The Pulse - March 2020

Pulse THE

Issue Number 96 March 2020

In this edition: Meet our ED team Managing migraines Read Annie’s story Research milestones

INFO Food and drink Feast@: West Atrium Level 1, open daily 7am - 1am Feast@ the Deli: West Atruim Level 1, open Monday – Friday, 7am-3pm Feast@ Café Bar: Outpatients East, open Monday - Friday, 7.30am - 4.30pm Coffee House: Plaza (West), open Monday Friday, 7am - 6.30pm; Saturday 9am - 4.30pm; Sunday, 9am - 3.30pm Little Costa: Outpatients West, open Monday - Friday, 7am – 5.30pm The Pod: Plaza East, open Monday – Friday, 7am - 8pm; Saturday, 9am - 6pm.

Shopping WRVS: East Atrium, open Monday – Friday, 8am - 8pm; weekends, 10am - 6pm WH Smith, M&S Food: Plaza (West), open Monday – Friday, 7am - 7pm; Saturday, 9am 5pm; Sunday, 9am - 4pm The Stock Shop: West Atrium Level 2, open Monday – Friday, 9am - 5pm; Saturday, 10am - 3.30pm.

Services Cash machines: East Atrium, Level 2, WHSmith and the Main Restaurant Lost property: Call 01603 286803 or ext 2803 Patient Advice and Liaison Service (PALS): For confidential help and advice call 01603 289036 Chapel: Open to all. For details of services or to contact the Chaplains call ext. 3470 Cromer Hospital Mill Road, Cromer, NR27 0BQ.Tel: 01603 646200 The Dome: Public living room, always open Hospital Radio Norwich: To request a song or a bedside visit, call 01603 454585 or from your Hospedia bedside unit dial *800.

Contact us: The Pulse Editorial Team: call 01603 289821 ext. 5821, email Communications@nnuh.nhs.uk.

The Pulse is funded entirely from charitable donations: N&N Hospitals Charity, registered charity number 1048170 Norfolk and Norwich University Hospital Colney Lane, Norwich, Norfolk, NR4 7UY Tel: 01603 286286; Website: nnuh.nhs.uk Cromer Hospital, Mill Road, Cromer, NR27 0BQ Tel: 01263 513571.

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NEWS from NNUH - March 2020

Letters I cannot begin to express my deep appreciation and admiration for ALL staff who looked after me during my stay.

From the porters, cleaners, junior nurses, qualified nurses, doctors, the list is endless.

They were the most dedicated people I have ever known.

Working under extreme stressful conditions, I did not see one who showed any kind of agitation, they are a credit to your hospital.

Checks endless and nurses always nearby asking if I needed anything.

It was simply incredible and I would like you to pass this message on to all those in the Acute Medical Ward, Gunthorpe and the Mulbarton Ward to say a very big personal thank you from me.

Staff dedication is an understatement and if I ever have to go in hospital again anywhere in the world, I will request to be bought back to the Norfolk & Norwich Hospital.

Yours sincerely, Teresa Laddiman

Social media @NNUH @NNUH thank you so much for the wonderful care & fabulous service you gave me yesterday at the day surgery unit - from check-in to discharge, you are all fabulous.

Lucy – Twitter

Experiencing @NNUH as a relative tonight. Staff on AMU have been unfailingly polite, caring & explained everything without being patronising. Reassured we can leave knowing he is in safe hands.

Pamela – Twitter

Currently sat on Dunston Ward after having a stroke last week and I would just like to say, from myself and my family, a massive thank you for the help and care you are giving me to get me back on my feet. I will never forget your kindness you have shown me, bless you all.

Chris – Facebook

A big thank you to the Norfolk and Norwich University Hospital (proudly flying the rainbow flag) @ NNUH and @EastEnglandAmb for their friendliness, professionalism and outstanding care which I have experienced first hand this week.

God bless you and our NHS. Guy – Twitter

I do just want to say a massive thank you to all on Buxton Ward who looked after my Leo. A special thanks to nurses Beckie, Tia, Shannon, Stuart, HCAs Kerrie, Jo and Sharon and the student nurses and Olivia the play leader! All of whom were absolutely amazing, they all went above and beyond to make sure our stay with you was lovely, they held me when I was at breaking point and nothing was ever too big or small! Thank you so much, we really are extremely grateful for all the hard work.

Frankie – Facebook

Have to say that currently having a stay at @NNUH and the staff, especially all the nurses, could not be nicer! Lively bunch of people and making this painful stay that much more “enjoyable”. Thank you NNUH. Tracey – Twitter I had to go to A&E yesterday, and received fantastic care and treatment. I arrived at 5.15pm, was triaged, sent to minors as urgent care, saw a fantastic doctor (who listened) and is going to arrange an MRI. Maria – Facebook

VIEWPOINT

Recognition for our Cardiology Rehabilitation team Patients who’ve suffered a heart attack, undergone a cardiac procedure such as angioplasty or have heart failure need continuing support to help them return to normal life and stay well – and our Cardiac Rehabilitation team has just received certification for 2019, putting them in the top 25% of teams in the country running such programmes.

“Certification means we’ve hit all national standards and that our programme is recognised by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR),” said Jo Hayward, Cardiac Rehabilitation Lead (pictured above left).

“It’s evidence that our patients can be confident about our service’s high standards and acknowledgment of the team’s hard work and vision.”

Led by Jo Hayward and Juleah Vernham, the team comprises nurses, occupational therapists, physiotherapists, dieticians, a pharmacist and a volunteer, and sees more than 1,000 patients a year – with around 25 new referrals a week.

“We aim to see patients within two weeks of leaving hospital and offer a helpline, clinics and a home-based programme where patients follow advice on areas such as diet, exercise and stress management,” said Jo. “We also offer group support sessions at Clover Hill in Bowthorpe, where people can attend a six to eight-week programme including talks, discussions and exercise, and have teamed up with Active Norfolk to provide Qigong classes, a form of Tai Chi. “In addition, we work with NSFT to provide a four-week course helping patients cope with anxiety related to their condition.”

“We’ve had a lot of great feedback from both patients and their families on how it helps them to rebuild their confidence and improve their quality of life,” said Juleah.

Augmented reality helps make blood tests less painful The N&N Hospitals Charity has funded a machine for Children’s ED that helps reduce young patients’ pain and distress when their blood is taken for tests.

“It’s a fantastic device helping to reduce stress and discomfort for our youngest patients attending the Emergency Department,” said Dr Jane Evans, Consultant in Emergency Medicine & Clinical Lead, Children’s ED. “On behalf of all our patients and staff in ChED, I’d like to say a really big thank you to everyone who helped to raise funds, it is truly appreciated.”

The AccuVein machine uses augmented reality technology to convert the heat signature of a patient’s veins into an image that’s superimposed on the skin, making the veins easier to locate.

On the cover of this issue and on pages 10 and 11, you can see the first in a series of departmental features that we’re calling “Life at NNUH”.

It gives us an insight into the Emergency Department’s work by telling the story through a focus on our people and their fascinating roles. Look out for more stories in future editions of the Pulse and our other communication channels.

The work of the Chaplaincy team is fantastic, I have huge respect for them and very much enjoyed reading about a day in the life of our lead chaplain Adrian Woodbridge’ on page 13. Their work talking with patients and relatives who need a listening ear and supporting them during a very difficult time is vitally important.

I’d also like to highlight Annie’s story on page 8. Her family shares their experience of a “desperate journey” until she was admitted to the N&N, where she was treated with dignity, respect and care and kindness. They felt that Annie was treated as an individual by the ward and superbly cared for by the Dementia Support team.

The safety, care and comfort of our patients is paramount – and it’s particularly important for more vulnerable patients, like those living with dementia. My heartfelt thanks to all staff for the care and kindness they give to every one of our patients every day.

Finally, I’d like to invite you to join us at this year’s Dementia Information and Advice Fayre at the N&N on Monday 4 May from 10am to 4pm, where there will be a range of stands, advisers and talks in the lecture theatre.

Mark Davies Sam Higginson, Chief Executive Chief Executive,Norfolk NNUH and Norwich

University Hospitals NHS Foundation Trust

NEWS from NNUH - March 2020

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FUNDRAISING NEWS

Norfolk boxer’s knockout performance for the N&N hospital charity Fundraising events Snowdrop Open Garden

Enjoy a circular walk around two acres of woodland and gardens leading down to the River Waveney at The Old Coach House, Brockdish (IP21 4 JY) in aid of the Boudicca Breast Cancer Appeal and other charities.

Look out for wildlife, birds and a beautiful display of snowdrops and spring flowers.

Teas, cakes and refreshments available, and dogs on leads are welcome.

Adults £3, children free with an adult.

Jenny Lind Children’s Hospital Birthday Help us celebrate Jenny Lind Children’s Hospital’s 166th birthday on 3 April.

Featherweight boxer Michael Walsh, from Cromer, has donated £4,000 to our Neonatal Intensive Care Unit as a thank you for the care given to his son Liam, who was born with a heart just 20% of its normal size.

The sum was half the purse from winning a fight in just 125 seconds last December, after Michael returned to the ring following a four-year absence. He donated the balance to Great Ormond Street Hospital, where Liam also received care.

Liam, who weighed 700 grams at birth, is now 20 months old and was with Michael and trainer Graham Everett to present the donation to the N&N Hospitals Charity and NICU team.

“I just wanted to pay them back for everything they have done for Liam,” said Michael.

“I have had great support from Graham and the promoter Mervyn Turner and referee Lee Cook also gave his fee and expenses along with the other officials.

“Liam has already had seven operations and he will be having another soon so I wanted the £8,000 to be split between the two hospitals where Liam has been treated.”

“Along with everyone at NICU, we want to say thank you to Michael for this amazing donation,” said Lynn Crombie, from the N&N Hospitals Charity.

Thanks to our supporters Thanks to everyone who has supported us over the past few months – you can read more about all our fundraising activities on Twitter (@NNUHCharity), Facebook (@NNUHCharity1) or on our website www.nnuh.org.uk

NNUH diary dates These meetings are held in public in the boardroom at NNUH.

Council of Governors All meetings run from 10am to 12pm: 13 February 30 July 2 April 29 October

Trust Board meetings

Staff from the Neonatal Intensive Care Unit present a Certificate of Appreciation to Michael Walsh, pictured with Liam and trainer Graham Everett.

Thank you for giving our patients a very Merry Christmas Thank you to every individual, company and organisation who helped brighten Christmas for everyone at NNUH - from the choirs and stallholders at the Christmas Fayre to the musicians who played in the West Atrium.

All meetings all run from 9.30am to 11am: 5 February 2020 5 August 2020 1 April 2020 4 November 2020 3 June 2020 As space is limited, please email communications@nnuh.nhs.uk if you wish to attend.

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NEWS from NNUH - March 2020

Chief People Officer Paul Jones and Medical Director Erika Denton deliver Christmas cheer to patients.

For the fourth year, every inpatient received a Christmas Day gift from our “Send a Smile with Santa” appeal, with people kindly donating presents, money to buy them, or visiting our Amazon Wish List.

Thanks too to the companies who sponsored the Snowflakes that brightened up the hospital plaza.

CHAIRMAN’S MESSAGE FUNDRAISING NEWS

New biopsy machine improves breast cancer care Thanks to Boudicca Appeal fundraisers and supporters, a new machine for biopsies is helping improve breast cancer care.

More than £400,000 has already been raised for the appeal, enabling work to start on a one-stop-shop breast cancer unit for all patients with suspected breast cancer.

The aim is to raise £800,000 to create a unit where patients can have images taken, undergo a biopsy and see their consultant in a single appointment.

Dr Arne Juette, Consultant Radiologist and Director of Breast Screening, said: “Thanks to the Boudicca Appeal, we have already been able to invest in new stereotactic mammography equipment, which brings us completely into the state-of-the-art in terms of what we can deliver to our patients here.

“It is the latest technological advance and enables us to see a lot more patients a lot more quickly, which is one of the aims of the Boudicca Appeal. The new machine also makes biopsies a lot more tolerable for women and we can diagnose more women more quickly.”

Left to right - Dr Arne Juette, Consultant Radiologist and Director of Breast Screening; Denise Marshall, Advanced Practitioner in Mammography; Tina Lucie-Smith, Consultant Breast Radiographer and Louise Cooper, Advanced Practitioner in Mammography.

The introduction of same-day diagnostic tests combined with clinical and imaging assessment for all patients with suspected breast cancer will mean patients only need to attend clinic once, which will result in a better experience and reduce the time waiting for results.

The next phase of the appeal will create a third ultrasound room and improve reception

and waiting areas. The appeal also aims to create quiet and counselling rooms for patients facing a cancer diagnosis.

Could you raise funds for our appeal?

Read more on: justgiving.com/ campaign/boudicca

N&N Hospitals Charity partners Run Norwich The N&N Hospitals Charity is an official charity partner of this year’s Run Norwich on Sunday 19 July.

The award-winning 10-kilometre city centre road race is organised by the Norwich City FC Community Sports Foundation (CSF).

Last year’s 7,000 places sold out in four days, and this year general entries took just hours to go.

Thirty N&N Hospitals Charity runners will raise money for the Jenny Lind Children’s Hospital to refurbish and create more inclusive play spaces on Buxton Ward.

If you’re taking part and would like to support us, please email fundraising@nnuh.nhs.uk.

NEWS from NNUH - March 2020

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RESEARCH NEWS

Our teams are proud to be at the heart of new research that is helping to improve the care and outcomes for patients with cancer.

Bowel cancer prehab study recruits 500th patient A study exploring the advantages of exercise before and after bowel cancer surgery has recruited its 500th patient - the halfway mark for the study.

The PREPARE ABC study, run by NNUH and the Norwich Clinical Trials Unit at the University of East Anglia (UEA), is the biggest trial of its kind in the world.

The £2m project, funded by the National Institute for Health Research (NIHR), opened in 2016 and is running at more than 25 UK sites.

It’s looking at the benefits of patients undergoing a home or hospital-based exercise programme compared with standard care in the weeks before and after colorectal surgery to see how moderate

or intense exercise affects quality of life one year after surgery and complication rates 30 days post surgery.

Chief Investigator James Hernon, Consultant in general and colorectal surgery and Honorary Senior Lecturer at UEA’s Norwich Medical School, hopes the study will shape future guidelines: “To date it is the biggest prehabilitation and rehabilitation cancer study worldwide and it is a big team effort involving our nurses, physiotherapists and the Norwich Clinical Trials Unit,” he said.

“It’s widely regarded that increasing levels of exercise before and after surgery leads to a better quality of life. However, there had been no studies that have been big enough to reliably show exercise makes a difference for these patients. We want it to influence national and international guidelines on the prehabilitation and rehabilitation of patients who are receiving surgery.

“We won’t know the results until a year after the trial finishes. However, we are recruiting patients young and old and with a range of fitness levels.

We have received letters of thanks from patients who have enjoyed the interventions and feel very supported.”

The study team celebrates recruiting 500 patients.

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NEWS from NNUH - March 2020

CHAIRMAN’S RESEARCHMESSAGE NEWS

This is just some of the groundbreaking research that we’ve been involved in over the past few months.

Top recruiter for bone marrow cancer treatment trial David Anstee says he feels at the forefront of new treatments for highrisk bone marrow cancer after joining one of our clinical trials.

The 58-year-old from Banham was diagnosed with myeloma in June 2018 after experiencing a lack of energy, exhaustion and a painful back and hips.

He jumped at the chance to take part in a clinical trial using genetic profiling and a novel drug regime tailored to an individual’s genetic subtype.

We’ve recruited the highest number of people – 39 - onto the nationwide study, which involves 472 patients and 40 hospitals and is funded by Janssen, Celgene and Myeloma UK and led by the Clinical Trials Research Unit at the University of Leeds.

David had some knowledge of clinical trials through his work for a scientific instrument company in Cambridge.

“Myeloma is incurable, but it is treatable and I have a high-risk type,” he said.

“My treatment involves taking five different drugs that have not been given in this way before. It feels like I’m at the forefront of new treatments.

“I have access to drugs that I would not have access to if I was not in this trial, so it was an easy decision to make.

The trial gives David Anstee access to new treatments.

“The treatment I am getting has been excellent and I feel a lot better than I was a year ago.

“Every stage of the process is explained to me and what is involved.

The level of control and safety is paramount and I am monitored constantly. I know that the drugs have been tested a lot before they have got to this stage.”

Exercising reduces side effects of prostate cancer hormone therapy Working in partnership with the University of East Anglia, our researchers have found that short-term exercise can help reduce the side effects of hormone therapy for patients with advanced prostate cancer.

Fifty patients due to start androgen deprivation therapy (ADT) took part in a study aiming to reduce side-effects such as weight gain and an increased risk of heart problems. Half exercised in two supervised sessions a week for three months at UEA’s specialist exercise science facilities.

The findings, published in the British Journal of Urology International (BJUI), show that the programme of aerobic and resistance training prevented adverse changes in cardiopulmonary fitness and fatigue.

Wilphard Ndjavera, Clinical Fellow for Urology at NNUH, said: “All the patients really enjoyed the sessions and the results have suggested that exercise does work to reduce these harmful side effects of treatment. It is one of only two studies in the world to look at this.

“After the supervised exercise was withdrawn, differences in cardiopulmonary fitness and fatigue were not sustained, but the exercise group showed higher quality of life and reduced cardiovascular risk compared to the control group.”

NEWS from NNUH - March 2020

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PATIENT EXPERIENCE

Nicola King, the daughter of Annie, who was a patient on Langley Ward, tells her story “Annie was a daughter, wife, grandmother, friend, highly-skilled theatre nurse, talented dancer and my wonderful Mum. She’d been in a care home for six years with vascular dementia - it had been a long journey and not a good experience.

“Mum was admitted to A&E at NNUH on 5 January 2019. She’d aspirated hours earlier and I knew she was dying. We’d been told by the first responder that the situation was critical and that Mum probably wouldn’t be with us for much longer – we were at the end of our journey.

“The A&E doctor was amazing and reassured us that she was in the best place.

Our experience was very positive, we found the team to be amazing and they provided the very best care for Mum. “They had so many patients and still showed empathy, understanding and kindness.

“Mum was transferred to Langley Ward and we completed a ‘This is Me’ form on her behalf. A few days later my husband and I came down with flu, and I was extremely distressed because Mum was critically ill and my doctor said it would be at least a week before we’d be able to see her. I was terrified that she’d pass away alone without me there.

“The same day, I received a call from Jenny Woolgrove, a Dementia Care Specialist Nurse, to check whether things were OK. I explained everything and she was so reassuring and kind. From then on, she phoned us daily, sitting with Mum every day playing her favourite music. I can never explain how much this meant to us at such a dreadful, desperate time.

“When we were able to visit Mum the staff greeted us warmly. They told us how emotional reading the ‘This is Me’ form had made them.

“A forget-me-not had been discreetly hung above Mum’s door – a small touch but very important. Dementia Support Workers Jenny, Jamie and Claudia continued to visit Mum every day and support us.

“It was the continuity of care that impressed us – staff were never too busy and nothing was ever too much trouble. They were truly amazing and there are no words to describe how much it helped us and Mum. “Sadly, Mum passed away after I’d left to get some rest but Tracey, a Staff Nurse, called to tell me, speaking with great empathy and respect, offering to go in with me to see my Mum if I couldn’t face it alone – she’s a very special lady.

“When I thanked the Sister for the care they’d given Mum, she said it had been an absolute pleasure. I’ll never forget these words, which sum up the staff who work on Langley Ward. We found the standard of care exceptional, as well as their kindness and empathy. From the moment Mum was admitted, she got her identity back, she was Annie again. They saw past the illness she had and they just saw her. The team was exactly the kind of people who Mum would have wanted to care for her.”

Annie as a young woman.

“This is a story of hope, so we’ve held fundraising events and purchased two iPads for the team,” said Nicola.

“We’ve also trained as dementia champions, distributed lap blankets and Christmas cards to people who may have been alone or had limited carer support, and we’re raising funds to provide a mobile carers’ information service, ‘the Annie van’, which we hope to have in operation across Norfolk in the next few months.”

If you’d like more information about these projects or for Nicola to speak at a group session, please email her on: nicola.king67btinternet. com

Join us at our Dementia Information and Advice Fayre on 4 May, 10am - 4pm at the N&N.

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NEWS from NNUH - March 2020

CHAIRMAN’S MESSAGE PATIENT EXPERIENCE

How listening to you helps us shape our services Providing patients with the best possible care during their time with us is about more than meeting their medical needs, it’s also about ensuring that their whole experience of hospital is positive.

Ruby Allen, Patient Engagement and Experience Facilitator, (pictured left), is focused on listening to patients, their family and carers and the wider community to ensure that their views are central to the way we shape new services and improve existing ones.

“We’ve always listened and responded to what our patients tell us through, for example, Friends and Family Test Feedback or our PALS service,” said Ruby. “Now we’re strengthening this partnership by adding more ways for the people who use our services, or may use them in the future, to co-create them.”

This means listening to groups of people with specific needs when they’re in hospital, whether that’s because they have a protected characteristic such as their race, religion, sexual orientation or a disability, or to better meet the specific needs of people with conditions that make them more vulnerable, such as dementia.

“We’re building on the relationships we already have with organisations that represent people with, for example, visual impairment, and broadening the communities of people we’re working with to ensure that no one feels their needs aren’t recognised,” said Ruby.

Giving people whose voices may not often be heard an opportunity to share their experiences and ideas for improvement with NNUH is a continuing priority.

Currently, Ruby is expanding the existing Carers’ Forum, which now meets every other month to discuss how the Trust can better support people in this crucial role.

“The forum is for people who provide unpaid, informal care for a friend or family member who couldn’t cope without their support,” she said.

“By working together with carers and carer organisations, we can continually examine and improve the accessibility of our services, the hospital experience of both patients and carers, and help them access appropriate support in the community. Initiatives we’re already planning include improving the information we provide for carers and building a network to help them support each other.”

Join our Patient Information Forum Do you have a few hours to spare each month to work with staff and other patient representatives to ensure that all our leaflets are written in a way that’s easy to understand for all patient groups and contain the information they need?

Carer’s Passport One way the Trust currently offers support is through the Carer’s Passport, which provides concessions such as discounted meals and free parking for carers of adults on inpatient wards who support them with, for example, help at mealtimes, with washing, dressing and other aspects of personal care and by offering emotional and psychological support.

“We will build on what we currently offer by establishing a strong and continuing partnership with patients and those who support them,” said Ruby.

If you’d like to find out more about the Carer’s Passport, be part of our Carers’ Forum or have any feedback on how we could improve our services, please email the Patient Experience team on:

We’re recruiting new members to our Patient Information Forum, which meets monthly to review all new leaflets – normally eight to 10 a month - or you can participate via email.

“We want our patient information to be easy to understand and accessible, so having a wide range of people involved will help us ensure that everyone’s needs are met,” said Sarah Higson, Patient Engagement & Experience Lead.

If you’d like to get involved, please email: Patient.Experience@nnuh. nhs.uk

Patient.Experience@nnuh.nhs.uk

NEWS from NNUH - March 2020

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LIFE AT NNUH

“You never know what’s coming through the front door” Staff explain why they love working in the Emergency Department There’s no such thing as a typical day in the Emergency Department. With a patient arriving on average every four minutes, every shift is busy and demand can turn on a sixpence, with staff prioritising care for the most poorly patients and working hard to treat everyone in a timely way. Around 400 patients attend ED every day and NNUH is the busiest hospital in the region for emergency ambulance arrivals. Since ED opened in 2002, attendances have gone from 65,000 a year to more than 150,000.

What’s it like to be in Team ED? We spoke to staff across the department, who all highlighted the great teamwork and supportive working environment. One of the appeals is helping patients with a broad range of conditions as well as working in a number of different areas of the department, including the Rapid Assessment and Treatment Unit, Resuscitation room, Majors and Minors.

Danielle Curtis is a Senior Healthcare Assistant who has worked in ED for the last two-and-a-half years.

She said that working there is very rewarding and the team is very supportive.

Dr Shaun Price, ED Consultant, has been an emergency doctor for the last four years and says working in the department suits clinicians who like working at a fast pace.

“It is so fast paced every day and it is different,” she said.

“You’re constantly busy and you don’t know what’s coming through the front door. I love the job and I am naturally a caring person.

“When a patient says thank you and appreciates what you do, that is really rewarding.

“You can only do your job well and make sure the patient experience is the best they can have.”

“There is no boredom here,” he said. “I’ve worked on wards before but that doesn’t fit my skill set best.

“To work in ED you have to be able to adapt to rapid change and make pragmatic decisions under pressure.

“I get a lot of opportunity to teach in this role. You get a lot of variety in the work and I get to do the same as I did when I was a junior doctor in terms of diagnosing and treating patients.”

Danielle Curtis Senior Healthcare Assistant 10

NEWS from NNUH - March 2020

Dr Shaun Price ED Consultant

Shoby Sebastian, Deputy Sister on the Older People’s Emergency Department (OPED), said she loves working at NNUH because of the learning opportunities and helping to make a difference to the older generation.

“When a patient comes in as an emergency, we provide the best care and seeing them discharged home safely brings such happiness and it’s the best reward that I can achieve as a nurse,” she said.

“Caring for the older generation is my passion as I miss caring for my own parents and grandparents. So when I care for a patient I see my own parents instead. I come to work with a smile.”

Shoby Shoby Sebastian Sebastian Deputy Deputy Sister OPED onSister OPED

CHAIRMAN’S LIFE ATMESSAGE NNUH

New series Emma Wolton, Children’s Emergency Nurse, who joined the Children’s ED last year, said: “The team is great and has really good leadership. This is quite a new department and is developing and is a really nice place to work.

It is nice when children are happy and leave with a smile on their face and coming to ED is not a bad experience for them.”

Matt Jenkins joined the Trust as a nurse in 2012 and has been an Advanced Clinical Practitioner (ACP) for two years.

“I like the variety that ED covers. You don’t know what’s going to come through the door and every day is always different. I like working with a really good team and meeting lots of people day in day out.”

Dr Afzal Alam, a Junior Clinical Fellow, joined ED last September after studying to become a doctor in Saudi Arabia.

“Initially I was worried about being so far from London,” he said. “Everyone has been so supportive and all staff have been so nice from day one. We have very good consultants who are always on the floor and 24 hour consultant support.”

Emma Wolton Children’s Emergency Nurse

Matt Jenkins Advanced Clinical Practitioner

Dr Afzal Alam Junior Clinical Fellow

Lydia Dahl started in September as a newlyqualified nurse.

Her passion for emergency care started following a student nursing placement in ED when she was studying at the University of East Anglia.

“I love the people and the team in ED and the different people you meet every day,” she said.

Max Rudd, who has been an ED Receptionist since June 2019, said: “I like the flexibility with the working hours and that everyone looks after each other here.

There’s a strong element of helping others, which I really enjoy.

Tensions can sometimes run high for patients or family members and my job is to help reassure them and put them at ease.”

Lydia Dahl Nurse

In the last two years, the Emergency Department has grown with the development of the country’s first Older People’s Emergency Department (OPED) and an expanded Children’s Emergency Department.

Max Rudd ED Receptionist NEWS from NNUH - March 2020

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MANAGING MIGRAINES

How we’re supporting migraine sufferers Around one in seven people worldwide suffer from migraines – making them more prevalent than diabetes, epilepsy and asthma combined – and three times more women suffer than men.

It’s a recognised neurological condition, rated as one of the 10 highest debilitating by the World Health Organisation.

Lisa Sant, Neurology Specialist Headache Nurse in the Migraine and Headache Disorders service – one of only 50 such nurses in the country - runs clinics and offers advice to help sufferers manage their symptoms.

“We established the service two years ago after Dr Linda Damian, Consultant Neurologist, recognised the scale of the problem and the need to provide nurse support,” she said.

“We work to ensure patients receive the best advice and treatment plan, covering eight or nine clinics a week including telephone clinics. We’re also supported

by GP Dr Alex Valori, who runs a weekly clinic in the Neurology department.”

Migraines often start in puberty and people aged

35-45 are most affected, although children as young as two can suffer attacks.

Anxiety and depression are also significantly more common among sufferers.

“Migraine can often be misdiagnosed and Lisa Sant helps migraine misunderstood but sufferers manage their management of this symptoms. debilitating condition can offer hope to sufferers,” said Lisa. “The true cause isn’t known, although there’s often a family link and many sufferers identify common triggers.

“As yet, there’s no cure, although there are effective prescription drugs which can help manage the frequency and severity of symptoms. Alternative options are also available on the NHS, such as Botox injections.

Greater occipital nerve blocks are also offered and new monoclonal antibody drugs will hopefully be available soon to target certain pain receptors.”

What is a migraine?

Migraine is a complex neurological condition with a wide variety of symptoms. Most sufferers are genetically predisposed and there are certain common triggers, including stress, hunger, certain foods alcohol, lack of sleep, the environment and, in women, hormonal changes.

Sufferers fall into two categories, those who suffer episodic migraines (fewer than 15 headache days a month) and chronic migraines (more than 15 per month, at least eight with migrainous symptoms).

Migraine is usually characterised by an intense one-sided headache, although it can be on both sides and affect the face and neck. Other symptoms include feeling or being sick and increased sensitivity to light, sound and smells. Symptoms normally last four hours to three days and can leave people fatigued for up to a week.

Around one-third of sufferers have warning symptoms, known as aura, including visual problems, numbness or tingling, feeling dizzy or off-balance and difficulty speaking. These typically develop in around five minutes and last for up to an hour. Some people may experience aura followed by only a mild or no headache.

Debilitating effects Migraines have a debilitating impact - in addition to the pain, the psychological effects can become allconsuming. “Migraine can be very misunderstood, often dismissed as ‘just a headache’ by non-sufferers but it’s far from that, it’s a recognised neurological illness,” said Lisa. Her advice is to keep a headache diary to determine the frequency and pattern of attacks and help identify triggers. “I strongly recommend not over-using over-thecounter painkillers, as they can ultimately make the symptoms worse,” she said. “GPs are there to ensure that patients receive the correct medication, referring them to us if necessary.”

When to seek medical advice There’s currently no cure for migraine but medications are used to control the symptoms.

Consult your GP if you:

Migraine is a recognised neurological condition.

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• Experience frequent or severe migraine symptoms that you can’t control with over- the-counter painkillers - try not to use the maximum dosage on a regular basis as it can make it harder to treat headaches in the longer term. Avoid medication overuse by limiting painkillers to two days in a week or 10 a month.

• Have frequent migraines (on more than eight days a month).

NEWS from NNUH - March 2020

CHAIRMAN’S MESSAGE A DAY IN THE LIFE

A Day in the Life of... Adrian Woodbridge, Lead Chaplain Being in hospital is never an easy experience, and a listening ear can make a huge difference. Our team of five Chaplains, led by Adrian Woodbridge, is available 24/7 to support patients, their families and staff, whatever their circumstances or beliefs.

This is a typical day for Adrian: “We’re on site from 8am to 6pm seven days a week and on call outside those hours, so we’re always available when someone needs us,” he said. “There’s no completely typical day, but the first job is always to check who has asked to see us, followed by an 8.45am handover meeting, when we prioritise our schedules.

“We receive around five new referrals a day, which can come via staff or directly from the patient or their family. In December, we saw 469 patients, 95 family members and 72 staff. My colleague Mark Taylor offers a service at Cromer Hospital, and we’re helped by 33 volunteers.

“End-of-life patients and their families are always our top priority, along with supporting parents who have lost a baby, including through miscarriage. Parents may also ask us to give a blessing or conduct their Christening or naming ceremony.

Families often ask us to conduct their baby’s funeral, and we also offer a communal service at the Woodland Burial ground for families who can’t face a funeral, so there’s somewhere to go to remember their baby once they’re ready. We have a Remembrance Book too, and invite families to a yearly remembrance service.

“We value everyone and make sure that anyone who dies here receives a proper goodbye, so we also conduct funerals for patients who have no family or estate, something we did for 21 people last year.

“At the end of their lives, people often want our help putting their affairs in order, planning their funeral or simply in getting something off their chest.

“We’re here for anyone who needs us, so we often see patients who need help coming to terms with bad news, and their families.

Relatives often feel they need to be strong for their loved one, so sitting peacefully in the chapel or having a chat in our counselling room can help them to process their emotions.

“We’re all Christian Chaplains, but our services are non-denominational and we support people in any way they want. If they wish to see someone of their own faith, then we can arrange that too.

“We’re also here to support staff going through a tough time, as well as helping them cope with the death of a colleague, which we can mark with a memorial service or by dedicating a tree in the hospital grounds.

“Our doors are always open and the kettle is always on. Anyone is welcome to visit us, whether they want to sit quietly in our chapel or garden, talk things through, attend one of our Sunday or mid-week communion services or pray in our Muslim Prayer Room.

“The death of a patient is difficult for staff too, so we provide teaching sessions on the process of grief and loss and listening skills, enabling them to build their own resilience and better support the family. We also teach students at UEA’s Medical School about the importance of spirituality in healthcare.

“Every day is busy but we always try to sit down and eat lunch as a team so we can reset our priorities and support each other.

“It’s a huge privilege to share people’s lifechanging moments and help them through.

I’m always amazed by the courage and strength I see. And we share happy times too, such as when parents who have previously lost a child show us their new baby.

“At the end of the day, my drive home, which takes over an hour, gives me the time to reflect on my day and the people I have met.”

The Chaplaincy Team left to right: Alinda Woodrow, Rosemary Houghton, Mark Taylor, Jane Nursey, Adrian Woodbridge.

If you’d like to get in touch with the Chaplaincy team, please call 01603 287083 or email: chaplaincy@nnuh.nhs.uk.

NEWS from NNUH - March 2020

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NEUROSCIENCES AT NNUH

Neurosciences team recognised for its advanced care Our Neurosciences team provides specialist care for patients with complex neurological conditions and has achieved recognition by NHS England as a Neurosciences Centre – a status that reflects the advanced treatments and technologies our multi-disciplinary team offers stroke and neurology patients.

“Our journey to become a Neurosciences Centre has involved immense hard work from our teams, who have developed services which use the latest technologies and best practice to deliver excellent care for our patients,” said Chris Bean, Head of Neurosciences Development.

The team diagnoses and treats impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system and related blood vessels – such conditions include Stroke, Motor Neurone Disease (MND), Multiple Sclerosis (MS), headaches, Parkinson’s disease and epilepsy.

In total, they care for more than 3,500 inpatients annually and offer around 17,000 outpatient appointments.

The Centre includes one of the five largest combined stroke units in England, seeing patients for emergency assessment and treatments (including clot busting thrombolysis therapy) in the first few hours after stroke, through to rehabilitation (physiotherapy, occupational therapy, speech therapy and psychology) and continuing support.

Integrated services Currently inpatients are cared for on Heydon (our Hyper Acute Stroke Unit) and Dunston wards, but from the spring a new Neurosciences Unit will open in our new ward block, offering integrated stroke and neurology services.

“This is a fantastic development for our patients,” said Chris. “It means clinical experts with worldleading treatments at their fingertips will work side by side to provide the very best care for the people of Norfolk and the wider community.”

It’s another patient-centred innovation by a forward-thinking team who have already, with the support of partners and fundraisers, introduced video-EEG telemetry which videos patients and records their brain activity during episodes of transient impairment of awareness, which may include epileptic seizures, to help diagnosis and treatment, and created new roles to support MS and MND patients at home.

The NNUH Neurosciences team.

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NEWS from NNUH - March 2020

CHAIRMAN’S NEUROSCIENCES ATMESSAGE NNUH

Our MND Network reaches its second anniversary Our Motor Neurone Disease (MND) Network has just celebrated its second anniversary of supporting patients and their families. It was launched after we were awarded funding from the MND Association, and opened by their Patron, the Princess Royal.

“MND is a relatively rare and complex neurological condition that’s characterised by degeneration of the motor neurones, resulting in progressive muscle weakness,” said Helen Copsey, MND Care and Research Network Co-ordinator.

“It most commonly affects people aged 50-70, but can affect people who are much younger.

“It can affect multiple muscle groups in a short time, including those responsible for speech, swallowing, movement and breathing.

“It’s vital that patients receive the personalised care they require quickly, and that both they and their families are supported from diagnosis.”

Ours is the first MND Network in the area and was set up thanks to a grant submission to the MND Association by Consultant Neurologist David Dick. It’s led by co-directors Godwin Mamutse, Consultant Neurologist, and Caroline Barry, Palliative Care Consultant.

The Association also provided initial funding for Emma Larner, MND Specialist Respiratory Physiotherapist, who works in the community supporting patients with complex symptoms.

“We’ve established satellite services in Cromer and Beccles and provide outreach services to West Norfolk to ensure that patients don’t have to travel so far for specialist review,” said Helen.

“At any one time we’re caring for around 100 people. All patients are referred to me as a single point of contact for immediate postdiagnosis support and information.

I work with colleagues from across the network, including volunteers from the MND Association, to ensure that appropriate care is delivered in a timely way.

“We recognise the importance of psychological support and work closely with our palliative care colleagues. I liaise with local hospices who offer day therapy, inpatient and community-based support. Wherever possible, we aim to provide end of life care in a patient’s preferred place.”

Please contact Helen Copsey at: Helen.Copsey@nnuh.nhs.uk or 01603 647221 if you would like more information about the network.

Helen Copsey, MND Care and Research Network Co-ordinator.

Working with patients to improve lives through research As well as providing the best possible clinical care, our Neurosciences Centre is focused on improving the quality of life and outcomes of people living with neurological conditions through research.

Kath Mares, Neurosciences Research and Development Lead, is strengthening our research capability by working with the University of East Anglia (UEA), where she’s a Physiotherapy Lecturer, and other partners across Norwich Research Park to develop patient-led studies.

“We’re already involved in trials and our ambition is to build on this to develop our own funded research centred on the issues our patients tell us are important to them,” she said. “With a significant proportion of older people in the local population, and many people living with the effects of long-term neurological conditions, we feel we can make a real impact on improving people’s lives.

“In current funding applications, we’re looking to create a digital intervention to support people in managing fatigue after stroke and also aim to start a study investigating the impact of encouraging physical activity across the neurosciences pathway (from admission to early supported discharge).

“We’re looking to expand on this with a suite of research programmes that are led here and funded by the National Institute for Health Research or commercially. We’ve huge expertise both here at NNUH and UEA and will work together to benefit future patients living with a wide range of neurological conditions.”

NEWS from NNUH - March 2020

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NEWS FROM CROMER

Wendy is named Radio Norfolk Volunteer of the Year Wendy McDermott, 82, has been named the Radio Norfolk Volunteer of the Year in the Health category, in recognition of her contribution to the Muriel Toms Day Procedures Unit at Cromer Hospital.

She was nominated by her daughter Pat, who wrote: “She makes tea, makes up beds, talks to patients and chats to nervous patients in the unit.

“What makes mum special is that she herself has had cancer. She has had major surgery twice, but could not wait to get back to ‘work’, so she could get back to doing something she loves.

“Since I was young she has done voluntary work, through Brownies, Guides and St John Cadets, earning a medal for many years’ service in the adult division. She has always given to others even though she has been through so much herself.

“She retired from nursing after 41 years but in a sense she has never stopped!”

Wendy was told that she had won live on air, when Radio Norfolk presenter Wally Webb arrived to interview her at home on the pretext that she’d been shortlisted. “I just went blank and felt that I was dreaming,” she said. “I do it because I like to help and to get out of the house to meet people, so it was a lovely surprise. It was also lovely to hear what my daughter had said about me, as I hadn’t known that she’d nominated me until then.”

Wendy began volunteering at the hospital two years ago after she’d spent seven months receiving chemotherapy there after bowel surgery for cancer. “One day I was offered tea and biscuits but it was so busy no one was able to get them for me so I said that they needed a volunteer,” she said. “So that’s what I became when I recovered.”

Her colleagues think highly of her: “It’s great to have an extra pair of hands to support the staff in giving superb care to our patients on the unit,” they said. “Wendy loves to chat with everybody and feels very much part of the team.”

Work to begin on the North Norfolk Macmillan Centre Construction work begins on the new North Norfolk Macmillan Centre at Cromer and District Hospital this spring.

Opening in 2021, the centre will provide care closer to home for 20,000 patients each year. An old ward is being refurbished and expanded to create space for clinics, diagnostic equipment and treatment areas, alongside a Macmillan cancer information and support centre.

The centre will enable patients, many of whom currently travel to Norwich, to have their treatment and access support services closer to home. This will include chemotherapy, with six treatment chairs able to treat up to 50 patients a day, and the building will also host outreach teams who visit patients in their own homes across North Norfolk.

Most of the project will be funded from charitable sources in a partnership between Macmillan Cancer Support, the N&N Hospitals Charity, Cromer Community & Hospital Friends and donations from the public.

Moving some of the Cromer-based cancer services to the new centre will free space to deliver an extra 600 surgical procedures each year, including in orthopaedics, urology, vascular surgery and pain management.

16 NEWS from NNUH - March 2020

Joy Moulton, Macmillan Partnership Manager for Norfolk, said: “We can’t wait to see construction work begin on this fantastic project and help us move towards our goal of being able to improve cancer care for many people in North Norfolk.”

Simon Hackwell, NNUH Director of Strategy, said: “This is a great opportunity for us to deliver more treatments and appointments closer to home for patients in North Norfolk and is an important part of our plans to increase capacity for cancer treatment and other outpatient services at Cromer.”

An artist’s impression of the new North Norfolk Macmillan Centre.