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RD&Express Royal Devon and Exeter NHS Foundation Trust

November 2010

The newsletter for members of the Royal Devon and Exeter NHS Foundation Trust

Keep in touch The Royal Devon & Exeter NHS Foundation Trust is supporting a new ‘online visiting room’ service called justvisiting.com so that relatives and friends of patients can keep up to date about their progress whilst in hospital. The free, independent and secure website enables relatives to set up a virtual visiting room and post updates on the patient’s progress – instead of the hassle of coming home after visiting the patient in hospital and the time consuming and costly telephoning around to friends and family to tell them the news. Ideally the virtual visiting room will be set up by the patient or relative before admission to hospital so that friends and family know that will be the way they will be able to get updates and pass on their messages to the patient. RD&E Director of Nursing and Patient Care Em Wilkinson-Brice said: “This is a simple, free and secure way of keeping in touch with patients in our hospital. This service is particularly useful for family and friends who live out of the area or due to their commitments cannot come in to the hospital in person to visit their loved one. We also anticipate that more take up of this service should reduce the volume of telephone enquiries which come in to our wards asking for the same information about the same patient – which means our nurses can spend more time providing direct patient care. We encourage relatives to nominate one person in the family to be the point of contact who receives the update about the patient progress and then shares that with friends and family to reduce the number of calls which come in to our wards asking after the same patient.” The website, which is run by a not-for-profit organisation, can be accessed directly at www. justvisiting.com or through the Trust website at www.rdehospital.nhs.uk

A new mobile eye clinic service was launched this autumn - visiting Royal Devon & Exeter hospital patients in their home towns across Devon. The Royal Devon & Exeter NHS Foundation Trust invested £300,000 in this initiative which will increase the number of hospital eye unit patients being looked after each year from 3,500 to about 5,000. This is a first for the RD&E West of England Eye Unit which has served the community for over 200 years. It is also a first for three members of the specialist nursing team –Jane Kingett, Rachel Garratt and Jess Sanders – who all volunteered to train for a HGV licence so they can drive the 12-tonne mobile clinic. Pictured: Nurse drivers Jane and Jess • More page 2

Respond, Deliver & Enable


Eye clinic launch • Continued from front page Glaucoma nurse specialist Jane Kingett said: “The business case for the mobile eye clinic explored a number of options. We ruled out holding the clinics in community hospitals because expensive specialist equipment would not have been used for the rest of the month. Employing a driver meant they wouldn’t have had any duties when we were parked up and holding the clinic. I saw no reason why we couldn’t drive the truck ourselves and the Trust paid for our HGV training to achieve this solution. We know that our patients will be very appreciative of us taking the service to them and it will have real benefits back at the main eye unit freeing up appointments for other patients.” Consultant Ophthalmologist Mr John Jacob said: “Glaucoma is increasingly being picked up and diagnosed early by optometrists as a result of their improved skills. This combined with an ageing population has put pressure on ophthalmic services in confirming the diagnosis, starting the treatment and in particular the follow up for these patients for the rest of their lives. The new mobile screening unit will greatly increase the capacity of our team to see patients. It will also save patients the time, travel and stress associated with visiting a large hospital site by delivering the service much closer to their homes. We are hopeful that the profile of Glaucoma will be increased too by the presence of this large clinic vehicle in public places.” The towns to be visited by the RD&E mobile eye clinic are Okehampton, Crediton, Honiton, Cullompton, Dawlish, Exmouth and Exeter. Glaucoma is the name given to a group of eye conditions in which the optic nerve is damaged. It affects two to four per cent of people over 40 years old. Glaucoma patients need lifelong regular monitoring so that treatment can be changed accordingly. Failure to treat glaucoma can cost eye sight. The mobile eye clinic will provide the monitoring and advice service for these patients.

• Pictured: Trust Chairman Angela Ballatti hands over the mobile clinic keys to Mr John Jacob with Deputy Chair of Governors Richard May and members of the nursing & assessment team.

Video link for patients Haematology cancer patients across Devon are benefitting from video link up technology between the Royal Devon & Exeter and North Devon District hospitals. The video link up means that patients in North Devon don’t have to travel into Exeter for an appointment with their consultant haematologist. Instead, accompanied by a nurse specialist or doctor, they can go into the North Devon hospital and speak to their consultant about their treatment and any concerns they may have. Consultant Haematologists Dr Jason Coppell and Dr Tony Todd thought it would be useful to have for their patients after using the internet at home to video-conference worldwide with family and friends. As well as significantly cutting down on the time and expense of travelling between the hospitals for patients and staff, the video-link enables the service for patients to be more flexible. The technology has also been used for staff educational training sessions and sharing of good practice and knowledge. It is linked via a secure internet facility which is part of the NHS Connecting for Health initiative. Patient Lynn Hender said: “The quality of the video link is so good that it’s just like you are sitting in front of the consultant. It’s reassuring to know you can get in touch with the consultant and I think the use of video technology would also work well for Devon patients when they are referred to other hospitals elsewhere in the country to save them travelling hundreds of miles for an appointment.” 2


Just Ask The RD&E has produced in-house a new film for patients to explain what they can expect when they come in for planned (elective) surgery. Hayley Peters, Senior Matron Preparation for Surgery, (pictured right) said the purpose of the film was to reassure and explain to patients what they can expect from the assessment appointment before surgery through to discharge after surgery. She said: “We want our patients to know that they can and should ask staff at any point if they have questions or concerns about their hospital treatment or experience. This is particularly important so that patients can make informed choices and give us informed consent to do the surgery.� The film can be viewed on the external hospital website www.rdehospital.nhs.uk on the inpatients section along with the Coming Into Hospital Leaflet information.

Health services around the world are following the RD&E lead to improve theatres safety and efficiency. The Royal Devon & Exeter has started a two year roll out of The Productive Operating Theatre (TPOT) project across all the theatres it manages at Wonford, Heavitree and the four community hospitals (Axminster, Tiverton, Sidmouth & Exmouth). The focus is to improve staff and patient experience, including leadership, team work, patient safety and theatres efficiency. TPOT has also generated interest from health services in New Zealand, Canada, America and Australia. Frontline RD&E staff played a key role in testing the TPOT project. The Trust was one of three pilot sites for the NHS Institute for Innovation and Improvement project launched at the RD&E in September 2008. After the pilot development of this project, TPOT was launched nationally across the NHS in November 2009 and now it is being promoted internationally. 3


Governors News Round-up Council of Governors (CoG) meeting on 13 October 2010

The Trust Chairman, Angela Ballatti,

meeting cancer waiting times, although

welcomed the newly elected governors

these were currently all on target.

to their first Council of Governors meeting.

In terms of finance, Governors asked Mrs

Chief Executive’s Report

in terms of capital spend. They requested

Tracey why the Trust had not met its target reassurance that this was not adversely

Angela Pedder gave an update on the recent

affecting patients.

changes to community maternity services in

Mrs Tracey replied that

patients were not affected and that often

Devon. NHS Devon (the Primary Care Trust)

slippage in the capital spend programme

asked the RD&E to take on the running of

was due to timing and ensuring the project

maternity services from 1 April 2010 and to

was still fit for purpose.

ensure that community midwifery services in its community hospitals at least matched

Mrs Tracey reported that the Director of

those on offer at Exeter’s birth centre where

Nursing had commissioned a review into

all mums having a normal birth return home

the Trust’s complaints process with a view to

the same day. Mrs Pedder confirmed there

streamlining the process and ensuring timely

was now a more equal service in place, with

and appropriate responses.

staffing levels also more equal.

In other business

Performance Report Suzanne

Tracey,

Director

Governors discussed a range of other issues of

Finance,

including reviewing its own committee

presented a new look performance report

membership and hearing an update from

for the period up the end of August 2010.

the Chairman on the recent meeting of the

She gave information on the Trust’s financial

Board of Directors. Governors also were given

position as well as its performance against

an overview of the work of the Foundation

infection control and waiting time targets.

Trust Governors Association as well as the

Mrs Tracey reported that there had been one

work of the Membership Development

incidence of MRSA and 18 cases of C.Diff

Group. Governors have recently begun new

during the quarter. It was reported that the

membership recruitment initiatives and their

main issue for the Board of Directors was

success will be reported to future meetings. 4


Events for Members ‘Medicine for Members’ 2011 Medicine for Members’ talks feature leading clinicians (doctors, nurses, therapists) talking about their specialist area and patient services. Renal medicine (kidney care) – Tuesday 12 April 2011, 12.30pm-2pm

The Governors’ Membership Development Group has been looking at different ways that the Trust can recruit new members.

Consultant Dr Chris Mulgrew will be talking about kidney care and the work of the Exeter Kidney Unit.

They have decided to try several new recruitment methods to see which works best. One of the new activities has involved Governors manning a membership stand in the main hospital restaurant at the RD&E Wonford. Three sessions have taken place so far with over 40 new members recruited.

Due to there being a limited number of spaces available, please contact Bernadette Coates on 01392 403977 or email foundation. trust@rdeft.nhs.uk to book your place in advance of the talk. Details of the venue will be given when you book.

During November the Trust will be sending out a membership leaflet with all first outpatient appointment letters to let patients know about being member and how they can join and get involved. If this is a success, it may be rolled out further.

Council of Governors Meeting Wednesday 19 January 2011, 2pm-4.30pm

If you know of anyone, a friend or family member, who would like to be a member please get in touch with the Foundation Trust Office on 01392 403977 and we can send them the information. Or they can sign up on line by going to www. rdehospital.nhs.uk and following the link from the home page to our membership form.

Venue: FlyBe Suite, St James Centre, Exeter City Football Club, Stadium Way, Exeter EX4 6PX

• Pictured are Governors Kate Caldwell, Lynn Wright and Martin Perry who encouraged over 30 people to sign up as members.

How to get here Visitors to the RD&E are encouraged to use our dedicated Park & Ride service. It runs non-stop to Wonford Hospital from Digby (near Tesco and J30 of the M5) every 10 minutes and costs £1.30 return. Stagecoach bus service H runs to Wonford Hospital every 15 minutes or so from the High Street in the city centre. Buses from Exmouth, Dawlish, Torbay, Teignmouth, Plymouth, Crediton & Seaton stop next to the hospital on Barrack Road. Details are on our website www.rdehospital.nhs.uk 5


Constitution Review

Development Day

The Constitution of the Royal Devon & Exeter NHS Foundation Trust is currently under review by a small working group of Governors and Directors. They have made some recommendations and now want to hear your views.

The Foundation Trust Governors Association held its annual development day in October. The event was attended by RD&E public governors Dianah Pritchett-Farrell and Richard May.

The main issues are:

It was an opportunity to meet with over 150 other Foundation Trust Governors from across the country to share experiences and good practice. As newly elected Lead Governor for the RD&E, Richard May was also able to attend a seminar aimed specifically for his role.

• The number of governors on the Council of Governors • The balance of governors between public, staff and partner governors • The length of term of office for a governor • Process for the removal of governors and non executive directors

The day’s keynote speaker was Sir David Nicholson, Chief Executive of the NHS, who outlined the major challenges that Foundation Trust Governors face in the future. He encouraged governors to see themselves as ’guardians’ of their Trusts and that it would be increasingly down to them to hold their organisations to account. Key to this would be gaining the views of Trust Members and ensuring those views influenced the questions Governors asked of their organisations.

If you would like to give us your views, please complete the survey which can be found on our website at www.rdehospital.nhs.uk and follow the link.

Sign up for email We have email addresses for over 3,000 members but we want more. If we can send more of our newsletters out to you by e-mail then we save money on printing and postage and you get your newsletter sooner.

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Speaking about the day, Dianah said “This event proved of enormous value for Governors in gaining a clearer insight into the challenges that all Foundation Trusts face in the future and the key roles we play in promoting best practice in representing the views of members and the public. I would be happy to provide further information on request.” If you would like more information on the work of the FTGA from Dianah, please contact the Foundation Trust Office.

Our next edition of the newsletter will be sent electronically to all those members we have an email address for. To sign up for emailed newsletters get in touch with us at: Foundation.Trust@rdeft. nhs.uk

Have you recently moved house or changed your contact details? Let us know and we can ensure you continue to receive information from us.

The Foundation Trust membership office can be contacted by telephoning 01392 403977, by emailing Foundation.Trust@rdeft.nhs.uk or by writing to: RD&E NHS Foundation Trust Office, Room E219, RD&E Hospital, Barrack Road, Exeter, EX2 5DW.

For more information about the Foundation Trust visit the RD&E website: www.rdehospital.nhs.uk We can arrange language translation if you do not speak English. We can arrange British Sign Language interpretation, and also give you this information in larger text. Please ask us on (01392) 403977. 6


Behind the scenes The RD&E laundry provides a vital quality service turning around over 10 million items a year. As well as cleaning, mending and delivering all linen and uniforms for the Trust, the laundry also has on its client list Devon & Cornwall police force, Plymouth Hospitals NHS Trust and South West Ambulance Service Trust. Linen Services Manager John Herbert said there is a strong team ethic among the 66 staff to ensure that patients and public sector staff have what they need. He said: “Staff care about their role and will bend over backwards to ensure a job gets done properly.”

Gold standard The RD&E Coronary Unit and Dyball & Yeo Wards have achieved the top Gold standard in our own Nursing Quality Assessment Tool (NQAT) Audit. NQAT is an audit of all inpatient wards looking at 11 core standards including communication, food and nutrition, infection control and pain management. The audit takes place across one day surveying six ward patients, assessing six sets of patient notes and observing a normal day’s activity. At the end of the audit the ward is given a percentage score and rating of red, bronze, silver or gold. To achieve the gold rating a ward must score 95% or more. •

Dyball Matron Debbie Larsen said: “Our big focus on the ward has been patient safety because it is essential to providing good and effective care for all our patients. This strong focus on improving documentation and listening to our patients and their problems has helped us to achieve the top rating.”

Lorna Morse, Coronary Care Unit Matron, said: “The achievement has been down to educating the staff in best practice and keeping them motivated. The gold standard cannot be reached without the whole team working together. We try to use opportunities when the staff are routinely with the patients, such as mealtimes and observation rounds, to discuss any concerns they may have.”

• Yeo Ward Sister Clare Rowley said: “We put real focus in to clear and accurate documentation as this was something that was highlighted in the previous audit. We used team meetings to discuss how we could improve and came up with an achievable action plan that everyone has a part in.” 7


Less paperwork The RD&E is investing in technology to replace paperwork needed for a range of key hospital functions. • The Trust is planning to implement a full Electronic Patient Record (EPR) by 2014. • The first phase is the introduction this current financial year of Order Communications for diagnostic services. This system will handle around 1.5 million requests a year including all laboratory and radiology investigations, patient meals, portering and transport. It will also provide up-to-date results from the full range of diagnostic services to support clinical decisions. The software will be fully integrated with the existing information systems at the RD&E including PAS, Pathology, Radiology and Pharmacy.

City of Science The Exeter City of Science programme brings together key partners from across the city to promote its strengths and achievements, as well as its potential for the future. The RD&E has joined forces with Exeter City Council, the University of Exeter, the Innovation Centre, the Met Office, the Environment Agency, the Peninsula College of Medicine and Dentistry, St Luke’s Science and Sports College, Exeter College and Devon Education Business Partnership. • A new website has been launched this month - www.exeterscience.org – as a source of information on the expertise in Exeter, scientific job opportunities and events.

• E-Prescribing will be used to distribute about 574,000 items a year from the Trust’s Pharmacy department. Vaughan Lewis, Consultant Paediatrician, Clinical Director for Child and Women’s Health and chair of the Project Board, sees this as “an opportunity to make a real difference to the care of patients throughout their journey from the GP referral to discharge. Hospitals that have successfully implemented similar software have seen a reduction in length of stay for patients as well as significant improvements in patient safety.”

RD&E cervical screening exemplary The RD&E cervical screening programme for North & East Devon is exemplary. In a visit report by The South West Regional Quality Assurance Reference Centre, the cervical screening service provided by the RD&E has been described as excellent at all levels. The report commended the team saying: “All individuals in key roles are knowledgeable, efficient and have time for the role with good accountability arrangements. The Trust at Board level is well aware of cervical screening issues and the staff are well supported.” Cervical screening services provided at the RD&E include cytology, histology, colposcopy and hospital-based programme co-ordination. 8


RD&Express November 2010