Royal Devon and Exeter
NHS Foundation TrustHeading
Royal Devon and Exeter NHS Foundation Trust staff newsletter
New role on wards page 3
Stroke patients get
right care quicker
outstanding staff page 8
n Pictured is Joint Medical Director Dr Vaughan Lewis during a site visit.
A yawning space has appeared on the Wonford hospital site with the demolition of the Postgraduate Education Centre. Over 90% of the dismantled structure of the building will be recycled – the majority being used for road building aggregate. The disappearance of the former education centre is a strong visual
milestone in the creation of a new Research, Innovation, Learning and Development (RILD) Centre which will bring together skills, education and medical research on the hospital site.
The NHS Staff Survey results this year overall placed the RD&E in the top 20% of all Trusts for many of the topics colleagues shared their views on Top 20% scoring measures included staff appraisals, health and safety training, safety in the workplace regarding stress, physical violence from staff and patients and harassment/bullying from patients and staff; equality and diversity training and experience of discrimination.
Where there is room for improvement is staff satisfaction about the quality of the work they do and reporting of errors, near misses or incidents within the previous month. The survey results will shape initiatives at the RD&E to improve working lives and staff health & wellbeing.
The RILD project is a partnership between the Royal Devon & Exeter NHS Foundation Trust, Peninsula College of Medicine and Dentistry and the University of Exeter.
The RD&E will be promoting hand hygiene on Thursday 3rd May in support of the World Health Organisation 2012 campaign ‘Save Lives: Clean your hands.’ Our own Infection Prevention and Control Team will be planning events including an information stand in Oasis and education on wards to raise awareness of this issue. Colleagues will be asked to sign up to a hand hygiene pledge commitment to n comply with the ‘5 moments for Hand Hygiene’ n challenge non-compliant colleagues n be ‘bare below the elbows’
New tvs have been put in Oasis & Heavitree Fine Fillings thanks to our Staff Lottery
Improving patient care
The pride Suat Erten radiates on the front cover of the RD&E News this month reflects the real buzz about the introduction of the new Ward Housekeepers across Wonford hospital. They stand out with their waist coated uniforms and after bespoke training for their roles they are ready, willing and able to organise, supervise, audit and support the delivery of nonclinical services on their ward. Key aspects of their work include meeting and greeting patients and showing them the facilities; and focussing on cleaning, food and hydration of patients, and the maintenance and presentation of the general ward environment. They will deliberately not have the same set hours each day to
Key aspects of their work include meeting and greeting patients
ensure a real understanding and measure of what is happening at different times on the ward. Introduction of the Ward Housekeepers was done in phased stages, followed shortly by the implementation of the new Domestic Assistant and Catering Assistant roles from the
end of March. A new networking forum has been set up just for the Ward Housekeepers to share ideas and good practice as this role becomes established. n Suat Erten is pictured in discussion with Taw ward colleague Karen Rivers
Patients rate the outpatient clinic services and standard of care at the Royal Devon & Exeter hospital highly – placing the RD&E in the top 20% of best performing NHS trusts in the country. The independent healthcare regulator, the Care Quality Commission, carried out its fourth survey on patient satisfaction with adult outpatient services in 2011. The Emergency Department (A&E) and fracture clinics were among the hospital departments where patients aged 16 years or older were asked to share their views about their hospital experience. Patients gave their feedback on questions about appointments, waiting times in clinic, cleanliness, test, treatment and medication information, care and communications with doctors and other healthcare professionals, privacy, dignity, correspondence for GPs and who to contact after discharge if worried about their condition. RD&E Director of Nursing & Patient Care Em Wilkinson-Brice said: “Our outpatient services are a significant
part of our hospital care. There were over 440,000 attendances at our outpatient clinics last year. We have pro-actively started a Trust-wide review of outpatient services because we want to be more efficient and improve patient experience from the time an appointment is booked and treatment is received, through to discharge advice for a safe and successful recovery at home.
“We are capturing patient feedback in a number of ways including survey results and asking local people, through our Foundation Trust membership, what they think about our outpatient services. Their suggestions and views will inform positive changes in the future. “New initiatives in place at the RD&E include a pilot for an appointment reminder service for patients, specialist advice from our consultants in paediatrics and urology for community GPs to avoid unnecessary patient attendances at hospital and a re-design of how we arrange diagnostic tests to reduce the need for return patient visits to hospital as much as possible. Some of these improvements have been generated by our own staff and others by investing in new technology to make processes more streamlined and co-ordinated.”
Our Oncology department is thrilled with this Toshiba Wide Bore CT scanner for use in radiotherapy planning. Lead clinical oncologist Dr Peter Bliss explains why: Radiotherapy is undergoing something of a revolution. The advent of more sophisticated computer software and a greater understanding of ways to reduce normal tissue toxicity has led to the realisation in clinical practice of our ability to deliver more accurate treatments with less toxicity and potentially higher cure rates in the future. None of this will be possible unless we are able to accurately identify the tumour volume and outline with accuracy the surrounding normal tissues. This requires more scanning time. Before having our own scanner we had two sessions per week in the radiology department but the need for CT planning for radiotherapy could not be met. The present thrust is to deliver Intensity Modulated Radiotherapy (I.M.R.T.) which is a form of treatment that allows more tailored conformity of the radiation beam to the tumour. This requires a CT scan to identify both the primary and the close by organs at risk. The margins for error are tighter with this treatment and so detailed images of the treatment set up are required to ensure that the target volume is treated accurately and safely every day.
This scanner will help to maintain our position as a service delivering state of the art treatment to the local community.
n Dr Bliss is pictured (fifth from left) with Toshiba medical systems account executive Megan Newberry, Radiotherapy Services / Oncology centre manager Geraldine Jenner, Head of Radiotherapy Physics Steve Blake, Lead radiotherapy planning radiographer Lee Merry, Toshiba medical systems engineer Steve Bird, Toshiba medical systems CT applications specialists Andrew Watson and Mark Condron with Radiotherapy treatment superintended Helen Slaney. More of our patients receiving palliative treatment can be better treated by also using a CT scan to delineate the target volume and allow radiotherapy to be more
accurate and delivered with less side effects. We feel indebted to the Trust who have supported this endeavour at a time of financial restriction.
Bridging the gap Exeter University academic researchers and RD&E clinicians came together at a two day retreat to translate theoretical and laboratory research ideas into clinical practice to benefit patients. Professor Andrew Shaw from Exeter University said: “The retreat provided an excellent opportunity for us to exchange ideas and understand
the challenges in developing new diagnostics techniques. There was significant support for another event in the near future.” Consultant urologist Mr John McGrath said the event demonstrated the enthusiasm and the capability between scientists and clinicians in Exeter have to work collaboratively on
world-leading research for the benefit of patients. In a ‘Dragon’s Den’ style pitch, for small research grants to develop ideas, was won by Mr Ian Daniels (Consultant Colorectal Surgeon)/Dr Julian Moger (Dept BioPhysics, University) and Mr McGrath and Dr Stephen Michell (Dept Biosciences University of Exeter).
The Improving Working Lives Staff Lottery wants project ideas to fund – contact us v
Quicker stroke care
Our stroke service has been at the forefront of a research study to reduce the time it takes for patients to receive vital clot-busting treatment. The study is investigating the whole process of emergency treatment that follows when a person suffers an acute stroke from a blocked artery in the brain. For most patients in this situation, the earliest possible administration (thrombolysis) of a clot-busting drug can greatly improve their chances of recovery. The drug is currently licensed for delivery up to three hours from the onset of a stroke, but in that time the patient needs to call an ambulance, get to hospital, have a brain scan, and be assessed by specialists before receiving the treatment. Our acute stroke team, radiology department and Emergency Department colleagues have been working with researchers on this from the University of Exeter, Peninsula College of Medicine and Dentistry (PCMD), and the ambulance service. By looking at what happens ‘on the ground’, researchers have been able to create computer simulations that imitate the various permutations of stroke victim identification, transport, arrival at hospital and treatment. Analysis of over 1,400 episodes of care has enabled them to identify the bottlenecks in the system, and take steps to speed up the
This is a great example of NHS collaboration with university academic researchers to improve patient care.
process of emergency care which can lead to earlier clot-busting treatment. The researchers estimate that the number of people whose stroke could be greatly improved by earlier treatment could treble. The research team is currently working on a thorough evaluation of the pilot scheme. Dr Martin James, RD&E Consultant Physician and Lead Clinician for Stroke, said: “This is a great example of NHS collaboration with university academic researchers to improve
patient care. Using the simulation has enabled us to identify and unblock the bottlenecks in getting the treatment to patients much more quickly than we could in the past.” Dr James, pictured at work on Clyst ward, said the simulation can accomplish in an afternoon what used to take months or even years of trial and error so research findings can be applied to patient care much quicker and reduce the misery of disability after a stroke.
An Hour to Remember Staff are invited to attend An Hour To Remember session which aims to raise awareness, understanding and respect of the needs of a person with dementia. Year on year the RD&E is looking after more patients diagnosed with Dementia - a physical condition which comes from the progressive deterioration of the brain tissue and its functions.
via IaN (look up L for Lottery) or speak to Bernadette on ext 3977
These sessions are open to anyone working at the RD&E who may be interested in this from a professional or personal perspective. The one hour sessions will be held in the PEOC lecture theatre: 17 April and 26 April at 11am, 12 noon, 1pm and 2pm There is no need to book a place.
Improving patient care
We have set ourselves a challenge to achieve within 100 days a plan for how we want RD&E hospital discharge to work and a timetable to deliver the actions. A range of new ideas and approaches has been tested in recent weeks and shared with our own Patient Engagement Group and local strategic partners to improve co-ordination and management of care. This work continues but here are some examples: • Onward Care Assessment April launch planned - We have been testing an improved referral process for patients needing Onward Care when they leave the RD&E. In response to feedback from colleagues that the current Health Needs Assessment form is lengthy and time consuming, and at times, an unreliable referral process, a new electronic process will be introduced in April. The current Whiteboard Patient Transfer Form – incorporating two sections called the Onward Care Referral – will replace the current health needs assessment.
This will link in with the merged Access & Hospital Discharge Teams – now a single point of contact called the Onward Care Team. •R isk Assessment & Prediction Tool – to be introduced at the RD&E to identify patient need for early physio and OT therapy intervention. • Increasing Voluntary Sector Patient Advocacy – we are exploring
volunteer presence on wards to assist clinical teams, families and carers to plan discharge and a follow up telephone hotline service for vulnerable patients.
At the heart of our discharge service we want: • No delays for patients • The right information at the right time for patients & staff • A seamless patient experience between our services and community health & social care • On going learning from patient experience • Increased discharge numbers to patients’ own homes • Reduced unplanned and unnecessary admissions to hospital
Fit For The Future
A message for staff from Chief Executive Angela Pedder Now is a useful time, towards the end of the financial year, for us to reflect on what has been achieved with our ‘Fit For The Future programme.’ Each and everyone of you should feel justly proud of the way you have risen to the challenge of maintaining ‘business as usual’ for our patients whilst, behind the scenes, we have been reviewing what we do and how we do it; and introducing new and sometimes radically different ways of working. Our focus continues to be on providing the safest and best patient care and it is testimony to your professionalism and hard work that in a year of uncertainty and change, the RD&E has been ranked in the top 20% in patient satisfaction surveys and we were one of only four hospital trusts in the country to be named Dr Foster Hospital of the Year. We recognised from the outset that the innovation and flexibility of all of our staff would be essential if we wanted to strengthen our position as a healthcare provider and centre for research and education. You have not let us down on that score. Staff have been thinking outside the box and adopting an entrepreneurial spirit to how we can improve patient experience
I intend to share this with you over the next few months so that we can be as clear as possible about how you can get involved and help us shape the approach we take.
and the quality of our services. This fantastic work is happening right across the hospital including pharmacy, theatres, wards, I&MT and procurement. ‘Fit For The Future’ gives all of us the licence to iron out longstanding frustrations which historically have got in the way of providing a smooth, clear and seamless healthcare experience for our patients. Over the coming year we will all need to continue to identify more opportunities to think about how we can provide the best and safest care for our patients each and every time in a sustainable way. We want to work ever more closely with staff to really understand some of the blockages that prevent us doing things differently and the opportunities that exist to make significant transformational change. We are confident that we will reach our target of £17 million this year and we are now taking stock on what we need to focus on for 2012/2013. A senior management review led by Unipart is well underway to identify the changes needed to ensure that we can deliver the strategic objectives we have set to provide the best healthcare services in the future.
We have also taken a step back and looked at our programme objectives. I intend to share this with you over the next few months so that we can be as clear as possible about how you can get involved and help us shape the approach we take. We do appreciate that the pace and impact of change can be unsettling but over the next year I want to enable all staff with an idea - however big or small – to feel that they have the opportunity to share their ideas and to be listened to by their managers. You can also positively influence and contribute to improvements which will benefit the community we serve. Thank you for all your hard work.
We celebrated the achievements and star qualities of our staff at a special annual awards event. The Chairman’s Awards gives us an opportunity to nominate colleagues we believe go ‘above and beyond’ what is expected of them for this formal recognition. Trust Chairman Angela Ballatti said: “Each year we are impressed by the calibre of individuals and teams nominated for an award. They are inspiring role models who consistently work to a high standard but want to improve our services and quality of patient care further. It is evident that colleagues recognise and appreciate working alongside people with this commitment and enthusiasm right across the organisation. We are very proud of them.” Certificates with vouchers or engraved glassware were presented to the winners. Individual award winners: Georgie Adams, Matron, Acute Medical Unit (AMU) For her leadership and dedication in driving through change in the department and inspiring and encouraging team members to develop. Paul Bowler, Supervisor, Portering Department For his longstanding excellent and friendly reliable service. Bridget Cann, Lead Nurse for Bowel Cancer Screening For the key part she has played in developing and implementing the business plans for the Bowel Cancer Screening service with her professional, friendly and common sense approach. Vivienne Drew, Nursing Assistant, Kenn & Bovey Ward For her wonderful sunny personality and hard work in support of the ward team. Tricia Greenslade, Ward Sister, Knapp Ward For her instrumental role in enabling the ward to achieve ‘gold’ status in its nursing quality audit and successful introduction of the enhanced recovery process.
John Herbert, Linen Services manager For his leadership and vision which has contributed greatly to the linen services being ranked within the top three NHS laundries in the UK. Gaynor Hitchcock, Governance Lead for Trauma, Orthopaedics, Critical Care & Rheumatology For transforming the division approach to patient safety and quality particularly with meticulous followup of agreed actions and a major role in the ‘What went well, even better’ initiative nominated as a finalist in the 2010 National Patient Safety Awards. Matthew Kirby, Healthcare Assistant, Yeo Ward For his valued contribution to service improvement and dedication to patient care with a warm nature and sense of humour. Sheila Mackie, Team Leader, CT/MRI Department/Medical Imaging For her longstanding dedication and valued support of members of the large team she manages. Colin Stewart, Mortuary Manager For his longstanding tireless service, successful upgrading of facilities and caring qualities. Ros Wade, Physiotherapy Manager, Physiotherapy Department For her leadership, support and forward
looking approach to running a large department and promotion of therapy in the hospital. Team awards were presented to: Diabetes Research Network Team (DRN) working on Clinical Trials: Lorraine Scaife accepted the award on behalf of the Diabetes Research Network Team working on Clinical Trials in a variety of settings on the hospital site and home visits. In the last 12 months the Exeter network team have recruited more than 450 volunteers into research studies, the team working hard to create strong collaborative relationships with other partners in research internally and externally, expanding the range of research activity available to patients with diabetes. The team is innovative in its approach and the patient is at the heart of everything it does. Trauma & Orthopaedics Ward Administration Team Carolyn Hobbs accepted the award on behalf of the Trauma and Orthopaedics Ward Administration Team. They provide a crucial service that keeps the wards running to their high standards. The nine ward clerks are essential to an effective ward environment and they constantly go above and beyond expectation to ensure that ward nurses and other professionals are supported.
nP ictured are the award winners who attended the event.
Innovation for Life
Royal Devon and Exeter NHS Foundation Trust
“eNotes gives me access to my patient’s health record at the click of a button”
An exciting new chapter is beginning at the RD&E which is set to revolutionise patient care and our management of patient records. Our modernisation of patient record management will be achieved with eNotes. In future hospital health records and notes will be digitised and held electronically. This will enable clinical decisions at the point of patient care to be supported by easy, prompt access to historic and current patient information. The electronic records can be updated directly and paper notes can be scanned and added. eNotes will dovetail in with other clinical tools including CDM, PAS and pathology systems. The first services and departments to adopt eNotes will be Orthodontics, Oral Surgery and Paediatric Cystic Fibrosis in September. Joint Medical Director Dr Vaughan Lewis and e-notes champion, said: “We will be at the forefront of introducing this technology in NHS acute hospital trusts but our project team is liaising with other healthcare services to find out their experiences and inform the approach we take to adopt it at the RD&E. We believe this technology will improve the security, access and
We believe this technology will improve the security, access and management of hospital health records.
management of hospital health records and should make our patient care safer and efficient. Its success will be determined by the active involvement of clinical, managerial and administrative service colleagues in the development and implementation.” A Clinical Reference Group chaired by Dr Chris Sheldon is the main decision-making project body for eNotes. Clinicians interested in contributing to this initiative are invited to contact The roll out of NHSmail at the RD&E has started – giving staff the ability to use a secure email from any location and an email address which stays with the individual throughout their NHS service. A pilot was launched at the start of March with IM&T and Research & Development. The implementation plan intends
Dr Sheldon or the programme manager James Rutherford on ext 6916. The project team is working alongside colleagues across the Trust demonstrating the technology and discussing how best to apply eNotes in their working lives. n A date for your diary: An eNotes information stand will be in Oasis restaurant from 2630 March and project updates will be posted on IaN. to bring NHSmail into effect in seven phases between now and mid-April. There will be a short period when staff will have both an rdeft email account and their new nhs.net email accounts receiving communication and needing management. Guidance and updates are regularly being posted on IaN.
Staff health & wellbeing
The school on Bramble Ward is recruiting parent governors for the management committee. The only qualification for this rewarding role is to be a parent and an interest in the work the school, which is run by Devon county council. This is a voluntary post and involves attending Management Committee Meetings (usually three a year) and
visits to the schoolrooms on the ward to gain an understanding of the needs and responsibilities of the service. Interested? Contact Karen Squires, clerk to the management committee on ext 2675 or by email: Karen.firstname.lastname@example.org
Our Equality Commitment to You
– personal staff stories about diversity in the workplace on IaN Royal Devon and Exeter NHS Foundation Trust
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time to escape the everyday
Discover Knightshayes If it’s gorgeous spring and summer walks you’re looking for, somewhere to let the kids run free, or simply a chance to escape the hustle and bustle of every day life - then discover Knightshayes. Situated just off the M5 and on Tiverton’s doorstep with a children’s play area, a garden blossoming with colour, and an extraordinary house Knightshayes is a gem waiting to be discovered.
Thinking of giving up smoking? Why not sign up to a new stop smoking group at the RD&E for advice and support? The group meets weekly on Monday from 5pm until 6pm in Bramble seminar room. You can also save money! To find out more or to book a place on the group call Devon Stop Smoking Service on 01884 836024 or call Stephanie Parker, based in Wonford Respiratory Outpatients on ext 6133.
Call 01884 254665 nationaltrust.org.uk/ knightshayes
Time well spent Registered charity No. 205846.
Over a quarter of you try your luck with the Staff Lottery – 70% of money paid in is
for prizes & the rest helps improves our working lives
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