, we are certain you will see improvements in how the wards feel and look.
Our proposed merger with Ashford & St Peter’s Hospitals NHS Foundation Trust Since our announcement in May, proposing a merger between Ashford & St Peter’s Hospitals, teams from both organisations, including clinicians, have been working hard to look at how to achieve the greatest benefits for patients by bringing the two organisations together. Both Trusts are performing well clinically and financially, but the next few years will prove extremely challenging across the NHS. To meet Sir Bruce Keogh’s (Medical Director, NHS England) review recommendations that hospitals provide consultant cover seven days a week, for example, the Royal Surrey (acting alone) would need to recruit an additional 25 consultants. The principle is one that we fully support, but in practice this would not only be extremely challenging in terms of the availability of consultants to recruit, but equally the cost would be prohibitive. By joining our workforces, we would have enough consultants on a manageable roster that could provide the seven day cover that Keogh recommends across a number of specialties. As a merged organisation, the vision is to further develop Ashford Hospital (near Heathrow) as a centre for elective procedures, particularly orthopaedics for patients in that area. We would also expand outreach cancer 6
services such as chemotherapy and, in time, potentially radiotherapy at Ashford Hospital. St Peter’s A&E may be developed as a specialist emergency centre (subject to commissionerled process), building on its well established expertise in cardiovascular services. At the Royal Surrey, A&E will continue to offer all the services it does today and we will be able to further diversify and expand cancer services becoming a referral centre for much of the South East of England. As you can see, our vision for a new merged organisation includes a strong future for all three hospitals, and a number of clear benefits for patients. Nick Moberly, Chief Executive, said: “This merger is about enhancing existing services and improving the experience and quality of care (for example by providing more services seven days a week, and looking for opportunities to bring services from Central London back into Surrey) for all our patients. It is about ensuring our sustainability in tough times for the NHS so that we can continue to provide core services locally (e.g. A&E, childrens services and consultant-led maternity services). Importantly, patients won’t have to travel further for routine treatments.” For more information or to take part in our survey, please visit www.working-together.org
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Would you recommend the Royal Surrey? To make sure that we are providing the best care, anywhere to all our patients during their stay, we use and value the feedback we receive from the friends and family test as described below. When patients leave the hospital, or sometimes before they leave, they will be asked via postcard, SMS or telephone to tell us how likely they are to recommend our services to their friends and family if they needed similar care or treatment using the scale below.
8
Extremely likely
■
Likely
■
Neither likely nor unlikely
■
Unlikely
■
Extremely unlikely
■
I don’t know
■
Below are our Friends and Family Test results for October 2014: Percentage recommend
Percentage not recommend
Percentage neither recommended or not recommended
Inpatient
94%
2%
4%
A&E
84%
9%
7%
Trust
91%
4%
5%
Maternity
95%
2%
3%
Here are just a few comments from our patients: “The ward was very well run, patients were free to ask if they had worries and they were usually answered. The ward was clean. Staff worked as a team. I include the receptionist who brought telephone messages and the doctors who explained what they were doing and why.”
“I have no hesitation in fully recommending the service I have received. I do not have any suggestions for improvements as I think everyone is doing a great job already.”
“Staff were very good in the care provided. Nurses always on hand to offer help and assistance if required.”
“All the staff were experts at their job and answering questions. Very caring, kind and pleasant. There is always a chance to improve but can’t think of any. Private patients could not have had better service. Thank you all.”
“The staff have been fantastic. The only improvement would be to know what procedures would be expected because as lay people, we don’t know! Wonderful care.” “The staff all work extremely hard and do all that they can to make you comfortable and I do not feel that they can improve on this. The food could be better. Cold sandwiches and salads, more hot dishes.”
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Our Culture of Compassionate care
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Compassion, Care, Competency, Courage, Communication and Commitment are the six enduring values and behaviors that underpin Compassion in Practice; a three year vision and strategy for nursing, midwifery and care staff. Below is an update on how these values are continuously being embodied at the Royal Surrey:
empathy, honesty and recognising boundaries. The induction also incorporates the use of an age simulation suit (pictured left) which provides staff with the opportunity to experience the impairment of an older person’s vision, mobility and co-ordination to better understand their needs.
The Trust has recently launched its new induction programme for Healthcare Assistants and Midwifery Support workers, based on the Department of Health’s minimum training standards. The aim of the induction is to prepare healthcare assistants and midwifery support workers to provide patient care with the constant themes of: caring, kindness, compassion,
St Luke’s patient feedback ‘I must praise all the staff at St Luke’s who contributed to making what could have been a very depressing centre, into quite a happy place. More like a social centre, where friendships are made and worries forgotten for a while. My experience with the NHS has been exemplary and I am very grateful and proud of the service you provide’
In July, the Trust’s Senior Sisters took part in a training day that enabled them to gain an understanding of care and compassion from a patient’s perspective.
The Trust provides ‘Mentor’ and ‘Sign off Mentor’ training to our staff so that they are competent to mentor, teach and assess University of Surrey student nurses and midwifes, on their placements here at the hospital. Having competent mentors, creates competent students, who become competent nurses and midwives of the future, able to provide a high quality of care for patients. To book a place on either the ‘Mentor’ or ‘Sign off Mentor’ training, please email Deanna Hodge on dhodge@nhs.net.
There is a National campaign to encourage nurses to return to working in the NHS. The Trust is supporting this campaign and asking nurses to have the courage to return to this rewarding profession. For those who would like to return to nursing, there is National financial help towards the cost of course fees and other associated costs. University of Surrey are the training provider and the Royal Surrey provides the practice placements. If you would like to come
back to nursing or have any questions, please contact Deanna Hodge dhodge@nhs.net or Simon Pawlin s.pawlin@nhs.net.
Albury ward has been leading the way with #hellomynameis a campaign encouraging anyone in a patient-facing role to introduce themselves. It was launched by Dr Kate Grainger following her own experience of NHS care from both sides of the doctor’s desk – as a practitioner and terminally-ill cancer patient. This initiative is being rolled out across the medical wards and has been incorporated into the Achieving Excellence project. Louise Stead, Director of Nursing and Patient Experience, is requesting everyone’s commitment to ‘Hello my name is…’ as it is important that every member of staff, irrelevant of their role, joins this campaign. As Dr Kate Grainger promotes, ‘Good and consistent communication, the ‘little things’, putting the individual person at the centre of their own care and ensuring a human connection make a huge difference’. Relative’s feedback ‘I would like to express my thanks and appreciation
for the excellent care my Brother received in A&E. I was so impressed by the efficiency and good communication of all the staff in the department’
We would like to recognise the dedication and commitment of A&E Matron Tamsin Enticknapp-Green who has left the Trust after 23 years to take up a promotion as Head of Nursing at Portsmouth Hospital. We would like to wish her the best of luck and thank her for all her hard work.
Interested in working as a nurse or midwife for the Royal Surrey? We were voted one of the Top 100 NHS Employers for 2014. If you are interested in working with us as a nurse or midwife, or are already qualified and would like to join the team, please email: rsc-tr. resourcing@nhs.net or call 01483 571122 extension 6687 for more information. 11
News in brief - Highlights from ➜
April 2014 – Achieving Excellence Programme Launched Achieving Excellence was launched in April of this year and is a Trust-wide programme of work where ward teams across the hospital, will be trained, coached and supported to use a number of new techniques that will change the way they manage their work. The aim is to develop a culture of continuous improvement across the Trust. Achieving Excellence also encourages staff to learn from how things currently happen, see problems as opportunities to improve, know that everyone is responsible for improvements and demonstrate that we have the courage to innovate.
May 2014 – Winners of the Patient Safety Award On 13 May, at the CHKS Top Hospital Awards, the Hospital was announced as the winner of the Patient Safety Award. This is a national award for outstanding performance in providing a safe hospital environment for patients. It is based on a range of indicators, including rates of hospital-acquired infections and mortality.
July 2014 - RESET w Reset week took place was the hospital’s opp things work, reset tho better and renew the experience and the wa Royal Surrey. During this week, Roy and colleagues from t and Waverley CCG (C Group) volunteered as Liaison Officers (WLO Coordinators on the h wards. The role of the volunteers was to ass wards with administra problem solving. This that the medical staff c concentrate on patien enabling them to be s treated and discharge referred much quicker providing a better overall patient experience.
June 2014 - New Intensive Care Unit opens On Friday 20 June, Jeremy Hunt, MP for South West Surrey and Secretary of State for Health, officially opened the new Intensive Care Unit (ICU) at the Hospital. The new state of the art extension to the ICU has provided 12 additional beds (giving us 23 in total), additional storage, office space and enhanced facilities, all of which are required to meet the rigorous standards put down by the Intensive Care Society to deliver a quality service to our patients. 12
m this year >>>>>>>>>>>>>>>
week ce between 7-13 July and portunity to review the way ose things that could be done hospital to improve patient ay it feels to work at the
yal Surrey staff members the NHS Guildford Clinical Commissioning s Ward Os) and hospital ese sist the ation and was so could nts, seen, ed or r, Nick Moberly, CEO of the Royal Surrey, Volunteering during Reset week
July 2014 – Launch of the new Surrey Cancer Research Institute (SCRI) On Friday 18 July, the new Surrey Cancer Research Institute (SCRI) was officially launched by Professor Hardev Pandha. SCRI aims to be the ‘umbrella’ encompassing all types of research into cancer, a mechanism of communication to facilitate interactions and collaborations across the Trust. In this way resources can be shared and researchers can work closely together.
August 2014 – Visit from Jeremy Hunt On 4 August, staff were honoured to host Secretary of State, Jeremy Hunt, as he laid out the next phase of the government’s plans to further reduce waiting times.
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August 2014 - Royal Surrey hosts the Kent, Surrey and Sussex CEOs The Trust, as host of the KSS Clinical Research Network, welcomed Chief Executive Officers from across the region met on 6 August 2014, to discuss clinical research in the NHS. Future meetings will be held four times a year. Applications are sought from members of the public who would like to be lay members of the Board.
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T M E EWendy Mitchell Clinical Nurse Specialist for Women’s Health Clinical Nurse Specialist, Wendy Mitchell, reveals what it is like to work in the Royal Surrey’s Women’s Health department. What interests you about working in Women’s Health? My role as Clinical Nurse Specialist enables me to assist women through their various treatment pathways. It is very varied and covers all aspects of gynaecological care ranging from medical to surgical options. It is a privilege to work in this speciality and know that you are able to make a difference and influence the care provided. It is diverse, challenging and recognises the importance of working as part of a multidisciplinary team (MDT) as well as an autonomous practitioner; always developing and being adaptable to meet both patients and governments expectations. Describe your average day? I have my own clinics in the gynaecological outpatients department and see women who will be admitted for a 23hr stay for a Laparoscopic 14
Hysterectomy or for major combined surgery (bowel) to treat the symptoms of Endometriosis. My role is to fully prepare patients for their whole journey, from pre admission, right through to discharge and monitoring them at home.
We are all obligated to give our best not only to the patients but to our colleagues and the hospital and by working and ‘playing’ as a team, helping and supporting each other, we can all achieve marvellous things! I am a qualified counsellor and offer psychosexual counselling and support to patients and their partners as it’s vital to understand that we are offering a complete holistic approach to care; psychological and physical. In your role, how do you ensure that the best care is provided to our patients? Education and striving for excellence is the way
forward. Medical and surgical treatments are forever changing and developing so I ensure that my skills, knowledge and expertise are kept up to date - most importantly by listening to women to know what they want from our service, to ensure we deliver the best we can. How do you strive to make sure our patients are having the best possible experience? Listening to and understanding the patients’ journey is the best way to enhance their experience. Often women will tell me that they were pleased to have the opportunity to talk about their experiences and feel that someone was genuinely interested and wanted to help them. Sometimes it’s very humbling listening to women who have coped with often quite severe symptoms, which has had a life changing effect on them. Sometimes they just need permission to show their emotions and know they are in safe hands. I also facilitate an Endometriosis patients support group who meet
….for Frontline Nurses and Midwives
monthly in the department; hold awareness and teaching sessions throughout the hospital and through invitation, speak at local and international workshops, study days and conferences. What is the most rewarding part of your role? Every part of my role is rewarding. Having the opportunity to work with women from teenagers through to older ladies and enabling them to have a better quality of life. Assisting patients to make the right choices for them and to be there when they need support. I love teaching patients and my MDT colleagues to ensure we are all working to achieve the best we can with a passion!
Staff at the Royal Surrey County Hospital and in the Guildford area as a whole, are now being given the chance to apply for and participate in a national leadership development programme for Frontline Nursing and Midwifery. The NHS Leadership Academy launched their refreshed Frontline Nursing and Midwifery Programme back in April this year. So far, nurses and midwives in around 70 areas have been given the opportunity to apply, with nearly 2000 nurses and midwives signed up nationally. The Guildford area is now open for applications and provides an opportunity for staff in this area to participate in the programme, which is aimed at all nurses and midwives in bands five, six, seven (or equivalent) who work in organisations which provide or commission NHS services. To find out more, please contact: yourteam@kssleadership.nhs.uk
Welcome to the Surrey Cancer Research Institute (SCRI) Our new virtual cancer research institute We know a strong research base is essential for improvements in patient care. We have high quality multidisciplinary cancer research ongoing in our network, but little opportunity for researchers to interact, collaborate or just be aware of local innovation and the breadth of our achievements. SCRI aims to be the ‘umbrella’ encompassing all types of research, a mechanism of communication to facilitate interactions and collaborations. In this way we can share resources and work together on ways to secure research funding. SCRI is one of seven new Clinical Academic Groups (CAGs) that have been set up by Surrey Health Partners, working in collaboration with the University of Surrey, Royal Holloway, University of London, Surrey and Borders Partnership Trust, and Ashford & St Peters Hospital. A successful SCRI will benefit all of us and result in a high national and international profile for our cancer centre and cancer network, and ultimately drive benefits for our patients. Hardev Pandha, Director, Surrey Cancer Research Institute, Prof of Medical Oncology University of Surrey. Consultant in Medical Oncology, St Luke’s Cancer Centre, Guildford. 15
Launch of Musculoskeletal (MSK) service at the Royal Surrey On 1 June 2014 the new Musculoskeletal (MSK) service was launched. Patients with problems affecting bones, joints and muscles can now be referred to the Musculoskeletal (MSK) service at the Hospital via the GP’s Referral Support Service.
What is the MSK service? This is a ground breaking, multi- professional screening, assessment and treatment service. It has been set up by the Royal Surrey together with the Guildford & Waverley Clinical Commissioning Group (CCG). It is made up of members of the Rheumatology, Pain and
Orthopaedic teams. The service aims for the effective and prompt management of a patient’s condition with the most appropriate person and clinical service. This may include x-rays or scans and treatment/interventions. Clinics are run at The Royal Surrey or neighbouring community hospitals.
What happens next? Referrals are screened by a member of the MSK team, often an ESP (Extended Scope Practitioner) physiotherapist working with consultants, within 48 working hours (Monday - Friday) of receiving the referral. It will then be directed to the most appropriate service and the patient receives a letter informing them of the next steps.
Celebrating 40 Years of the Health and Safety at Work Act The Health and Safety at Work Act 1974 (also known as HASWA) is legislation which covers Occupational Health and Safety in Great Britain. The Health and Safety Executive (HSE), is responsible for enforcing this act, as well as many other acts and regulations which cover working environments. The act provides people with a legal right to be protected from work related risks. The act demands that employers and employees as well as others such as contractors, follow duties dealing with health and safety issues and the management of health and safety. Since the Health and Safety at Work Act was introduced in 1974, the number of fatalities from work related accidents has decreased substantially. In 1974 there 16
were 651 fatalities in the workplace in Great Britain and the latest figures for 2012/2013 highlighted 148 fatalities. Even though this is a clear indication that Health and Safety awareness is reducing this figure, even one death in the workplace is one too many. There are also still thousands of cases to do with people suffering from work related health problems. Therefore Health and Safety and Occupational Health are more important than ever, and there are still improvements that can be made and lessons to be learned. Useful Links: http://www.hse.gov.uk/legislation/hswa. htm - Health and Safety at Work Act 1974 http://www.hse.gov.uk/myth/index.htm HSE, Health and Safety Myths
Do you have an email address? Building is underway for the new M&S food store and larger Costa Coffee The Royal Surrey’s planned makeover of its main entrance is well underway. These plans include an M&S Food, a larger Costa coffee with double the current seating capacity and general improvements to the main reception, making for a more pleasant environment for those arriving at the hospital. Building work has already begun and it is hoped will be completed in the first few months of next year. Watch this space!
In the quest to be more environmentally friendly, we are looking to send out our usual communications to as many people as possible via email. We currently only have a small proportion of email addresses belonging to our members. So, if you do have an email address and would like to receive our newsletters electronically, please send an email to rsc-tr.communications@nhs.net, including your full name and address.
Check your junk mailbox If we already have your email address, but you are not receiving emails from us, please check your junk mailbox. If our emails are going into your junk mailbox, you will need to add our email address to your safe list.
Did you know we have a simulation suite? The Simulation Suite at the Royal Surrey is an award winning department whose progressive thought sets the bar for others. The future of education lies in experiential learning with a move away from ‘chalk and talk’ type presentation.
No longer practicing on patients but getting a near real experience with the safety of peer evaluation and instruction. Undergraduates from St Georges and Southampton remark on the reality of experience and the support the team offers. 17
A new appeal for lifesaving breast cancer technology One in eight* ladies will be diagnosed with breast cancer during their lifetime. As part of our early detection of women’s cancers campaign, we are aiming to raise funds of £500,000 to buy a new, high-tech ultrasound for gynecological cancer and innovative new equipment for early breast cancer detection. The larger cost of these two technologies lies with the purchase of a Tomosynthesis machine which is proven to detect at least 25% more breast cancers than standard mammograms. Detecting cancer early reduces the need for complex, long-term and invasive treatment such as mastectomy and chemotherapy. Tracey Irvine, Clinical Director of the Royal Surrey Breast Unit, is the face of our campaign. As a centre of excellence, Tracey and her team at the Royal Surrey County Hospital and St Luke’s, see patients from all over Surrey, Hampshire and Sussex. As Tomosynthesis is more specific, it also reduces the number of ladies recalled to the hospital with ‘false negatives’. 18
Sometimes healthy tissue when compressed in a traditional two dimensional mammogram can look like an area of concern. The three dimensional images enable the clinician to see the tissue more clearly without confusing overlapping normal structures. Areas causing concern can be examined in far more detail. Tomosynthesis is also better at imaging the breast tissue in younger patients. Traditionally mammogram images are taken from two directions – top to bottom and side-to-side. Ladies are still positioned as for a conventional mammogram and an x-ray tube moves in an arc taking several images in just a few seconds. The images are re-constructed into three dimensional ‘slices’ of the breast tissue for the radiologist to examine. It is the science behind the imaging that means at least 25% more cancers can be seen earlier than using the traditional equipment. This life-saving technology is a must-have for all the ladies living in our catchment area.
Get involved - Upcoming fundraising dates: 5 December Guildford High Street Christmas Collection 9/10 December - Christmas Fair, Restaurant Courtyard, Royal Surrey Hospital 12 December - Christmas Raffle Draw and Rock Choir, Restaurant Courtyard, Royal Surrey Hospital To volunteer, take part in fundraising or make a donation please contact: Fundraising Dept, The Royal Surrey County Hospital, Egerton Road, Guildford, GU2 7XX. t: 01483 464146 e: rsc-tr.fundraising@ nhs.net w: royalsurrey.nhs.uk/ Fundraising Source * Cancer Research UK
William Bremner - Bolt Round The Holt 2014
London Marathon Runner - Hayley Grant
ICU staff, The Nuts Challenge
Tim Roulston - Hokas Highland Fling
Lynda Mellor and Waitrose Staff
T h a n k y ou fo r y o u r su pport 19
Clinical Research Network: Kent, Surrey and Sussex The Royal Surrey is proud of its ethos to support and undertake clinical research to deliver the best possible outcomes for its patients. That’s why being awarded the opportunity to host for five years, the National Institute for Health Research (NIHR), Clinical Research Network (CRN) for Kent, Surrey and Sussex (KSS), is so important to us. Chief Executive Officers from all over Kent, Surrey and Sussex met for the first time on 6 August 2014 to discuss clinical research
in the NHS. We are seeking to appoint new 3 Non-Executive Lay Members to the Network Partnership Board.
Executive Appointment Non-Executive Lay Member - Clinical Research Network: Kent, Surrey and Sussex The NIHR Clinical Research Network (CRN) is the research delivery arm of the NHS in England. It operates through a national coordinating centre and 15 local networks, one of which is the Clinical Research Network: Kent, Surrey and Sussex. Following a major reorganisation, the 15 local networks came into being on 1st April 2014. The NIHR CRN provides the infrastructure that allows high-quality clinical research to take place in the NHS, so that patients can benefit from new and better treatments. This includes clinical research staff, sessional support for clinicians, research management and governance systems and staff and NHS support costs. It helps researchers to set up clinical studies quickly and effectively; support the life-sciences industry to deliver their research programmes; provide health professionals with research training; and work with patients to ensure that their needs are at the very centre of all research activity. The CRN: Kent, Surrey and Sussex 20
is hosted by the Royal Surrey. The Network supports research activity throughout Kent, Surrey and Sussex at NHS trusts and in general practices. We work in partnership with universities and the Kent, Surrey and Sussex Academic Health Science Network. The Network Partnership Board includes Chief Executives from the NHS Trusts across Kent, Surrey and Sussex, and the Clinical Directors and Chief Operating Officer of the CRN: Kent Surrey and Sussex. The board meets 4 times per annum. We are seeking to appoint new 3 NonExecutive Lay Members to the Network Partnership Board. We are looking for individuals who share our core value of involving the public in the operation of the CRN: Kent, Surrey and Sussex. As a Lay Member of the Partnership Board, you will represent the view of the public and patients of Kent, Surrey and Sussex. Working with colleagues, you will provide the public perspective, ensuring that this is included in strategic
development, and that the activities of the CRN: Kent, Surrey and Sussex are focused on the local community with the most effective utilisation of public funds. We are looking for an individual with significant board level or equivalent experience to ensure research is central to the provision and development of the NHS service locally. You will have the opportunity to contribute to the future development of the Kent, Surrey and Sussex Research Network, ensuring that public views guide our principles and practice. Please see our website www.crn.nihr.ac.uk/ kent-surrey-and-sussex for the job description and application form. For a confidential conversation about the opportunity please contact: Dr Mark Hayward on 01273 265896 Closing date: Friday 19 December at 5pm. Final interviews: Early January 2015
M E ET Jo Murray Matron, Achieving Excellence Assessor – Nursing and Patient Experience I joined the Royal Surrey County Hospital on 1 July, having spent the last 16 years working in the primary care setting as a District Nurse and Community Matron both in Hampshire and West Sussex. As a hands on clinician I was at the frontline, managing patients both in their own homes and in Nursing Homes. I was responsible for case management and facilitation of seamless care between primary and secondary care settings for those patients under my care. I am qualified as an Independent Nurse Prescriber and have a passion for palliative care and long-term condition management. I was lucky enough to have been nominated for a national award this year by one of the nursing homes I supported in Bognor Regis. I was a finalist in the Kate Granger Compassionate Care Award, which was a huge honour. I decided to come to Guildford to expand my nursing skills further, taking on the challenge of the Matron - Achieving Excellence Assessor role. I lead on all aspects of the Trusts Achieving Excellence programme, ensuring that all clinical areas are taken through the assessment process. It is a pivotal role which I hope will prove a success and be integral in driving forward other new initiatives, moving towards the potential merger with Ashford and St Peters, and improving standards in our trust. I am already enjoying the challenges and changes being back in the hospital setting after so many years. Outside of work I keep myself busy as part of a sports team and I am a recently elected Parish Councillor. 21
Leading the way in ground cancer work Tom Milner who spent time with the breast team as an academic Foundation Doctor has won the British Journal of Surgery Prize at the recent Association of Breast Surgery meeting for his groundbreaking work looking at the use of One Step Nucleic Acid Amplification (OSNA), a technique that can rapidly assess if cancer has spread to lymph nodes. The breast unit in the Royal when she wakes up from her I am delighted operation that the cancer has Surrey has been leading the not spread. way in management of the to have won lymph nodes in breast cancer If there is cancer in those the Association patients for many years. It first lymph nodes then more of Breast Surgery has been offering OSNA to all lymph glands are removed prize, and pleased suitable patients since 2008. to see if the cancer has The technique can analyse the first few lymph nodes (sentinel lymph nodes) that a cancer cell would reach if it was going to spread to the lymph nodes. It is important that all patients with invasive breast cancer have this surgical assessment of the lymph nodes. If the first few lymph nodes do not contain cancer the patient does not require any more surgery and is told
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spread further up the lymph node chain. The patients in the Royal Surrey choose the OSNA technique because they know that if they need more lymph node surgery it can all be done at the same operation as the OSNA machine analyses the first few lymph glands while they are asleep. In a lot of patients where the cancer has reached the
that our work is receiving recognition at a national level.
first lymph nodes it has not gone any higher up the chain. At present the only way of finding this out is to remove extra lymph nodes. If we could predict which patients would not have any more disease we could safely spare them this extra lymph node surgery. Tom’s work looked at ways we could predict which patients would have more cancer in lymph nodes higher up the chain and those who wouldn’t so that we could develop a prediction model that would allow us to only perform extra lymph node surgery on the patients who would benefit from it and avoid extra surgery in those that wouldn’t.
d-breaking This work is in its early stages but it clearly has great benefit for our patients and he is a deserving winner of the prestigious British Journal of Surgery Prize when he presented this work at the recent Association of Breast Surgery meeting. “I am delighted to have won the Association of Breast Surgery prize, and pleased that our work is receiving recognition at a national level. I am incredibly grateful to the Breast Department at the Royal Surrey County Hospital, and the Department of Healthcare Management and Policy at the University of Surrey for all their support. I was very fortunate to have worked at the Royal Surrey County Hospital. I feel that it provides a very supportive environment, with seniors taking an active interest in the career progression of their junior doctors.” Tom Milner
Volunteers Summer Tea Chairman Peter Dunt was joined by members of the board and senior managers to serve afternoon tea to the volunteers. The annual summer tea, held this year on 25 July, is an opportunity to say ‘thank you’ to the loyal team of volunteers for the support and help that they provide to both patients and staff at the hospital.
A Taste Of Medicine at the Royal Surrey A collaboration between Mr. Solan, Mr. Templeton-Ward, Chrissie Beard and Catherine Hobbins brought a ‘Taste of Medicine’ to students hoping to follow a career in Medicine. Forty students spent two days at the hospital where they learnt about the life of a medical student, career options available, including a talk from Dr. Ben Gupta who works around the world with Médecins Sans Frontières. The students watched surgery via a live link to theatre; they were able to experience the world of 3D surgery with Dr. Kat Schwab, surgical skills simulation in the MATTU and clinical encounters in the hospital. We already have a comprehensive work shadow programme and a student volunteer scheme. Following the success of the ‘Taste of Medicine’ it is hoped that we will be able offer this opportunity to potential medical students on an annual basis. 23
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