InTouch magazine - July - September 2019

July - September 2019

InTouch

Welcoming our people strategy Recognising Our Amazing People at local awards Care Quality Commision next steps Our dementia team in action respectful | caring | responsible | committed 1 InTouch September 2019_v6_final.indd 1

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Foreword Contents 3

Our people strategy

4

Leadership conference

5

Our Amazing People Awards

6

Care Quality Commision - next steps

10

Quality First - improving patient outcomes

12

A focus on ...

13

Research trails success

14

Our dementia team in action

15

Our amazing people

16

#PAHTPeople

Hello Welcome to the new monthly In Touch magazine with an insight into the latest news and updates from across PAHT. You will all be familiar with the regular In Touch weekly bulletin and I am pleased to let you know that this will continue alongside this new magazine, which means there are more opportunities to share your news with colleagues across the organisation.

This edition includes a real mix of features – ranging from our new people strategy and leadership conference to the fantastic work of our research team and a round-up on the brilliant activities for patients organised by our dementia team.

If you have any stories that you would like to feature in In Touch please let the communications team know at paht.communications@nhs.net I hope you enjoy the read.

Best wishes Lance McCarthy Chief executive

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Welcoming our people strategy In Touch takes a look at the new people strategy and hears more about the aims of the strategy and the support it offers our people as we work towards becoming an outstanding organisation.

The strategy has five strategic objectives, or pillars, which underpin how the aims and goals of the strategy will be successfully achieved.

These relate to everything that everyone at PAHT is responsible for delivering and are a shared set of objectives for us all.

Lance McCarthy, chief executive, and Ogechi Emeadi, director of people, organisational development and communications, outline the background and desire to continue to improve the way we work and the experience that our people have as part of the PAHT

team.

Our ambition is clear – to deliver outstanding care to our local community. Our patients deserve this and should be demanding it. It is also clear that our people, our biggest asset, are key to achieving this ambition. Outstanding care and patient experiences will only be achieved if our people also have outstanding experiences and joy at work on a daily basis.

This means having a supportive culture with consistent values and behaviours aligned with this, always feeling supported and having the opportunity to develop personally and professionally and working in a modern, technologically enabled organisation. Our people strategy is focused on making PAHT the best hospital in the NHS in which to work, making it a joy to work to here, and enabling our local community to consistently receive outstanding care.

Lance McCarthy Chief executive We have a lot to celebrate.

Our people are talented and dedicated. They are passionate about what they do and the many thousands of patients they care for. Without their dedication we could not deliver our diverse range of services and they are key to designing how we will deliver our future services which will provide excellence in patient care. Ensuring they have joy at work through how they are

recruited, developed, supported, engaged and valued is critical to our success.

Ogechi Emeadi Director of people, organisational development and communications

Find out more Visit Alex to read and download a copy of our people strategy or contact paht.communications@nhs.net

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Leadership conference

In July, senior leaders from across each healthcare group and corporate teams came together for the second PAHT leadership conference.

The conference theme centred on PAHT 2030 plans, which align to the NHS Long Term Plan and delivering modern healthcare as part of our journey to be an

outstanding organisation.

Lance McCarthy, chief executive, said: It was great to be able to share our plans and ambitions for the future. We still have much to do on our journey to outstanding and this will need strong and resilient leadership to underpin the improvements

we still have to make and how we deliver the many changes to the way we work and care for our patients.

The event also included four chatroom style sessions where new technology already in use in the public sector was demonstrated and discussed.

Are you ready for the flu fight What better way to keep those around us safe than to protect them from unnecessary illnesses and flu is one of those.

this illness. No one wants to be the person who infects someone else with flu, so now is the time for immunisation – before the flu season gets going.

We had some great responses last year when the flu campaign got under way. This year, we are hoping to start earlier to make sure that you, your family and your patients do not fall prey to

We aim to start our vaccination programme in September and hope to give the flu fight a big boost during Event in a Tent (24 – 26 September). We will also be offering the vaccination again in our outpatient clinics. This means that patients can have the immunisation there and then when they are attending the hospital.

Keep a lookout for the flu champions during the autumn months and be a flu fighter.

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Recognising our amazing people at local awards Our Amazing People Awards recognise the efforts and achievements of our committed and dedicated people and volunteers who go the extra mile to make a difference to the lives of the people and community we care for.

This year, there are more categories to celebrate your achievements than ever before and an incredible 800 nominations were submitted.

Lance McCarthy, chief executive said: Each year I am delighted by the number of nominations we receive. The last 12 months have seen so many positive changes and improvements at PAHT and it is a great opportunity for our patients and visitors to acknowledge the care they have received too.

It will come as no surprise that the judging panels for each health care group had a difficult task in deciding the winners and a runner up for each category. Local events have taken place and the winners are now going forward as finalists for the annual Our Amazing People Awards being held this month at the Event in a Tent.

Congratulations to all the amazing

people who were nominated for an award and all of the worthy winners - thank you for your hard work, dedication and commitment to PAHT.

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Care Quality Commision next steps “It is critical that we also recognise how much more we need to do and the areas we need to improve further must absolutely remain our top priority.

We cannot be complacent; together, improving the care we provide and the way we work is our absolute priority as we continue our journey to

Urgent and emergency “We can be proud of how care far we have come. For the become an outstanding last three inspections, from hospital - I know that we

Medical care (including October 2016 to July 2019 can make this happen.”

older people’s care) we have moved from 23% Lance McCarthy Inadequate assessments Surgery Chief executive to 0% and from 44% rated Maternity as Good or Outstanding to The CQC ratings grid provides a very visual indication of how 72%. far we have come in three In Touch looks at the details of our recent Care Quality Commission (CQC) rating and the next steps in PAHT’s journey to outstanding.

“Thanks to the hard work and commitment of everyone across PAHT our CQC report showed further improvements with In March and April this year (2019) five of our core services a team of 25 inspectors from the now rated as Good and Care Quality Commission (CQC) our care for children and spent two full days at PAHT young people rated as inspecting a number of our core Outstanding. services:

Services for children and young people

End of life care

In July, the CQC published the results and full report from their inspection. The overall rating for the trust remained the same, requires improvement. PAHT was given an overall rating of Good for the well-led assessment and 72% of the care provided across the trust was rated as Good or Outstanding. This included, care for children and young people rated as Outstanding and improved quality ratings in end of life care and surgery.

years:

CQC ratings October 2016

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Look how far we have come Our improvement journey:

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Next steps However, if we take a look at the two most recent grids, from March 2018 and July 2019 the improvements in ratings are much less pronounced.

To continue our journey of improvement it is vital that we put our passion and focus on the areas we know we can improve – making it better for our patients and the people we care for.

Patients were positive about the care and treatment they received and felt involved in decision making.

Hazardous chemicals always in locked cupboards As we continue to improve and

Good oversight of the develop the care we provide and deteriorating patients using the way we work we need to keep focused on always delivering high NEWS2

Policies reviewed in a quality care; all of the time. It is

timely manner very easy, once an inspection

Fetal growth charts has been completed, to become distracted by other demands and completed

Cardiotocogaphy (CTG) overlook to maintain the best

traces to be in line practice that we are striving for.

with national guidance Everyone has a responsibility to

Review of all incidents in a be part of making sure that we

timely way do not lose our energy or our focus and to play an active part of our improvement journey to Should do outstanding. (a total of 20):

Four-hour standard We know that we can expect our achieved next CQC inspection in the next

Safeguarding training 12-18 months. We need to use

completed for all relevant the time from now until then to staff absolutely make sure that we are

Monitor national audits ready. Firstly, we will action the

Revise the consenting of must and should do points raised

patients on the day by the CQC; these include:

of surgery

Dirty utility in antenatal clinic

Re-useable equipment Must do

cleaned appropriately (a total of 22):

Electrical equipment up to

Improve record keeping date with testing

Ensure medical people Advanced paediatric life

are compliant with

support (APLS) trained

statutory and

nurse on every shift

mandatory training Timely discharge

Have sufficient nursing staff summaries to GPs

Embed risk process at

Seven-day face to face

ward level

service for patients at the end of their life

Work is already underway to take action on the improvements we must and should do and this is being supported and progress monitored by the quality compliance improvement group chaired by Sharon McNally, director of nursing, midwifery and allied health professionals.

There was an open culture where patients, their families and staff could raise concerns without fear.

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Get involved Monthly quality peer reviews, led by the associate directors of nursing and the health care group senior leadership teams, have also begun. The reviews are aligned to best practice standards, are in the format of a peer review and aim is to develop a culture of taking a look with fresh eyes. As such, everyone is invited to take part and get involved in taking us to a Good CQC rating – simply contact any of the associate directors of nursing.

Staff cared for patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

Staff felt respected, supported and valued. The trust promoted equality and diversity in daily work and provided opportunities for career development.

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Quality first - improving patient outcomes Sepsis update One of our top priorities as a trust is to improve our mortality rate and patient outcomes, as well as the experience of care for our patients.

A key measure of success will be to achieve the as expected mortality rate across all specialties

by March 2021 in comparison to other NHS trusts. To ensure the target is met, five work streams have been developed, led by our senior doctors, nurses, therapists and managers. One central element to improve patient outcomes at PAHT focuses on sepsis.

Sepsis is a serious complication of an infection and, without rapid treatment, can lead to multiple organ failure and death. Sepsis kills 44,000 people in the UK annually. It’s vitally important to detect and treat sepsis early and before the patient’s condition deteriorates.

A sepsis and acute kidney injury board of multi-disciplinary team members who are committed to improving outcomes at PAHT and the wider community has been set up. They have introduced several changes to improve patient outcomes at the trust. This includes a 24 hour sepsis nurse role, to ensure the rapid delivery of sepsis treatment within one hour and to complete necessary documentation accurately.

the emergency department (ED).

Neutropenic patients have a low level of neutrophils which are a white blood cell that helps to fight off infections. If a neutropenic patient can’t fight of their infection, they are at risk of developing sepsis.

Blood culture analysers have also been introduced to ED,

the analyser provides us with patient’s infection results quickly, particular during the out of hours, and supports the clinical teams’s assessment and timely decision making for the next phase of treatment.

UCLPartners recently awarded us a grant of £10,000, after we successfully completed their

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service quality improvement competition that aims to improve patient safety and care. PAHT were competing against forty-two other organisations.

The funds are being used to pilot a procalcitonin (PCT) test, which will help to detect a possible early diagnosis of sepsis; resulting in rapid treatment, monitoring, higher quality care and improved outcomes for our patients.

Taking steps to becoming a hypo free hospital Hypoglycaemia also known as a hypo is when a patient has a low blood sugar level and can cause serious complications for patients with diabetes. The improving patient outcomes team have identified that resources to treat a hypo are not always readily available.

It’s great to see the hypo boxes introduced to the clinical areas, they will provide added reassurance to our patients and staff, as well as strengthening the high quality care we provide.

Dr Ranjna Garg, consultant physician and lead for the hypo box project As a result, the team have been working hard to ensure that all our clinical teams are equipped with hypo boxes. The hypo boxes are bright orange and easily identifiable; with contents that provide treatment for patients with diabetes who have a potentially dangerous low blood sugar level, to ensure that their condition doesn’t deteriorate.

Data shows that a patient who

experiences a hypo will increase their length of stay in hospital by an extra two days.

The hypo boxes have been rolled-out in each clinical area.

In support of the introduction of the boxes, tea trolley training sessions have been delivered by the improving patient outcomes team to show staff how to use the boxes and where they can find them.

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A focus on ...

This month, In Touch puts the spotlight on our research, development and innovation team‌ Taking part in a clinical trial is viewed by patients as a very positive experience, as the benefits include getting a new treatment before it is widely available and being one of the first to benefit if the drug or treatment works. Patients taking part in a clinical trial receive additional monitoring and care and also feel they are helping advance medical knowledge.

The details: The research, development and innovation (RD&I) team are achieving growing success in recruiting participants to trials.

In 2018-19, they recruited 1001 participants - a 38.5% increase compared to the previous year.

The team have been raising the profile of research at PAHT in the community we serve through hosting information stands and events in Harlow town centre and community venues to encourage people to support our research studies.

Evidence shows that patients are more likely to have better outcomes in hospitals that are actively involved in research.

Valerie’s story highlights the benefits. (page 13)

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Research trials success Valerie’s story Valerie explained her background and reasons for wanting to be involvement in a clinical trial: “I was very incapacitated in my daily living and in constant pain because of psoriatic arthritis. I had to have adapted equipment for work and I had a stick to get about.”

As a print-maker Valerie was unable to hold a paint brush or the tools of her trade. Doctors tried numerous treatments but she found they did not ease her condition and had serious sideeffects. Previously unaware that PAHT has a very successful research department, Valerie was informed at a regular clinic about a trial at the hospital for a new drug for her condition and invited her to take part.

The trial involved a first injection

at the hospital; she was then shown how to perform the injection herself at two-week intervals. She says that she was astounded at the improvement by the time she had her third injection and admits that, for her, she considers that the results have been near miraculous.

Three years after her first injection, Valerie has restored mobility and can more easily manage pain. She has started walking for pleasure again and has even taken up speed walking, managing an amazing five mile course. She has gone back to painting and is in the process of completing a mural in Harlow.

She proudly points to a picture of herself on a ladder, paints at the ready and recalls that: “When I had to roll myself to the bathroom when the psoriatic arthritis was at its worst I could

never have envisaged myself climbing a ladder.This has given me my life back.”

Valarie says she is thankful for the chance the trial has given her, and is keen to show others how taking part in clinical research can help them. She is full of support for the research team at the hospital and keen to encourage others to take part in a clinical trial.

Nikki Staines, lead research nurse, said: “Come and speak to the research team to find out how we are carrying out research to improve healthcare, and see how you could help.”

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Our dementia team in action Changing Lives

Our first Gibberd Ward fete Just a year after the VIP opening of our specialist Gibberd Ward, we had an additional occasion to be really proud as we welcomed patients, friends and staff to our new sensory garden for its first summer fete with more than 100 people attending.

The fete was officially opened by the Chair of Harlow Council, Councillor Clive Souter and entertainment included the Princess Alexandra Hospital Choir, as well as music from Princess Alexandra Hospital Radio on a 1950s and 60s theme.

The frustration experienced by dementia patients can often be misunderstood and Caroline and David consider that a good place to start the process of building an understanding of how dementia affects people is in school, so they held a programme at Mark Hall School, in Harlow, as part of the Changing Lives project, which involved an interactive discussion with eight to 12 year olds regarding life experiences, work roles in the NHS and dementia care, encouraging younger people to develop a positive and fulfilling life.

The Gibberd sensory garden was created with the invaluable help of volunteers, some of whom have dementia, together with staff, our dementia champions, supporters and friends, to provide a peaceful outdoor space for the hospital’s elderly patients, especially those with dementia.

David Page, dementia support practitioner, and Caroline AshtonGough, dementia clinical nurse specialist, were instrumental in the work to create the sensory garden and are full of praise for the support they have had, from planning to preparing and equipping the site and developing its therapeutic environment.

Caroline and David are committed to improving the wellbeing of people living with dementia. They have worked tirelessly, together with ward staff and other colleagues, in promoting understanding of dementia with the public and community. As well as building the sensory garden, their wide programme includes expanding the trust’s dementia champion team, providing specialist training and holding events with a therapeutic effect for patients.

In tune With the role of music therapy in the care of people with dementia becoming widely recognised, the dementia team introduced weekly music therapy sessions, called Singing for the brain, and now host weekly Singing for memories sessions on Friday afternoons.

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Our amazing people Nursing Times finalist Caroline Ashton-Gough, dementia clinical nurse specialist, who has worked tirelessly to make improvements in care particularly for people living with dementia has been nominated for the title of Nurse of the Year in the annual Nursing Times Awards.

The nomination for Caroline included that: “She's a campaigner, an educator and a researcher but first and foremost she is a nurse who displays the utmost compassion for her patients and colleagues. She has dedicated her life and career to her patients and has shown unwavering commitment to enhancing dementia care specifically.”

Sharon McNally, director of nursing, midwifery and allied health professionals, said: “Caroline’s genuine compassion and care is outstanding. She is a really wonderful asset in our hospital and a great support for our patients and their families. She always goes far above and beyond her duties and her quiet energy and dedication are an inspiration to everyone.”

Winners will be announced at the final, which is taking place on 30 October 2019.

NHS Parliamentary Lifetime Achievement Award nomination Launched last year as part of the celebrations for NHS70 the NHS Parliamentary Awards are now an annual event. This year, Kathy Gibbs who recently retired from her role as deputy education and CPD liaison manager was nominated for a lifetime achievement award by local MP Robert Halfon.

Kathy, our longest serving member of staff, worked for 53 years in the NHS at the Princess Alexandra Hospital. Kathy started to work in the NHS at PAH as a cadet nurse in 1965 aged 17. She qualified in 1969 and stayed at the Princess Alexandra Hospital, working in the emergency department, where she stayed for over 32 years. Kathy continued to develop her clinical skills to become an emergency nurse practitioner, a role that she helped established in the emergency department. More recently, Kathy joined the training and education department as the deputy education and CPD liaison manager, advising and supporting our nursing teams and allied healthcare professionals to continue their professional development.

Disappointingly, Kathy was not a winner although she had the opportunity to visit the House of Commons. Kathy is now enjoying a busy retirement and spending time with family and friends.

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#PAHTPeople

Sheena Parekh, maxillofacial senior house officer, right, works to demonstrate the importance of oral health to patients and the public.

Mouth hygiene is important in preventing pain and the need for treatment and also has an impact on general health.

To help patients the team is working with wards to develop a team of brushing buddies.

Weight monitoring is a regular measure of inflammatory bowel disease (IBD). Pharmacist Clare Macpherson, seen in the weight monitoring room, is part of a multidisciplinary team which focuses on diagnosis and the clinical management of IBD.

Good foot care is a major factor in preventing complications from diabetes. The specialist foot care clinic has seen benefits in the two years since its introduction at PAHT – bed stay has reduced and amputation rates improved.

Our specialist respiratory nurses, who treat patients in hospital and in the community, work together with our doctors to provide guidance and training so staff on different wards can teach patients in the use of respiratory aids.

They also work to raise awareness of conditions such as asthma and its management among patients and families.

It is among the services that have led to a high satisfaction rate in a recent survey of diabetes patients.

Harlow Healthcare Library, located on the hospital site, has received very positive feedback from its users.

It offers essential library services and evidence based resources for clinicians, students, junior doctors, therapists and practitioners in all services and plays a vital role in supporting clinical decision-making and enhancing patient care and safety.

The radiology department at PAHT processes 20,000 radiology images a month and has been in the forefront of adopting a new system of reporting. This has placed it among the top six trusts nationwide in a review of radiology reporting standards in NHS organisations.

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Our team who care for patients with severe abdominal pain were finalists in the prestigious national HSJ (Health Services Journal) awards for their work in designing a new pathway which means patients can be quickly transferred from ED for assessment and seen and treated by the clinical team.

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