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Doncaster and Bassetlaw Hospitals NHS Foundation Trust

April 2014

Young people & their health

BASSETLAW’S A&E

30th Birthday

Pioneering neck surgery

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

Contents

If you have any comments or want further information about any of the articles in Foundations for Health please get in touch with the Communications & Engagement team on 01302 647085 or email Lee Kilby, Acting Head of Communications & Engagement, on lee.kilby@dbh.nhs.uk.

11 4

3 #hellomynameis

9 Insight

3 Pioneering surgery

9 The Productive Ward – more time for patients

4 Custom made, individual crafted supports 5 First in Europe to benefit from new arthritis drug

6 10-12

Special Guest Section

13 NHS Leadership Academy

5 Keeping you in touch

14 Bassetlaw Hospital’s A&E Department: 30 years old

6 Behind the scenes...

Who’s the Governor?

7 UNICEF Baby Friendly Award

Governors support

7 Gold and Silver for haemodialysis team

Member census

8 Tai Chi physiotherapy

Doncaster and Bassetlaw

Prostate Cancer Support Group Cancer can affect many areas of your life and coping with the emotional effects of cancer can be tough. It can also be very hard for family and friends; they may not know what to say or how they can help. The Doncaster and Bassetlaw Prostate Cancer Support Group offers valuable support and information to anyone affected by prostate cancer.

The next meeting is on Friday 2 May between 2.00-4.00pm in the Education Centre at Doncaster Royal Infirmary. Try out the Park and Ride from Doncaster Racecourse. It’s free! If you are interested and like further information then contact Tina or Julie on 01302 553222. For more information about prostate cancer go to www.prostatecanceruk.org.

Tina Soar, Uro-oncology Nurse Practitioner, said: “Prostate cancer can affect one in eight men at some time during their lives. Being told you have cancer is a massive thing to deal with and having this support group means that you don’t have go through it alone. We offer expert knowledge and specialist advice as well as giving you the opportunity to talk with others who are also experiencing the same. We also have guest speakers on topics of interest. We hope that anyone who is affected by prostate cancer to come along.” Meetings of the support group are run by the Trust’s Uro-Oncology Nurse Practitioners, Tina Soar and Julie Horseman and also a Prostate Cancer UK representative.

Dr Mahmoud Al-Khoffash, Consultant Rheumatologist

Member Event Do you have arthritis or know someone who has, or perhaps you just want to find out more about this condition? If so, why not come along to our next member event on 19 June at Doncaster Royal Infirmary. We’re focusing on arthritis and speakers include Dr Mahmoud Al-Khoffash, Consultant Rheumatologist, plus a representative of Arthritis Research UK.

(I-r): Julie Horseman and Tina Soar, Uro-Oncology Nurse Practitioners

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For further details, or an invitation, please contact the Foundation Trust Office on 01302 381355 or foundationoffice@dbh.nhs.uk.

Pioneering surgery to remove huge tumour A woman who had been living with a two kilogram tumour on the side of her neck for over 20 years has made a remarkable recovery following surgery to remove the massive lump.

(I-r): Shirley Fearn, Ward Manager; Mike Pinkerton, Chief Executive; Dr Susie Thoms, Anaesthetic Registrar; and Lynne Whitaker, Outpatient Matron

#hellomynameis We’ve pledged our support for the #hellomynameis campaign.

he campaign was launched last summer by Dr Kate Granger, a doctor working at Leeds Teaching Hospitals, who has terminal cancer. While in hospital as an inpatient, Dr Granger observed that hospital staff didn’t always introduce themselves properly to patients. She felt that a simple introduction by staff would go a long way towards putting patients at ease. As a result, Dr Granger decided to start the #hellomynameis campaign on Twitter and through her on-line blog. Her mission is to make a cultural change and get as many members of NHS staff to pledge to introduce themselves properly to their patients.

“Dr Granger’s story is incredibly powerful, as anyone who has read her blog on-line would agree.” Dr Susie Thoms has championed the #hellomynameis campaign at Doncaster and Bassetlaw Hospitals. She said: “Dr Granger’s story is incredibly powerful, as anyone who has read her blog on-line would agree. Her illness enabled Kate to experience patient care first hand where, despite her own medical background she felt many of the fears and concerns that all

“A confident introduction is the first step to providing care and is often all it takes to put patients at ease and make them feel relaxed whilst using our services.” patients must share. She believes that all healthcare professionals could take simple steps to improve the hospital experience for their patients. “Here at Doncaster and Bassetlaw Hospitals we wanted to show our support for the #hellomynameis campaign - and for Kate - by asking staff to make more of a conscious effort to introduce themselves to any patient, the first time they meet. “A confident introduction is the first step to providing care and is often all it takes to put patients at ease and make them feel relaxed whilst using our services. We are also reminding staff to ask the patient how they wish to be addressed and ensure their name badges are visible at all times whilst on hospital premises.” To find about more about the #hellomynameis campaign and about Dr Granger, please visit her blog at: http:// drkategranger.wordpress.com/2013/09/04/ hellomynameis/

April 2014

Joyce Haigh, 79, from Thorne Moorends near Doncaster, amazed doctors when she went to Doncaster Royal Infirmary’s Emergency Department in October 2013 with the football sized tumour. Joyce had been brought to hospital by husband, George after the lump had started to bleed relentlessly. After initial treatment, medics referred Joyce to the hospital’s Ear, Nose and Throat (ENT) specialist Mr Muhamad Quraishi who surgically removed the tumour during a five hour operation on 7 January 2014. Mr Quraishi, Consultant ENT Surgeon, said: “In the whole of my 20-year medical career I can honestly say that I have never seen or treated such a massive tumour. The operation itself was quite challenging and I am happy with the outcome and that the operation was a complete success. The greatest challenge was to prevent the side of Joyce’s face from becoming permanently paralysed which we successfully prevented. I have since found out that Joyce’s lump is the largest to have been removed from somebody’s head or neck at Doncaster and Bassetlaw Hospitals and the largest ever reported in UK. “That we were able to carry out this operation in Doncaster, and not have to transfer Joyce to another hospital, is a great testament to the skill of the people who worked with Joyce. It now means that we will be able to carry out similar surgery in the future, should the need arise.” Joyce’s story has since been picked up by news outlets in over 15 countries across the globe.

Joyce before

Joyce after

surgery

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Orthotic device with pattern

The hospital staff who create custommade, individual crafted supports

team of highly-skilled craftspeople have joined the Trust to create bespoke devices for children and adults who need more specialist additional support or stability for their bones and joints than is provided from off-the-shelf versions. We have has set up our own workshop manufacturing custom-made, individuallycrafted devices for patients with a range of conditions including cerebral palsy, multiple sclerosis, motor neurone disease, arthritis, diabetes-related foot problems, stroke, and injuries caused by trauma. The team of three experienced orthotics technicians lovingly craft everything from tiny leg braces for toddlers with developmental conditions that affect their walking to body braces for teenagers with scoliosis, a curvature of the spine that can be corrected over time with the right support.

They also make a wide variety of foot insoles and supports, all painstakingly manufactured to create the perfect fit and level of comfort. Patients can even choose to have their ‘orthosis’ made in a range of different patterns or colours. It’s a new venture for us as until now we had purchased orthotics from private manufacturers. Patients who are referred by their consultant first have a detailed assessment by a qualified orthotist. The orthotist carefully studies the patient’s gait and position, taking hundreds of measurements along with drawings or plaster casts and foam impressions to design the perfect insole, brace or support for them. They also use their specialist expertise in understanding different plastics, foams and other materials to make sure the final piece provides exactly the right level of comfort and support.

Then it’s over to the new orthotics manufacturing team who receive the drawings or casts and impressions and craft them from the raw materials, piece by piece, starting with the main element and adding cushioning, additional support and fasteners as required. Patients can see the Orthotics team at a wide choice of venues including Chequer Road Clinic in Doncaster town centre, Doncaster Royal Infirmary, Bassetlaw Hospital, Montagu Hospital in Mexborough, and Tickhill Road Hospital in Doncaster. The team also visit Heatherwood School in Doncaster and St Giles Special School in Retford to see patients who are studying there. • You can view short film clips showing how orthotic devices are made on the Doncaster and Bassetlaw Hospitals YouTube channel at http://www.youtube.com/user/ DBHHospitalsNHS.

Orthotics workshop manager Steve

Steve polishing

Orthotics technician

Hague with orthosis on vacuum

an orthosis

Harriet Mallinson

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Doncaster man is first in Europe to benefit from new arthritis drug A

The Ascertain trial is one of several clinical trials that Dr Yee is hoping to bring to Rheumatology patients of Doncaster and Bassetlaw Hospitals.

Mr Wynne was the first person in Europe to sign up for the trial, which will see if the drug can help control severe Rheumatoid arthritis.

Dr Yee added: “It’s great that Mr Wynne’s arthritis is responding well and hopefully that will continue for him. When I came to Doncaster and Bassetlaw Hospitals I wanted to bring in more clinical trials like this. The Department of Rheumatology and the Trust’s Research and Development team has made it possible.

Doncaster man with severe arthritis is benefitting from the trial of a new drug at the Trust.

In October, 63-year old Peter Wynne, of Clay Lane in Doncaster, who has severe rheumatoid arthritis in his hands, knees and shoulders, agreed to take part in the ‘Ascertain trial’ after he was contacted by Consultant Rheumatologist, Dr Chee-Seng Yee.

As part of the trial Mr Wynne has been receiving fortnightly injections of the trial drug, known as Surilumab. It’s hoped that the Surilumab – a biologic drug that targets a specific molecule that can cause arthritic inflammations - will help ease Mr Wynne’s condition. Mr Wynne said: “I’m very glad that I’ve taken part in this trial as I am already seeing results. I’ve suffered with arthritis since my forties but in recent weeks the arthritis in my hands has improved and I am feeling a lot better in myself too. “When Dr Yee asked me if I wanted to take part in the trial I thought it was worth a shot and if it worked, would not only benefit me, but many other people in the future. I’m very glad that I went for it.”

Keeping you in touch by email, Twitter and Facebook We can email you this magazine and other relevant news and information. Just contact the Foundation Trust Office on foundation.office@dbh.nhs.uk to give us your email address. You can follow us on Twitter @DBH_ NHSFT and find us on Facebook for all our news and other interesting updates.

Twitter lesley_turley: Mini me enjoying lunch today post Op at Doncaster Royal Infirmary. Big thx to all staff #amazing #doncasterisgreat

“Doncaster and Bassetlaw Hospitals is very progressive with its outlook on Research and Development, which is good news for patients as more and more often we are able to provide people with new or alternative treatments. “It is also a very positive thing for patients to be involved in, as trials can break the cycle of treatment that patients may be experiencing. Many patients are also very happy to know that they are part of a process that could bring long-term benefits to many people with their condition in the future.” Anyone who is interested in finding out more about Doncaster and Bassetlaw Hospitals Research and Development, and other trials that are being carried out should contact the Research and Development department via 01302 366666.

High-tech maternity computer system funding Our maternity services have won £444k government funding for a new information system that will dramatically increase the amount of time midwives can spend caring for women rather than doing paperwork. We have estimated that a staggering 12,483 hours a year of midwives’ time could be freed up by the new software, which is being part funded by the Safer Hospitals, Safer Wards Technology Fund. The new computer system will be fully electronic and web-based so that hospital and community midwives can enter information straight away instead of writing paper records.

It will be integrated with other hospital IT systems to provide an electronic maternity record with all the clinical notes relating to each woman’s care. Because midwives and other staff will only need to enter information once, clinical records will be completely up to date, eliminating any time delay between handwriting notes and inputting them into one or more computer systems. Authorised staff will be able to enter and access this information immediately from any location via a secure web link. Women having babies in Doncaster and Bassetlaw will also be able to use the new computer system, giving them a greater level of

access to and involvement in their care records than has previously been possible. Deirdre Fowler, Head of Midwifery, said: “We are absolutely delighted that our bid for this funding has been successful. It will totally transform the way midwives work, enabling them to spend much more of their time caring for women having babies and working with families, rather than on paperwork. “It will also enable us to improve the service by giving mothers access to online records. A further benefit is that it will provide better, more complete clinical data that will improve our ability to audit and strengthen the safety and quality of our maternity care.”

April 2014

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(l-r): Nursing Student Salina McMullen,

Kelly Knight, Service Assistant/Cleaner

and Sister/Clinical Educator Fran Taylor

doing high dusting

Behind the scenes...

in Critical Care

If you’ve ever had a family member or close friend who has needed critical care, you will know just how daunting this environment can be.

ere at the Trust we provide intensive care medicine at Bassetlaw Hospital and Doncaster Royal Infirmary. Patients who come into the Critical Care Unit have serious conditions, medical or surgical that require constant, close monitoring by a team of critical care specialists. Quite often patients will need medical equipment to help them breathe, monitor their condition and support their body functions.

“Most of our patients need the use of a ventilator to support their breathing.” First impressions on entering the unit are how quiet it is – the only sounds are those coming from the ventilators and monitors and the staff as they go about checking their patients’ condition. Some critically ill patients are so poorly that they require a lot of support. One nurse is allocated to only look after a single patient during the whole of their working shift. This is because of the complicated and challenging nature of this group of patients and having a designated nurse means that any deterioration is spotted quickly and acted upon. When we visited the unit there was a gentleman who had been on a

ventilator for about 48 hours after being resuscitated following a heart attack at home. Another patient was very ill with a brain haemorrhage. Both of these patients are classed as level three, requiring a ventilator to assist their breathing around the clock. The unit also cares for high dependency or level two patients. These are patients who are less severely ill and can stay awake, but still need continuous and specialist monitoring. Fran Taylor, Sister/Clinical Educator, has just finished assisting with a tracheostomy on a patient, she explains: “Most of our patients need the use of a ventilator to support their breathing. We perform tracheostomies to create an opening at the front of the windpipe so that a tube can be inserted and connected to a ventilator to make breathing more comfortable for the patient. It allows the patient to be supported by a ventilator without having to be sedated. “In my Clinical Educator role I provide practical training to all new nurses on how the ventilators, monitors and any other new equipment works. I also look after the nursing students during their two week placements showing them how to look after critically ill patients.” Salina McMullen, a second year nursing student on day two of her two week placement, said: “I was nervous when I first arrived. The machines and equipment can be

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daunting until you get to know what they do. It’s a totally different nursing experience. The patients have very complex medical needs and each nurse focuses on one patient. I am looking forward to the rest of my time in the unit.”

“I clean every inch of the unit, from high dusting, to the bed frames, windows, vents and damp dust and mop all the floors.” There is a great team spirit on the unit and the patient is the main focus with everyone helping out in times of need. Kelly Knight, Service Assistant/Cleaner has worked at Bassetlaw Hospital for two years and her role involves cleaning the unit. She said: “Since working here it’s the first time I have felt part of a team, they are friendly bunch. Some of the patients can be here for a long time and you do get attached to them. Although they can’t talk because of the ventilators you develop a form of sign language to communicate. I clean every inch of the unit, from high dusting, to the bed frames, windows, vents and damp dust and mop all the floors.”

UNICEF Baby Friendly Award We’ve been awarded the prestigious Baby Friendly Award from UNICEF and the World Health Organisation, for the high standard of care given to pregnant women and breastfeeding mothers and babies. The Baby Friendly Initiative is a global programme which provides a practical and effective way for health services to protect, promote and support breastfeeding and to strengthen the mother-baby and family relationships. The Award comes after an assessment by a UNICEF (United Nations Children’s Fund) team which found that recognised best practice standards are in place at our Maternity Units at Doncaster Royal Infirmary and Bassetlaw Hospital.

The assessment also found that 66.09% of mothers at Doncaster Royal Infirmary and 67.56% of mothers at Bassetlaw Hospital choose to breastfeed their babies.

3 accreditation. Stage 3 is the highest level of the Baby Friendly Hospital accreditation and means that Doncaster and Bassetlaw Hospitals has introduced and implemented the Baby Friendly standards in the care of pregnant women and new mothers.

The UNICEF assessors commended staff for their work and efforts and confirmed that we met all of the criteria relating to Stage

For more information about the UK Baby Friendly Initiative go to www.unicef.org.uk/ babyfriendly or www.babyfiendly.org.uk

Infirmary achieved 100% in 6 areas and achieved over 90% in 11 areas.

The UNICEF team visited the Trust’s Maternity Units at Doncaster Royal Infirmary and Bassetlaw Hospital in December 2013. Both units were assessed against criteria relating to antenatal care, keeping mothers and babies together, offering practical information and support, breastfeeding and artificial feeding. The findings from the assessment showed that both Maternity Units scored significantly higher than the 80% standard required in all the criteria. Bassetlaw Hospital’s maternity unit scored 100% in 15 of the 26 criteria used in the assessment, and Doncaster Royal

(I-r): Infant Feeding Coordinators Elaine Merrills and Susan Henderson

Gold and Silver for R

haemodialysis team

enal unit staff celebrated with colleagues from across Yorkshire and Humber after winning recognition at the national Training Journal Awards. The Yorkshire and Humber Shared Haemodialysis Care Team scooped the Gold award for Best Public Sector Programme for a bespoke training programme that gives nurses the skills they need to support patients having kidney dialysis. They also won the Silver award for Best Training Partnership for their work on the programme with Berkshire Consultancy and the Health Foundation. The course was developed as part of a programme supported by the Health Foundation to help staff involve dialysis patients more in their own treatment. Hospital staff hear from patients talking about their experiences of care and get a better understanding of people’s learning styles. They also learn about motivational interviewing, a technique that healthcare professionals can use to support clients and patients in achieving an agreed outcome or behaviour. Patients receive a booklet that helps them gain excellent levels of competency in self-care and nursing staff can access an electronic journal full of useful information and guidance. The training programme is now offered at all 26 dialysis centres in Yorkshire and Humber and has gained national acclaim.

Gold and Silver for haemodialysis team

The course was developed by clinicians from across the region, led by matrons from Sheffield and York, with the help of a patient and shared care educators.

April 2014

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Tai Chi physiotherapy

for arthritis patients P

atients attending physiotherapy sessions at the Trust’s hospitals now experience the power of Tai Chi to ease their arthritis symptoms all thanks to a special programme called ‘Tai Chi for Arthritis’. A team of 25 physiotherapists have been studying the principles and practice of Tai Chi to promote good health and the management of arthritis and falls prevention to their physiotherapy patients. Tai Chi is well known for its health benefits as a way to relieve pain, improve health and the ability to do things. There are many types of Tai Chi and the Tai Chi for Arthritis programme has been developed by teams of medical and Tai Chi experts from around the world. Ruth Bruce, Physiotherapist, said: “Many of our patients who attend the hospital for physiotherapy have arthritic conditions which are characterised by joint stiffness and impaired movement. We know that Tai Chi gently frees up stiff joints and muscles and patients benefit from increased muscular strength, flexibility and fitness. This is why we have incorporated the Tai Chi principles and techniques into our

physiotherapy sessions.” The Trust’s physiotherapists decided to embark on the Tai Chi for Arthritis programme and enlisted the help of local Tai Chi for Arthritis instructor Ken Campbell to teach them the principles so that they can pass on the techniques to their patients.

“This is why we have incorporated the Tai Chi principles and techniques into our physiotherapy sessions.” The benefits don’t stop there, Tai Chi helps people to relax and feel better which improves sleep and overall wellbeing. It is especially beneficial for older people because it can be easily adjusted to suit all levels of fitness. Practicing Tai Chi for Arthritis improves your balance so it is a real prevention against falls which can be devastating for older and younger people alike. Tai Chi works

(I-r): Physiotherapist Helen Sparks and Tai Chi Trainer Ken Campbell

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in three ways, it increases muscle strength which protects the joints and reduces pain, it improves flexibility allowing better blood and joint fluid circulation, and it improves relaxation of the mind which in turn reduces pain and stress. Those who practice this ancient art form often experience less depression and enhanced immunity.

The Productive Ward

– more time for patients

n 2008 we introduced a pilot scheme on one ward. The scheme was called the Productive Ward and it proved so successful that we decided to roll it out across other wards in the Trust. You may not have heard of the Productive Ward but the principles behind it are very simple. It’s about changing the ward environment and finding better ways of doing things so that staff can spend more time with their patients. The beauty of the Productive Ward is that it’s a team effort. All staff become involved, the nurses, cleaners, ward assistants, doctors, supplies people, and dieticians, just everyone. Staff know the problems, take control and focus on what makes real improvements on their wards. It’s about harnessing small changes to demonstrate improvements, for example by just completing some of the paperwork at the patient’s bedside helps to engage the patient and gives them the opportunity to ask questions. Having a tidy ward or store cupboard where staff can find dressings and equipment quickly saves a lot of time searching and fetching.

“When you go onto a ward that has implemented the Productive Ward scheme you can see the benefits straightaway. ” Some wards have introduced a red tabard system so that the nurse administering medicines is not interrupted. This means less errors and a faster process for administering medicines. Anita Hobson, Productive Ward Project Manager, said: “A well organised ward provides patients with safe, unhurried and timely care. We know it works and my role is to support

Anita Hobson, Productive Ward Project Manager

Insight NAME: Gary Metcalfe. OCCUPATION: Complaints Officer. FAVOURITE HOLIDAY DESTINATION: Italy. FAVOURITE RESTAURANT: Butler’s Bistro at Cusworth Hall. WHO MAKES YOU LAUGH? Miranda Hart and Mrs Brown (Mrs Brown’s Boys). INVITING FIVE FAMOUS PEOPLE TO DINNER, WHO WOULD YOU CHOOSE? Stephen Fry, Miranda Hart, Mel and Sue (from the Great British Bake Off) and Carl Pilkington. MOST MEMORABLE MOMENT IN YOUR CAREER: My involvement with the victims and families of the Selby train crash.

David Cuckson, Patient Governor and Productive Ward representative

and guide staff and make it easier for them to stay on track when there are so many competing demands on their time. “Scrutinising processes, identifying the problem areas and coming up with solutions can be liberating. Let’s take a look at mealtimes: Common issues that arose included taking too long, patients not prepared for their meals, not identifying those patients who need help eating, the meal trolley too far away from the patient areas, resulting in cold meals. “Using the Productive Ward programme we introduced a red tray to identify those patients who need help eating or at risk of malnutrition, allocated specific staff to patients to help them with their food, provided hand wipes for patients who can’t reach a sink, and introduced protected mealtimes so that no other routine activity occurred during this time. It made the whole process smoother and calmer but most of all the patient benefits.”

WHAT WOULD BE YOUR IDEAL WEEKEND? Sunshine, a good bottle of dry white and a meal on my patio. FAVOURITE CD OR MUSICAL ARTIST(s): My taste is too wide to choose just one. FAVOURITE BOOK OR AUTHOR: I really don’t have one. STRANDED ON A DESERT ISLAND WITH ONE/TWO PERSONS WHO WOULD YOU CHOOSE? My wife and Bear Grylls – I’d need him to find food, get a fire going and build us a shelter. WHAT IS YOUR GREATEST FEAR? Being trapped in a burning building. THREE WORDS YOU THINK DESCRIBE YOU: I’m told that I’m friendly, approachable and a bit of a flirt.

Even having a noticeboard where staff can see at a glance each patient’s status saves time instead of searching through individual records. It’s a simple idea but it frees up staffs’ time to focus on what’s important - the patient. Patient Governor David Cuckson takes a keen interest in the Productive Ward and regularly visits a couple of wards, he said: “When you go onto a ward that has implemented the Productive Ward scheme you can see the benefits straightaway. The ward is tidy and the staff are able to find things quickly. I like to speak to patients and carers because their views and experience are vital to the process. I ask them how they have been treated, what the food’s like and the hospital routine. I also chat to the staff and observe the look of the ward, for example if the storeroom is in order and the noticeboards tidy. These may seem like small things but there’s evidence to show that they do make a big difference to how much time staff spend with patients.”

April 2014

Gary Metcalfe, Complaints Officer

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Special Guest Section

Young people and health

Students from Retford Post 16 Centre are our guest editors for the next section of Foundations for Health. They’ve written and edited all the articles and photos on these pages and they have done brilliantly.

A Day in the Life of a Teenage Diabetic by Joe Birch

7.00am: I wake up usually in a groggy state occasionally I surprise myself with an energetic start!. There on my bedside table is my insulin pen, amongst all my books and needles. I inject my bolus (aka ‘long-term’) insulin into my leg. Calling mum to help me really is a last resort. I get ready for my day and head downstairs to test my blood sugars by pricking a finger with a very small needle. The tiny little holes stick around for quite a while. The blood is placed on a strip in a machine which analyses my blood, calculating how much glucose there is. If it’s too high, it will calculate how much I have to inject to bring it back down to a normal level, normal being classed as about 6. My blood sugar levels are usually between 10 and 15 in the morning, so a quick injection into the leg or stomach is needed to bring the level down. 8.15am: The first thing that goes into my bag is my blood machine followed by my insulin pens, a mini can of coke (the full fat type!) in case the blood sugars go low, and then of course it’s my schoolwork. Whilst at the Post 16 Centre I have an

alarm set on my phone to go off every couple of hours until lunchtime. I stop whatever I’m doing at each alarm and retake my blood sugar test and depending on the level I might have the can of coke or I go through the injection again if too high. For the first few weeks in sixth form, I would step out of the classroom to inject. Now, I feel more comfortable in being able to inject whilst in the classroom (I opt for the stomach rather than getting my legs out!). To be honest, I don’t think many people notice, which is a good thing and even if they do they usually just want to know if it hurts! No, not really after 11 years, unless of course I hit a nerve. 1.00pm: After lunchtime, it’s very weird, my blood sugars creep higher so my alarm is switched to hourly. If too low, I have a sugar top-up, if too high, another injection. I also inject every time I eat. I eat a lot so that means a lot of injections, but I’m not one to go without food. I enter how many carbohydrates are in my food again into my machine. A list of carbs is imprinted on my brain. The injections mimic the way that the body uses background

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insulin. When we have something to eat the pancreas, a small yet important organ hidden just behind the stomach, releases insulin to break down food into useable fuel. The injection is therefore equivalent to the pancreas. 4.00pm: At the end of a grueling day at sixth form (I have to put that!), I revert to my two hourly routine. I eat as soon as I get home and just inject but can’t usually be bothered to do yet another test. At dinnertime I do my blood sugars and they are usually a bit high so dinner with injection on the side. 8.00pm: I take my other ‘long-term’ injection which should keep my level stable until the morning and then the routine starts all over again. I know that in the future I won’t need to do these twice a day but a teenager with raging hormones doesn’t have an option. As the weekend approaches I know that mum is going to remind me I need to do a clean sweep of my room as my used needles need to go in my Sharps Bin. Needles and young people in the house are not the safest of combinations, but in their favour, they are all well-educated now in the world of insulin and injections.

Depression: Myths and the truth

Artist Liz Gray, Year 13

Photos of these paintings were taken by Hannah Cave

Artist Kasia Dzilinska, ex-student

Myth: Depression is just feeling sad Truth: Depression is a lot more than just feeling upset. It’s a severe feeling of negativity targeted at the self, the world and the future. A sufferer will feel withdrawn from society and struggle to function in a way that others take for granted. A person with depression may begin to hate themselves and believe they are not worthy of living. This is what causes some severely depressed individuals to commit suicide. Depression is a very debilitating disorder that carries an unjust stigma of inferiority and weakness. We all feel sad from time to time but when this sadness impacts on your ability to function in everyday life, depression may be setting in. Myth: Depression isn’t a serious illness Truth: Depression is a serious mood disorder. There are many types of depression, some include symptoms of other mental disorders such as mania and hallucinations. Depression can sometimes be seen as a gateway illness that leads to many other mental health problems. Myth: Depression can only affect the unintelligent Truth: Psychologists have yet to make any links between low intelligence and any mental illness. On the contrary some of the most successful people in history have been thought to have depression. Charles Dickens, Isaac Newton and Wolfgang Amadeus Mozart all experienced major depressive episodes. Myth: You can’t get depression unless it runs in your family Truth: Although psychologists have found a strong genetic link, it’s thought that depression is caused by numerous factors. Having a close relative with

April 2014

depression does increase the risk of developing the disorder, however it does not guarantee that they will. Similarly, a person without a family history of depression can still develop the illness. Myth: You can only get depression if you’ve suffered a trauma Truth: Psychologists recognise that trauma can trigger the onset of depression in some people but this is not always the case. Over time most people with depression are able to pinpoint when and why their depression began, however some people never know. Anybody can develop depression regardless of age, lifestyle and status. Myth: Everybody with depression wants to die Truth: This is absolutely untrue. Though suicidal thoughts are common in people with depression, the majority of patients do not act on these impulses. Only 10-15% of people with severe depression commit suicide. Myth: Depression could be cured if patients would just ‘cheer up’ Truth: It’s recognised that treatments are enhanced by the patient’s willingness to ‘cheer up’ but this is rarely successful alone. Counselling, psychotherapy (analysing past experiences to understand why a person is depressed) and cognitive behavioural therapy (encouraging people with depression to alter the way they think about themselves) are both commonly arranged to decrease depressive symptoms. Prescribed medication may also be offered by a GP. Recent advancements in treatments are making it more and more possible for even the most severe cases of depression to be overcome. Help is available!

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Special Guest Section

OCD by Charlotte Hessey Definition Obsessive Compulsive Disorder is a mental disorder, (commonly known as OCD) and is characterised by intrusive thoughts and a need to perform repetitive behaviour and is coupled with intense anxiety. The description given implies that this disorder has no serious effects. This is certainly not the case.

from the illness can’t do this, due to fear of contamination or dirt. This may be a thought you can shrug off easily, but to some it’s the reality. The main symptoms of OCD include obsessions (for example, dirt and contamination) and compulsions (an example could be what’s called ‘checking rituals’ which is checking and re-checking a certain action, such as door locking.) Some people spend hours checking and rechecking. It has been found that OCD is often linked with other mental disorders like depression.

“My room is white, white bed, white sheets, white curtains, white Causes lamp; all the TV One cause of OCD is thought wires are behind to be biological due to a lack white plaster, of serotonin to the brain. plug sockets Serotonin is a neurotransmitter are concealed in which contributes to a person’s emotions and well-being, the wardrobe.” Impact of OCD OCD drastically changes the lives of those affected, bringing with it a multitude of issues. Imagine not being able to leave your house. In some cases a person suffering

although there is no definitive proof of this. Others believe that OCD comes from an individual’s personal experience, is a way of coping from a trauma. Another theory cites the individual’s upbringing as a factor for causing the disorder, though it is not held

Artist Becca Thorpe, Year 13

in high regard compared to the biological explanation.

Treatments There are plenty of palliative treatments to aid the condition and help reduce symptoms. Drugs such as Prozac or Tofranil have been found to be an effective aid for the disorder. For those who prefer other therapies, there are counselling options or Cognitive Behavioural Therapy.

Case study: Jamie’s 18 and has OCD. “My surroundings have always been highly ordered and I wouldn’t wish them to be any other way. I don’t think I developed OCD over time but, due to exposure to order in my home life, it’s now a part of me.

“I put black binders on all my books, which are ordered by size on my black book shelves. All my clothes have their own wash cycle; a green wash, a black wash and a brown wash. If I wear an outfit it will all be washed, tumble dried, ironed, folded and put away in the same day. That’s why I don’t sleep that much! If I’ve had a night out, there is just a really drunk Jamie in the pantry with a tumble dryer going. On holiday I sometimes buy new clothes or take ones that I can dispose of when I am unable to undertake my routine of washing. At Leeds Festival I was one of the very few who showered and I left all of my clothes and my tent at the campsite. I’ve even had to remove all of my facial piercings, they are no longer symmetrical as the placements have altered over time.” The future for those with OCD is positive; if it’s not treated individuals may experience the same symptoms thirty years later in life. However, with treatment the majority of people diagnosed with OCD make a full recovery, or recover enough to enjoy a healthy lifestyle. They can regain a more enjoyable life, in which they feel free to socialise and to enjoy the outside world.

Artist Becca Thorpe, Year 13

Photos of the paintings taken by Hannah Cave, Year 12 12

“My room is white, white bed, white sheets, white curtains, white lamp; all the TV wires are behind white plaster, plug sockets are concealed in the wardrobe. Can you imagine black wires on a white wall? That wouldn’t be right! There’s not a lot I can do about the black TV screen.

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NHS Leadership Academy: Recognising outstanding leaders in the NHS T

he NHS Leadership Academy is a brand new leadership training programme for NHS staff. It aims to develop NHS staff to create a working environment where innovation can thrive and in doing so improve the health services for patients. We have 44 staff who’ve been accepted and enrolled on the training programme. Improving compassion and the quality of patient care starts with leadership and these programmes are to ensure NHS leaders of the future are committed and passionate, it doesn’t matter what job you do or how experienced you are. Deirdre Fowler, Head of Midwifery, is doing the Nye Bevan programme, she said: “This programme is set to equip the students with the skills to powerfully lead culture change at a regional, national, and organisational level as an executive leader. The programme feels different from others I’ve undertaken and reflects the recent NHS emphasis on quality, improved clinical outcomes, patient experience and staff engagement, in addition to maintaining financial stability. It has been an amazing opportunity to participate in sessions facilitated by internationally renowned business and academic experts, KPMG, Manchester Business School and University of Birmingham. It involves intensive work with multidisciplinary peers where we are charged to challenge the existing systems of healthcare and innovate new ways to deliver even better patient care. It’s tough but definitely worth it.”

Deirdre Fowler, Head of Midwifery

Pictured centre is Lynne Whitaker, Matron

Lynne Whitaker, Matron Outpatient and Clinical Administration CSU, said of her experience so far on the Mary Seacole programme: “Self-awareness is one of the main topics covered in the first part of the Mary Seacole Program, looking at your own ‘emotional intelligence’ and learning styles, thought of as key qualities of today’s NHS leaders. I started the course in November 2013 and I’m pleased to say that I have passed the first of five assignments. There are nine online learning units aimed at inspiring a practical and resourceful leadership style, and the group leadership workshops bring

Mel Fox, General Services Co-ordinator

together those on the programme to continue with the learning from each other. Patient stories are very emotive and help to stimulate the thought process, and learning from the Francis enquiry and others is also included. It has definitely taken lots of my time to work through the programme so far but I aim to have passed by the end of October this year. Three words sum it up ‘intense, revealing, inspiring’. Melanie Fox, General Services Coordinator, tells readers her thoughts so far: “The Mary Seacole Leadership Programme is a very intensive 12 months study course. As well as the modules and assignment, we are also looking at issues or problems within our own services to develop improvement initiatives using effective leadership skills to provide quality services. Following on from Mid Staffs we all need to adapt to new challenges and work together to develop best practice as integrated, well communicated, motivated and engaged teams of staff that all have one thing in common - patient centred care. I feel that this programme will help me develop into an experienced, effective and efficient leader, with a vision to care for the hospital, its services, staff, patients and visitors with commitment, respect, quality and compassion.” For more information please visit www.leadershipacademy.nhs.uk

April 2014

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History Matters

Don’t throw it away! Garry Swann is always keen to hear about all aspects of the history of any of the Trust’s hospitals, and to add items of interest to the Trust Archive. You can email him at garry. swann@dbh.nhs.uk or call him on 01302 647014.

Bassetlaw Hospital’s A&E Department: 30 years old

hirty years have passed since Bassetlaw Hospital’s Accident and Emergency Department was officially opened. It was the first phase of the District General Hospital for which the people of Worksop had waited so long. First mention of a District General Hospital for the area appeared some 16 years earlier, in June 1968. Those 16 years were filled with assessments, reports, costings, plans, delays and, for the local health authority, frustration and hard bargaining. In 1972 a press conference was told that the first phase would provide an accident and emergency department, a maternity unit, two operating theatres, two X-ray rooms and an intensive therapy unit with supporting services, the whole to cost £1.5 million. Even after drastic scaling down of the original concept, when the first phase opened in March 1984 it had cost £5.6 million, plus £1.88 million for additional equipment. The maternity unit had been shelved, though some much-needed mental health services were included in the new facilities. On Saturday and Sunday 24/25 March 1984, orthopaedic patients were transferred from Worksop’s Victoria Hospital to the new orthopaedic accommodation, and on the following Monday the new Accident and

Emergency Department opened its doors. Generally, patients were impressed by their new surroundings, though some misgivings were expressed about the lack of waitingroom space and the need for more frequent buses to the new hospital. Two of the transferred female orthopaedic patients took exception to the ‘No Smoking’ rule (the Victoria Hospital had permitted smoking), and threatened to discharge themselves if the ban was not relaxed. Reluctantly, the managers gave in, if only as a temporary measure. The first two patients to enter the new Orthopaedic Department were 90-yearold Sybil Craik from Retford, and nursing auxiliary Margaret Brown from Kilton, both were presented with bouquets by the Bassetlaw Health Authority Chairman, Councillor Wally Bloomer. Work was completed in 1987 and casualty and inpatient facilities at Retford Hospital were transferred to Kilton Hill the following year. Since 1984 many things have changed: the A&E Consultant then was Mr W A ‘Tony’ Downie, an innovative surgeon who pioneered, sometimes to the bafflement of his colleagues, several techniques that are still in use today. In 1984 the department saw approximately 18,000 patients. Today the figure is 48,000, and there has been a consequent increase in the number of

The first patient to arrive at the new department, 90-year-old Mrs Sybil Craik, from Retford, receives a bouquet from Councillor Wally Bloomer, Chairman of Bassetlaw Health Authority. Looking on is Nursing Officer Chris Coldwell

departmental staff. Then the hospital’s catchment area included some 12 collieries, and about a third of patients were coal miners and their families. Several other local industries which also yielded patients have, like the coal mines, vanished from the area. Treatments too, have moved on. The soft collars handed out to many patients with neck problems are now rare, as are wash-outs for drug overdoses. These days, as well as the usual trauma cases, many medical conditions arrive at the door; people with chest pains, respiratory problems, diabetic disorders, stressrelated issues, victims of drug and alcohol abuse, and of course, as life expectancy rises, many of the aged. The present Lead Consultant, Mr Murad El-Salamani, and his staff are kept constantly busy. Bassetlaw’s health services achieved Trust status on 1 April 1992, to be known as Bassetlaw Hospital and Community Services NHS Trust. A partnership agreement with Doncaster Royal Infirmary and Montagu Hospital NHS Trust (formed in 1991) was sealed in 1995. A formal merger between the acute services element of Bassetlaw Trust and the Doncaster Royal Infirmary and Montagu Hospital NHS Trust was proposed in 1999, and was the subject of public consultation during 2000. The merger took place officially on 1 April 2001. Margaret Cox, Chairman of the Bassetlaw Trust, and Nigel Clifton, Chief Executive of Doncaster and Montagu Trust, were appointed Chairman and Chief Executive respectively of the new Trust.

‘Open at Last!’ Children’s Nurse Miss Margaret Brown of Worksop, the second patient to arrive, is greeted by Councillor Bloomer and Chris Coldwell. Looking on are Nurse Avril Hughes and Ambulanceman Bob Layhe

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Garry Swann, Archivist With thanks to Retford Times for the pictures, and to Chris Coldwell and Anne Shaw.

News from the Governors

Who’s the Governor? D

oncaster Public Governor Maureen Young is a nurse by trade. She completed her nurse training at St James’s Hospital in Leeds and then in 1968 she moved to DRI to do the night shift. After taking time off to have her family, she worked as a District Nurse in Doncaster for 14 years and then became a health visitor in Carcroft for a further 23 years. Maureen talks about her interests and what inspired her to be a governor.

“I am very passionate about the level of care given, especially to older patients and felt that with my nursing background I could influence further improvements.” Interests I do voluntary work with the Youth Offending Service as a community panel member. This

involves setting up contracts with young people on referral orders, agreeing what reparation and interventions will be put in place to help them avoid reoffending.

I am also a member of an art club and paint landscapes in watercolour and pastel. My main interest is in fostering for cats protection. I have two pens in my back garden for cats and kittens looking for new homes. This is quite hard work. I get up every morning no matter what the weather and go outside to empty litter trays, clean the pens, and feed the cats. I also take them to the vets when the need arises as well as spending time handling them and to help them socialise.

Why did I become a governor? I’ve been an inpatient on several occasions and visited relatives and friends in Doncaster Royal Infirmary. I am very passionate about the level of care given, especially to older patients and felt that with my nursing background I could influence further improvements. There have been many changes over the years and feel

Maureen Young and Pearl

that the standard of care has improved, but we mustn’t forget the basics and make sure that basic care keeps up with fast moving improvements in medicine.

Is the role what I expected? Not at first but now we are more involved in visits to wards and have more contact with patients and visitors so that we can ask them what they think of the services and how they can be improved. We also have more knowledge about the Trust’s long term planning, strategy and financial situation. This has made the role become more of what I expected.

Board of Governors meetings in 2014

Governor Summary

Come along to our Board of Governors’ meetings this year. The meetings are open to the public and it’s a chance to find out more about what’s happening at your local hospitals and to ask the top team questions.

Your governors have been involved in a range of activities over the last few months. Patient experience was the key focus of the Health and Care of Adults sub-committee, while the Health and Care of Young People subcommittee concentrated on education and play facilities for our young patients.

Meeting dates are: • Tuesday 29 April, 6.00pm, The Ivanhoe Centre, Gardens Lane, Conisbrough, DN12 3JX.

• Tuesday 17 June, 6.00pm, The Mary Woollett Centre, (formerly Carr House Centre), Danum Road, Doncaster, DN4 5HF. • Tuesday 23 September, 4.00pm Annual Members’ Meeting followed by Board of Governors’ Meeting, at the National Fluid Power Centre, Carlton Road, Worksop, S81 7HP.

Don’t forget to vote! It’s time to elect your governors so keep an eye out for your voting packs arriving through your post boxes in April. You have until 5 May to return your completed ballot and we will announce the election results soon after.

April 2014

The improvements to how the Trust deals with complaints was top of the agenda at January’s Board of Governors’ meeting. The Governors’ Timeout last December, focused on the Trust’s continuing work to promote care and compassion a vital ingredient for today’s health services. Other topics discussed included finance and the Keogh review.

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(l-r): Visiting the DRI kitchen are Governors Dev Das; Mike Addenbrooke; Nicola Hogarth; Pat Ricketts and Dennis Benfold

Governors support

the Global Nutrition & Hydration Week

uring the Global Nutritional & Hydration week (17-23 March) our governors and non-executive directors were invited on tours of the hospital kitchens to see the preparation and production of our patients’ meals.

It aims to raise awareness and improve understanding of the vital importance of good nutrition and hydration in social and healthcare settings, and illustrates how, by making changes to eating and drinking habits, people can improve their quality of life.

Catering staff explained the process of turning patients’ menu choices into ‘meals-on-theplate’. Governors even got involved by helping to load the meals onto patient trolleys ready for transportation to the wards.

It also keenly promotes a number of nutrition

and hydration initiatives including protected mealtimes for patients, the minimum standards for good nutrition and continued education of professionals on good nutrition and hydration. If you would like more information about the nutrition and hydration week go to http://nutritionandhydrationweek.co.uk/

After the tour of the kitchens, they then followed a meal trolley to a ward to observe the food service and to speak with patients about the quality and service of food. The verdict: an enjoyable and informative visit and satisfied customers all round. More about the Nutrition & Hydration Week Nutrition & Hydration Week is a collaboration between the Hospital Caterers Association (HCA), National Association of Care Catering (NACC) and Patient Safety First.

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(l-r): Visiting Bassetlaw Hospital kitchen are Governors David Cuckson; Hazel Brand and Clive Tattley, with Non-Executive Director Alan Armstrong.

Member census We want to provide our members with the best service possible and tailor the communications and activities we provide to you. Please take a few minutes to complete this short census so that we can make sure the details we hold for you are correct and up to date.

Name:

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I would like to receive this magazine electronically in future. I would be interested in receiving invitations to member events in future. I would be interested in standing for election as governor in future. I have been treated as an inpatient at this Trust. I have been treated as an outpatient at this Trust. I am a relative / carer of a patient of this Trust. I consider myself to have a disability.

Please take a couple of minutes to complete and return this form to: Doncaster and Bassetlaw Hospitals NHS Foundation Trust, FREEPOST NAT 17898, Doncaster DN2 5BR April 2014

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OCTAGON DE SIGN & M AR K ET I NG LT D

Working in partnership with the NHS

August 2012 | Issue 10

s of Liverpool Women’s News for the members and communitie

Inside

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

amazing family Jeanette and Arthur celebrating their

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

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

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

❛❛

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

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

lift their spirits.

That gave them the courage to try a third IVF which was unsuccessful - but with their fourth in 2005 they unknowingly hit the jackpot, starting off with the birth of Millie in February, 2006, 12 years after they were married. With their remaining embryos frozen, the for couple decided in 2007 to try for a sibling Millie - and Adam was born in January, 2008. He should have been a twin but sadly his twin was lost 17 weeks into pregnancy. In February, 2010, Matthew was born to final make it three. Then, last year, using their stored embryos, Jeannette, now 42, became pregnant again with Isaac and Lulu, who were born on June 28, 2012, making theirs one of the most successful IVF treatments ever at the Hewitt Centre, the largest of its

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

kind in Europe. (continued on page 2)

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

December 2013 WE CARE FOR YOU

New rehab centre ‘Blessed’

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

Centre for IVF dream come true Joyful parents pay tribute to the Hewitt School in 1991, went back to dancing to of which was

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

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Choose Well

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NHS Foundation Trust

Doncaster and Bassetlaw Hospitals NHS Trust has not vetted the advertisers in this publication and accepts no liability for work done or goods supplied by any advertiser. Nor does Doncaster and Bassetlaw Hospitals NHS Trust endorse any of the products or services. Every possible care has been taken to ensure that the information given in this publication is accurate. Whilst the publisher would be grateful to learn of any errors, it cannot accept any liability over and above the cost of the advertisement for loss there by caused. No reproduction by any method whatsoever of any part of this publication is permitted without written consent of the copyright owners. Octagon Design & Marketing Ltd. ©2014. Britannic Chambers, 8a Carlton Road, Worksop, Notts. S80 1PH. Tel: 01909 478822

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Bassetlaw Health Partnerships

Providing health services in your community

STOP SMOKING START LIVING Improve your chance of successfully going smokefree with advice and support from Bassetlaw’s NHS Stop Smoking Service. Specialist Stop Smoking clinics available on the following days: MONDAY Children Centre, Hallcroft 10:00 - 11:30 Bridgegate Surgery, PCC Building, Retford 13:00 - 15:00 Retford PCC Building 1:1 - appointment only 15:30 - 19:30 TUESDAY Antenatal Clinic, Bassetlaw Hospital 9:30 - 11:30 Children Centre, Gateford 9:30 - 11:30 Riverside Surgery, Retford 13:00 - 17:30 Newgate Medical Centre, Worksop 13:00 - 18:00

WEDNESDAY Bassetlaw Hospital, Outpatients 9:00 - 11:30

THURSDAY Antenatal Clinic, Bassetlaw Hospital 9:30 - 11:30

Children Centre, Retford Central 9:30 - 11:00

Newgate Medical Centre, Worksop 9:30 - 16:30

Crown House Surgery, Retford 10:00 - 11:30 Fortnightly

Children Centre, Langold 13:30 - 15:30

Harworth PCC Building 15:00 - 16:30 Childrens Centre, Manton 13:00 - 15:00 Leisure Centre, Worksop 16:00 - 18:00

Crown House Surgery PCC Building, Retford 13:00 - 17:00 Retford PCC Building 17:30 - 19:30

Please contact an advisor to make an appointment, on 0800 328 8553 or text SUPPORT to 60060

FRIDAY Newgate Medical Centre, Worksop 9:00 - 17:00 Gateford Children Centre 10:00 - 12:00 Retford Central Children Centre 14:00 - 16:00 GP Practices delivering the Bassetlaw Stop Smoking Service at practice level: •D rs Brown North Leverton •D r Finch & Partners Tuxford •D r Gilbert & Partners Tall Trees, Retford •D r Raheem, Harworth • Larwood Surgery • Misterton Surgery

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