InTouch magazine: Events not in a tent special edition

October 2020

InTouch

New hospital update Events not in a tent CQC: Learning from deaths

Coverphoto: photo: Event Cover Events not in a tent (2019) in a tent (2019)

Ev a e te nt nt s sp no ec t in ia l

#PAHTPeople

respectful caring responsible committed 1

Contents 2

Welcome to In Touch magazine

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New hospital: Models of care

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Events not in a tent

Foreword

Hello 5

Events not in a tent your feedback

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CQC: Learning from deaths

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#PAHTPeople

If you would like to share your news with colleagues and to see your team featured in In Touch magazine, please let the communications team know via paht.communications@ nhs.net.

Welcome to In Touch magazine – your insight into the latest news and updates from across PAHT. In this special edition, you can read all about our spectacular staff recognition programme, Events not in a tent.

We invited you to take part in a series of fantastic virtual events, which you could join from your desk or from home. The three day programme gave you the opportunity and platform to share ideas, develop new initiatives, learn the support and benefits available, and build relationships from across PAHT. Sessions included a special virtual guest appearance from Ruth May, chief nursing officer for England, and emotional resilience, mindfulness and supporting your mental health with Alexis PowellHoward (MA., System. Prac., BACP (Accred) from the multi-award winning Fortis Therapy and Training. We also enjoyed award ceremonies for long service colleagues and the Our Amazing People Awards for all to attend.

Additionally, we met virtually to hear an engaging talk on change and resilience from renowned keynote speaker Gavin Oattes, to ask a panel of experts your questions about the flu vaccination, to learn more about quality improvement at PAHT and much more. Thank you to everyone who took part – as a speaker and as a participant – you can read the full details on page four.

This edition also includes the latest update on the programme to build a new hospital that is fit for the future.

Finally, I urge you to please take the time to read the article on learning from deaths. We have made significant progress over the last year to ensure that we are delivering the highest quality, safe care for our patients at all times.

I hope you enjoy the read.

Best wishes Lance McCarthy Chief executive 2

New hospital: Models of care Some highlights of how care will be delivered include:

The new hospital programme has made significant progress over the past few months with key outputs such as the design brief, models of care and demand and capacity modelling being completed.

Board.

At the heart of developing these outputs has been our new hospital clinical leads and the clinical teams across the healthcare system who have been working together to push the boundaries of how healthcare is planned and delivered.

The models of care outline how services will be delivered in the future, ensuring our patients will receive the right care, at the right time, by the right team, in the right setting.

Early interventions and prevention for common conditions

A community model to enable patients to access

care locally

Rapid diagnostic centres in the community to

enable faster, more efficient diagnosis

Digital enablement ensuring integration with the

community and real-time data flows

Patient-centred discharge which goes beyond

traditional organisational boundaries

Personalised care which supports patients to

understand the choices available to them

Paediatric services which are integrated with GPs,

statutory agencies and other service providers

across the system

Diagnostics and cancer Discharge The journey to our new hospital begins now. Through ongoing engagement with our patients, our people and our community we will be sharing the changes being made to the way care is delivered.

Over the coming months and years we will be sharing our transformation journey with you.

Please share any ideas or feedback around the new hospital by emailing paht. newhospital@nhs.net.

We have developed our models across the following areas:

Elective care

Urgent care

Family and women’s services 3

Officer’s Silver Awards for Francina Mushaninga, matron on a care of the elderly ward, and Victoria Andrews, lead nurse for practice development.

organisation, and a session on careers in nursing, midwifery and the allied health professions with speakers from across PAHT and from the NHS regional team.

Additionally, staff could find out An extract from Francina’s more about celebrating equality, nomination reads: diversity and inclusion, as part of our continued commitment to ensuring that all of our people feel Fran is dedicated and committed to providing the highest supported. standards of care to our patients, Staff also enjoyed some specifically those who are frail and elderly. Fran has continuously spectacular award ceremonies Celebrating the dedication of driven improvements in the areas for long service colleagues and our teams with a spectacular programme of staff recognition for which she is responsible. She the Our Amazing People Awards for all to attend. Staff had the has an amazing ability to reach events and support families, often in very opportunity to ask a panel of experts their questions about the We celebrated the dedication difficult circumstances. flu vaccination, and renowned of our teams with a spectacular keynote speaker Gavin Oattes led programme of staff recognition Additionally, an extract from an engaging session on change events last month.

Victoria’s nomination reads: and resilience.

From Monday, 28 September, to Over the last 18 months, Ogechi Emeadi, director Wednesday, 30 September, we Victoria has undertaken the of people, organisational invited our staff to take part in a role of lead nurse for practice development and series of virtual events, which they development, leading an communications, said: could join from their desk or from expanded team in addressing home. a number of key challenges for We were delighted to celebrate nursing and midwifery across the hard work and commitment of The three day programme – PAHT and has demonstrated all our people with this fantastic named Events not in a tent outstanding leadership in the series of virtual events. gave staff the opportunity and way she has role modelled an platform to share ideas, develop adaptive, innovative approach in new initiatives, learn the support We have been overwhelmed adopting new ways of working. and benefits available, and build by the positive feedback of how These included supporting 185 relationships from across PAHT. beneficial our people have found overseas nurses through the This was in place of the highlight our health and wellbeing events Objective Structured Clinical of the annual calendar at PAHT – Examination (OSCE) programme and our sessions which shine a Event in a tent - in which a series with a 100% pass rate. spotlight on the work of teams of events are held in a marquee across the hospital and foster on The Princess Alexandra Staff also took part in sessions on collaboration.

Hospital site every September. emotional resilience, mindfulness Thank you to everyone who and supporting their mental health A key highlight of the three took part – as a speaker and as a with Alexis Powell-Howard (MA., days was a special virtual guest participant – and we look forward System. Prac., BACP (Accred) appearance from Ruth May, chief from the multi-award winning to you joining us again next nursing officer for England, who Fortis Therapy and Training. year. thanked the nursing, midwifery They had the opportunity to learn and allied health professional more about quality improvement teams for their commitment. Ruth at PAHT, the culture at the announced two Chief Nursing 4

Thank you to our amazing nurses, midwives and allied health professionals Well done to you all and thank you all for being truly amazing.

So proud to be part of the PAHT family – well done to all.

Your feedback

What a lovely, heartfelt session.

I have a fantastic team supporting with all that we do. All of the nurses who are here and join us are always engaged and want to learn and participate.

Gavin Oattes: Tree of Knowledge Fantastic session – thank you.

Class act – thanks Gavin.

Brilliant session – thank you Gavin.

Fantastic and real.

Absolutely brilliant.

Amazing – thank you Gavin.

So refreshing and inspirational.

I’m very excited to attend the next Schwartz Round.

Celebrating diversity, inclusion and equality Thank you for a great session.

Thank you all for a very insightful session.

A really good and informative discussion.

Thank you for the session – it has been beneficial.

I’m proud be working with you all – fantastic session.

An insight into Schwartz Rounds I think that Schwartz Rounds are really important and are a fantastic way to provide emotional support to everyone (on the panel and in the audience). They enable colleagues to feel more supported and enable more open dialogue.

This leads to everyone being happier at work. They are open to everyone in the organisation to attend and cover a hugely wide range of topics over time - please attend as many as you can.

Nursing, midwifery and allied health professionals careers session An absolutely fascinating and inspiring hour. Thank you all for sharing your stories. There is so much skill, experience, dedication and passion.

It was brilliant and inspiring to hear such fabulous and diverse Thanks for your amazing experiences and your fantastic I have found Schwartz Rounds energy, observations, humour and stories. The commitment and humbling, inspiring and they getting us all to think. passion is so evident. always resonate with what I’m Thank you. .

Very informative and have not going through. stopped laughing.

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The therapies team delivered an exercise session as part of the event

Your feedback Our culture Well done - good session.

Thank you for this great event.

An excellent session - thought provoking.

A great session and I would love to be part of the change.

Models of care Very exciting, thanks everyone.

Well done, everyone.

Thank you all for your input into designing our clinical pathways for the future - great work.

Thanks all and thanks to all of our clinical teams who have worked really hard on this over the last 3-4 months.

Quality improvement A really informative session, thanks all.

It was an excellent session.

Great session – thank you.

Flu myth busting session Thank you very much, really interesting.

Great session.

Emotional resilience and mindfulness A really useful session.

Thank you for the informative session.

A very insightful session.

A brilliant reflective session.

Amazing session.

This was really helpful – thank you.

Really interesting and informative.

Thank you, very useful.

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CQC: Learning from deaths At PAHT, we now have a learning from death process that meets the national requirements. Every death has a level one review by a medical examiner. At least 25% of all deaths are referred for a Structured Judgement Review (SJR) to be undertaken, including all the mandatory reviews and those of our local outliers. All other deaths are reviewed through the local mortality and morbidity process, using a standardised level 2 review template. For any death that has an avoidability score of 1 or 2 (definitely avoidable or strong evidence of avoidability), these cases are referred to the Second Review Panel.

There is ongoing work to continually embed the process.

Mortality and morbidity workshops have been undertaken in September, along with training on completion of SJRs. The objective is that all specialities will have introduced the new standardised format for mortality and morbidity workshops by the end of October 2020.

Total deaths versus number of SJRs completed The graph (top right) shows the number of deaths verses SJRs during this year.

The graph (bottom right) shows the number of deaths over a four year period, highlighting the COVID-19 peak in April 2020.

At PAHT, we have been below

Themes of mortality data and SJRs.

Total deaths (in month) versus four year average

our average death rate after the peak. This has been seen by NHS trusts across the country, following the impact of the COVID-19 pandemic.

Aspiration pneumonia pathway to be reviewed Four child deaths reviewed in September, these deaths have been discussed at the Incident Management Group (IMG)

The SJRs have identified the following key pieces of learning Positive aspects of care from over the last few months: SJRs include:

Increased admissions of Good communication with

end stage oncology families recorded patients

Early initiation of and

Missed opportunities to delivery of end of life care

complete DNACPR

and TEPs

Work plans to improve

patient outcomes

Missed opportunities to

discuss patients’ preferred There is a learning from deaths

place of death work plan to improve patient outcomes, based on our mortality 7

data and mortality review findings. Acute respiratory pathway This includes work on the including aspiration pneumonia following areas:

End of Life Quality

Improvement Programme

Implementation of non- invasive ventilation outside of critical care.

Two patients have now received NIV on Locke Ward and both patients have responded well to their treatment

For more information, please contact Nicola Tikasingh, mortality and quality matron: nicola.tikasingh@nhs.net.

Focus on identification and

referral to correct pathway

Training and development

for all staff involved to

improve confidence

Developing solutions for

and capability

better communication

regarding patients feeding

Assessment and recording

at risk

of individualised plans of care

Project group set up and

have completed root cause

Acute kidney injury (AKI)/

analysis to inform focus sepsis

for QI work for aspiration pneumonia

Focus on early recognition

and early intervention

Focus on compliance

with pneumonia and COPD

Business case being

admission care bundle

prepared to purchase AKI/

with early identification and

Sepsis Safety Track interventions

and Trigger tool on NerveCentre Fractured neck of femur

Speciality assessment tool

A baseline audit has been

undertaken and shared,

with targeted

improvements identified

to improve documentation

and the capturing of co-

morbidities. The associate

medical director for

unplanned emergency care

is taking forward

ongoing monitoring and

compliance as business as usual

Focus on expediting patients safely and in a timely manner from the emergency department (ED) to the hip fracture ward and ensuring an escalation bed on the ward is always available

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#PAHTPeople

Staff Survey – have your say Help us to make a difference together and have your say in the latest NHS Staff Survey.

You will have received a personal link to the survey in your email inbox and our estates and facilities team will have received a hard copy of the survey from their line manager.

In these unprecedented times, it is more important than ever that you tell us what improvements you would like to see at PAHT. Another great reason to complete the short survey is that you could be in with the chance of winning a fantastic prize. This year, we have 20 £100 Amazon e-vouchers up for grabs.

Your responses remain strictly confidential - an independent survey company, Picker, gathers all responses.

Baby Loss Awareness Week: 9-15 October Taking place between 9-15 October every year, Baby Loss Awareness Week aims to raise awareness about pregnancy and baby loss in the UK. Throughout the week, bereaved parents, and their families and friends unite with others across the world to commemorate the lives of babies who passed away during pregnancy, at or soon after birth and in infancy.

In support of the awareness week, parts of the building were lit up at night-time.

World Sepsis Day The ninth World Sepsis Day took place on Sunday 13 September and the dedicated sepsis team took part in a sponsored 5K fundraiser run and walk to raise awareness of the potentially life-threatening disease (pictured above).

The team raised £1275 for the sepsis charitable fund at PAHT. The funds raised will continue to support education, promotion and events to raise sepsis and acute kidney injury awareness for our people, patients and visitors – well done all.

Celebrating Black History Month at PAHT October is Black History Month and to mark the occasion, we have hosted a series of webinars including the impacts of the last year on black leadership networks and mental health with two pioneers in their field, Rob Neil, OBE, culture change ambassador at the Department for Education and Marcel Vige, head of equality improvement at Mind.

Produced by the communications team

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