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
Letters and social media
@NNUH
To the fab team on Mattishall ward, I just wanted to say a big thank you for all you did for my mum and the support you gave to myself and family during her short stay on the ward. Everyone we encountered worked so hard under a great deal of pressure, yet remained calm, professional and caring. She died peacefully on 8 June at home with us there just as she wanted. Please keep up the amazing work.
SH
I would like to wish the cardiology department and cath lab a thank you for looking after me for a heart ablation. I had six members of staff looking after me whilst the procedure went ahead. I am sorry I can’t remember all your names but Dr Richard Till did the procedure. I am so humbled by you and I adore my NHS. We are truly blessed to have the wonderful skills and hospital to look after our needs.
J
I had a vascular procedure carried out at Arthur South Day Unit. It was first class and an excellent experience with professional, friendly and efficient staff on the day and the pre-op assessment.
MR
The cardiology department are professional, efficient and caring. I was booked in quickly and exploratory surgery was completed with minimum of fuss. Excellent team of professional workers.
DI
Please note that all opening times are currently subject to change.
On behalf of myself and my wife, we would like to thank all of the staff in the Kilverstone ward for their empathy at a particularly difficult time after I had a heart attack. My thanks also go out to the two ambulance crews that took us from Heacham to Norwich. I think we were lucky to have experienced such kindness and professionalism.
I would like to thank everyone who took care of me on Cley ward following my recent surgery. I felt safe and well looked after over a difficult week. The HCAs on this ward were amazing; some remembered me from previous admissions, and they definitely deserve recognition. Thank you for everything and helping me adjust after major surgery.
CM
Blakeney Ward, thank you guys for taking care of myself and my family. We really appreciate the time, effort, and care after we had our little girl. She was born via C-section. I can’t thank the staff enough for helping me feel safe and cared for after going through the section. Keep up the great work.
GL
I recently had the misfortune to experience an adrenal crisis when on holiday in Norfolk. This resulted in emergency treatment and an ambulance journey to the NNUH where I spent two days recovering and having tests while being monitored. I am obliged to say how impressed I was with the exemplary levels of care, courtesy and consideration I experienced from arrival in A&E to admission on the Acute Medical Unit and eventual discharge. All levels and grades of staff I saw demonstrated impressive levels of professionalism which made a distressing situation so much easier and for which I am very grateful.
DM
#PATCat Harry has been stealing hearts as the 1st PAT Cat in Suffolk & Norfolk making his debut with staff and medical students at @NNUH.
Here at NNUH, our focus is always on giving our patients the best care we possibly can - and one way we ensure we’re at the forefront of delivering new treatments is by being active in research. At any given time, we’re involved in hundreds of clinical trials, ranging from neonates to older people’s medicine and we’re incredibly grateful to our many patients who support this important work by taking part in them. We’re lucky enough to sit in the heart of Norwich Research Park, enabling us to work closely with partners such as the University of East Anglia and Quadram Institute Bioscience. We’re already engaged in world-leading research, and our new Associate Medical Director for Research, Clinical Associate Professor Jon Lartey, is continuing to develop our research capability so we achieve our ambition to be recognised nationally and internationally as a centre of clinical research excellence. It’s an ambition I am confident we will achieve – and you can find out more about how inside this issue!
Another important aspect of delivering the best care we can is ensuring we treat our elective orthopaedic patients as quickly as possible, so we were pleased to open the doors of the Norfolk and Norwich Orthopaedic Centre (NaNOC) at the end of July. We’re not yet using it at full capacity and are dealing with a few teething problems, but we’ve treated our first patients and, once fully operational, will carry out around 2,500 ankle, foot, knee, hip and shoulder operations a year, enabling us to treat patients much faster. We’ve already got plans for a similar centre that will enable us to keep pace with demand well into the future.
Not all our services have to be delivered here in Norwich, and we understand that many of our patients would rather be treated closer to home – so I’m delighted that our Respiratory team has opened a new clinic in Dereham Community Hospital. It’s a fantastic example of how we try to think imaginatively about providing services in a way that makes things easier for our patients, and it’s an approach we take whenever we can.
I recently attended a civic reception at Norfolk County Council, hosted by Council Chair Stuart Dark who has dedicated his year in office to celebrating volunteers and spoke about the enormous contribution they make to our community. Like so many local organisations, we rely on our wonderful volunteers who make such an enormous difference to our patients, as well as their families and carers, in so many ways, from guiding them through our buildings to offering comfort and support at difficult times. Thank you if you are one of them!
Prof Lesley Dwyer, NNUH Chief Executive
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Pilot respiratory clinic takes care closer to patients
Our Respiratory team is piloting a clinic at Dereham Community Hospital for patients with chronic respiratory disease.
Run in partnership with the Norfolk and Waveney Integrated Care Board (ICB), the clinic is led by a respiratory consultant and a senior GP with a special interest in respiratory medicine.
“The aim is to ensure patients are seen as quickly and effectively as possible, providing a onestop specialist assessment for individuals with chronic conditions,” said David Fasham, Programme Improvement Manager.
“The clinic will help to reduce our out-patient waiting list and enable patients to be seen faster. Using offsite facilities also frees out-patient clinic space, which can be used for additional clinics to further reduce waiting times. If successful, we could widen the model to other specialties.”
A total of 18 patients attended the first monthly clinic in July, with the potential for them to be offered more frequently and offered by GPs on referral.
Sundari Ampikaipakan, Respiratory Consultant, pictured right, said: “This has been a great example of how effective collaboration with the ICB provides a good service to our patients.
Our Transformation team has been invaluable in helping us to implement this project.
The patients who I had the great pleasure in seeing were delighted that they could access specialist services in a relaxed environment outside the acute hospital.”
Daryl Freeman, Associate Clinical Director Primary Care and GP, added: “I’m delighted to be part of this joint initiative. Not only is it an exciting new project in itself, but the potential for providing patients with care closer to home, linking with primary care and colleagues working in the community, means that we should improve care for patients with respiratory disease outside an acute hospital setting.
The feedback from patients was overwhelmingly positive and the prospect of being able to progress and provide more services like this is very exciting, paving the way to the development of an integrated respiratory service involving all parts of the patient care pathway.”
Extra bodycams to reduce violence and aggression
It is a sobering fact that cases of violence and aggression against NHS staff have been on the rise in recent years.
There were more than 250 physical assaults on our staff in 2022/23.
In response to this, our Emergency Department launched a body camera trial last year, which has now been embedded, to help make the department a safer place.
Senior nurses in ED have access to four body cameras, which can be used in the event of a difficult incident.
Using cameras brings our clinical staff in line with our Serco security staff, which can help to de-escalate a situation if a patient starts to get aggressive and can provide video evidence to the police and courts.
The bodycam project has been proven to improve staff safety when used correctly. The next step will be to work with the Site Operations team to consider if the model can be rolled out for the benefit of the wider hospital. The camera will be activated only in certain situations after informing the patient that it is being used.
Johnny Wells, Senior Emergency Department Matron, said: “We have not had to use the cameras for a prosecution. However, we believe the use of bodycams is acting as a deterrent and can help de-escalate a situation. It is a sad indictment of the times and we are trying to give our staff all the tools and education to reduce the risk.
Violence and aggression has had an impact on the staff working in the Emergency Department. We have had two members of staff who were assaulted and are now very wary and nervous when drunk people come into the department.”
Hospital patients across Norfolk and Waveney will benefit from £88m technology investment
A new digital patient record system has been approved worth £88million that will benefit patients across Norfolk and Waveney.
The Electronic Patient Record (EPR) will enable our Trust and the other acute hospitals in Norfolk and Waveney to drastically change the way we operate.
The EPR, supplied by provider Meditech, will be a strong foundation for the use of more advanced technology systems for patient care.
The new system will enhance patient experience and make looking after patients simpler for staff. It will also improve and co-ordinate the flow of information between services, making it easier to provide care.
The EPR will bring an end to an array of paper-based records and disjointed systems and herald a new era of cutting-edge technology across the region’s three acute hospitals that enable clinicians instant access to real time health and care information in one secure place. The project includes NNUH, the James Paget University Hospital and The Queen Elizabeth Hospital King’s Lynn. These hospitals make up the NHS Norfolk and Waveney Acute Hospital Collaborative which has joined forces with provider Meditech to deliver the system.
The new digital patient record solution, which is planned to launch in 2026, will transform acute hospital healthcare by storing patient information electronically and streamlining communication between patients and staff. The EPR will introduce time-saving features and facilitate safer, more personalised care, ultimately enhancing the overall quality of care provided by the three Trusts. The EPR also minimises the potential for human error, ensuring that patients receive the right care at the right time.
Alice Webster, Chief Executive Officer at The Queen Elizabeth Hospital King’s Lynn and Senior Responsible Officer for the EPR Programme, said: “This transformative initiative will empower our healthcare professionals to deliver exceptional patient care by providing them with accurate, up-to-date, and easily accessible patient information. We believe this investment in digital
innovation will greatly enhance our ability to meet the healthcare needs of our community now and in the future.”
Dr Ed Prosser-Snelling, Chief Digital Information Officer
and EPR Senior Responsible Officer at NNUH said: “The acute hospitals in Norfolk and Waveney are now joining other systems across the country to move away from using paper records. This EPR system will form the backbone of our electronic clinical data systems and open the door for our staff and patients to access the benefits that artificial intelligence and other technologies bring. We will work closely with our regional, national and international partners to make sure the new system is safely deployed.”
With the implementation of the EPR system, patients can expect a range of benefits. Medical professionals will have a comprehensive view of each patient’s medical history, enabling them to make informed decisions and provide personalised care. The system will also enhance patient safety by reducing medication errors, allergies, and adverse events through real-time alerts and reminders.
The EPR will facilitate seamless information sharing between the acute Trusts and other healthcare organisations, such as primary care providers, community services, and social care agencies.
The approved Full Business Case, which has had ministerial approval, secures funding and support to begin the EPR programme.
This funding is provided from both NHS England and Norfolk and Waveney Integrated Care Board.
Hospital Fayre and AGM, Wednesday 2 October
You are invited to our Hospital Fayre and AGM event which is open to the public on Wednesday 2 October. From 2pm you can tour the marketplace of exhibition stands about our services and meet our staff in the East Atrium.
From 4pm to 6pm, there will be presentations from our clinical teams in the lecture theatre. They will include a review of the year, plans for the future at the Jenny Lind Children’s Hospital, and how we are improving care in our hospitals.
The event will include our Inspiration Awards from the Norfolk & Norwich Hospitals Charity. The event concludes with a question and answer session with a panel of the executive team. The event takes place in the Benjamin Gooch Lecture Theatre, Level 1, East Atrium at the Norfolk and Norwich University Hospital and there is no need to book a place.
If you would like more information, please get in touch at: membership@nnuh.nhs.uk
NNUH Chief Executive Prof Lesley Dwyer, Alice Webster, Chief Executive of The Queen Elizabeth Hospital, King’s Lynn and Joanne Segasby, Chief Executive of James Paget University Hospital signing the EPR contract
Saving lives with cervical screening
Our Cytology department processes around 400,000 cervical screening samples every year.
The service, based at the Cotman Centre, has grown rapidly since 2019 when our hospital won the bid to provide the East of England cervical screening services taking samples from Norfolk, Cambridgeshire, Suffolk, Essex, Hertfordshire, Bedfordshire and Milton Keynes in Buckinghamshire.
The NHS Cervical Screening Programme (NHSCSP) sets a target of 98% for the 14-day turnaround time (TAT) standard, the time from when a sample is taken to when the patient should receive their result letter. Our performance showed a dramatic improvement over the course of the last financial year, from just over 60% in April 2023 to consistently exceeding the target in the latter half of the year. By July we had surpassed the NHSCSP target, achieving 99.5% TAT for all patients across the East of England cervical screening service.
Cervical Screening Provider Lead Viki Frew said: “In every sample, we test for 14 different genotypes of human papillomavirus (HPV), the virus strains which are associated with cervical cancer. By identifying the virus in the screening sample we can then analyse those samples under the microscope for any abnormal cell changes. Since 2019 we have more than doubled our total staff, several of whom have embarked on a two-year training programme to undertake microscope screening of slides.”
NNUH also has the largest colposcopy unit in the East of England. The cervical screening cytology laboratory refers patients to colposcopy if abnormal cells are found in their sample. At the colposcopy clinic a closer examination of the cervix is completed where the clinician looks for any areas of abnormality.
The tissue biopsies taken from the cervix are sent to the histology department and reported by a specialist team of gynaecological histopathologists. The aim is to treat women at risk of developing cervical cancer at the precancerous stage.
“I’m very proud of our colposcopy and histology departments who work very well together to provide the best care and outcomes for patients,” added Viki.
Each year Viki audits all cervical cancer diagnoses, and these show that fewer and fewer younger women are developing cervical cancer and last year the peak incidence was in the 61-70 age group. Viki said: “It shows the HPV vaccine and the screening programme are helping and that our colposcopy and histology departments are diagnosing and treating patients earlier, which is fantastic.”
Looking to the future, there is the potential for AI to be used to scan slides of cells and staff are already reviewing cases online to build up our experience of using digital technology to report slides. Viki has one last plea: “Every year we see a surge in samples in the new year after people book appointments after Christmas. Similarly, we see a spike after awareness months. It’s great that awareness campaigns have the desired effect, but I’d encourage women to attend their appointments as soon as they receive a letter. And if you realise you’ve missed your last one or you’re not sure, you don’t have to wait another three years until you get your reminder. Just call your GP surgery to check and book yourself in with the practice nurse.”
Update from Cromer and District Hospital
The team at Cromer and District Hospital are pleased to report that the work to improve the flooring in the North Norfolk Macmillan Centre (NNMC) is on track and will be concluded by mid-August.
Matron Anita Martins said: “We are pleased that the project has progressed well and we have still been able to run a full service as our priority is to ensure patients still receive the care they need at Cromer. Staff and contractors have worked together to ensure flexibility and a continued safe and quality service whilst this important work is carried out which will further improve the centre.”
Cromer and District Hospital is also expanding the clinical care it offers. This includes increasing the number of urology, cardiology, rheumatology and dermatology clinics as well as the formation of a cataract hub later this year which will be part of the Allies Eye Clinic.
New Operational Manager Sandra Lilley has recently joined the team from NNUH where she spent several years managing the Oral Health, ENT and Head and Neck Cancer Service. Sandra said: “It’s a real privilege to be part of Cromer Hospital and I look forward to working with the whole team for the benefit of our patients and the wider community.”
New orthopaedic centre welcomes first patients
The new state-of-the-art Norfolk and Norwich Orthopaedic Centre has welcomed its first patients at our hospital.
The 50-strong NNUH Trauma and Orthopaedics team began treating their first patients in the centre on 23 July and is in direct response to the profound impact the Covid-19 pandemic had on patients waiting for treatment.
Very much a patient-centred unit, it has been developed with its own facilities including same day admissions unit, treatment rooms, two laminar flow theatres, Post Anaesthetics Care Unit, a 21-bedded ward, called Ashill, physiotherapy rooms and a pharmacy and dispensing room for the embedded Pharmacy Team.
The first patients were Alan Miller, who had a right knee replacement, and Alison Hall who had a right hip replacement.
Some of the most up to date surgical equipment has been provided by the N&N Hospitals Charity which supported the build with a £2m grant – the biggest single grant in its history.
NaNOC will being carrying out procedures three days a week, with an ambition of running six days a week later in the year. Once it is running at full capacity, the team will carry out around 2,500 orthopaedic cases a year for patients who need ankle, foot, hip, knee or shoulder operations. To help with this work four new consultants - experts in hip, knee, shoulder and hand surgery, have been employed to bring the most innovative techniques to the team.
Consultant Surgeon Jim Wimhurst said: “The main ethos of the unit is for ‘enhanced recovery’ ie getting patients up and about after surgery with a combination of surgical, anaesthetic techniques, tailored analgesia regimes and targeted physiotherapy. Our current length of stay is three days.
The idea is to get patients home after a day for hip and knee replacement and some even home on the day of surgery. The unit is slightly removed from the main hospital and suitable for patients without complex medical needs. By moving those patients to NANOC frees up space on the in-patient orthopaedic ward (Cringleford) for patients with more complex medical needs or more complex surgery.”
He added: “This has been incredibly challenging at times as we have had to convert an existing clinical unit with a purpose-built unit on the side to create a brand-new orthopaedic centre. We have learned a lot, and it is really exciting that we are now ready.
“We have been supported amazingly by the N&N Hospitals Charity, which has helped us with buying some of the most up to date equipment currently available. I’d like to say a huge thank you to them.”
Trauma and Orthopaedics Matron Cristiana Jorge said: “This is such a big day for us. We have been checking, double checking and triple checking all our processes, running elective, emergency and drug simulations so we don’t leave anything to chance. I am so pleased to be welcoming our first patients next week.”
Julie Cooper, Head of Charity for the N&N Hospitals Charity said: “It has been lovely to hear how pleased the Elective Orthopaedics team are with their new facility. We look forward to continuing our support for the unit, having seen how our £2m grant is being put to good use to improve the patient experience.”
If you would like to find out more to support the N&N Hospitals Charity, contact charity@nnuh.nhs.uk
Listen to the NaNOC podcast
Our latest podcast provides a walking tour of the new Norfolk and Norwich Orthopaedic Centre, NaNOC. Hear from James Wimhurst, Consultant Orthopaedic Surgeon, and Cristiana Jorge, Matron for Trauma and Orthopaedics, who were heavily involved in bringing this project to life. They talk about the facilities including two theatres, a ward, recovery area and physiotherapy room, and explain how patients will benefit from using a standalone unit and how it will help to reduce waiting lists. You can listen to “Behind the Hospital Curtain” on Spotify or Apple Podcasts now.
Showcasing research at the NIHR Norfolk CRF
A special event showcasing the NIHR Norfolk Clinical Research Facility (CRF) was held to promote the world-class facilities and research taking place at our hospitals with key partners.
Jenny Longmore, Director of Research Operations, opened the event on 18 June by highlighting the CRF’s partnerships with other members of Norwich Research Park, reviewing the Trust’s five-year research strategy and discussing our ambition for growth.
In 2022, NNUH was awarded funding by the National Institute for Health and Care Research (NIHR), alongside 27 others in the country, to expand the delivery of early phase clinical trials, experimental medicine and translational research. We specialise in neonatal research, early phase clinical trials and microbiome research.
Research carried out in the CRF located in the Quadram Building (CRF-QI) covers a broad of range specialities such as gastroenterology, hepatology, diabetes, endocrinology, cardiology, orthopaedics and respiratory and also clinical research studies led by the University of East Anglia (UEA) and Quadram Institute Bioscience.
Felicia Rowe, CRF Operations Manager, gave tours of the CRF-QI, a dedicated purpose-built out-patient facility located at the Quadram Institute. There are eight clinic rooms, one of which is for paediatric patients, and two of which are ensuite, in addition to a six-bedded bay.
Felicia said: “Last year we were visited by members of NIHR and Department of Health and Social Care (DHSC) who were very impressed with the facility, the NRP campus location and the quality of service delivery. We’re incredibly lucky our consultants can see patients in these facilities, which provide great patient experience. We also have a large back-office space, there’s a well-equipped clinical laboratory with four centrifuges, a -80C freezer (for vaccine storage) plus a local pharmacy to dispense trial drugs. We’re now able to store both liquid and capsules form
faecal microbiota for transplantation research, which is one of requirements to becoming a centre of excellence in this area.”
Visitors from the James Paget, Queen Elizabeth Hospital and other NHS and industry partners from across the region attended the event. They explored stands showcasing current and completed research studies from NICU and Paediatrics, early phase clinical trials plus stands about the NRP Biorepository, food, microbiome and health studies at Quadram Institute Bioscience, UEA research and research at Cromer Hospital.
Jenny added: “It was fantastic to meet so many people at the event, which celebrated being awarded NIHR CRF funding. We really hope some new collaborations may come out of it. We are proud to help deliver both academic and commercially-funded studies to better understand what causes disease and test new treatments in patients. We’re already involved with groundbreaking research such as personalised vaccines for melanoma. Research helps improve diagnosis, treatment and prevent disease so it’s vital we continue to develop it and I’m thrilled we’re at the forefront of delivering high quality studies that ultimately will be important for patients and the NHS.”
Jon Lartey appointed new Associate Medical Director for Research
Clinical Associate Professor Jon Lartey has been appointed our new Associate Medical Director for Research.
Jon joined us as a Consultant Obstetrician in maternal medicine in 2017 and is the Trust lead in preterm birth and infectious diseases in pregnancy. He became a Clinical Associate Professor in 2022 and has many active research collaborations with researchers at UEA, Earlham Institute (EI) and Quadram Institute Bioscience (QIB) exploring the use of genomics in diagnosing and treating prematurity and fetal growth disorders in pregnancy.
Prof Lartey will take over from Prof Kristian Bowles who was appointed as the new Dean of Norwich Medical School at the University of East Anglia (UEA) earlier this year.
He said: “There was an excellent cadre who could do this job. I applied because of the excellent R&D team who I know well and have been very supportive over the years and are a very dynamic team. I am very pleased to be working with them further and raising the profile of research regionally and nationally. We are already doing world-leading research at NNUH and if we choose what we are excellent at, we will thrive and be successful.”
Neurosciences Physiotherapy research empowers carers and patients
A new Neurological Physiotherapy research study has opened at our hospital, a pivotal step in AHPled research.
The study protocol was designed by our NNUH Neurosciences Physiotherapists and funded and supported by brain injury recovery charity 3 Million Steps.
The “Carer involvement in exercise in an acute Neurosciences unit” trial is run by our Physiotherapy department. It will explore whether patients and carers in an acute hospital can be taught exercises to complete themselves to aid the recovery process as well as getting their feedback.
The study will take place using consenting participants in our Neurosciences Unit on Heydon and Ingham wards. Rebecca Rayner, Neurosciences and Cancer Care Physiotherapy Operational Lead, and Physiotherapist Rekha Srinivasan are running the study at NNUH.
Rebecca said:
“We know intensity of exercise and task practice is very important for recovery after brain injury. There is some evidence that carers supporting their relatives/ friends with their rehabilitation can help their own confidence and understanding of the impact of the brain injury too. In the acute hospital setting, this has not been adequately studied, so we are hoping to find out some early information to help guide physiotherapy practice on this topic. The research project will involve a set of individualised exercises for patients to help muscle strengthening with daily practise. The study will also monitor how they complete the exercises and the feasibility and acceptability of this intervention.”
The trial has been set up with support from National Institute for Health and Care Research (NIHR) Capability Funding and Charity 3 Million Steps.
Critical Care research team is top regional recruiter
Our research team is the top recruiter in critical care research for the Eastern region for the third year in a row.
National Institute for Health and Care Research (NIHR) figures show that of 561 patients recruited across the region, 34% were from NNUH.
Georgina Randell, Critical Care Senior Research Sister, said: “We’re very proud to be the top recruiter for the third year running. Being a patient on the Critical Care Complex (CCC) can be a very difficult time for both patients and their relatives and asking them to take part in a research trial while critically ill is no small thing.
“We fully appreciate the patients’ involvement and have been overwhelmed by their wiliness to participate. We would like to say a big thank you to all the staff and patients for their continued support, without whom this would not be possible. Our unit is currently running five research trials, all with very different aims and requirements, from drug trials to target oxygen therapy on ventilated patients.”
Four clinicians join research internships
Four NNUH staff have joined a research internship run by the National Institute for Health and Care Research (NIHR).
Sonographer Emily Gowers, Speech and Language Therapist Rebecca Tidd, Clinical Scientist Lindsay Coupland and Nurse Umar Abdur-Razaq joined the latest cohort to support the beginning of their research journey.
Our successful NNUH interns had their induction day at the Centrum on the Norwich Research Park, led by Rebekah Girling, Divisional Clinical Support Services Research Lead, who is a mentor on the scheme.
The internship gives “new to research” healthcare professionals the ability to apply for an internship to support the delivery of an NIHR portfolio studies. The scheme is aimed at staff who would like to gain research knowledge and how they can support this in their clinical role.
Providing cancer care closer to home
Our Mobile Cancer Care Unit provides a vital service, allowing us to treat cancer patients closer to their homes, in the community.
Patients who need non-complex treatments including chemotherapy, immunotherapy, targeted therapy and hormonal therapy are able to use the unit as a normal part of their treatment plan.
Hope for Tomorrow is a charity that currently fund a fleet of 12 mobile cancer care units in operation throughout England which allows NHS Trusts to provide care to patients closer to where they live. The units allow us to drive out to patients, saving them long, regular, and often disruptive journeys to hospital for their cancer treatment. The charity relies on generous donations as they do not receive any government funding.
The unit, named Amara, was supplied to us by the charity Hope for Tomorrow in October 2020. The N&N Hospitals Charity supported its introduction with a grant of £517,000 which funded equipment and the first three years of staffing on the unit. Since it arrived, more than 4,000 treatments have been given on the unit. It currently operates in supermarket car parks in Dereham, Attleborough and Beccles, with plans to start a fourth day in Diss soon. It is staffed by two of our specialist chemotherapy nurses and a driver. Last year just under 2,000 treatments were given on board Amara, equal to around 6% of all cancer treatments given to NNUH patients.
Amy Gonzalez, Deputy Sister, works on the unit one day a week. She welcomes plans to add a fourth location at Diss, in the near future.
“Norfolk is a huge area and there is absolutely no doubt that the unit plays a major part in easing stress levels for people attending the unit,” she said.
“By its very nature it offers a personal, holistic touch.
“We try as much as possible to put the same teams together for the same locations as that continuity for patients to be seen regularly by familiar faces undoubtedly helps towards reducing stress,” says Amy.
“When people are not feeling well or they are tired it’s important to make things as easy as possible.
“Whether that is reducing travel time, taking the hassle out of parking or removing the fear of having to deal with strangers at every
appointment, it all helps to put patients at ease.
“And that can only be beneficial to their whole experience of enduring cancer treatment and how they respond to it.”
Amara is fitted with four treatment chairs, so depending on treatment times our team can see up to 20 patients a day.
Sixty-eight-year-old patient Anne Steel (pictured) from Diss is currently having treatment for bowel cancer and attends the unit in Attleborough. She said: “I now attend the mobile unit every three weeks and take medication at home in between those visits, and I much prefer it to going into the hospital.
“Everything about cancer and the treatment that goes with it is quite an emotional experience. But for some reason, I really don’t know why, it seems less of a big thing going to the mobile unit for my treatment. I think the intimate environment really helps to take the stress out of it. It’s friendly and it’s sociable. I often bump into a familiar face and we exchange a smile and say hello and that’s reassuring and comforting.
Our driver on the bus, Jack, is great. He always seems to be able to remember everyone’s name and he is always eager to have a little chat and a laugh. It’s those little things that help you through. The bus works on every level for me. Less hassle parking is a plus. Shorter appointments are great, and I appreciate the allround less formal environment.”
Although the units are small with only four chairs available, the space is kitted out with everything the patients need and would expect inside the hospital.
Call for Concern launches in support of Martha’s Rule
Our hospital has launched a Call for Concern service in support of Martha’s Rule.
Call for Concern is a patient safety service run by the Recognise and Respond Team (RRT) at NNUH - a team of nurses specialising in the care of very unwell patients and patients recovering from critical illness.
The service enables patients and their significant others to access support from the Recognise and Respond Team when they are concerned their own or their loved one’s condition is getting worse.
Martha’s Rule is named after Martha Mills, who died at a London hospital in 2021 after developing sepsis. Martha’s family’s concerns about her deteriorating condition were not responded to, and a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.
Alanna Forrester, Recognise and Respond Team Clinical Nurse
Lead, said the project builds on the success achieved by the team since 2021 where all adult in-patients have access to a rapid review from a critical care outreach team.
“We are aware that patients, their relatives, or carers are often the best people to identify the early signs of someone getting more unwell. This service aims to ensure that if there are ongoing concerns a patient is getting worse after having spoken to the ward nurse or doctor, they are able to get support as quickly as possible from a specialist team.
This system empowers them to escalate these concerns,
allowing the RRT to work alongside ward teams to provide the best possible care.”
“We encourage all our patients to discuss concerns with their ward nursing and medical teams, and we recognise the importance of listening to our patients. This service is an additional safety net which offers a dedicated number for families to speak directly with the RRT should they notice any changes in the patient’s condition they are concerned about.”
By implementing a Call for Concern service patients, relatives, carers, and staff will have 24/7 access to a dedicated team with specialised training in treating and recognising deteriorating patients.
The Call for Concern service is initially going to be rolled out for the patients, relatives and carers of all adult patients who have been admitted to the hospital. Over the next 12 months, the service will be expanded to cover paediatric, maternity, Emergency Department and outpatient services.
Children’s nurse specialist takes on national advisory role
Lead Paediatric Rheumatology Nurse Specialist Catherine “Kit” Tranter has been appointed to a national advisory role on the GIRFT programme. She joins a team alongside two clinical leads Dr Flora McErlane (Great North Children’s Hospital, Newcastle), Dr Gavin Cleary (Alder Hey Children’s Hospital, Liverpool), physiotherapist Ginny Ward (Bristol Children’s Hospital) and occupational therapist Claire Pidgeon (Birmingham Children’s Hospital), who will lead an in-depth review into inflammatory and non-inflammatory paediatric rheumatology.
Get It Right First Time (GIRFT) is an NHS England programme designed to improve the quality of NHS care by reducing unwarranted variation. The programme undertakes clinically-led reviews of specialties, combining data analysis with the input and professional knowledge of senior clinicians to examine how things are currently being done and how they could be improved.
It is the first time that paediatric rheumatology has ever been through the GIRFT process. The review aims to develop national pathways, share best practice and extend support to centres facing challenges, with a particular focus on the variation in transition and transfer pathways for inflammatory conditions.
Kit said: “We’re looking to find evidence from the ground up. That’s the beauty of GIRFT, it’s driven by clinicians who have credibility because they’re the ones with an in-depth knowledge of the subspeciality, delivering the care.”
“I’m really pleased to have the opportunity to put Jenny Lind Children’s Hospital on the map and be a voice for more rural hubs, which gives us a different perspective to urban hubs. I’ve been in my role over 20 years so it will also be an exciting opportunity to share my knowledge, experience, and expertise to help improve care for our young patients.”
New video triage for suspected stroke patients
Video assessments are being used for patients suspected of having a stroke to help them receive faster access to life saving treatment.
We are working on a pilot with the East of England Ambulance Service NHS Trust (EEAST), where paramedics can video call a stroke consultant and lead nurse for a virtual assessment.
The video assessment helps identify what type of scans, clot-busting drugs or treatment may be needed. The team can then advise the crews where to take the patient so that they receive the specialist care as quickly as possible. This can include rapid transfer to the hospital without the need to go to ED, redirection to the TIA clinic (for those suspected of having a mini stroke) or avoiding admission altogether.
After the video call the stroke specialists can request imaging and tests before the patient arrives here, providing prompt imaging, earlier treatment and improved patient outcomes.
Kneale Metcalf, Consultant Stroke Physician, said: “This innovation is helping to provide patients with access to high level stroke care, wherever they are, ensuring they are then given the appropriate treatment and investigations as quickly as possible. We’re able to pre-alert our CT scanner so patients can be sent straight for a scan and onto the relevant ward. It is therefore also reducing unnecessary transfers to ED and
the burden on the ambulance service. Bypassing ED appropriately is better for everyone. It is better for the wait times in ED and the volume of patients in ED that need to be seen.”
Brittany Wells, Clinical Lead for Stroke Video Triage at EEAST, said: “Stroke video triage is now live at nine sites across the East of England, and we are seeing some excellent results. With the ability to undertake a Direct to CT pathway we have seen a significant reduction in arrival to CT times for acute stroke patients, with an average of four minutes from ambulance arrival to imaging at established sites thanks to video triage. The video link between stroke specialists and ambulance crews allows for early triage which streamlines patient care. Feedback from patients has been very positive with patients feeling that their specialist care has begun before they have even left their home.”
Two Consultants receive King’s Birthday Honours
Congratulations to Professor Nick Levell, Consultant Dermatologist, and John FitzGerald, Consultant Clinical Scientist in Audiology and Lead Healthcare Scientist at NNUH, who have both been named in the King’s Birthday Honours list.
The Member of the Order of the British Empire (MBE) is granted to those who have given outstanding achievement or service to the community.
Prof Levell has been made MBE for his commitment to the field of dermatology as well as furthering charitable and research causes through his work with the Dowling Club and the National Institute for Health and Care Research (NIHR).
He said: “I feel very humbled by this award which I think reflects the amazing work done by our brilliant dermatology admin, secretarial, nursing and medical teams at NNUH to provide care for people in Norfolk. It has been a huge privilege to work alongside you all for the last 30 years.”
Dr FitzGerald receives his MBE for his services to audiology and healthcare science in Norfolk. He joined NNUH in 1996 and has had national roles in the British Society of Audiology, British Academy of Audiology and played an instrumental role in the Newborn Hearing Screening Programme.
Dr FitzGerald said: “I received a letter in May and it was a shock and a very nice surprise. It is not something I expected and I feel very honoured.”
Dr FitzGerald specialises in balance assessment, paediatric hearing assessment and service research and development. Working alongside neonatology and pathology he introduced a test that identifies cytomegalovirus (cCMV) in newborns and helps to prevent hearing loss in babies with the virus. He has been championing the role of healthcare scientists in the NHS for many years and is the lead at NNUH where we have more than 400 healthcare scientists who cover over 20 different specialisms.
Understanding and managing osteoarthritis
By Dr Tarisai Mandishona, core surgical trainee, and Seungchan Yoo, medical student
Osteoarthritis is a common joint condition that affects an estimated 8.75 million people nationally.
It is the most common type of arthritis in the UK and is more commonly found in older people. It can also affect younger people - especially if there has been an injury to a joint.
Osteoarthritis affects the joint, causing pain, stiffness, and sometimes swelling. It happens when the protective cartilage that cushions the ends of your bones wear down over time. This can make movement difficult and uncomfortable, particularly in joints, such as spine, hips and knees, that bear your weight.
There are several factors that can contribute to the development of osteoarthritis. These include age, as the risk of osteoarthritis increases with age due to the natural wear and tear on the joints over time. Other risk factors include obesity, joint injuries or overuse, genetics, and certain medical conditions such as rheumatoid arthritis.
The symptoms of osteoarthritis can vary from person to person, but often include pain (especially on movement and after exercise), stiffness (especially in the morning and lasting for less than 30 minutes), swelling in the affected joint and loss of muscle around the joint. People with osteoarthritis may also experience decreased range of motion in the joint, as well as a creaking and grating sensation or sound when moving the joint. Most people with osteoarthritis will find that they experience good days and bad days with their condition, as well as days when the pain goes away completely.
Diagnosing osteoarthritis
typically involves a combination of a medical history review, a physical examination, and imaging tests such as X-rays. Often, no special tests are needed to diagnose osteoarthritis, but your doctor may consider your symptoms and may perform specific tests to rule out other conditions with similar symptoms.
To reduce the risk of developing osteoarthritis or manage its symptoms, it is important to maintain a healthy weight, engage in regular exercise to strengthen the muscles around the joints, and protect your joints from injury or overuse. If you already have osteoarthritis, treatments may include pain management techniques such as using overthe-counter or prescription medications, physiotherapy, lifestyle modifications, and in some cases, surgery.
If surgery is to be considered, your primary care doctor or physiotherapist can refer you to specialist orthopaedic surgeons for assessment. In Norfolk, almost 4,000 total joint replacements took place between April 2022 and March 2023.
For reliable information and support regarding osteoarthritis, there are various resources available to you:
• Versus Arthritis – www.versusarthritis.org
• Action Arthritis - www.arthritisaction.org.uk
• NHS - www.nhs.uk/conditions/osteoarthritis/
Furthermore, healthcare professionals such as doctors and physiotherapists can offer personalised guidance and support tailored to your specific needs and circumstances. If you think you have arthritis and you would like advice, and possibly treatment, a good starting point would be to self-refer at www.norfolkandwaveneycommunityhealth. nhs.uk/msk/self-refer/
Showcasing volunteering at our Trust
As part of National Volunteers’ Week, we spoke to one of our amazing volunteer drivers Gerald Bradley in our ‘Behind the Hospital Curtain’ podcast.
Gerald explains why he decided to volunteer for us, what he does, and how rewarding he finds it. We also spoke to Sally Dyson, our Voluntary Services Manager, about the huge range of volunteer opportunities available at NNUH.
As part of the 40th anniversary of Volunteers’ Week, our executive team supported our volunteers to see all of the great work that they do.
Chair Tom Spink helped on our wards, offering his time to support our busy staff and enhance patients’ experience, helping with the mealtime rounds and Chief Executive Lesley Dwyer assisted Butterfly Volunteer Rena, supporting palliative patients and those at end of life. Additionally, Stuart Dark, Chairman of Norfolk County Council, attended our Volunteering Showcase on Wednesday 5 June.
To listen to the podcast, visit www.nnuh.nhs.uk/news-and-events/podcast/ and for more information about volunteering, visit www.nnuh.nhs.uk/getting-involved/volunteer-with-us/
Chief Executive Lesley Dwyer with the Butterfly Volunteers
Coffee mornings for home dialysis patients
The Home Therapies Dialysis Team are hosting regular coffee mornings, known as ‘Home Huddles’.
These coffee mornings provide a sense of community to patients as well as providing the opportunity for social interaction, support, and health education between those with similar experiences.
The first Home Huddle, which took place in May at the Norfolk and Norwich Kidney Centre in Bowthorpe, was a heart-warming and enriching experience for all attendees.
Rebecca Lorimer, Chronic Kidney Disease Clinical Nurse Specialist, said: “The ‘Home Huddle’ is aimed at those who are already on home dialysis (peritoneal or home haemodialysis), alongside those who have chronic kidney disease and may be considering home dialysis. The team encourage people to come along to chat to those who understand exactly what you are going through and share your experiences.”
“In addition, there were kidney-friendly cakes available to try and the recipes to take home! Needless to say, the first coffee morning was a resounding success, highlighting the importance of community and support in managing chronic
Update from the Council of Governors
It has been a busy period for the Council of Governors at our Trust
We are the elected governors of the Foundation Trust; our role is to represent the interests of hospital members to help improve services and shape how the organisation is run, plus to hold the Non Executive Directors to account for the performance of the Board.
In addition to attending regular Council of Governors and Trust Board meetings, some of us are observers on the various sub committees of the Trust Board.
Several of us attended the Jenny Lind 170th anniversary celebrations and received a tour of the new paediatric theatres. Some of us attended the Royal Norfolk Show to speak to potential new members and I attended the Advance Care Planning conference run by our palliative care team.
Five of us have been on the judging panel for the 2024 NNUH Staff Awards and three of us attended the NHS Providers Annual Conference for Governors of Foundation Trusts on 9 July.
Carol Edwards, who is a Public Governor, along with Elaine Bailey have been instrumental in supporting the Carer Coffee and Chat sessions, which run on the first Wednesday of every month at the Mardle Café at Cromer and District Hospital.
The Home Therapies Dialysis Team
illness. It was a morning filled with warmth, laughter, and valuable connections, proving once again that sometimes, the best medicine is simply spending time with those who understand. Patients can just turn up on the day, no need to book ahead. However, if patients have any questions regarding the event, they can call 01603 287070.”
The next one takes place on Thursday 28 November between 9.30am to 11.30am.
Shahnaz Asghar has been busy supporting the N&N Hospitals Charity and has sold 2,500 raffle tickets this year. She has been meeting with Serco staff and attended the NHS Big Tea and NIHR Norfolk CRF research showcase at the Quadram Institute.
Nina Duddleston also represents NNUH at Patient Participation Group meetings at a GP surgery in Breckland and had a stand at the Health and Wellbeing roadshow.
Governors Chris Hind and Jackie Hammond completed Care Assurance visits, including at the Colney Centre and Endoscopy Unit at the Quadram Institute and Chris has been attending the digital transformation committee meetings about the new Electronic Patient Record (EPR). Bruce Fleming and Elaine Bailey are part of the Sustainability and Green Plan Committee for the Trust.
If you want to contact your local Governor please email membership@nnuh.nhs.uk or want to find out becoming a hospital member and Governor visit www.nnuh.nhs.uk/getting-involved/benefits-ofbecoming-a-member/ Erica Betts, Lead Governor
Governor
Talking healthcare, research and science at the Royal Norfolk Show
Teams from our hospitals met thousands of people at the Royal Norfolk Show, talking about careers in healthcare, research and science.
The N&N Hospitals Charity stand offered games and competitions as well as hearing from past and present patients, putting bandages on a mascot, dressing up as a surgeon and testing hand-eye co-ordination.
The Jenny Lind Children’s Hospital and Charity teams heard from people keen to share their stories, including a child who had surgery for advanced appendicitis and now wants to become a paediatric surgeon.
Khizer Mansoor, Paediatric Surgeon, said: “It was a very exciting two days for me on the N&N Hospitals Charity stand, helping to promote the Children and Families Appeal. It was fascinating to hear all the stories and comments and makes us all feel proud to be a part of this fantastic institution.”
“We also met a nine-year-old born at 26 weeks. His grandma told us about the exceptional care and support they received. He’s done really well and wants to play football for England,” he said.
Many other teams were also at the show. The STEMM village was a hive of activity, with Audiology staff
educating children about hearing with a giant model of an ear. Visitors could also have a go at making ear impressions and look inside models of ear drums with different conditions using a special camera.
The Pathology stand had slides to view under a microscope showing different blood disorders and conditions. Children practised using a pipette and could find out what causes urine to be different colours. Visitors also saw how blood is split into three parts after donation and learned what the different components are used for.
Our research colleagues from the NIHR Norfolk CRF teamed up with the Quadram to promote their Harvest study and speak to people about taking part in research. Some of our Consultants joined members of Diabetes Norfolk to highlight projects that the charity has funded over the last 25 years and Lead Governor Erica Betts spoke to people about becoming a member of our Trust.
The Organ Donation Team were presented with the Reserve award for the most effective and well laid out display by a charitable or voluntary organisation.
Hospital charity boost for Norwich clinical research fund
An innovation fund successfully pump priming clinical research projects between Quadram Institute scientists and doctors at our hospital is being expanded thanks to extra funding from the N&N Hospitals Charity.
The Quadram Institute Clinical Seedcorn Fund was first established in 2021/2022 to help clinicians develop research ideas with scientists at the Quadram Institute. Funding to date has come via Quadram Institute Bioscience (QIB) grants from the Biotechnology and Biological Sciences Research Council.
In 2022/23 the fund was oversubscribed, and six projects were funded from 14 applications. Some of the projects funded have included work with respiratory medicine consultant Dr Eleanor Mishra and group leader Prof Mark Webber on bacterial colonisation of tubes used to remove fluid from the lungs, and work with consultant paediatric endocrinologist Dr Emma Webb and group leader Prof Arjan Narbad on the gut microbiome and obesity.
Funding from the Norfolk & Norwich Hospitals Charity means the fund can be extended to support more clinical research projects for patient benefit during 2024/25.
The Clinical Seedcorn Fund supports secondments of NHS staff to Quadram Institute laboratories and associated Quadram Institute research costs. In 2024/25 QIB will fund £150,000, with up to another £150,000 funded by the Norfolk & Norwich Hospitals Charity.
John Paul Garside, Director of the N&N Hospitals Charity, said, “The hospital is one of the four partners in the Quadram Institute and working together the Partnership is serving to increase knowledge and deliver benefit for patients. This is important work and the Charity is delighted to be supporting the research and innovation of NNUH clinicians working alongside scientists from the Quadram Institute.” To support the hospitals charity, email charity@nnuh.nhs.uk
Hospital charity champion to trek Great Wall of China
A N&N Hospitals Charity fundraiser who has raised thousands of pounds for cancer care is back on the fundraising trail, this time facing her biggest challenge yet.
Last year’s Charity Champion Inspiration Award winner Louisa Dye is training to trek along the iconic Great Wall of China on 12 October.
In 2023, Louisa battled shin splints, blisters and every imaginable weather condition to walk 500 miles in a month, raising more than £8,000 to support even better care for cancer patients at NNUH.
The walk, which received the support of Scottish music duo The Proclaimers, was in memory of her parents – Stuart Clarke, who died from pancreatic cancer in 2006 and mother, Christine, who died after being diagnosed with breast cancer in 2021.
But far from taking a break, Louisa, from Sprowston, has now decided to take on a five-day Great Wall of China challenge which will see her trek thousands of steps each day along what is described as one of the New Wonders of the World.
Louisa said: “Since losing mum, I have struggled greatly with grief. Losing one parent is hard, losing two is heartbreaking. This is where the challenges have come from. I never knew I had this in me until last year, but I now have the inner urge and adventure to do anything I can to help raise money for oncology at NNUH and this is giving me focus that is helping me through my grieving period. All this is in memory of my beautiful parents who I miss every day.”
Find out more and support Louisa via her JustGiving page: www.justgiving.com/page/louisadye-china If you would like to find out more about the N&N Hospitals Charity and find out how you can support us, please email charity@nnuh.nhs.uk
Norfolk and Suffolk Rock Choir donate to breast cancer unit
The Norfolk and Suffolk Rock Choir has donated over £500 to our breast cancer unit after one of their members was cared for by the department.
Sixty-seven-year-old Gill Wilson, from Costessey, was diagnosed with breast cancer in August 2023. Following a mastectomy, she was given the all clear last November.
Gill has been a member of the Norfolk and Suffolk Rock Choir since 2010. There are five choirs which meet in in Beccles, Norwich, Thorpe and Wymondham each week.
The Rock Choir regularly fundraises for charities which are close to its members’ hearts. The choir performed at the Costessey Fete in May and held a tombola, raising £566.75.
Gill said: “I am very grateful for the excellent care and level of professionalism shown to me. All of the staff showed great dedication and made me feel special and not just a number. I will have annual mammograms for the next five years but am relieved that I don’t need any further treatment. I’m one of the lucky ones.”
More than £800,000 has been raised through the N&N Hospitals Charity’s Boudicca Breast Cancer Appeal, which has funded new equipment and improvements to the breast cancer unit to improve patient experience and reduce the need for multiple visits to hospital.
Celebrating NHS anniversary with Big Tea Party
The N&N Hospitals Charity hosted its NHS Big Tea Party on 5 July which was open to patients, staff and visitors.
The event celebrated the 76th anniversary of the NHS with free tea and coffee as well as cakes being sold with funds going directly to the N&N Hospitals Charity.
The wide range of cakes on offer were donated from Bread Source, Aylsham Garden Centre, Broadlands Lodge Care Home and from some of our wonderful bakers around the Trust.
Rachel Cocker, Interim Chief Nurse, was also present to draw the raffle tickets for the Charity Summer Raffle.
