The newsletter for Foundation Trust members
Issue 16 | September 2012
Janette Mills and ice star, Dan Whiston hold the Olympic Torch while Trust fundraisers, Nicci Hayes, Heather Eckton and Kathy Ancell look on.
Going for Gold... CELEBRITIES ENDORSE GOING FOR GOLD
Skies Hospitals Fund has launched its Going for Gold page :â€œBlue Appeal which has already been endorsed by two well known celebrities. Gold medallist ice skater, and Dancing on Ice star, Daniel Whiston helped to launch the appeal on July 25th and then internationally renowned tenor, Alfie Boe agreed to also lend his name to the appeal.
The newsletter for Foundation Trust members
ELCOME to the latest edition of the Trust’s Your Hospitals newsletter. I have now been in my post as Chairman for a number of months and it has not taken long to realise that this is an extremely busy job as part of a Trust that is constantly driving forward to develop improvements for patients in the local area. A number of those achievements are featured in this newsletter and I hope you enjoy reading about them and keeping up-to-date with our future plans. One of our most recent developments has been the opening of the new clinical research centre. As you can read on page 4, this new area will help to further develop the rapidly increasing work the Trust is undertaking in clinical research with staff all now housed in the same building and able to see patients in a fresh, welcoming environment.
The Trust has now started work on its new car park, which is one the biggest developments for a number of years. Car parking is an issue that I have had a
Membership Officer: Tel: 01253 306673 firstname.lastname@example.org
Governors: Tel: 01253 306673 email@example.com
number of discussions about already since being here and this new facility will be a massive improvement for patients and their families visiting the hospital and make their experience far more pleasurable. Another thing very clear to me is that we have a very loyal and dedicated workforce who are extremely committed to providing high quality care and you can read about some of the recent success and awards the organisation has won on page 11. We have a busy time ahead and if you want to keep up with all that’s going on you can now follow the Trust on Twitter @BlackpoolHosp or on our Facebook page. You can also sign up to our new e-newsletter via the front page of our internet site that will be sent to you every two weeks. I am very proud of the achievements of the Trust and I look forward to meeting many of you at our Foundation Trust events over the coming months.
Ian Johnson, Chairman
Trust’s website: www.bfwh.nhs.uk/members
Trust’s Freepost Address: FREEPOST: RRZB RRAU TGET Membership & Communications Officer Blackpool Victoria Hospital
Celebrities endorse Going for Gold
LUE Skies Hospitals Fund has launched its Going for Gold Appeal which has already been endorsed by two well known celebrities. Gold medallist ice skater, and Dancing on Ice star, Daniel Whiston helped to launch the appeal on July 25th and then internationally renowned tenor, Alfie Boe agreed to also lend his name to the appeal.
support a charity that helps the running of a hospital is a great thing to be able to do. I still have a close link to the Fylde Coast because my family is here. I have agreed to endorse the campaign because I want to do all I can to be able to help such a great cause.” The appeal was inspired by the London Olympics and aims to raise unrestricted funds to help achieve a gold standard of care for patients. The charity often receives much appreciated support for specific areas of its hospitals and services, however, through the campaign hopes to raise money for those areas which do not readily attract charitable donations.
Daniel said: “I was really excited to be asked to launch this appeal, especially because I’m from Blackpool. I would really urge people Ice star, Dan Whiston holds his skates while Trust to get involved. fundraisers, Nicci Hayes, Heather Eckton and Kathy Anything you can Ancell hold the balloons. do, or any money you can raise, will If you would like to support the benefit patients, and if you can help appeal by either donating money, somebody else it’s a gold medal to you. fundraising or organising an event It’s a pleasure to be involved in the please contact 01253 657904, visit Going for Gold Appeal because it’s close www.blueskieshospitalsfund.co.uk or to my heart.” to follow the charity on Twitter go to Alfie said: “I think it’s important to www.twitter.com/BlueSkiesFund or for support local hospital charities because Facebook go to www.facebook.com/ hospitals are for the community and to BlueSkiesHospitalsFund. The newsletter for Foundation Trust members
Official Opening of the new Clinical Research Centre D
R Jonathan Sheffield, Chief Executive of the National Institute of Health Research, officially opened the Trust’s new £330,000 Clinical Research Centre recently. The new centre aims to improve research further by providing a base for experts to study new developments in medicine which could drastically change - or even help save – the lives of local patients in the future. Dr Sheffield said: “This is an excellent facility where patients can undertake research in a caring environment. We are grateful to the commitment shown by all the staff at Blackpool towards the delivery of research.’’ Chief Executive, Aidan Kehoe, praised the development, saying: “We have seen massive changes to our research work over the past few years and this will help us take the next step. Four years ago we had about 200 patients on trials and now we have about 2,600 from across the Fylde Coast. This centre is a fantastic boost for staff and gives us a great opportunity for us to expand our work further.’’ Michelle Stephens, Research and Development Manager, added that previously the team had very limited space and was spread across the hospital site. She said: “Now everyone is together and we can share best practice and have the space to run clinics five to six days a week.’’ The development was boosted by
Dr Jonathan Sheffield, Chief Executive of the National Institute of Health Research, officially opens the new Clinical Research Centre at Blackpool Victoria Hospital with Trust Chairman, Ian Johnson.
support from Blue Skies Hospitals Fund and the Rosemere Cancer Foundation. Blue Skies Fundraising Manager, Kathy Ancell, said: “Research is highly important to the Trust and our patients and the charity was delighted to be able to support this venture. We hope that the dedicated Clinical Research Centre will greatly enhance patient care across the Fylde Coast and beyond.” Chief Officer of the Rosemere Cancer Foundation, Sue Thompson, said: “We are pleased to have been able to support the new centre which provides fabulous new facilities for patients.’’ If you would like to know more about how you can take part in research in Blackpool please contact the team on 01253 655547.
Victoria Hospital extends visiting hours
ATIENTS are now able to spend more time with loved ones after Blackpool Victoria Hospital extended visiting hours on some wards.
mealtimes and visiting”.
The new hours have been hailed a success by patients being cared for on Ward 19, the hospital’s short stay ward.
Ward 19 - 11am to 12.30pm, 1.30 to 5.30pm and 6.30 to 8pm.
Jennifer Duckworth, of Cleveleys, said: “My family have been able to visit everyday which is great. The original hours were too restrictive, but now they can visit at a time that fits in with their lives”.
Wards 25 and 26 - 2pm to 8pm (with protected mealtimes).
Sue Jones, Matron for Unscheduled Care, explained the former visiting times, 2pm to 3pm then 7pm to 8pm, were having a detrimental effect on both patients and visitors. She said: “The time family spend with patients is important and we did not want to take away those precious moments, although we need to be aware there are sick patients on the wards and make sure we get the right balance between rest,
The wards and new times are: Acute Medical Ward and Ward 18 11am to noon; 2 to 5pm and 6 to 8pm.
Wards 11, 12, 23 and 24 - 2pm to 5pm and 6 to 8pm.
Stroke Unit - 2 to 3pm (except Thursday) and 7 to 8pm. ITU - 3 to 7pm Wards 34 and 35 - 2 to 3pm and 7 to 8pm. However, the hospital is asking that visitors appreciate the needs of patients and hospital staff and understand that sometimes they may be asked to leave the clinical area, particularly when patients may need urgent care, or at protected mealtimes to allow patients to have uninterrupted meals. During meals visitors are welcome to attend the ward to assist their loved ones with their food, but other visits are discouraged.
Ward 19 sister Laura Taylor with patient Jennifer Duckworth The newsletter for Foundation Trust members
Marie Thompson, Director of Nursing for Blackpool Teaching Hospitals NHS Foundation Trust, said: “The Trust recognises the importance of family involvement in supporting the recovery of their loved ones and we are keen to do whatever possible to ensure their involvement during hospital stays.” PAG E
Trust goes International showcasing its work
LACKPOOL Victoria Hospital’s Microbiology department has featured at an international conference, highlighting its pioneering work. Seven members of staff from the Trust gave presentations to experts from across Dr Achyut Guleri at the Conference the world at the 22nd European Congress of Clinical Microbiology and Infectious Diseases in London. The conference sees internationallyrenowned experts share best practice in the fields of clinical microbiology, antimicrobial chemotherapy and infectious diseases. Dr Achyut Guleri, Consultant Microbiologist and Head of Department for Clinical Laboratory Medicine at the Trust, said: “It was a great achievement for our team to be able to showcase the outcomes of excellent collaborative working, high quality innovative initiatives, surveillance, audit and research work being undertaken at Blackpool Teaching Hospitals.’’ He added: “Our Trust has made great strides in infection prevention and control in recent years and seen huge reductions in rates of MRSA and C.Difficile and this has been recognised nationally and internationally.’’
Mr Zacharias in Brazil
ARDIAC surgeon, Mr Joe Zacharias showcased his work at an international conference in Brazil. He spoke about the benefits of minimally invasive heart surgery (keyhole surgery) to an audience of more than 1,500 cardiac specialists from around the world. He was invited to attend the conference as Brazil has a particular problem with a condition called rheumatic fever, which affects younger adults and leaves them requiring heart surgery. Mr Zacharias said: “The incision used for minimally invasive heart surgery is about three to four inches instead of the six to eight inch incision required for traditional surgery. This is cosmetically appealing to many younger people in countries such as Brazil who unfortunately suffer from problems like rheumatic fever which affects heart valves. “The Lancashire Cardiac Centre is one of only a few hospitals Mr Joe Zacharias. in the UK that performs minimally invasive surgery and we have performed about 150 of these operations. There are definite advantages to patients in terms of the cosmetic look, but there is also a reduced risk of infection, less bleeding, less pain and a decreased length of stay in hospital after surgery. “There is a real desire in areas like Brazil for this type of surgery and the interest I had in what we do in Blackpool was amazing.’’
FTER being told she had lung cancer, Christine Fiddler was devastated. A keen swimmer she thought she would never be able to enter a pool again. But she made a pact with Blackpool surgeon, Mr Nidal Bittar, who said he would have her back in the water within six months. “I have swum all my life,” said gran-offour, Christine. “I was born in Windermere and used to swim in the lake when I was growing up. But after the diagnosis I was fearful I would not be able to swim again – but Mr Bittar changed all that. “He gave me my life back and just 18 months after surgery I did the Great North Swim in Windermere for Marie Curie Cancer Care thanks to Mr Bittar.
diagnosed in her lung along with modules from childhood Chicken Pox.
Christine was transferred to Blackpool Victoria Hospital under the care of cardiothoracic surgeon Mr Bittar. “I was so worried,” said Christine. “My dad died from lung cancer when I was 27 and in those days there was little they could do. The treatment I received was wonderful. I thank God for Mr Bittar every morning I wake up. “I was determined to do the Great North Swim. Mr Bittar had said he would have me back in the water within six months. After a month I went to a hydro pool and was back at the local swimming baths not long after that.” Christine will go for her final check up at Kendal Hospital this year – five years after her surgery – but her greatest wish is to return to Blackpool Victoria to say thank you to the thoracic team.
Mrs Christine Fiddler
“I would just like to say a big thank you to Mr Bittar and his team for giving me my life back. The wonderful staff at Blackpool gave me the best possible care.” Christine said she had been suffering with breathing problems then suddenly one day she coughed up blood and called her doctor. After undergoing biopsies and scans a tumour was The newsletter for Foundation Trust members
Mr Bittar said: “Initially Mrs Fiddler was very worried about the post operative period, whether her breathing would be worse and if she would be able to swim again. I reassured her as much as I could, but I am delighted to hear that she completed the Great North Swim.” PAG E
Grandmother has a splashing time after battle with lung cancer A
Blackpool MP praises local nurses and midwives
HE Trust’s nurses and midwives were praised for their work by local MP, Paul Maynard at a special day of celebration in May.
range of topics covering nurses’ unique contributions in areas such as dementia, end of life care, vascular services and the desire to put patients first.
Mr Maynard, MP for Blackpool North and Cleveleys, was a guest at the Trust’s Nurses and Midwives Celebration Day to mark International Nurses Day, an annual event to celebrate the contribution made by nurses in our communities.
Marie Thompson, Director of Nursing and Quality at the Trust, said that the event was a fitting tribute to the nurses who work locally.
Mr Maynard said: “It is great to know that nurses and midwives are at the heart of so much good work that is going on in our local hospitals.
The celebration event saw Nurses from across the Trust giving talks on a wide
“We have a lot to be proud of in the Trust. We have had major reductions in falls and pressure ulcers and I am proud to lead such a dedicated team of nurses. Days like this are designed to show that their contributions really are valued by everyone.’’
Paul Maynard, MP talks to Consultant Midwife, Nicola Parry at the Trust‘s celebration event to mark International Nurses Day.
“There is a lot of leadership being shown by nurses and midwives to improve the lives of local people. I was particularly impressed with the maternity team that recently won a national award for their work with mums who abuse substances because they have faced a problem that affects them and have dealt with it in an excellent manner.’’
She said: “Nurses hold a privileged place in our society. Nurses and midwives make a massive difference to patients in our hospitals and we should never underestimate the human impact of what we do.
International Nurses Day, organised by the International Council of Nurses, is celebrated around the world every May 12, the anniversary of Florence Nightingale’s birth.
£16.5m building project for Blackpool hospital
LACKPOOL Teaching Hospitals plans to relieve traffic problems on the site by creating 1,000 new parking spaces with a three-storey car park along with a plush new main entrance for patients, visitors and staff. Preparatory work has already begun on the £16.5m project with demolition work on the hospital link bridge and on Trust buildings along Whinney Heys Road. The money has been borrowed from the Department of Health and will be paid back from income generated through parking charges. “The car park will be a major step forward in the provision of high quality patient care,” said the Trust Chief Executive, Aidan Kehoe. “It will provide better access to the hospital for our patients, visitors and staff. “More importantly it will support our drive to recruit more nurses and other key clinical staff from the Fylde coast and outside the area.” The main construction project will take a year to complete and give a total of 2,056 available car parking spaces to meet the demand for all staff, patients and visitors. Prominent from Whinney Heys Road, the new three-storey entrance will provide an impressive access to the hospital and include a pharmacy, retail units, café, main reception, waiting area and office accommodation. The entrance will link into the main hospital and will be the main access point for most patients, visitors and staff apart from those using Accident and
The newsletter for Foundation Trust members
Emergency and the Delivery Unit which will continue to use present entry points.
Artist’s impression of the new multistorey car park and new entrance.
The scheme will also involve a redesign of the road layout surrounding the Vic making it much easier for patients to enter and exit the site, easing the current traffic problems. Designed for easy flow for visitors, the car park will have a significant Impression showing the inside of the new entrance number of entry and exit routes and be covered by CCTV cameras. A redesigned bus terminal will also be incorporated into the plan. Director of Clinical Support and Facilities Management, Robert Bell added: “Blackpool Teaching Hospitals NHS Foundation Trust believes Artist’s impression of the exterior of the plans the new entrance will be of considerable benefit to patients and help them make Blackpool their first choice hospital”. PAG E
Consultation 11: Improving the patient WiFi experience T HE Trust is continually seeking ways in which it can improve the patient experience.
Part of the quality of the patient experience involves accessibility and flexibility of services not only to the patient, but also patients families and carers. We are seeking your views on patient’s internet access whilst in hospital. Your feedback is important to us and 1.
Are you a public or staff member?
the Trust invites you to contribute to this month’s Consultation Corner by taking a moment to answer these questions. Please help us to improve by completing this form and returning it to:-
FREEPOST: RRZB RRAU TGET, Communications Department, Trust Headquarters, Blackpool Victoria Hospital by Friday, October 19th 2012. Public
Would access to the internet be beneficial to patients in the hospital?
Would patients be willing to pay for this additional service?
Do you think the following costs would be reasonable?
15 minutes: FREE , 3 Hours: £3.20 , 1 day: £6.00 , 1 week: £12.00 , 1 month: £15.20
Do we need to restrict the times that patients have access to the internet? Yes
Should the Trust develop a code of conduct to cover internet access
for patients and staff?
Please enter your details below (optional):
Name: ................................................................................... Address: .............................................................. ................................................................................................................................................................................... ................................................................................................................................................................................... ..................................................... Postcode: ............................. Tel: ............................................................... PAG E
Kitchen staff celebrate top award The Team collecting their award
Blackpool maternity staff pick up leading national team of the year award
ATERNITY staff at Blackpool Victoria Hospital are celebrating after winning a top national award.
OR the second year running, the Trust’s kitchen staff are celebrating being awarded a five star rating for their food hygiene which is the highest rating achievable nationally by the Food Standards Agency. Site Services Manager, Caroline Hargreaves, said: “Achieving this standard again is excellent. We are really pleased and it’s a real achievement. “I’d like to say thank you to the team for all their hard work; it really is a team effort to achieve these results.”
The Trust’s Maternity Substance Misuse team won the British Journal of Midwifery (BJM) Team of the Year award. Over the last three years the maternity service in Blackpool, working with support from Blackpool Council, has developed and improved the care and support given to pregnant women who misuse substances and this good practice has been recognised both inside and outside the Trust. Pauline Tschobotko, the Trust’s Head of Service, said: “The Trust and the Women and Children’s Department are especially pleased to win this National Award as it recognises how staff throughout the Trust and wider Community can work together to improve the services for pregnant women and improve the The newsletter for Foundation Trust members
Members of the kitchen staff at the Trust with their 5 star rating food hygiene certificate.
outcomes for newborn babies. Judges said: “The changes have been made possible due to strong leadership and a commitment to supporting staff and women, implementing relevant guidelines, training and a positive culture towards supporting women through this difficult time.’’ PAG E
HERE have been four membership seminars since our last issue.
On Thursday, May 31st 2012, Mr Peter Hudson, Clinical Specialist in Blood Transfusion, hosted an informative seminar entitled ‘The Role of Blood Donation in Healthcare’. On Thursday, June 14th 2012, Dr Abu Ahmed, Consultant Physician and Endocrinologist; Dr Rabin Mohanty, Consultant Paediatrician; Dr Augustine, GP and other members of the team hosted a very well attended seminar on topics, such as ‘Diabetes in Children’; ‘Diabetes in the Community’; ‘Deafness and Diabetes’; ‘Research in Diabetes‘ and ‘Driving and Diabetes’. On Tuesday, July 17th 2012, Mr Aidan Kehoe, Chief Executive; Mrs Marie
Thompson, Director of Nursing and Quality and Mr Robert Bell, Director of Clinical Support and Facilities Management, took questions from Foundation Trust members. This was the first of future seminars where Mr Kehoe and his Executive Directors will take questions from members. On Tuesday, August 21st 2012, Mrs Anne Smith, Fylde Public Governor and other public and staff Governors, hosted an interesting seminar on ‘The Role of a Governor’. The presentations given during the above seminars can be viewed on the website at www.bfwh.nhs.uk/members/ events.asp Thank you to all our members who make the time to attend.
Seminar Dates for 2012
ERE are some important dates for your diary for the remainder of the year (all seminars will be held at Blackpool Victoria Hospital) and you will need to contact the Membership Office on 01253 306673 to book your place:Date & Time:
Tuesday, 30th October, 11.30am - 12.30pm
Lecture Theatre Education Centre
Mr Aidan Kehoe, Chief Executive and members of the Executive Team are holding an Open Public Question Time Forum
Wednesday, 21st November, 10 - 11am
Lecture Theatre Education Centre
Dr Lau, Consultant Medical Oncologist, Seminar on “Lung Cancer”
HE Trust’s Annual Members’ and Public Meeting was due to take place on Monday, September 24th 2012 at the De Vere Hotel, Heron’s Reach, East Park Drive, Blackpool in the Inspiration Suite. A full write up will appear in the next issue.
ORDER OF EVENTS FOR THE EVENING 5.30 pm
Tea/Coffee Opportunity to visit display stands Annual Members’ and Public Meeting Presentations:-
• ‘Quality Care at the End of Life: The Work of the End of Life Care Project Team’ • ‘Today’s Research, Tomorrow’s Care – What does this mean to you?’ Light Buffet and Refreshments
Opportunity to visit the display stands Cardiac Nurse of the Year Award
DVD and Presentation of Awards for:• Long Service • Personal Achievement Dottie Hall Memorial Award
The newsletter for Foundation Trust members
HESE are your governors. Governors are elected by you to represent your views on the Council of Governors.
BLACKPOOL CONSTITUENCY Eric Allcock, John Butler, Mark Chapman, Clifford Chivers, Hannah Harte, George Holden, Chris Smith, Chris Thornton. FYLDE CONSTITUENCY John Longstaff, Anne Smith (Lead Governor), Anthony Winter. WYRE CONSTITUENCY Peter Askew, John Bamford, Ramesh Gandhi, Lynden Walthew. LANCASHIRE AND SOUTH CUMBRIA CONSTITUENCY Joanne MacDonald. NORTH LANCASHIRE CONSTITUENCY Chris Lamb.
Your Staff Governors NURSING & MIDWIFERY Samantha Woodhouse, Andrew Goacher. MEDICAL & DENTAL Dr Tom Kane. NON-CLINICAL SUPPORT Tina Daniels. CLINICAL SUPPORT Cherith Haythornthwaite. COMMUNITY HEALTH SERVICES Claire Lewis. If you wish to contact a governor please contact the Membership Office on 01253 306673. PAG E
Annual Members’ Your Public Governors T and Public Meeting T
Please write your answers in here: 1. ...................................
Send to: Freepost RRZB-RRAU-TGET, Blackpool Teaching Hospitals NHS Foundation Trust, Communications Department, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool FY3 8NR Name: ............................................................................... Address: ........................................................................... ........................................................................................... ............................................ Postcode: ........................... Preferred Tel No: ............................................................ (Please tick as appropriate)
HOWN above are eight sections of English football team badges, all you have to do is name the football clubs they belong to. The first all correct entry drawn on Thursday, November 22nd 2012 will receive a £50 gift voucher courtesy of CDC printers of Poulton.
Last Edition’s Winner
ONGRATULATIONS to Mrs Claire Grumme a public member from Blackpool, who correctly identified the eight advertisements from the picture quiz in the last issue of Your Hospitals. On hearing the news she had won Claire said “It’s made my day, I remember entering some time ago but had forgot all about it, it’s quite a nice surprise”. Claire receives a £50 gift voucher courtesy of CDC Printers of Poulton.
The correct answers were: 1. Halifax Banking, 2. Virgin Media, 3. Gaviscon, 4. Pedigree Dentastix, 5. Premier Inn, 6. Aviva Insurance, 7. Sheila’s Wheels Car Insurance, 8. Swiftcover Insurance
Inspirational fundraiser crowned Blue Skies Ambassador
launched the initiative to encourage people to get involved in fundraising.
THE Trust’s annual remembrance ceremony has been confirmed for Monday December 3rd this year. This is the seventh Tree of Lights service to be held and will include the opportunity to enter names of loved ones into a special Book of Remembrance, a special tree lighting ceremony with music, readings, and seasonal refreshments.
AN inspirational fundraiser from Preston has been crowned the newest Blue Skies Ambassador.
Neil has organised numerous events and taken part in a 190 mile bike ride in aid of the Haematology Unit at Blackpool Victoria Hospital following the death of his Blue Skies Ambassador, fiancée, Siobhan Neil Bontoft. (known as Shiv) Cavanagh from leukaemia last year.
Neil Bontoft is the latest person to join the list of ambassadors for Blue Skies Hospitals Fund, the charity for Blackpool Teaching Hospitals NHS Foundation Trust, which
He said: “We’re still raising money now but so far for Blue Skies we’ve
The newsletter for Foundation Trust members
raised about £12,000 which is an amalgamation of the bike ride, a birthday party, donations from the funeral and continued fundraising activities. It was a special moment being asked to be a Blue Skies Ambassador. We’ve done a lot of fundraising for the hospital and we are going to continue to do so. I’d encourage anybody to fundraise; it’s a life changing experience.” To view the Blue Skies Ambassadors DVDs go to: http://www. blueskieshospitalsfund. org.uk/supporters.asp. PAG E
Bereavement Support Officer, Wendy Thomson, said: “This event is for bereaved families, carers
and friends Bereavement to pay Services at tribute to Blackpool their loved Teaching one at Hospitals NHS Christmas Foundation time. The Trust. Blue Skies staff members Nicci ceremony Hayes and Kathy Ancell. is not If you would religious in tone and like to attend the Tree of open to anyone who Lights event and/or make wishes to attend. It does a donation, call 01253 not matter whether your 657904 or email info@ bereavement was recent, blueskieshospitalsfund. many years ago or if the org.uk. person you lost was cared for at one of the local The Tree of Lights hospitals.” Event will take place on Monday December 3rd All donations made to at 7.30pm, in Oliver’s Blue Skies Hospitals Fund Restaurant at Blackpool for the Tree of Lights Appeal will support Victoria Hospital.
Tree of Lights ceremony confirmed for this year
Membership is FREE, and it is easy to join. Simply complete this form and send it back to us at Freepost, RRZB-RRAU-TGET, Membership and Governors Office, Trust Headquarters, Blackpool Victoria Hospital, Whinney Heys Road, Blackpool FY3 8NR. Or visit our website and fill in the online form at: www.bfwh.nhs.uk
Do you consider yourself to have a disability?
Please state here:
(Fields marked with â€œ*â€? are mandatory)
Do you have any specific requirements for attending events? (e.g. mobility, hearing loop, sight aids, interpreter)
Your Areas of Interest Please indicate any areas of healthcare that you would be interested in attending a seminar on
Please state here: *Postcode: *Date of Birth:
Mobile Number: We would prefer to send you information about the Trust and membership issues by email. Email address: (please print clearly) If you would prefer to receive this by post, please tick here:
About You We want to involve the whole community and build a membership that is representative of the region. The following information will help us know if we are achieving this. Gender (please tick)
Are you in the same gender as the one at birth? (please tick)
Ethnicity (please tick) White White British White Irish White Other
Mixed White and Black Caribbean White and Black African White and Asian Other
Asian or Asian British Indian Pakistani Bangladeshi Other
Black or Black British Caribbean African Other
Status (please tick) Married Single
In a civil partnership Divorced
Sexual Orientation (please tick) Heterosexual Prefer not to say
Getting Involved As a member you can give as much or as little time as you wish. We have different levels of membership and these are detailed below: Level 1 (please tick) Receive members newsletter and voting information only. Level 2 (please tick) As level 1 plus taking part in surveys, consultations and questionnaires. Level 3 (please tick) As level 1 and 2 plus involvement opportunities, such as, attending seminars/events, taking part in discussion groups, volunteering for the Trust and/or standing for election to the Council of Governors.
Public Register The Trust is required to keep a public register of its members. If you DO NOT wish your name to included, please tick this box . Signature:
Religion/Belief Please state your religion/belief:
(The data you supply will be used only to contact you about the Trust, membership or other related issue and will be stored in accordance with the Data Protection Act. Full details available upon request.)
Your Hospitals Staff and Members Magazine for September 2012