Feast@: West Atrium, Level 1, open daily 7am - 1am
Feast@ the Deli: West Atruim, Level 1, open Monday - Friday, 7am-3pm
Feast@ Café Bar: Out-patients East, open Monday - Friday, 7.30am - 4.30pm
Coffee House: Plaza (West), open MondayFriday, 7am - 6.30pm; Saturday, 9am - 4.30pm; Sunday, 9am - 3.30pm
Little Costa: Out-patients West, open Monday - Friday, 7am - 5.30pm
The Pod: Plaza East, open Monday - Friday, 7am - 8pm; Saturday, 9am - 6pm Charity Café: Car park G outside the Emergency Department, 7.30am - 4pm weekdays
The Mardle Café at Cromer Hospital: 8am4pm Monday to Friday
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, 9am5pm; Sunday, 9am - 4pm
The Stock Shop: West Atrium, Level 2, open Monday - Friday, 9am - 5.30pm; Saturday, 12pm - 4pm. We open 8am Thursdays.
Services
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 01603 287470 Cromer Hospital, call 01603 646200 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 289822 or ext. 5822, email Communications@nnuh.nhs.uk Design: Medical Illustration
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 and District Hospital, Mill Road, Cromer, NR27 0BQ Tel: 01263 513571
NNUH Dementia Fayre - 21 May 2025
The NNUH Dementia Fayre will be returning to the East Atrium and Benjamin Gooch Lecture Theatre on Wednesday 21 May 2025 between 10am and 4pm.
The event is open to all staff, patients and carers to provide advice and support to people and families affected by dementia.
Liz Yaxley, NNUH Dementia Services Manager, said: “The Dementia Fayre is one of our highlights of the calendar year because of the level of support we receive from the local dementia support community and we see how valued the event is for our patients, carers and families affected by dementia.”
“The aim has always been to provide as much information and support to people living with dementia in a caring and supportive environment - we are looking forward to welcoming a host of experts and organisations to the hospital on the day.”
This year’s event will be attended by the prevention team from Norfolk Fire and Rescue Service who complete home fire safety visits for vulnerable and elderly residents. We will also be joined by Norfolk Police, Age UK Norfolk, Norfolk and Suffolk NHS Foundation Trust, Admiral Nurses, Alzheimer’s Society, the NNUH Dementia Support team and local dementia support groups.
Prof Michael Hornberger, Professor of Applied Dementia Research at the University of East Anglia, will deliver a talk on the latest in disease modifying drugs between 2.15pm and 3.15pm.
There will also be sessions earlier in the day about keeping well and independent and another on keeping safe and planning ahead.
Advance Care Planning Conference - 7 May 2025
The annual national Advance Care Planning Conference 2025 will take place on Wednesday 7 May at Norwich Research Park.
This year’s conference will take place at the John Innes Conference Centre, with live streaming to centres across the UK and globally.
Last year’s event was a sell-out, and live streams have been arranged at Tapping House in west Norfolk, James Paget University Hospital, Priscilla Bacon Lodge and at NNUH.
The first speakers for the conference have been confirmed. Dr Christian R Ntizimira’s talk will focus on ‘What Matters Most to You’. Christian is the Medical Director at Kibagabaga Hospital in Kigali City, Rwanda. Other speakers include Evie King, Celia Kitzinger, Clare Fuller and Vicki Caldwell. Tickets are free to attend in person or accessing the live stream.
Please note that all opening times are currently subject to change.
Please email PCBookings@nnuh.nhs.uk for further information. For more information and to book a free ticket, visit: www.advancecareplanday.org/national-conference-2025/
The longer warmer days and the colourful bulbs popping up around the hospital grounds are a sure sign that spring is finally here after a long winter. I want to start by saying a huge thank you to all our staff and volunteers for your continued hard work and the support you have provided to each other during the difficult winter months – I also want to thank the loved ones and families of our staff for the extraordinary daily support you provide so that our people can be here every day.
It has been a challenging winter with high demand on our services and higher than expected levels of flu. However, our teams have done an amazing job to limit the spread of winter viruses. It has not been easy and again I want to acknowledge the way our teams across the Trust have responded to manage the very cold and busy winter we have had.
The spring is an equally busy time of year as we enter a new financial year and there is a big focus across the NHS to reduce waiting times for planned and emergency care during 2025/26, and we’re already working on ways to prevent unnecessary hospital admissions, particularly for the elderly.
We have already made some difficult budgetary decisions this year to control spending on agency and temporary staffing and some non-essential costs and during this new financial year all hospitals are expected to improve productivity, but to also live within our financial means whilst not compromising on patient safety.
One of the ways we can improve efficiency in Norfolk and Waveney and ensure we are delivering value for money is closer working with our health and social care partners.
I’m pleased that we have taken the first steps at NNUH alongside our colleagues at the James Paget University Hospital and the Queen Elizabeth Hospital King’s Lynn to adopt a group model way of working that will start in April 2025.
Working together is already helping to roll out a single electronic patient record for all three hospitals, which will be launched next year, and has resulted in the building of three new diagnostic centres in Norfolk and Waveney.
As part of World Cancer Day on 4 February, I visited our teams in the Weybourne Unit and Radiotherapy’s Winterton Unit and was so impressed with what I saw –such dedication and focus on the care of our patients, and their families, at such an incredibly anxious time for them. In Norfolk and Waveney we are really fortunate to have expertise that is truly world-class.
It’s just one of the things that makes me so proud to be a part of this wonderful organisation and I see the greatness shine through every day.
Prof Lesley Dwyer,
NNUH Chief Executive
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Transitioning to a group model for three acute hospital trusts
Since 2020, the three acute hospitals in Norfolk - The Queen Elizabeth Hospital, James Paget University Hospital and Norfolk and Norwich University Hospital - have been collaborating to address shared challenges.
This partnership, called the Norfolk and Waveney Acute Hospital Collaborative, has demonstrated the value of working together to deliver better care for patients, improve staff experience, and make more effective use of resources.
The collaborative has begun the roll out of a single electronic patient record system across all three hospitals and built three new diagnostic centres across Norfolk and Waveney.
Now, endorsed by NHS England and Norfolk and Waveney Integrated Care Board (ICB), the three hospitals have begun the process of transitioning to a group model of operation.
Moving to a group model will improve patient care and outcomes. It will mean that there will be a single decision-making process across the three hospitals combined with strong site leadership. It will enable the hospitals to share resources more effectively and tackle the large-scale challenges our hospitals face with a single unified approach. At the same time locally focused delivery of healthcare will continue to meet the specific needs of communities. The group model helps create the opportunity for our patients and communities to:
• Deliver a consistent best practice model of urgent and emergency care with a particular focus on frailty.
• Implement safe and sustainable care models.
• Tackle some of the underlying financial challenges facing the hospitals.
• Deliver better outcomes for people with cancer at all stages of the pathway and optimise elective care pathways.
• Ensure a co-ordinated approach to the development of the two new hospitals in King’s Lynn and Gorleston.
• Make the most effective use of workforce capacity.
• Enhance research, training, and innovation.
In the case of the three Norfolk acutes, each hospital has a strong base in the community it serves and is trusted and valued by its population. The hospitals are committed to preserving this ethos and building upon it.
The operating model is being developed to ensure the needs of local people are represented with clear leadership at site level as a key component.
There will be a single Chair and a single Chief Executive appointed across all three Trusts. There will also be a single set of Executive and Non-Executive Directors across the three.
Each Trust maintains its own legal autonomy with its own Council of Governors who will hold the Group Non-Executive Directors to account and ensure that local considerations remain central in how we deliver acute care. In addition to this each hospital will have a Managing Director who will be a full member of the Group Board.
Implementation of the group model will begin in April and be complete by the end of October 2025.
Emergency Department features on national television documentary
Our Emergency Department has featured on national television in the latest series of A&E After Dark.
The series has been featured on 5Star and is available to view on catch-up and features life behind the scenes on night shifts at NNUH. The A&E After Dark production team spent five weeks at our ED last summer as well as at hospitals in Birmingham and Tunbridge Wells.
The documentary series filmed the whole multi-disciplinary team in ED and includes a range of patient stories, including major trauma cases, road traffic collisions, dog bites, dislocations, heart conditions and head injuries. Johnny Wells, Senior ED Matron, said: “It has been great to be involved in this new series to give a behind the scenes view of what happens in a busy Emergency Department and the challenges we face. Working in an Emergency Department is hugely rewarding, but also comes with its challenges and pressures and we hope the series will raise awareness of the realities and the importance of only attending ED with life-threatening and serious conditions.”
For more information, visit https://www.channel5.com/show/a-e-after-dark/season-6/episode-1
Dr Tarek Ahmed
The Neonatal Outreach team - helping babies and families
This year is the 25th anniversary of our Neonatal Outreach service, a lifeline for many new parents when their babies are discharged home from NICU with ongoing clinical nursing needs.
Launched in September 2000 at the old N&N, the team was one of the first Neonatal Outreach services in the country to be established. They facilitate earlier discharge from hospital and support families caring for their babies with feeding tubes, home oxygen, cardiac and surgical conditions and palliative care. They visit nearly 300 families every year travelling up to 20,000 miles around Norfolk.
Early discharge enables improved patient flow on NICU but it’s not just about flow, as Charlotte Devereux, Senior Sister, said: “Babies thrive at home with their families. Our priority on NICU is to support parents to learn to care for their baby at home as soon as possible. Reducing hospital admission reduces stress, improves bonding, attachment, breastfeeding and developmental outcomes.”
Not all hospitals currently have outreach teams working in their neonatal units. The NNUH team is small, with just three nurses providing the service seven days a week. The team manage their caseload on NICU and liaise with the neonatal team each day. They attend nursing handovers, organise discharges and endeavour to introduce the service to parents in preparation for home. Each day one nurse will make home visits within approximately a 35-mile radius. Some days they can make more than nine visits in different locations.
The families can feel incredibly vulnerable, and the team not only carry out nursing checks on the babies but are there to support parents too. “That’s a huge part of the job,” said Anna Smith, Deputy Sister. “You never know what you’re walking into. Some families are really struggling, and we do a lot of signposting onto other support services like health visitors, mental health support and the baby bank who can provide items for families in need.”
Anna adds: “The team is very good at getting together to support each other on the unit if there’s been a particularly difficult case. We’ve also got three other members of staff on the unit who are training up to cover outreach work so we can cover annual leave, and having their support is invaluable.”
The visits are crucial to identify fragile babies who could be deteriorating at home and require further hospital treatment. Joint working is paramount, with the nurses in regular touch with other outreach teams just outside the patch, colleagues such as the neonatal dietician, speech and language therapist, occupational therapist and cardiac specialists at Great Ormond Street Hospital.
For the babies who progress but still need nursing support, the team hands over the care at 44 weeks to the Children’s Community Nursing team at NCH&C.
It’s a challenging but rewarding role. From helping organise complex discharges to seeing families settle into their new normal. Charlotte said: “I love the challenges of my role and working with a fantastic team on NICU. It’s so rewarding to see parents grow in confidence in caring for their baby independently. To support them in being a family all together at home is a privilege. Many parents wait a long time for that moment.”
Apprenticeship Week podcast special
To mark National Apprenticeship Week, we’ve spoken to a recent graduate for a special episode of our podcast ‘Behind the Hospital Curtain’.
We chat to Kerry Baldwin, who was the first to undertake a Trainee Operations Manager role as part of her studies, and Sophie Carter, Career Development Manager, about apprenticeship opportunities at the Trust and the benefits of them to the NHS.
Listen on Spotify or Apple podcasts now.
Jane Foster, Anna Smith, and Charlotte Devereux from the NICU Outreach Team
Our priorities to reduce waits for treatment
Cutting long waits for planned care, improving cancer performance and reducing the time patients wait for emergency care are key priorities for the NHS over the next year.
NHS England has set objectives for this financial year, which include the expectation that all trusts live within their financial footprint whilst also increasing the proportion of patients who receive their treatment within 18 weeks and proportion of patients who start their cancer treatment within 62 days of a referral.
Reducing waits for treatment is a key priority for us and is part of our Best Care for Every Patient programme to increase activity in our theatres and clinics.
Chris Cobb, NNUH Chief Operating Officer, said: “It is a priority of ours to accelerate our elective recovery, which includes a programme of work to increase elective and day case activity and to also increase the number of new out-patient appointments as well as the proportion of patient-initiated follow-ups.”
“We continually review our waiting lists - we are prioritising cancer treatment, the most urgent and longest waiting patients. Our teams are carrying out additional theatre lists and clinics at weekends. Where capacity is available at other trusts, some patients are also being offered treatment at other hospitals to help reduce waiting times.”
The expectation is that 65% of patients receive their treatment within 18 weeks by March 2026 with each hospital delivering a minimum of 5% improvement over the 2025/26 financial year.
For planned care
• We are increasing productivity of our operating theatres and working to get the Norfolk and Norwich Orthopaedic Centre fully operational
• Two new children’s theatres have already helped to increase productivity by 40% at the Jenny Lind Children’s Hospital in the first year of the paediatric theatres complex opening
• Our Ambulatory Procedure Unit is treating more patients as day cases by extending the working day
• We are increasing the number of new appointments in our out-patient clinics and expanding Patient Initiated Follow-ups (PIFU) where patients are in control of their hospital follow-up appointments.
New approach to assessing frailty benefits patients
A new approach to assessing frailty in older patients is helping us to ensure that we’re delivering care based on their specific healthcare needs rather than simply their age. To achieve this, we’re using a new app which allows clinicians to quickly and accurately capture a Clinical Frailty Score for every patient aged 65 and over at the point of their admission to our Medicine Division.
Previously, patients aged over 80 were typically cared for by Older People’s Medicine (OPM) regardless of their frailty level, while those under 80 were cared for by other specialties. This approach doesn’t account for the growing number of younger patients with frailty, so now clinical condition is prioritised, with those aged 65 and over who are frail triaged to OPM, and patients over 80 who are not frail are cared for by the appropriate specialty.
Urgent and Emergency care
We continue to be one of the top performing hospitals in the country for the A&E four-hour performance standard, which is testament to the work of our multi-disciplinary Emergency Department teams, specialities and in-patient wards.
We have been consistently performing above NHS England targets to see a minimum of 78% of patients admitted, transferred or discharged within four hours across our Emergency and Urgent Care Services. We have reconfigured our services and having senior clinicians triaging patients at the front doors of ED really helps our patients to get a quicker diagnosis and start treatment earlier.
However, we know we have more work to do to continue to improve our ED performance and reduce ambulance handover delays. This includes a focus on reducing the number of escalation spaces across the hospital, increasing the proportion of hospital discharges before midday and maximising Virtual Ward capacity.
As always, it is really important that people come to ED or call 999 if they have a life-threatening or serious condition. If it is not serious, we’d urge people to use the right service for their needs and that could be a pharmacy, their GP or by contacting NHS 111.
New Community Diagnostic Centre opens to patients
Our new Community Diagnostic Centre (CDC) was fully opened at the end of February to increase imaging and diagnostics capacity for patients.
The centre is the last of three out-patient imaging facilities to be built as part of a programme to deliver CDCs at each of the three hospitals in Norfolk and Waveney. It follows a combined £85.9million capital investment from the Department of Health and Social Care, the local health system and a £1.6million grant from the N&N Hospitals Charity, in partnership with the Norfolk Heart Trust, towards a cardiac heart scanner and two CT scanners. The Charity is also running the centre’s cafe.
Amongst the first in were Philip Hunt and Karen Playford, who were attending for CT and MRI scans respectively.
Philip said: “I am very happy with everything so far – and I was seen bang on time. It doesn’t get much better than that.”
Karen added: “It is so lovely, clean, fresh and calming. I love it. And the staff have been very helpful explaining everything to me.”
Situated away from the main hospital next to the Quadram Institute on Norwich Research Park, the centre will offer Ultrasound, X-ray, CT and MRI scanning and will be open between 8am-8pm seven days a week. It is anticipated that the team will see 430 patients a day once at full capacity.
Team members gave NNUH CEO Professor Lesley Dwyer and NNUH Lead Governor Elaine Bailey a tour of the building which incorporates calming patient-centred design and sustainability features including highly efficient air source heat pumps, LED lighting, solar panels and natural ventilation all to reduce the demand on energy sources and reduce carbon footprint.
Marking World Cancer Day
Lesley said: “We’re delighted to see our new Community Diagnostic Centre up and running. It is a real triumph and such a testament to the people who have made this happen.
Our team will be able to see approximately 150,000 patients a year, which will help to significantly speed up diagnosis times for people with a range of health conditions including some cancers.”
NNUH Radiology Service Operations Manager, Seshni Mohammed, said on the day of opening: “This has been an exciting day for us with the facility open for dedicated out-patient imaging. The building has been thoughtfully designed to provide a calm, soothing and relaxing environment, recognising that diagnostic imaging can be a bit overwhelming and uncomfortable for some.” Programme Senior Responsible Owner (PSRO) Julia Kazimierczak added: “I would like to thank everyone who has played a role in delivering this facility successfully. It is a programme we are particularly proud of bringing together innovative design, workforce and operational standardisation across Norfolk and Waveney Radiology services –all with patients and staff at the centre. I would particularly like to thank members of the Patient Panel who gave their views on our design ideas, accessibility and signage.”
To mark World Cancer Day, which took place on 4 February, our Cancer Services Team created an ‘A-Z of Cancer Services’ to showcase the comprehensive care our Trust provides to our cancer patients.
Throughout the week, we shared the A-Z on our social media channels to raise awareness and provide valuable information about the support available to our patients. The A-Z includes videos from our Cancer Services including information about Genomics, the Colney Centre, Holistic Needs Assessments, Oncology, Radiotherapy and Palliative Care.
For more, visit www.nnuh.nhs.uk/our-services/cancer-services/a-z-of-cancer-services/
Delivering expanded Radiology services to improve patient care
Imaging technology is used during a variety of procedures, both diagnostic and therapeutic, including national screening programmes and within research.
The use of Imaging in treating or diagnosing can prevent patients requiring invasive surgical intervention and give clinicians accurate and timely information about a patient’s condition, before taking any steps towards treatment.
Last year, more than 495,000 examinations were carried out, an 11% increase from the previous year. With the new standalone Community Diagnostic Centre (CDC) opening, the department is expanding to meet the increasing demand for its services.
Patients may be familiar with X-rays, MRI or CT scans, but the department consists of other areas, including bone density scanning, ultrasound, breast imaging, fluoroscopy, nuclear medicine, vascular access services and interventional radiology. There are also imaging services at Cromer and District Hospital and the new CDC.
The department has approximately 500 multi-disciplinary team (MDT) members which include radiographers, clinical scientists, medical, nursing professionals, ODPs, paramedics, admin and clerical staff, radiology department assistants, and housekeeping teams.
It has been accredited with the Quality Standards in Imaging (QSI) Award since 2012, which publicly endorses the high-quality patient-centred services continually provided by the department.
Radiology services are being used earlier and more extensively. In a population that is aging and expanding, the number of patients requiring imaging and the complexity of imaging, continues to increase.
Seshni Mohammed, Radiology Service Operations Manager, said: “The Imaging department, as a whole, goes above and beyond in their delivery of care, always keeping the patient’s best interests at the forefront of decision-making.’’
Supporting emergency care
The Radiology team provide a 24/7 service to the Emergency Department (ED) and play a key role in supporting rapid diagnosis, through the use of stateof-the-art imaging technology and facilities.
Diagnostic tests in emergency care settings need to be fast and accurate and Radiology teams undertaking this work not only have highly specialist skills, but are experienced in the care and techniques required for scanning very ill patients who require urgent assessment during a critical period.
Magnetic Resonance Imaging (MRI)
The team provide trauma spinal imaging as well as neurological, oncology, orthopaedic and cardiac imaging. MRI is used to investigate or diagnose conditions that affect soft tissue.
Nuclear Medicine
Nuclear medicine therapy uses radioactive molecules as a drug. The drug recognises tumour cells. It’s injected intravenously or taken orally, then circulates in the body, sticks to the tumour cells, delivers radiation directly and destroys them.
Computed Tomography (CT)
The team provide rapid trauma imaging for patients from resus and to diagnose and treat strokes. Patients can require imaging for a variety of reasons, including staging for cancer diagnosis, orthopaedic and surgical planning, along with cardiac CT imaging.
Cancer care
The department supports cancer MDTs and specialist meetings reviewing approximately 300 patients’ imaging every week. Within the Norfolk Centre for Interventional Radiology (NCIR) we provide treatments and interventions for cancer, such as chemotherapy directed into known cancers via the arteries. Imaging Matron Cherry King said: “The role of interventional radiology in the treatment and management of cancer and its associated symptoms is a growing field, with Interventional Oncology becoming more prevalent in our case mix.”
The Vascular Access Team works within the hospital to insert PICCs (Peripherally Inserted Central Catheter) and Midlines for patients who need longer term intravenous treatments or forms of intravenous nutrition. They are a key part of a patient’s care to other services such as Outpatient Antibiotic Therapy (OPAT) and Oncology. Last year the team placed more than 1,500 lines across the Trust.
Ultrasound
An ultrasound scan can be used to monitor an unborn baby, diagnose a condition, or guide a surgeon during certain procedures. The multidisciplinary team provides all the ultrasound scanning within Radiology and supports the Obstetric and Vascular services through specialist imaging.
Training and Research
The East of England Imaging Academy, established in 2005, hosted at the NNUH, set a new standard for imaging education. To date, the Academy has delivered significant value into the region’s imaging workforce, providing excellent specialist training for Clinical Radiology trainees, supporting recruitment into consultant posts across the region.
It has supported dedicated learning space, an immersion into image interpretation, reporting, ultrasound skills and access to simulation for imaging staff and other multi-professional specialties.
Karen Reid, Imaging Academy Manager, said: “We have a proud and long tradition of imaging education within the East of England. Our focus is to empower the future workforce to be innovative and well-equipped in order to provide excellent patient-centred care”.
Radiology is one of the fastest growing research departments in the hospital publishing approximately 53 peer reviewed papers in the year 23/24.
Areas of research interest include:
• Artificial intelligence, in particular breast imaging and cardiac MRI
• Multiparametric prostate MRI
• Tumour ablation
• MRI scans and dementia patients
Rebekah Girling, Lead for Imaging Research, said: “We are extremely proud of our Imaging Research achievements and the collaborations we have made with the UEA in particular with our dedicated Cardiac MRI Research with Dr Garg. We encourage our Radiographers to encompass research in their careers through schemes and applications for funding.”
Fluoroscopy
Fluoroscopy demonstrates dynamic bodily functions, such as the swallowing action. The team also run specialised clinics with the Speech and Language Therapy Practitioners and feed into the benign oesophageal MDT meetings.
X-Rays and DXA
X-rays and DXA services cover primary and secondary care referrals. They also provide screening for procedures in theatre settings. A DXA scan is often used to diagnose or assess risk of osteoporosis.
Breast Imaging
Radiology is used for delivering mammograms or ultrasounds in the Breast Clinic and for the NHS Breast Screening Service. Our “one-stop” clinic offers triple assessment (examination, imaging and biopsy) and is a recognised gold standard service.
Seshni said: “People are likely to need follow-up and surveillance imaging for a while as screening programmes are providing earlier diagnosis. This raises the need for adequate imaging resource to meet the increasing service demands. It is crucial to invest in radiology workforce and infrastructure, in addition to improving screening services.’’
The Future
The new Community Diagnostic Centre (CDC) will redirect most of our adult out-patient activity away from the acute site, except for urgent on the day clinic imaging and interventional radiology procedures. This will ensure there is increased capacity on site for in-patients and those attending ED.
Looking ahead there is opportunity to use AI to enhance patient care.
The regional Eastern Diagnostic Imaging network, made up of around eight Trusts are in the process of getting an AI solution approved, to assist with lung nodule identification on CT Lungs studies.
Using AI to identify patients more at risk of developing skin cancer
A Consultant Dermatologist at NNUH has teamed up with computer scientists at the University of East Anglia (UEA) to utilise Artificial Intelligence (AI) to identify medications that could increase the risk of sun burn and skin cancer.
Dr Zoe Venables, who is also a Clinical Associate Professor at our hospital, has received a British Skin Foundation Young Investigator Award to develop her research which will analyse the anonymised prescription data of more than a million patient records.
The national study, which is being led by Dr Venables and supported by Prof Wenjia Wang, professor of AI at the School of Computer Sciences and Dr Kathryn Richardson, Senior Statistician at UEA, aims to use Artificial Intelligence to investigate possible links between certain prescription medications and rising rates of skin cancer.
Dr Venables said: “We know that some medications increase photosensitivity which make it more likely to get sun burnt and in turn this could lead to an increase in the likelihood of skin cancer. There is good evidence to suggest there is a blood pressure medication that increases the risk of sun burn and in turn skin cancer risk and there are many other drugs that cause photosensitivity.
However, it is difficult to give a definitive answer and this project will help to provide a more
The Princess Royal visits the Quadram Institute
Her Royal Highness the Princess Royal visited the Quadram Institute to hear about its work in protecting and improving health.
The Quadram Institute opened in 2019 and combines a regional endoscopy centre, a clinical research facility and state-of-the-art bioscience laboratories with a mission to deliver healthier lives through innovation in gut health, microbiology and food.
It’s a partnership between our hospital, Quadram Institute Bioscience, the University of East Anglia and the UKRI Biotechnology and Biological Sciences Research Council (BBSRC).
The institute brings together researchers, academics and NHS clinicians and during the tour, she spoke to over 60 members of staff and students who are working to address challenges in human health, food and disease.
She visited the Endoscopy Unit, meeting Medical Director Bernard Brett and Chief Nurse Rachael Cocker,
informed discussion with patients as to whether certain medicines may pose an increased risk.”
Our ageing population, changing sun exposure behaviours and improvements to cancer registration are believed to be the reasons why there has been a 26% increase in skin cancer cases over a six year period.
Dr Venables will use AI to help analyse the prescriptions of over a million patients to see if there’s any connection with certain drugs and skin cancer.
It is not the only use of AI in the field of dermatology –other research projects are also using the technology to spot cancer risks from images of people’s moles.
She said: “AI is a fantastic tool to use with big datasets and this work could help us identify future studies that are focused on specific drugs. This is the first time we have done something like this and the results could help us to inform patients about the risks and to take extra precautions in the sun or switch to medications that are less risky.
Additionally, we may find a medication that helps protect against skin cancer that we didn’t know about.”
as well as clinical staff and some of the unit’s patients. Next she met Jonathan Lartey, our Associate Medical Director for Research, who explained the work of the Clinical Research Facility, and staff, including the team planning a clinical trial on biofortified foods, along with research champions who have taken part in previous trials.
The tour also included the Quadram Institute Bioscience laboratories to learn about the cutting-edge research projects being undertaken.
Dr Brett said: “It was a great opportunity to showcase cutting-edge collaborative work that’s going on here in Norfolk to bring about improvements to patient care and treatment.”
European-first to trial new test to diagnose joint inflammation
Patients at our hospital have become the first in the UK to join a new clinical trial that aims to improve the speed and accuracy of diagnosing the causes of joint inflammation.
More than 200,000 knee and hip replacements take place in the UK every year with less than 1% of patients experiencing a rare but serious complication following joint replacement surgery.
A new genomic test to help diagnose and differentiate between infectious and non-infectious inflammation has been developed by Australian-based OrthoDx, which is now being trialled at NNUH in the first UK research study, and is able to cut testing times from days to hours.
The Synvichor system is a genomic PCR (polymerase chain reaction) test for rapid diagnosis of joint pain and is being tested by the Orthopaedic, Research and Development department, Rheumatology, Microbiology and Pathology teams with support from University of East Anglia (UEA) researchers.
Prof Iain McNamara, NNUH Consultant Orthopaedic Surgeon and UK Chief Investigator, said it has taken a large amount of work over 18 months to establish the research study and is the first time the system has been tested outside of Australia and is the first clinical trial to test the Synvichor.
This study is likely to determine whether this new diagnostic test offers improvements in differentiating infectious from non-infectious joint pain alongside existing methods currently in use.
He said: “Many patients attend A&E, Orthopaedic or Rheumatology clinic with joint swelling and pain and one of the biggest challenges is to differentiate infectious and non-infectious causes. Both normal and replaced joints can develop swelling and pain which needs a diagnosis.
To determine if the fluid in a joint is infected, we draw some of the synovial fluid out with a needle and send to the lab to be looked at under a microscope, which is a technique that has been used for over one hundred years but it is not necessarily a reliable diagnostic test.”
“The Synvichor system is designed to give a quick and more accurate ‘yes or no’ result to show whether infection is present in the sample within three hours and uses similar technology that was used during the pandemic to test people’s saliva for Covid-19. If it is a yes, it gives us more certainty around the need for surgery. If it is a no, it helps save time and could mean that a patient does not need an admission to a hospital bed, antibiotics or surgery and can be managed by the community team.”
Prof McNamara said that the ELIJA clinical trial will involve 500 participants.
Dizziness device goes national to help speed up diagnosis
A device which aims to help the diagnosis of dizziness problems, is being tested by patients across the country in a research study.
The Continuous Ambulatory Vestibular Assessment (CAVA) device has been created in partnership between NNUH and University of East Anglia (UEA) to speed up the diagnosis of the most common causes of dizziness by analysing hours of eye and head movement data. The lightweight and durable device has been developed over the last six years by a team led by ENT Consultant John Phillips at NNUH and Prof Stephen Cox in the School of Computing Sciences at UEA and is supported by the National Institute for Health and Care Research (NIHR).
Around 20 hospitals across the country are taking part in the latest clinical trial, which involves hundreds of patients wearing the device who have the most common causes of vertigo to help train an AI algorithm
to identify moments of dizziness within several hundred hours of data. CAVA is designed to be worn daily for many weeks by dizziness sufferers, and the data it records is then analysed by a computer to identify periods of dizziness and to suggest their possible cause.
John said: “We are pleased that the UK patent for CAVA has been approved and we are awaiting the US patent, and we believe the device can hugely help society by using technology to help diagnose patients in the community.
“We currently have 600 days of data and an AI algorithm developed by the team at the UEA will help to analyse that information. We have some international links with a site in the US who would like to use CAVA and we are exploring its potential use for non-balance problems.”
The NNUH research team running the ELIJA study
Family donate new mole mapping machine after £50,000 donation
A new machine to help detect skin cancer has been unveiled following the fundraising efforts of a Norfolk family who raised £50,000.
The Horus mole mapping machine is a state-of-the-art tool designed to meticulously map and monitor moles on the skin and has been donated in memory of Norfolk-born Neil Evans, who died of melanoma in Australia in 2021, four years after his diagnosis. His parents, Wendy and Stan, partner Sonia, sister Carina and niece Chloe visited the hospital to see the new equipment before it was used for the first time in clinic.
The Gorleston-based family raised £50,000, which started with a tea party in 2021, and held a number of charity days at Eaton Golf Club to raise money for the new machine. By capturing detailed images and tracking changes, it provides dermatologists with essential information to identify potentially malignant moles at an early stage which can significantly improve the chances of successful treatment and survival.
Dr Jennifer Garioch, Consultant Dermatologist, thanked the family
for their support and that the new machine will help to improve the detection and diagnosis of skin cancer.
Neil’s partner Sonia said: “It is wonderful that the Norfolk and Norwich community will benefit from this. The Horus mole mapping machine will serve as a symbol of Neil’s enduring legacy and a reminder of the power of community and compassion to also provide the community with a crucial tool in our mission to save lives.”
The family were joined by Colin Glover from Melanoma UK who helped source the machine to benefit NNUH patients.
Advance Care Planning clinic set up at Cromer
Planning how you’d like to be cared for as you near end of life can be difficult to face, but NNUH can provide the support to ensure your wishes are known.
Consider walking two roads: hope for the best, but plan for the rest…
Everyone entering their last year of life is encouraged to complete an Advance Care Plan, in which they describe their wishes, feelings, values and religious beliefs so these are respected if and when they require future care. The plan also includes information such as what’s important to them in relation to their health, where they’d like to be cared for and what they don’t want to happen.
Thanks to a £24,000 grant from the N&N Hospitals Charity, an Advance Care Planning clinic has opened at Cromer Hospital every Friday, to which patients living in North Norfolk can be referred for support in completing their plan.
Governor election results
The results of the latest staff and public governor elections at our Trust have been announced.
Two new staff governors have been announced: Cherry Cubelo for Nursing and Midwifery and Michelle Frost for Clinical Support. Admin and Clerical governor Gemma Lynch has been re-elected.
The seats for public governors are as follows: Adele Swallow and Kevin May have been elected for Broadland, David McNeil has been elected for Breckland, Christopher Baxter has been elected for the
“Please ask your healthcare professional for a referral to our clinic or raise it at your next outpatients or GP appointment,” said Dani Ayre, Palliative Care Matron.
“It can be a hard conversation but make a huge difference to your future care, ensuring your family, carers and healthcare professionals understand your wishes and preferences. You keep the document with you, so it’s there whenever you might need it.”
The next national Advance Care Planning conference in Norwich will take place on 7 May.
For more information, visit: www.advancecareplanday.org
Rest of England seat. Existing governors Erica Betts and Elaine Bailey have been re-elected for Breckland and North Norfolk respectively.
Chair of NNUH Tom Spink said: “We are delighted to welcome six new governors to our Council of Governors, as well as retaining three experienced governors, who can offer valuable insights when we are making decisions about the future of our hospitals. Governors have an important role in the organisation, ensuring that our hospitals are closely in tune with both our staff and the community we serve.”
The family of Neil Evans visit NNUH and Dr Jennifer Garioch after donating a new mole mapping machine
Supporting patients with Chronic Kidney Disease
Senior Chronic Kidney Disease (CKD) Clinical Nurse Specialist Rebecca Lorimer talks about her role and the support available for patients.
What is your role?
Whilst there are many rewarding aspects of my job, what I find most fulfilling is the privilege of guiding patients through their CKD journey. Together with my colleague Jude, we provide care to around 500 patients with CKD - we offer predialysis education, manage renal anaemia, and run Hepatitis B vaccination clinics. Additionally, we facilitate the Patients Know Best platform, allowing kidney patients to access and track their blood results online. I also work closely with our medical colleagues in the Low Clearance clinic, which is dedicated to supporting patients with advanced kidney disease. Beyond clinical care, we are committed to promoting patient advocacy and engagement, running regular education sessions and a peer support service to foster community, shared experiences, and emotional resilience among people with CKD. Whilst specific numbers and statistics fluctuate over time, the prevalence of CKD is undoubtedly on the rise. Within the CKD team, we’ve already seen a 15% increase in referrals for pre-dialysis education compared to the previous year.
What is your favourite part of your job? And what are the challenges?
I often encounter individuals at their most vulnerable, and they place their trust in me to help them make informed decisions about their health. The transformation I see in patients, from uncertainty to strength and clarity, reinforces the significance of our work and the profound impact it has on their lives. Helping patients take control and find hope in the face of their challenges is what keeps me dedicated to my role.
One of the most challenging aspects of my role is navigating the emotional demands of having difficult, life-changing conversations with patients. As a healthcare professional, it is hard to see patients struggle, especially when their resilience and determination isn’t always enough to overcome the challenges they may face. Fortunately, I am very lucky to have an extremely supportive specialist team that I can talk to whenever needed.
What are the main causes and what can we do to prevent CKD?
Chronic kidney disease is a long-term condition where the kidneys gradually lose their ability to function properly over many years. The two main causes for CKD are uncontrolled diabetes and high blood pressure. Other contributors can include genetic conditions, autoimmune diseases such as lupus or vasculitis, recurrent kidney infections, or prolonged use of certain medications like ibuprofen or other nonsteroidal anti-inflammatory drugs.
Prevention of CKD involves adopting a proactive and healthy lifestyle to reduce risk including managing diabetes and attending your routine medical check-ups.
What are the symptoms?
In the early stages, CKD is often asymptomatic, which can make it difficult for people to recognise or come to terms with the condition. Many people feel completely fine and continue functioning normally until their kidney function decreases to about 10–15%. However, as CKD progresses, some common symptoms may become noticeable:
• Fatigue
• Loss of appetite
• Swelling
• Nausea/vomiting
• Itchy skin
Whilst there is no cure for CKD, treatment focuses on managing the underlying causes, slowing disease progression, and alleviating symptoms.
What support is there for patients with CKD?
There are several support groups and events available to help patients and their families:
Patient Education Information Sessions - Jude and I facilitate these sessions every other month at the Norfolk and Norwich Kidney Centre. They run from 12.30pm to 4pm and include information on the various types or renal replacement therapy we offer.
These sessions fill up quickly, so if you or a family member have been diagnosed with CKD and are interested in attending, please call 01603 288920.
Peer Mentor Scheme - We have a group of volunteers who have lived with CKD for some time and are eager to share their experiences with others.
Polycystic Kidney Disease (PKD) Charity - PKD
Connect is an online meetup via Zoom where anyone affected by PKD can chat.
Additionally, the charity often host local face to face events in Norfolk www.pkdcharity.org.uk/support.
United Norwich Kidney Patients Association (UNKPA)
- A local charity run by patients, for patients. UNKPA supports kidney patients and their families in Norfolk.
The Norfolk Renal Fund - This charity provides financial support to kidney patients, helping cover the cost of equipment and services not available through the NHS. Visit www.norfolkrenalfund.com
Kidney Care UK - Sandy Lines is the Local Advocacy Officer for Norfolk. She can assist individuals in accessing support services, help with benefits and welfare checks, offer support with employment and housing issues, and provide advice on respite or dialysis holidays.
Email sandy.lines@kidneycareuk.org
Walking aid recycling project goes live
A pilot project to recycle old or disused walking aids for new patients has been launched across Norfolk and Waveney.
The Norfolk and Waveney AHP Faculty, part of the Integrated Care System (ICS), aims to make it easier for patients to recycle the walking aids given to them after treatment by taking them to Norfolk Recycling Centres.
A pilot involving ourselves and the James Paget University Hospital (JPUH) has already resulted in 400 walking aids being handed in over the last two months.
The equipment is refurbished and cleaned by inmates at HMP Norwich before being returned to the NHS to be used by new patients.
People who have an old walking aid at home and no longer need it can take it to their nearest recycling centre. There are 19 recycling centres across Norfolk, which are run by Norse Environmental Waste Services (NEWs) on behalf of Norfolk County Council. There’s no need to book an appointment.
Across the county, 40% of people recycling their walking aids would save 501,500 kilogrammes of CO2 emissions annually, which roughly translates to 5,670 car trips from Norwich to London. Recycled walking frames will go back to NNUH, JPUH and the Queen Elizabeth Hospital King’s Lynn.
Tazi Masarira, Physiotherapy Services Manager and project lead for Norfolk and Waveney AHP Faculty, said: “Previously, patients were asked to dispose of the walking aids in whichever way they saw fit because we do not have the facilities to refurbish them at NNUH, and many ended up in landfill. To help prevent this excess waste and support our Trust’s mission to become more sustainable, we now have the recycling scheme in place, giving patients more sustainable disposal alternatives. In lots of cases, they even end up in charity shops, or kept in people’s lofts and sheds, because until now, there hasn’t been a clear way to deal with them.
“This is a pilot project and we are continuing to investigate how to improve the project and explore how we can support patients who cannot return their aids to the recycling centres.”
James Laurens, Industries Manager for His Majesty’s Prison and Probation Service at HMP Norwich, said: “In the first two months of the pilot, we’ve received 400 frames to be refurbished and cleaned in our workshop. This is purposeful activity for the inmates. We have already had positive feedback from them that they are giving something back to the community to benefit local patients.”
Maternity Care Assistant wins award for saving baby’s life
Maternity Care Assistant Sarah Arnold has been named Healthcare Professional of the Year by the Mama Academy.
The Mama Academy Awards 2024 celebrate the unwavering dedication and hard work of all healthcare professionals in the maternity industry who tirelessly support expectant parents and their babies.
The Healthcare Professional of the Year award goes to someone who has gone above and beyond to deliver exceptional care.
Sarah was nominated for her lifesaving work she carried out during a routine shift on our postnatal ward. Whilst checking a baby’s observations she heard an abnormal heart rate and escalated this to her midwife and the NICU team.
A later EGC confirmed an abnormality, and the patient has since been referred to Great Ormand Street Hospital for further investigation.
Director of Midwifery Stephanie Pease said:
“Sarah’s skills and knowledge undoubtably saved this baby’s life. We are incredibly proud of her. Her award recognises the vital work of our MCA team and how this role can be pivotal in the lives of mothers and babies.”
Sarah said: “I would like to thank whoever nominated me for this award. I work with a great team of people and love my job. It is a privilege to be part of a great team of people including midwives, MCAs and the neonatal team. We all do a great job caring for mums and babies.”
Tazi Masarira, Physiotherapy Services Manager, receives the first batch of refurbished walking aids at NNUH
Volunteers - Here to help!
Whether it’s support from a mealtime assistant, a therapeutic hand massage or a visit by one of our Pets As Therapy (PAT) dogs, the services provided on the wards by our hugely committed volunteers are going from strength to strength.
Building on this programme of services for our inpatient areas and ensuring volunteers are available on the right day, at the right time and in the right place, is our In-patient Volunteer Project Coordinator, Louise Willimott.
“We explore with a ward where they need support and how volunteers can help,” said Louise.
“All our volunteers receive appropriate training and guidance from our specialist teams, such as Speech and Language Therapy, Complementary Therapy or Dementia Support, to deliver services to our patients.
“Our colleagues on the wards then play a crucial role in settling in a volunteer and once they’re familiar with the area and their tasks, our volunteers enthusiastically set about providing the help they can, contributing a great deal in value and support to that ward.
“With all our ward volunteers, we arrange for them to come in on specific days, so the wards know when to expect their volunteer and can get to know them. We also have PAT dogs visiting specific wards which means that they’re prepared for these weekly visits from a dog and owner who they know. Though ad hoc referrals for a PAT dog visit can also be made directly to me.
“Last summer, around 30 volunteers took part in updated hand massage training with the Complementary Therapy team.
“For just a brief five-minute massage treatment for each hand, the impact is incredible. It helps patients in a number of ways. Patients who might be apprehensive find it soothing and patients talk about how it helps to make them feel relaxed and helps them to sleep.
We’ve had some amazing feedback which has all been 100% positive.
“We are keen to develop the support to wards further and welcome requests and referrals for patients who would benefit from this service or wards who would like to look at welcoming volunteers to their area.
“It’s amazing to be part of the Voluntary Services team supporting our volunteers. We’re extremely busy – there’s always a great deal to do and I love it!”
“It’s great working with the wards – our volunteers come in full of energy and super-willing to help and when they’re welcomed and supported by the wards, what they receive back from volunteers is an immense amount of help!” said Sally Dyson, Voluntary Services Manager.
If you would like to become a volunteer please contact the Voluntary Services team at volunteers@ nnuh.nhs.uk or ring 01603 286060.
N&N Hospitals Charity Golf Day to support surgical robot
appeal
The Norfolk & Norwich Hospitals Charity is delighted to announce Desira Group as headline sponsor for its first ever Golf Day at Barnham Broom Golf Club.
Golfers will get the chance to win a car at the event, which is supporting the charity’s latest appeal to fund two state-of-the-art surgical robots for use at the Norfolk and Norwich University Hospital.
The Golf Day on Thursday 22 May will provide an opportunity for individuals and local businesses to network and engage in a friendly and competitive round of golf while supporting a worthy cause.
The day will begin with tea, coffee and bacon rolls on arrival, followed by an 18-hole competition with handicap. This will be followed by a two-course meal and evening entertainment, and a charity auction which will include prizes including golf vouchers, signed memorabilia, sporting goods and much more.
You can find more information about the Golf Day and to register, visit https://register.enthuse.com/ps/ event/NampNHospitalsCharityGolfDay
Trained Volunteer Robert Smith gives a therapeutic hand massage to a patient
New heart failure clinic set up in Cromer
A new clinic for heart failure patients has started at Cromer and District Hospital.
With £107,000 funding from the N&N Hospitals Charity for 23 months, the nurse-led clinic will enable patients living in North Norfolk to receive treatment closer to their homes.
Heart Failure Lead Nurse Specialist Lucie Legg will assess patients, review and prescribe medications and organise iron infusions, freeing capacity at NNUH to introduce an extra clinic.
“It’s an exciting opportunity to support patients and community nurses in North Norfolk area,” she said. “I’m grateful to the Charity for funding this clinic and to Cromer Hospital for accommodating the expansion of servicewe’re working towards reducing the number of patients who require a hospital admission.”
The heart failure service is expanding to meet the needs of a rising number of patients. One in seven people over the age of 70 will be diagnosed with heart failure and, with a high proportion of older people in Norfolk, the team are seeing more patients.
Kristian Skinner, Consultant Cardiologist, said:
“We’re incredibly grateful to the N&N Hospitals Charity for supporting this clinic. It’s a busy time for our service.
We’ve currently got two of our nurses going through their prescriber training. Once qualified, they will be able to run more nurse-led services to optimise patients’ medication. These developments will benefit patients and the Trust overall, because the quicker you can get patients on the right medication, the less chance they have of being admitted, which is better for everyone.”
John Paul Garside, Director of the N&N Hospitals Charity, said: “We are delighted to make this further investment in expanding the services available to the people of North Norfolk at Cromer Hospital. We will gather feedback on the new clinic in the hope that it can continue after the initial two years.”
Round Two: boxing mum returns to ring for NICU
A Norwich mum has returned to the boxing ring to raise funds for the Neonatal Intensive Care Unit (NICU) which saved the life of her baby four years ago.
Jasmine Tobias stepped into the ring for the first time last April, to support NICU where daughter Isla was born at just 24 weeks and spent the first five months of her life. She was given only a 10% chance of survival after being born weighing just 1lb 4oz and later underwent surgery for a gut and bowel perforation.
Six months after her first fight, Jasmine, from Coltishall, returned to the ring in November after months of training at Tower Fitness in Norwich.
The fight ended with a standing ovation for both competitors, with Jasmine taking home the winner’s cup and raising nearly £600 more for NICU. In November 2022, Jasmine’s husband, Troy, also took part in his first fundraising boxing match, and the couple have now raised an amazing £7,275 with more fundraising events to come as Troy takes on the challenge of walking Hadrian’s Wall in May.
Jasmine said: “There’s something about stepping into that ring that makes me happy, and I’m so proud of myself for working hard in training, powering through the rounds and proving to myself I can do things if I put my mind and heart into them. That’s exactly what I want these children on the ward to remember when they grow up - no matter what they go through in life, they can do whatever they put their minds to.”
Julie Cooper, Head of Charity, said: “We are incredibly grateful for the support of donors and fundraisers like Jasmine and Troy. With their help the N&N Hospitals Charity has been able to support even better care for NICU babies with grants totalling over £300,000 over the last five years.
“The Charity’s aim is to do even more, and we are currently fundraising for £500,000 towards providing additional accommodation for parents and families to be able to stay near to their baby or child while they are in hospital.”
For more information about the N&N Hospitals Charity and to support the work we do, contact charity@nnuh.nhs.uk
