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RD&Express Royal Devon and Exeter NHS Foundation Trust

November 2009

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

Swine Flu The Trust has planned and prepared for the pressures caused by significant increases in swine flu cases among patients, staff and in the wider community. Swine flu (also known as Influenza A/ H1N1) is a new type of flu which infects humans and spreads easily worldwide. Symptoms are similar to those of seasonal flu infection. The aim of the Trust Pandemic Flu Plan is to enable the RD&E to be able to ensure critical services can continue to be provided during a flu pandemic. It sets out a range of scenarios when the Trust will not be able maintain ‘business as usual’ and have to change its operational activity to manage exceptional infection control rates, staff absence and prioritisation of patient treatment. There are a range of measures the Trust can take. For patients this can range from promoting Health Protection Agency messages about hygiene and protection from the flu virus and where to get advice, appointments may be postponed or cancelled, and some services may be suspended or significantly reduced. Visiting the hospital may be restricted to only relatives or carers of patients who are severely ill. Vaccination is being offered to frontline hospital workers (see page 2).

ü Pictured: Renal & Diabetes Matron Gerry Copley

looking at plans for the new unit with project patient representative Mr Tim Riley.

Two million pounds has been invested by the Trust to create a new haemodialysis unit in Exeter for renal patients. To meet an expected increase in the number of patients needing this specialist service over coming years, the new unit at Heavitree hospital in Exeter will have 24 dialysis stations, including six single rooms. Haemodialysis treatment involves technology to clean the blood of toxins and water which kidneys with acute or chronic disease cannot do naturally. Creation of the modern purpose-built facility in the former Rougemont Ward will enable the transfer over a period of time of 70 haemodialysis patients across from the outdated accommodation on Sid Ward at the RD&E Wonford. Building work at Heavitree started last June and is scheduled to be providing haemodialysis services from early 2010. Acute renal services, for example kidney transplants, will continue to be provided at Exeter Kidney Unit at the RD&E Wonford hospital.

Respond, Deliver & Enable


Protect & prevent If unwell with flu or caring for someone •

Stay at home and keep away from work, school or crowds as much as possible. Within home patient should stay isolated in room if practical.

• Rest and take plenty of fluids •

Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose of the used tissues properly. Carers can buy masks or make their own as long as material used is disposed of or cleaned properly

Patients and carers should wash hands with soap and water frequently and thoroughly, especially after coughing or sneezing

Inform family and friends about your illness and seek help for household chores that require contact with other people such as shopping

Staff vaccination The Royal Devon & Exeter NHS Foundation Trust has started its swine flu vaccination programme for frontline hospital staff. Hundreds of frontline staff will be offered the vaccine protection in line with Department of Health guidance because they are more at risk of infection in the course of their working life and could spread infection to susceptible patients.

• Ventilate (open windows) room where patient is staying • Keep the environment clean with readily available household cleaning agents.

Supporting the vaccination programme at the RD&E, Joint Medical Director Dr Vaughan Pearce and Director of Nursing & Patient Care Marie-Noelle Orzel said: “Protection against this flu virus through vaccination is being offered to those most at risk among our staff. The vaccine not only has benefits of protection in the workplace for staff, and for patients in our care, but also among our family and wider community circles where we are in contact with vulnerable groups including babies, young children, pregnant women and people with long term health conditions.

Useful sources of information National Pandemic Flu Service: 0800 1513 513 www.pandemicflu.direct.gov.uk Health Protection Agency: www.hpa.org.uk NHS Choices: www.nhs.uk

“Having this vaccine is not mandatory but in a global pandemic, taking steps to prevent spread of this infection is a social responsibility at a very local level among our own family and friends, as well as for the general public.”

Royal Devon & Exeter: www.rdehospital.nhs.uk

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The Royal Devon & Exeter NHS Foundation Trust has achieved an Excellent rating for financial management and Good for quality of services in the 2008/09 Annual Health Check assessment. The results were published by the Care Quality Commission on 15 October.

RD&E scoring: ¸ Safety and cleanliness ......14/14 ¸ Waiting to be seen ...........11/12 ¸ Standard of care ...................8/8

¸Dignity and respect ...............9/9 Chief Executive Angela Pedder said: “The Annual Health ¸Keeping the public healthy...5/5 Check results confirm that the Royal Devon & Exeter ¸Good management ...........16/18 is performing well on the issues and services most important to our patients and the community we serve. The skills and dedication of staff have achieved top marks for safety and cleanliness, standard of care, dignity and respect and keeping the public healthy. “The overall 95 per cent quality score (63 out of a possible 66) – Excellent for financial management and Good for quality of services – is an achievement to be proud of. We narrowly missed out on an Excellent rating for the quality of services because of a technical error around data. What matters is that this did not in any way have a detrimental effect on patient experience and the care received at the RD&E.”

Privacy & dignity More improvements have been made to ensure privacy and dignity of RD&E patients during their hospital stay.

“In addition, more monitor equipment has been purchased so that flexible use of the Emergency Medical Unit can create more privacy between male and female patients.

Director of Nursing & Patient Care MarieNoelle said: “In the recent Annual Health Check assessment, the RD&E scored top marks for privacy and dignity from the Care Quality Commission.

“Some of the changes have been generated by frontline staff, such as Dart Ward where frosted glass achieves more privacy between male and female designated bays.

“The Trust is committed to enhancing patient experience and is seizing opportunities to improve patient privacy and dignity. We are investing £270,000 from the South West Strategic Health Authority to create more side rooms at the RD&E Wonford hospital. Building works to have more side rooms on Durbin ward in the Princess Elizabeth Orthopaedic Centre are scheduled to be completed by mid-December.

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“As well as gender segregation within the built hospital environment, there are practical ways to ensure patient dignity and privacy is not compromised, such as the three-armed theatre gowns which prevent gaping at the back. The refurbishment of the main hospital concourse reception area at RD&E Wonford, due for completion next month, has improved privacy and dignity including a new bereavement suite and private discussion space for patients or relatives using our Patient Liaison Service.”


News highlights Emergency Department consultant Adrian Harris has shared his expertise and supported local adventurer David Brooks in readiness for a challenging single-handed row across the Pacific and Atlantic Oceans. Preparation for the epic task included shadowing Dr Harris on duty to learn wound care skills, including how to self-sew deep cuts or dress open wounds, when he is on his own at sea. Dr Harris created a medical pack for David to take with him and if any health issues arise at sea, he will be able to get in touch with Dr Harris via satellite phone for advice. Nurse Charles Conibear made his 75th blood donation when the National Blood Service (NBS) bloodmobile visited the RD&E Wonford site. He was one of about 40 staff to attend donation appointments and plans are afoot for a return visit. Charles, a staff nurse on Tavy & Dyball ward, was 18 years old when he made his first donation in Barnstaple and he has been donating blood for the last 33 years. To commemorate his amazing contribution, the NBS presented him with a crystal plate. A privileged opportunity for members of the public to tour the Pathology laboratories at the RD&E Wonford was hosted recently as part of National Pathology awareness week. Health care of the heart was the focus of the event. The Clinical Biochemistry service completes over 200, 000 tests every year which determine prevention, diagnosis and treatment of heart attacks, heart failure and heart disease. Good practice at the Royal Devon & Exeter hospital was the focus of national Patient Safety First week. Frontline staff featured on the campaign podcast during the September event explaining progress at the RD&E on a range of initiatives to improve safety including the deteriorating patient condition and patient falls whilst in hospital. This was the culmination of work since January when the Trust signed up to a campaign for no avoidable patient harm or death. 4


RD&E staff played a key role in testing a national initiative with potential to transform the way operating theatre teams work and improve patient experience. As one of the pilot sites, the RD&E took part in the national launch for the NHS Institute for Innovation and Improvement programme called The Productive Operating Theatre (TPOT). The focus of this initiative is to improve staff and patient experience, including leadership, team working, patient safety and theatre efficiency. Surgeons, anesthetists, theatre nurses, operating department practitioners and theatre assistants step back and look at theatres activity and ways of improving what they do and how they do it.

Want to get involved? Patient Information Advisory Group (PIAG) The RD&E is setting up a group aimed at raising the standard of information provided for patients. We are looking for members of the public to join the group, which will also include patients, relatives, carers, and staff. The Patient Information Advisory group will regularly review patient information. It is expected that a sample of up to four documents (although this could vary) will be selected every two months and passed to the group for review. Using a series of checklists, the group will review and comment on each of the documents. We would like to send out the information electronically and receive the information electronically with changes made where necessary, so having an email account is preferable. The group will start work in Spring 2010. If you are interested in joining contact Patient Information Manager Val Montgomery for more information. Telephone: 01392 402080 or email: val.montgomery@rdeft.nhs.uk 5


Governors News Round-up Council of Governors (CoG) meeting on 7 October 2009

The Governors heard reports from Elaine Hobson, the Trust’s Chief Operating Officer, and Suzanne Tracey, Director of Finance, highlighting the main issues in 2009/10 to the end of August. Elaine Hobson explained the targets Trust staff are working hard to achieve: •

Infection control - the Trust is making excellent progress. There have been no new cases of MRSA since May and only three cases in the reporting year 2009/10. The patients did not contract MRSA whilst in the RD&E. The Trust’s laboratory is a public laboratory and as the tests for MRSA were completed there, the cases are included in the Trust’s figures.

Cancer waiting times – it was explained that the Trust was still waiting for confirmation of what the national targets would be for this year. Where targets were known, the Trust was performing well. However the Trust had fallen behind on a 31-day surgery target but was working hard to get back on track.

Emergency Department waiting times – the maximum waiting time in the Emergency Department is four hours from arriving to admission, transfer or discharge. The Trust meets this in 97.7% of cases, against a target of 98%.

Finance

New Governors

Suzanne Tracey reported to the Governors that: •

To the end of August, the Trust had a surplus of £2.7 million, which was £600,000 below plan. This was because there had been some overspending on pay and on some clinical supplies, which the Trust was addressing. The Trust is still on track to meet the plan of a £7m surplus at the end of the financial year.

£4.2m had been spent on capital projects to the end of August. This includes building works, such as the refurbishment of the main entrance and theatres on the Heavitree hospital site.

Thank you to everyone who voted in our Mid, North, West Devon & Cornwall by-election held during August and September. Paul Nielson and Dianne Pearson were elected, with a turnout of 43%. Paul is a GP working in Okehampton and Holsworthy and has been elected for a three year term. Dianne has been elected for a term of one year. She decided to stand after being a patient at the RD&E and now having the time to dedicate to the role of Governor.

During the meeting the Governors were also briefed on: •

Pandemic Flu planning

Winter bed allocation planning

Community Theatre transfers

Paul and Dianne took up their posts at the Trust’s Annual Members’ Meeting on Wednesday 16 September along with the other newly elected Governors from June and attended their first Council of Governors meeting in October. 10 6


Welcome to Malcolm Harrington as the new Deputy Chairman of Council of Governors. Malcolm was elected by Governors and took up his post at the Trust’s Annual Members’ Meeting in September. Malcolm has been a Governor, representing East Devon, Dorset & Somerset, since 2007. Malcolm trained in hospital medicine and later worked for the London School of Hygiene and Tropical Medicine. This is why he took up this role: “The Foundation Trust has been in existence for five years and I have served as a Governor for two of them. As Governors we are beginning to understand more clearly our role in representing our Members and how important it is that we should use our wide and varied expertise to influence the direction of the Trust. We have created a Steering Group of Governors to take this work forward and it is a privilege for me to lead such a dedicated and talented group of people.”

Members influencing Trust’s future plans The RD&E has kick started a review of its strategic plans. Originally agreed in 2007, the strategic directions set out the purpose, direction of travel and goals for the Trust. The strategic direction was led by the organisation’s Board with strong input from the Council of Governors, members and the wider public. Now the Trust Board has decided that the time is right to look again at the strategy to ensure that it remains relevant in the years ahead and that it reflects the needs of the community that the RD&E serves. It is clear that many of the assumptions made three years ago when developing the Trust’s strategy need to be looked at again. For example, the recession is likely to have a significant impact on the resources available to the NHS in the future and it is important that the Trust takes this into account in its forward plans. As a membership organisation, it is essential for the Trust to listen to the views and opinions of members. During the course of the first half of next year, members of the Trust will be asked to express their views on the issues they think are important for the RD&E, on our services and on the Trust’s future priorities. The Trust will be asking members to participate in a number of ways in helping the Trust develop its plans. If you are interested in participating contact the Foundation Trust office.

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, Room 114, Noy Scott House, RD&E Hospital, Barrack Road, Exeter EX2 5DW.

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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.

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For information about any of the events contact Bernadette Coates in the Foundation Trust Office on 01392 403977.

Events for Members

‘Medicine for Members’

Open Meetings

‘Medicine for Members’ talks feature leading clinicians (doctors, nurses, therapists) talking about their specialist area and patient services.

Please note that the Exeter and Tiverton meetings for November/December have been cancelled whilst the Trust reviews these meetings.

Bowel Cancer – Tuesday 12 January 2010, 1.30pm-3pm

Council of Governors Meetings 2010 All meetings at the FlyBe Suite, St James’ Centre, Exeter City Football Club, Stadium Way, Exeter EX4 6PX.

Venue – Lecture Theatre, Princess Elizabeth Orthopaedic Centre (PEOC), RD&E Wonford

Wednesday 20 January, 2pm-4pm

Staff from the specialist team will be talking about the symptoms and treatment of bowel cancer.

Events may be cancelled at short notice if the hospital is restricting visiting to the hospital site for infection control reasons.

* Venue space is limited so please contact Bernadette in advance to book your place. Contact details above.

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RDExpress November 2009