Pulse 31 - Autumn 2018

News for staff and friends of NDHT

Autumn 2018

We love our volunteers!

70 years of the NHS Page 15 – 16

What’s inside – – – – –

What do our patients say about us?

Fantastic year for Project SEARCH Medical mythbusters – endoscopy Over and Above update Update from the Trust Board

Spotlight on research Page 9 – 10

Contents Lundy Ward wins national nursing award . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 CQC inpatient survey results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 NDHT tops table in national staff survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 More volunteers in hospitals than ever before . . . . . . . . . . . . . . . . . . . . . . . 5 What do our patients say about us? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Clinical research at NDHT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Our inspiring staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Meet Devon’s first hospital-based Admiral Nurse . . . . . . . . . . . . . . . . . . . . 12 What a year for Project SEARCH! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Celebrating NHS70 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 EndPJparalysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Campaigns and events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Medical mythbusters – endoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 You said, we did . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Living With and Beyond Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Join the Patient Voice group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Boardroom bulletin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Research and development at NDHT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Over and Above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

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Fill out the form on our website or email ndht.communications@nhs.net

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Northern Devon Healthcare NHS Trust Raleigh Park, Barnstaple, Devon, EX31 4JB t: 01271 322577 e. ndht.contactus@nhs.net w: northdevonhealth.nhs.uk @ndht 1 | pulse – Autumn 2018

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Get in touch If you have a suggestion or submission for future editions of Pulse, please call the communications team on 01271 322460 or email ndht.communications@nhs.net.

Other formats If you need this newsletter in another format, such as audio tape or computer disk, Braille, large print, high contrast, British Sign Language or translated into another language, please telephone the PALS desk on 01271 314090.

Lundy Ward wins national nursing award The team on Lundy Ward triumphed at the recent Nursing Times Awards for their work to enhance patient dignity.

Their award entry focused on the creation of ‘The Snug’, a new-look side room that has been redesigned to give patients and their carers/families a more private, welcoming and dignified space when it is most needed – such as when patients are at the end of life, or when patients with dementia or a learning disability are admitted.

“The team were exceptional throughout and I felt really supported as a carer. They helped to facilitate what I would describe as a successful and happy end for him.

“When the team asked for ideas to help improve the ward environment for people like us, we felt it was really important to be a part of it. It’s fantastic to be able to do things like make a cup of tea or coffee when you want and not have to bother a member of staff about it. Simple things like that make a real difference.”

The Snug was officially opened by former patients and the families of people who have stayed on the ward, including Sophie Holker.

Special features

Sophie said: “My uncle’s diagnosis was really quite sudden, it was emotionally exhausting.

• Sensory lighting, aromatherapy diffuser and de-escalation aids help to create a peaceful environment

• Tea and coffee station

• Comfortable chair and a put-up bed so that a loved one/carer can stay overnight • Meal vouchers for carers • Talking books, music, TV and DVD player • Handcrafted blankets and cushions • Nice toiletries in en-suite bathroom • Boards to display cards and write down ‘What is important to me today?

Northern Devon Healthcare NHS Trust | 2

Patient survey: high scores and improvement in overall experience of inpatient hospital care The latest Care Quality Commission (CQC) national inpatient survey revealed patients rate their experiences of care at NDHT highly and better than care delivered at other trusts across England in a number of aspects.

Survey highlights: • Significant improvements in a variety of aspects since last year, including for overall experience – over 81% of patients scored the Trust 8/10 or higher • More than 98% of patients felt they were treated with respect and dignity

• High scores (nine out of 10 or higher) in many aspects, including for confidence and trust in doctors, nurses and other clinical staff providing treatment, patients feeling well looked after by non-clinical staff, cleanliness, getting enough to drink and choice of food • Better scores than most other trusts in many aspects, including for patients feeling they were given enough notice about when they were going to be discharged Suzanne Tracey, chief executive, said: “It is really important to us that our patients feel they have a good experience with us, and we are pleased to see that the results are largely really positive. Our hardworking staff deserve a massive pat on the back.”

The survey highlighted one score that had dropped – patients felt the length of time they were on the waiting list before admission to hospital was worse than the previous year.

“Alongside this we are developing our plan for winter, which will help us to reduce the likelihood of needing to cancel non-urgent operations.

Suzanne added: “We know people are currently waiting too long and we are really sorry for this. We have experienced difficulties over the past 18 months and our plan to address these problems is underway.

“It will take us some time to get back on track, but we are absolutely committed to reducing our waiting lists to improve the experience for patients.”

Find out more about the survey www.cqc.org.uk/inpatientsurvey 3 | pulse – Autumn 2018

NDHT tops table in national staff survey

The Trust has been rated the top trust of its kind in the country in the latest NHS Staff Survey.

Every year, staff across the NHS are asked what they think of the organisations they work for.

The survey results published in March place NDHT 1st out of 37 acute and community providers across England.

Overall staff engagement scores at NDHT were amongst the highest in the country, with high scores for staff recommending NDHT as a place to work or receive treatment.

Suzanne Tracey, chief executive, said: “We are extremely pleased with this year’s survey results.

“It has been a challenging year for the NHS and it is great to see our results bucking the downwards national trend.

“It’s fantastic that our staff feel they work in a supportive environment, where teamwork and a culture of improvement are at the heart of how we work.”

The 2018 survey is currently underway and the Trust hopes to see improvements in the lower-scoring areas.

Read more in the Boardroom bulletin – p. 27

The Trust’s highest scoring areas were: • Support from immediate managers • Effective team working • Staff feeling able to contribute towards improvements at work • Recognition and value of staff by managers and the organisation • Organisation and management support for staff health and wellbeing

Northern Devon Healthcare NHS Trust | 4

More volunteers in hospitals than ever before Recent figures published by the BBC show that the number of volunteers in hospitals across the country has risen by 8% between 2016 and 2018.

We have developed our volunteering programme over this time and now have 130 volunteers, almost double the amount we had two years ago.

Ian Roome, head of fundraising and volunteering, said: “Our volunteers are amazing people! They support the work of the Trust and enrich the experience for our patients.

Each and every one of them makes Over 130 volunteers a real difference to our staff and patients.” are making a

difference!

Meet Doreen, our longest-serving volunteer Doreen Hornagold is a vital part of the library service at NDDH, where she has been volunteering for a staggering 31 years. She takes a trolley of books and magazines around the wards two afternoons per week, helping patients choose something to read.

At over 80 years old, Doreen is still incredibly active and volunteering is a big part of this.

Doreen said: “I don’t really know why I’ve been doing this for so many years, I think it’s just because I enjoy it. I get to spend time with patients, and it is really rewarding when I see people’s eyes light up when they see a good book.

Doreen Hornagold (right) with fellow volunteer Pam Moore

“Everyone is really grateful for the trolley service.

I will keep doing this for as long as I can.”

Do you have any books you no longer want?

The library would love to receive donations of good quality books and magazines to add to the library trolley and give our patients a wider variety of things to read.

Please take any donations to the library, level 1 at NDDH, or the information desk in the main entrance.

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Royal recognition for Trust volunteer Trust volunteer Roger Pullen, 71, has been awarded a British Empire Medal (BEM) in the Queen’s Birthday Honours List for 2018.

The medal was awarded in recognition of his voluntary work and for helping to raise thousands of pounds for local charities.

He started volunteering at NDDH in 2000 and currently helps with inpatient surveys through the patient experience team. Roger has spoken to over 3,000 patients, nearly a third of all surveys undertaken.

Roger is 94% dependent on his pacemaker and has numerous health issues that cause him continual discomfort. However, he still comes into the hospital and carries out his volunteering with a smile and a kind word for everyone. We caught up with Roger after he received this wonderful news.

This is such a rare and incredible achievement, how do you feel?

I feel so proud to receive this medal in her Majesty’s Birthday Honours, and especially ahead of the 70th anniversary of our NHS. It has come as quite the surprise.

Why did you decide to start volunteering at NDDH? I have always felt really strongly that I want to give something back to society, the NHS and particularly our wonderful hospital in Barnstaple.

To describe how it feels to be a volunteer here, I would say I feel privileged to work in an organisation that is no doubt still the most envied in the world.

On behalf of everyone we’d just like to say thank you for your years of support – we love having you as part of the team It’s always a pleasure to come up to the hospital and be made to feel so welcome by the patients and the staff, who are so professional, so dedicated. Each plays their part in a team, where patient care always comes first.

Thank you Roger Darryn Allcorn, chief nurse, said: “On behalf of all at NDHT, I would like to congratulate Roger for this incredible achievement.

“The time our volunteers give really benefits our patients and I cannot thank all of them enough.

Roger (left) with fellow volunteer John Maycock

“Roger is a fantastic part of the team and has shown unwavering determination in continuing to do this despite his health problems.”

Northern Devon Healthcare NHS Trust | 6

Lots of ways to lend a hand Our volunteering programme has expanded and we now have all kinds of different roles available.

Some of our volunteers like to pick and mix, doing lots of different things.

Here are just a few of the volunteer roles we have – we are always looking for more people who are willing to give their time.

Clare – volunteer mealtime companion

Alex – ‘Friends and Family Test’ feedback volunteer

When our patients have someone to sit with them over a meal, it can help them feel more like eating and drinking.

Patient feedback means a lot to us, and you can help us get more patients involved.

Bob – volunteer dementia companion

Tony – meet and greet volunteer

Whether it’s cards, puzzles, reading books or just having a natter, you can bring a smile to someone’s face.

It can be daunting coming into hospital, but our volunteers offer a warm welcome.

To find out more about volunteering at NDHT, visit our jobs website at www.ndhtjobs.com, email ndht.volunteer@nhs.net or call 01271 313933.

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Congratula 72 services at NDHT tions! achieve 100% positive patient feedback for a whole year Almost half of the services provided by the Trust have achieved a perfect 100% would recommend score in the Friends and Family Test.

The test is used by NHS organisations across the country and asks two simple questions: would you recommend this service to your friends and family if they needed similar care or treatment, and why?

It is an important way of understanding what our patients think and their suggestions to improve.

All patient responses are entirely voluntary, anonymous and confidential.

Here are just some of our 100% scoring teams.

Ilfracombe MIU

Rapid response – North Devon

Endoscopy

EEG/EMG (electroencephalography/ electromyography)

Turn to p.21 to read Dr Andrew Davis’ myth-busting article about endoscopy.

Turn to p.22 to see examples of the changes we have made to improve our services thanks to patient feedback.

You can view Friends and Family Test scores and anonymous comments from patients on our website: www.northdevonhealth.nhs.uk/patient-experience Northern Devon Healthcare NHS Trust | 8

Award-winning, pioneering, life-changing: Clinical research at NDHT What research are you currently working on?

NDHT is a research active Trust. Over the past year we have increased the number of studies we recruit to, and we encourage our nurses, doctors and allied health professionals to lead research projects that are happening right here in northern Devon.

To find out more, we spoke to Jo Harness, advanced occupational therapist – rheumatology, who is an award-winning researcher.

Dr Roope Manhas, director of research and development, presenting Jo with award

Does a lot of research happen here?

Before I got involved myself, I didn’t realise there was so much research happening at the Trust.

With NDDH not being a teaching hospital or a major city hospital, I don’t think people realise how much happens here and just how important many of the projects are. We have been part of lots of projects that have contributed to national research that is changing lives for people across the country. It’s really exciting to be involved in that and I’m proud of what we do here.

How do you feel about research?

I’ve been an occupational therapist for 30 years and have been in North Devon since 1989, and it’s never a dull moment. Research has added lots to my job – there’s always something going on.

9 | pulse – Autumn 2018

OTTER – an outpatient study looking at therapy treatments for osteoarthritis of the thumb, investigating education, exercise and splinting.

We’re looking at treatments that are used as standard today, different types of thumb splints and we’re also looking at things like diet, managing health proactively and complimentary therapies.

We’re asking ourselves questions about whether we can help people in a different way, for instance if we know that someone is struggling with reading or using the computer because of their arthritis, can incorporating different methods of working, hand exercises or splinting make a difference?

What does this involve for patients?

Patients who could take part in research are identified by consultants and other clinicians, and we send them lots of information about the trial.

We follow up with anyone who wants to take part and will discuss things like eligibility criteria over the phone, before we have a face-to-face meeting.

Turn to p.28 to find out more about our research.

Consent to take part in research is so important.

We check patients are happy to take part at every step of the way, and make sure they know that they can change their mind at any time. After this there are tests and questionnaires as patients have their treatment.

What would you say to any staff thinking of getting involved with research?

Just remember that there is a whole team of people who are there to support you. The research and development team helps to recruit patients and provides invaluable admin support.

They are really good at supporting patients and will provide them with lots of information.

You don’t have to think of an original idea – there are lots of national studies you can take part in.

Research and development team

And if time is a concern, one thing I’ve definitely learned this year is that it’s amazing what people are doing alongside their day-to-day work right here at NDHT. Research doesn’t actually take a huge amount of time away from what you’re usually doing, and ultimately this research benefits so many people.

Get involved!

Interested in being part of our research projects? Email ndht.research@nhs.net or call 01271 311867.

Northern Devon Healthcare NHS Trust | 10

Our inspiring staff Gill Howard, senior healthcare assistant on Caroline Thorpe Ward, has won the Outstanding Contribution to Children’s Healthcare Award from children’s charity Honey’s Bravery Bags.

Gill first started working on the ward in 1995 and has helped generations of families.

Nominations praised her cheery, caring attitude and support for parents that goes above and beyond.

Lynsey Phillips, sister on the Intensive Care Unit, travelled to Bangladesh to assist with the diphtheria outbreak at the end of last year.

For three weeks, Lynsey was assigned to a 40-bed diphtheria centre within a camp where over 600,000 Rohingya refugees had settled. Living conditions were poor and they did not usually have access to medical care. Lynsey assisted with the triage and treatment of diphtheria cases, the vast majority being children.

Lynsey said: “We faced many challenges in providing care in this environment, but it was very rewarding to be able to successfully treat these incredibly resilient and yet so unfortunate people.”

Wendy Finch, community specialist nurse, was invited to Buckingham Palace in March to meet with the Prince of Wales, along with 300 fellow nurses.

Wendy is pictured (right) speaking to Prince Charles.

At the event, Prince Charles said: “You’ve all been invited because you’ve made exceptional contributions in your field in so many different parts of the country.

“Thank you more than I can say for the difference you make to this nation.”

Fran Greenaway, play specialist, has been awarded the Paul Lock Memorial Prize. Fran was nominated by her colleagues for going above and beyond to support patients, families and staff through very complex situations, as well as for her work for the Care for Kids charity.

Chris Lock presents Fran with her award.

11 | pulse – Autumn 2018

Meet Devon’s first hospital-based Admiral nurse North Devon now has its very own Admiral nurse – Angela Walter.

Admiral nurses provide expert support, advice and guidance to people with dementia and their carers and families. They are trained and supported by the charity Dementia UK. Angela has spent many years working in the hospital. In this new role she is the first hospitalbased Admiral nurse in Devon. This is the latest development in the Trust’s drive to improve dementia care.

Angela will also deliver education and training to staff to help them improve the care they give to patients with dementia and those who support them.

partners and close relatives, who are in need of specialist support. Angela will be supporting both groups with her amazing breadth of dementia expertise and experience.”

Angela said: “I am extremely proud to be an Admiral nurse. Helping our patients with dementia has been a real passion of mine, and I am really pleased to be able to focus on this now.”

Dr. Hilda Hayo, CEO and chief Admiral nurse at Dementia UK, added: “People often hear about the challenges that people with dementia go through, but it’s often the silent carers, such as

New dementia support café!

The dementia support café at NDDH is a place where people living with dementia, their carers and relatives can socialise with others in similar circumstances, and learn more about dementia and the local services available.

Location: Raleigh Galley Restaurant at NDDH Date and time: First Wednesday of every month from 2pm-4pm, third Wednesday of every month from 4pm-6pm

Tea and coffee are provided Come for a cuppa, stay for the support Northern Devon Healthcare NHS Trust | 12

What a year for Project SEARCH is a joint programme between NDHT, Petroc, Pluss and Sodexo that is helping young people with learning disabilities or autism get into work.

Over the course of one year, the students undertake three placements at North Devon District Hospital, with support from an experienced mentor. They also receive employability training.

The project has been running for five years, and this year has been truly incredible.

Minister praises Project SEARCH students Sarah Newton, Minister for Disabled People, Health and Work, met with some of the young people who have benefited from the project.

Highly commended at national awards Project SEARCH was highly commended for in the Disability and Health Employment category at the national ERSA Employability Awards. The project was also shortlisted in the Large Employer of the Year category.

Ms Newton said: “I can see that the Project SEARCH interns are busy people, carrying out important tasks and doing a good job. It is clear that staff in the hospital value the work that the interns are doing.

“Well done for being so determined, for not giving up, and for showing others what you can achieve.”

Dave Bridges, Project SEARCH instructor

Peter Heaton-Jones MP and Sarah Newton MP visiting one of our former Project SEARCH interns 13 | pulse – Autumn 2018

Project SEARCH!

Graduation Congratulations to last year’s cohort of students, who graduated in a ceremony at The Cedars Inn in June.

The students undertook a wide variety of placements this year, including in optometry, research and development, medical records, IT and on inpatient wards. Many of them are now employed by the Trust.

to anyone who feels they’re ready to seek employment and would like to work at the hospital. It’s definitely the best thing for them.

Corey Hallett graduated from the project and is now employed by the Trust as a ward support worker.

How did you find your placements?

My first placement was on Staples Ward. They found the work I did really useful, so we came up with an idea for me to continue my second and third placements on the ward, but also including Glossop Ward too.

During the first couple of weeks of my first placement I felt nervous, but after a while my confidence built up.

Would you recommend Project SEARCH? The Project SEARCH team and the ward staff have been really good. They tell me how I can improve.

I first took part in the project four years ago, but I wasn’t in the right frame of mind at the time. I would recommend this

How are you finding things now you’re employed by the Trust?

It feels really ‘real’. I’m enjoying my work and it’s busy.

It’s great to have a job – I’ve got bills to pay!

Find out more at www.northdevonhealth.nhs.uk/ project-search

Northern Devon Healthcare NHS Trust | 14

Celebrating NHS70 It’s been a special year for the NHS – the National Health Service began 70 years ago on 4 July 1948. At NDHT we have celebrated in lots of ways.

Charity family fun day at NDDH

tte

rth Devon Gaze

Photo credit: No Photo credit: North Devon Gaze

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South Molton Hospital open day – the hospital officially opened in 1988

15 |

Tyrrell Hospital open day

NHS70 Staff Awards

Sue Mason, adult learning disability physiotherapy lead – Innovation Award

Morag Vincent, specialist nursing practitioner, Torrington – Trust Values Award

Julie Whitton, fundraising officer – Inspirational Award

Michele Parks, specialist community nurse, Bideford – Outstanding Staff Award

Happy birthday from local campaign group

Doreen Hornagold – Volunteer Hero

NHS70 parkrun – Barnstaple, School poster competition Celebrating with Bideford and Tamar Lakes patients

Sign our memory book –

come to the information desk in the main entrance at NDDH, or email your message to ndht.communications@nhs.net

Hospital Northern Devon Healthcare NHS Trust | 16

Staff and patients join challenge to get people moving Staff and patients took part in the national #EndPJparalysis challenge to help more patients get up, dressed and moving when in hospital.

What is #EndPJparalysis?

The #EndPJparalysis concept is based on the reasoning that if patients on hospital wards stay in their pyjamas or gowns for longer than they need to, they have a higher risk of infection and loss of mobility, fitness and strength, and will ultimately stay in hospital longer.

Make it social, make it fun!

We held events like lunch clubs and exercise classes, which gave patients an opportunity to socialise and do something active.

17 | pulse – Autumn 2018

Royal Wedding tea party Patients came together to don hats, nibble on some cake and talk about the famous royal weddings of the past whilst watching Harry and Meghan tie the knot.

The #EndPJparalysis challenge started on 17 April and lasted 70 days to coincide with the 70th anniversary of the NHS. NDHT’s response to the challenge was one of the best in the country.

Teams across the Trust were also recognised in the national #EndPJparalysis awards – NDHT was shortlisted for best event and patient story, and two teams were shortlisted for best campaign.

How many patients got dressed?

But the campaign doesn’t end here. Our teams do everything they can to promote independence and will carry on encouraging patients to get up and moving.

• 3,755 patients at NDDH • 381 patients at South Molton Community Hospital

How many patients got out of bed?

• 4,256 patients at NDDH • 292 patients at South Molton Community Hospital

We’re continuing with lunch clubs, exercise classes and more!

Northern Devon Healthcare NHS Trust | 18

Campaigns and events World Book Day – March 2018 The library team visited Caroline Thorpe Ward to read stories, give out books, stickers, bookmarks and book tokens to the children. The hospital school organised special book-themed activities.

Alison Cairns, library and information services manager, said: “We wanted to make sure that children who are in hospital did not miss out on the fun of World Book Day or their £1 book voucher. It was a special day that brought some of the entertainment, excitement and all-important escapism of books to the children whilst in hospital.”

National Apprenticeship Week – March 2018 We caught up with our apprentices to find out how they are getting on and shared their stories on our website.

Gail Richards, training manager and apprentice lead, said: “I am really pleased to hear all their stories and I hope others will read them and see the opportunities that are available through apprenticeships.”

Dan Elston

Pamela Willerton

Ruby Pickard

Read their stories at www.northdevonhealth.nhs.uk/national-apprenticeship-week

National Operating Department Practitioner Day – May 2018

Members of the public were invited to come and see what it’s like to work in a hospital operating theatre during an open day at NDDH. Visitors found out more about some of the day-to-day activities of an Operating Department Practitioner (ODP) and had a go at some basic tasks on the sim suite manikins.

19 | pulse – Autumn 2018

Diabetes Week – June 2018 The North Devon Integrated Diabetes Service project team posted daily blogs on our website. They shared updates about the project and the support that’s available to people with diabetes and their loved ones in North Devon.

North Devon Integrated Diabetes Service

Find out more about the project at www.northdevonhealth.nhs.uk/north-devon-integrated-diabetes-service

Reserves Day and Armed Forces Day – June 2018 Staff saluted our forces on Reserves Day (27 June) and also Armed Forces Day (30 June) to say thank you and recognise the extraordinary commitment of armed forces personnel.

We have a Silver Award from the Armed Forces Covenant Employer Recognition Scheme, which acknowledges our commitment and support to the armed forces community and their families.

We are proud to support those people who have made sacrifices on behalf of the nation and will continue to offer support in both the workplace and wider community.

Work Experience Week – July 2018 We welcomed 26 year 10 students for work experience at NDDH and Pilton House Residential Home. Students came from local schools across northern Devon.

The students observed patient care, shadowed healthcare professionals, had tours of pathology, theatres, maternity, pharmacy and learned clinical skills.

More details about work experience at NDHT can be found at www.northdevonhealth.nhs.uk/ work-experience Northern Devon Healthcare NHS Trust | 20

Medical mythbusters – endoscopy In each issue of Pulse, one of our clinicians tells you the simple facts about an illness or procedure. This time, Dr Andrew Davis (pictured right), consultant gastroenterologist, has answered some questions about endoscopy.

Is it painful?

Although not necessarily a pleasant experience, it is usually uncomfortable rather than painful, and you will be given a choice of medications that can help. A gastroscopy is often performed with just numbing throat spray as the gastroscope is only the diameter of a Smartie and the procedure lasts just a few minutes.

What is endoscopy?

It’s when a flexible tube with a tiny camera on the end is used to look inside the gastrointestinal tract. A gastroscopy goes through your mouth and looks into your gullet, stomach and duodenum.

Sigmoidoscopy and colonoscopy go through your back passage to view your large bowel.

Patient with a gastroscope

What preparation is needed?

Why would you have an endoscopy?

Patients with indigestion or bowel symptoms (e.g. diarrhoea or bleeding) often have one to exclude problems such as ulcers, polyps (small benign growths) or cancerous growths. We also strongly encourage people to participate in the national bowel cancer screening programme when notified. This often detects precancerous changes in the bowel before symptoms develop.

Is it embarrassing?

Not really. Feedback from patients confirms what a caring, friendly and respectful team we have. We are very proud of that (read more on p.8).

21 | pulse – Autumn 2018

For a gastroscopy it is important to have nothing to eat or drink up to six hours prior to the procedure. The same goes for a sigmoidoscopy, but this will also require an enema to clear any waste from the lower end of the colon. A colonoscopy requires the colon to be completely empty, so there is a longer period without solid food and a powerful laxative to be drunk that thoroughly cleanses the bowel.

What happens after the test?

After a short period of rest and recovery, patients are usually ready to get up and have some tea, biscuits or fruit. On discharge, you are given a full report that tells you about the test results, any diagnosis or possible future test requests and follow-up arrangements.

You said, we did We are always working to improve the experience of our patients. Listening to what our patients think about the service they have received is a vital part of this process.

Here are some of the recent changes we have made as a result of patient feedback.

It would be helpful to have more You said visitor car parking spaces at NDDH.

We did!

We have created thirty additional visitor car parking spaces.

Food served on the inpatient wards at NDDH is not always hot enough.

We did!

You said

Plate covers have been introduced to help keep food hot during service.

The wooden seating in the You said emergency department waiting area is too hard and uncomfortable.

We did!

As part of the refurbishment of the emergency department, we have replaced the wooden seating with wipeable cushioned seating, which will be much more comfortable. We have also installed a couple of bariatric chairs, high chairs and low chairs so that patients can get up and sit down more easily.

More information on our patient experience feedback can be found at www.northdevonhealth.nhs.uk/patient-experience Northern Devon Healthcare NHS Trust | 22

How we are helping people live with and beyond cancer We are working on a project in partnership with Macmillan Cancer Support to improve the quality of life for people with cancer in northern Devon. We caught up with project lead Steve Johnson-Wood, who told us more about the Living With and Beyond Cancer project.

What is the project about?

Everyone who gets cancer is different. The care and support they will need to live with a cancer diagnosis in a way that makes sense for their own life will also be different. We want all cancer

patients to have access to support, feel that their needs are understood and feel enabled to take an active role in their care. The Living With and Beyond Cancer project will help us achieve this.

What’s happening now?

The first element of the project is being rolled out now – the recovery package. This consists of four key interventions: 1. A holistic needs assessment and care plan – assessment to identify the patient’s needs and concerns and a plan to address these 2. A health and wellbeing event – patients can find out about healthy lifestyles, side effects of treatment and support available in the local community 3. A treatment summary – a summary shared with a patient and their GP 4. A cancer care review – a conversation between a patient and their GP or practice nurse where any issues relating to cancer that impact on their quality of life or wellbeing can be discussed

What’s next?

By 2020, we also want to have rolled out stratified pathways of care. Put simply, this means we want to move away from having a general care pathway to tailoring the experience to suit the individual patient.

This could involve a patient taking more control of their care, but with support, for instance with remote monitoring. Or it may involve continuing with face-to-face appointments.

23 | pulse – Autumn 2018

More information, including available support services and upcoming events, is available on the NDHT website: www.northdevonhealth.nhs.uk/ living-with-and-beyond-cancer

Join the Patient Voice group A new group has been set up to help us make sure the patient voice is at the heart of everything we do to improve cancer services.

Why has this group been set up?

The direction of service delivery for our cancer services is guided by many things. There are national cancer agendas that need to be implemented, such as the Living With and Beyond Cancer project, and we receive a great deal of feedback from patients through surveys.

This new group goes a step further to recognise the value of patients as key stakeholders in supporting service development and change.

Through the Patient Voice group, patients who have first-hand experience of our cancer services can share their understanding and feedback in great detail. This information is both deeply personal and incredibly valuable, and it can help us improve our cancer services for all service users – patients, relatives and carers.

What does the group do?

The group meets once a month in Barnstaple.

They have developed an annual work plan of projects to support cancer services. Patient Voice group members are working on these projects together with staff. One project they are currently working on is to develop an information DVD that can help patients digest the vast amount of information they are given at their own pace.

We’re looking for more people to join us We’d love to hear from anyone who has previously had treatment for cancer at NDHT and feels comfortable to come back to help with the project, or who is a carer or relative of a former patient.

Who is in the group?

Back (l to r): Owen Pryor (chairman and former patient), Steve Johnson-Wood (Living With and Beyond Cancer project lead), Ann Pryor (former patient) Front (l to r): Emma Thoms (clinical matron for cancer services), Jess French (lead cancer care counsellor) and Heather Walters (deputy chair and former patient).

Owen said: “This is an amazing group of people and I am really proud to chair Patient Voice. Together we will discuss potential improvements and discuss what we feel works well or what is lacking.”

Heather said: “I’m really excited to be part of something that will help make sure that cancer services in northern Devon are what patients, their relatives and carers both want and need.”

Get in touch with Emma Thoms at emma.thoms@nhs.net Northern Devon Healthcare NHS Trust | 24

Boardroom Bulletin Trust chairman James Brent updates you with news from our board meetings.

Collaborative Agreement with the RD&E In June, the Boards of both NDHT and the Royal Devon and Exeter NHS Foundation Trust (RD&E) approved a Collaborative Agreement between the two trusts.

This sets out how we will work together more closely to address the challenges NDDH faces as one of the most remote hospitals in the country. The aim is to look at how we can secure the long-term sustainability of clinical services for the population of northern Devon and ensure that everyone across the county has good access to clinical care. The Collaborative Agreement came into effect on 18 June and Suzanne Tracey became chief executive of both NDHT

James Brent Chairman

and the RD&E. Roger French retired as chairman of NDHT on 30 June, and I became chairman of both NDHT and RD&E on 1 July, although I want to highlight that there will continue to be two separate statutory Boards for the two organisations.

We are very happy to be here and I would like to thank everyone for what has been the warmest of welcomes.

There are incredibly caring staff at NDHT and a number of areas of really outstanding practice.

An options appraisal process is now underway looking at longer term solutions to NDHT’s challenges. There may be a need to look at different ways of doing things, and we will work with the local population to make sure that healthcare needs are met.

Tim Douglas-Riley Robert Down Non-executive director

25 | pulse – Autumn 2018

Non-executive director

Pauline Geen Non-executive director

Tony Neal

Non-executive director

Changes to our non-executive directors Welcome to Mike Tucker, who joined the Trust as a non-executive director in July. Mike has a great deal of experience to bring to the Trust, having previously held senior finance roles across multiple organisations.

We said farewell to Judy Jones in June, who gave valuable insight and service to the Trust during her time as a non-executive director.

Mike Tucker

Non-executive director

Suzanne Tracey Chief executive

Changes to the executive team

to ensure we are as effective as we can be in our leadership and that we have the capacity to do the work we need to do Welcome to Angela Hibbard, – Andy Ibbs (previously director who joined NDHT in March of operations and strategy and as director of finance and interim chief executive) became performance. She has over executive director of strategic 15 years’ experience working development and is leading on in finance roles in the NHS the options appraisal work. To across Devon and Cornwall. cover the director of operations Angela will be responsible part of Andy’s role, Pete Adey for supporting the delivery of (currently the chief operating care to our patients within a officer at the RD&E) is now the framework that supports the interim chief operating officer financial sustainability of our services, now and in the future. for both NDHT and the RD&E. In August we made some key changes to the executive team

CQC action plan update The CQC report published in February 2018 rated the Trust as ‘requires improvement’. We took quick action to address the majority of the CQC’s recommendations, and the areas that are more complex and will take longer to address have been made improvement priorities in the 2018/19 quality account. This ensures the plans are scrutinised at the highest level within the Trust.

Darryn Allcorn Chief nurse

Angela Hibbard Director of finance and performance

Andy Ibbs

Executive director of strategic development

Darryn Allcorn (director of nursing, quality and workforce) is now chief nurse, which meant there was a need for leadership in workforce. There was also a need for leadership in this area at the RD&E, due to some changes to executive team responsibilities, and we have recruited an interim director of people for both NDHT and the RD&E. Welcome to Julie Cooper, who joined us at the end of August and is an experienced HR director, with an NHS and public sector background.

Finance update t 2018-19 We have submitted a plan to our regulators to end the year with an £11.9m deficit. This includes making £8m of savings to achieve the £11.9m deficit.

spend of £5.7m, which includes continuing to develop our major IT projects, carrying out backlog maintenance and purchasing medical equipment.

This plan recognises our need to invest in addressing our quality and performance issues, including implementing the longer-term elements of our CQC action plan, managing our waiting lists, and reducing delays for diagnostics. The plan also includes a capital

A significant level of scrutiny has taken place on this plan, both internally and externally with our regulators, and we believe this ‘reset year’ will give us the solid foundation we need for a three-year financial recovery plan.

Adrian Harris

Interim medical director

Iain Roy

Director of facilities

Pete Adey

Interim chief operating officer

Julie Cooper

Interim director of people

Northern Devon Healthcare NHS Trust | 26

Winter planning We have been planning for this winter and beyond to make sure we are a resilient organisation, with the appropriate, flexible capacity to manage periods of high demand and provide the best possible experience for our patients. We are developing initiatives which make patient flow (the movement of patients through the hospital from admission to discharge) everybody’s business. We’ve reviewed our bed capacity – there will be 20 additional beds year round and a further eight beds during winter months distributed across NDDH and South Molton Community Hospital. This plan is intended to help reduce pressure on our teams during the incredibly busy months ahead, and wherever possible, we hope it will reduce the need for us to cancel non-urgent operations.

Quick updates Holsworthy: We have e agreed an implementation plan with NHS NEW Devon CCG to reopen the inpatient beds at Holsworthy Hospital and are now putting this plan into action. The former matron at the hospital has returned to post and is prioritising the plan to reopen the beds, which includes recruiting to our vacancies so we can safely run the services.

Staff survey: NDHT was rated the top trust of its kind (providing acute and community services) in the latest NHS Staff Survey (see p.4). We have a plan to address the areas where we didn’t score so highly, including encouraging reporting of risks and incidents and ensuring staff have regular appraisals.

Patient stories At our board meetings, we hear stories from our patients about their experiences of our services.

At a recent board meeting we welcomed Simon ‘Storm’ Norman, who talked about his experience on the Intensive Care Unit (ICU). Storm was admitted to ICU with pancreatitis and put into an induced coma. At the time of his admission he was given a 50/50 chance of survival. He returned home after five months in hospital, including one month on ICU. Storm and his wife Carol talked to the Board about the impact this diagnosis had on their family, and how staff supported them through this. Staff also arranged for Storm and Carol to enjoy a takeaway meal together and decorated his room so that they could join in with an important rugby match they had planned to go to.

Search ‘Storm and Carol’s story’ on YouTube to find out more.

27 | pulse – Autumn 2018

CT scanner: T There has been increasing demand on our CT scanner. We have procured an additional mobile CT scanner to help us manage this demand in the short term and we are working on a long-term solution that will support us to deliver a consistent, high-quality and timely service for our patients.

Expanding ou our specialist services: We were successful in our bids to run sexual health services across Devon and Torbay and sexual assault referral services across Devon, Cornwall and the Isles of Scilly. Both contracts expand the reach of our current services.

Research and development at NDHT We are a research-active Trust and encourage our doctors, nurses and therapists to take part in clinical trials and research to improve patient care for now and in the future. Here is an overview of research and development in 2017/18:

650

We recruited patients to participate in research, against a target of 550 patients

35

We have principal investigators (PIs).

One PI, Jo Harness won the Outstanding Individual Research Award 2017/18 at an event organised by the NIHR Clinical Research Network for the South West Hear from Jo on p.9.

Patients were recruited across

all ages – from 0 to 90

3rd

In June 2017, we held our annual research and development symposium with attendees from across the South West, including a patient who talked about their experience of being part of research

The proportion of patients recruited to interventional studies increased to

30%, from 26% the previous year

The chief investigator of a nationally important Arthritis UK study congratulated NDHT for the contribution made by therapy and research staff to the

success of the study

Northern Devon Healthcare NHS Trust | 28

k raised for £650North Devon Cancer and Wellbeing Centre Appeal

£1.5M £1.5m

We’re over a third of the way Our Cancer and Wellbeing Centre Appeal launched in August 2017. One year on, we are excited to announce that we are over a third of the way towards reaching our £1.5 million target!

We have received lots of support from local businesses and individuals who want to see our vision for the North Devon Cancer and Wellbeing Centre become a reality, and we’d like to say thank you for all your efforts and donations.

£1m

Ian Roome, fundraising and volunteer manager, said: “Thanks to the overwhelming support from the people of North Devon, we have now raised £650,000 towards our £1.5 million target. Thank you so much for your incredible support.

£650,000 £500k

£100k

“We know our patients need this centre here in Barnstaple, and we look forward to providing them with a place that supports their needs. Our aim is to start building the centre in spring 2019 and to open it towards the end of 2019.”

We need your support!

We still have almost £1 million to raise, and we need your support to do this by next spring. We would be thrilled to hear from anyone who would like to support us by holding a fundraising event.

Get in touch with the fundraising team on 01271 311772 or email ndht.charity@nhs.net

29 | pulse – Autumn 2018

What have our brave and bold supporters been doing?

There are so many ways people have got behind the North Devon Cancer and Wellbeing Centre Appeal.

East and West Buckland Village Hall Committee organised a French-style breakfast in their village hall, raising a fantastic £607.15.

Need some inspiration? Look no further.

Join the new £1 weekly charity lottery for your chance to win up to £25,000!

Get in touch for a direct debit form.

Northam resident Kevin Reynolds swam a total of 21 miles in the outdoor sea pool at Westward Ho! (the equivalent distance of a cross-channel swim from the UK to France), raising over £1,600!

Tesco staff across North Devon have been supporting us in lots of ways, including with their very own football tournament.

You can support us too when you shop – look out for the charity tins.

Skydive from 15,000ft – choose a date that suits you!

Steve Hobbs and the Lynton Football Team undertook an 18-mile off road walking challenge, raising a phenomenal £2,115!

overandabove.org.uk

01271 311772

ndht.charity@nhs.net Northern Devon Healthcare NHS Trust | 30

Dementia support cafĂŠ Do you care for someone living with dementia?

Are you living with dementia?

Please drop in for a chat.

Tea and coffee are provided

First Wednesday of the month 2pm-4pm Third Wednesday of the month 4pm-6pm Raleigh Galley Restaurant, Level 0, North Devon District Hospital

Š 2018 Northern Devon Healthcare NHS Trust