Royal Free Charity - Breaking Point Investment Report

Investment Report April 2022

“Staff have never faced anything like the past year so I am honoured to help in whatever small way we can.”

Royal Free Charity supporter

We would like to take this opportunity to express our sincere gratitude to all our supporters. The depth of your commitment to staff and patients across the Royal Free London NHS Foundation Trust never ceases to inspire us. You have helped our hospital community through some of the most challenging times we have faced, and we are committed to regularly sharing the powerful difference you make.

This winter, we launched our Breaking Point appeal to meet the urgent need across Barnet, Chase Farm, and the Royal Free hospitals. Your response was nothing short of extraordinary. Together, you raised in excess of £700,000 to help patients and staff through the difficult colder months and beyond.

The unique blend of innovation and resilience showcased in this report is possible only as a result of your generous support.

Thank you.

Executive Summary As the Omicron variant began to surge, and our hospitals prepared to face another difficult winter, the Breaking Point appeal marked a new phase of our response to the Covid-19 crisis.

Throughout the pandemic, we have worked together with our supporters to meet the evolving needs of staff across Barnet, Chase Farm, and the Royal Free hospitals. From providing immediate essentials to frontline teams, to helping healthcare workers cope with the longterm psychological impact of the crisis, we have consistently pivoted to meet the demand where it is greatest.

As we headed into the winter months, our hospital staff were facing a uniquely complex array of challenges. Seasonal pressures, rising cases of long Covid, and lengthening waiting lists were placing additional strain on a workforce already exhausted by the intense demands of the previous two years.

Keen to implement the learnings gained from our previous response to the pandemic, we instantly understood the need to respond quickly and strategically.

We rapidly set our Breaking Point appeal in motion to ensure staff and patients did not have to face the difficult winter alone.

We were overwhelmed by the warmth and generosity of your response.

Prior to our launch, a small group of donors pledged to match the first £250,000 of contributions raised by our community in order to build excitement and critical momentum behind the campaign. An inspiring 298 people then joined us as champions, powerfully advocating for our cause across their personal and professional networks. As a result of these incredible efforts, we experienced an immense groundswell of support on the first day of our campaign.

After just 33 hours, the appeal had already surpassed its £500,000 target.

Altogether, our supporters have donated a phenomenal £701,394 to our Breaking Point appeal.

Working hand in hand with our colleagues across the hospital trust, we are pleased to report that we have invested these precious funds in:

£180,854

Powerful research to improve the clinical understanding of long-Covid with the aim of developing a panel of tests to identify patients who are most at risk of developing the condition. This will also help to identify what targeted treatments can be given.

£261,846

£113,000 £145,694

Digital innovation to shorten waiting times for people undergoing surgery.

Wellbeing initiatives to help staff navigate the continuing crisis.

Core funding to support our vital services, including our volunteer team, patient support hub, and complementary therapy services, and to facilitate the delivery of our work.

We are delighted to share further details about the scope of our investment and look forward to continuing to keep you closely updated on the impact of your tremendous support.

A pioneering research project to advance treatment for people with long Covid Funding awarded: £261,846 The Office for National Statistics (ONS) estimates 1.5 million people in the UK are experiencing symptoms associated with long Covid.1 Ranging from fatigue to gastric issues, muscle pain to persistent shortness of breath, the symptoms of long Covid are both bewildering and debilitating.

Many suffering from the condition feel isolated, perhaps even left behind, as the country begins to recover from the pandemic.

Since long Covid is so new, there is as yet no diagnostic test or evidencebased treatment plan, impeding the NHS’s efforts to support people living with the condition.

We are uniquely well-placed to drive much-needed research in this area.

Our partnership with the Royal Free London and UCL enables us to bring together multidisciplinary expertise across infectious disease, respiratory medicine, and pain with an impressive track record in immunology. Moreover, the Royal Free London has already been heavily involved in pioneering Covid-19 research throughout the crisis, including the development of lifesaving Covid vaccines, and participation in ground-breaking studies. Research into long Covid is the next frontier.

We have therefore invested a sizeable proportion of the Breaking Point funding in a ground-breaking research 2022

project to generate new knowledge and clinical understanding of the condition, and ultimately facilitate the generation of new approaches to treatment, so that people can receive the care and support they urgently need.

Led by consultant respiratory physician, Dr Swapna Mandal, the research seeks to identify a unique biochemical profile or ‘signature’ for long Covid. Once detected, this ‘signature’ will enable clinicians to predict who is most at risk of developing long Covid, and how severe their symptoms are likely to be. In the long term, the analysis and findings could lead to the development of better targeted treatments, helping people to recover faster.

Patient recruitment to the study is currently ongoing. Over the next eight months, the team aim to enrol 120 patients attending the Royal Free Hospital post-acute Covid clinic to the research. Participants will undergo a range of assessments, including lung function and blood tests, after six and 12 months. The final findings will then be published in an international journal in April 2024.

Your support constitutes a powerful early-stage investment in a unique project with the potential for significant impact here in our local community, nationally, and across the world.

The key project phases are as follows:

2023

2024

April - December

January - June

December

Patient recruitment to the research

Completion of 6 month follow up

Completion of 12 month follow up

February

April

Completion of data analysis

Publication of data in a high ranking international journal

1. Office for National Statistics, Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 3 March 2022

An innovative digital approach to reduce waiting times for people undergoing vital treatment Funding awarded: £145,694 The Covid-19 crisis has placed NHS services across the country under enormous strain. Nearly 6.1 million people are currently on a waiting list for hospital treatment – an almost 25% increase in the number of people waiting since before the pandemic.

The pre-operative and informed consent process is an integral part of a patient’s journey prior to having an operation.

Across the Royal Free London, 12,000 people a year undergo the process.

Patients are first screened to assess their suitability for surgery. They are then given information about the risks associated with the procedure either close to, or on the day of, their operation so that they can make an active and informed decision. If consent is not in place, or a patient decides not to proceed with the surgery, then operation slots can go unfilled, leading to an increase in waiting times.

The project will create one digital platform which will: •

Provide all patients undergoing elective procedures a digital option for their pre-treatment screening. This will mean people can complete the necessary forms from the comfort of their home, and will no longer need to make as many hospital visits.

•

Facilitate the increased use of remote consultations for low-risk surgery to offer patients greater choice. These procedures currently account for 40% of treatments. Moving these appointments online will ensure that patients are given the greatest flexibility surrounding their care, and that there are more in-person slots available for those who have complex needs or would prefer a face-to-face consultation.

•

Provide patients with relevant information about their treatment in an easy-to-read electronic format prior to their consultation. This will give them time and space to think carefully about their treatment and make an informed choice, reducing the delays in obtaining informed consent that lead to late-stage surgery cancellations.

•

Develop a single informed consent platform to capture and share patient information in a consistent and secure way. This will reduce reliance on slower paper-based systems and maximise efficiency to reduce potential delays and help patients into surgery faster.

•

Reduce late cancellations of operations to ensure as many theatre slots are filled as possible, maximising the number of patients able to undergo surgery, and shortening waiting times for procedures.

Though the preoperative assessment and informed consent processes are absolutely essential, they can slow down the route to surgery for patients.

Your support is funding the urgent development of an innovative digital solution, which will increase the efficiency of both processes, helping people to receive the care they need faster.

Right Volunteer Evelyn on a ward at the Royal Free Hospital.

Core funding to support our vital services and facilitate the delivery of our work Funding awarded: £180,854 Co-designed with patients and staff, this holistic digital solution will significantly reduce the waiting time for surgery, and will ensure that people already facing the anxiety of planned procedures have the smoothest and most positive hospital journey possible.

Crucially, the solution is also mindful of those who face barriers to digital inclusion.

Alternative options will be available so that no patient is left behind.

The project is currently underway. The team have already completed the scoping, analysis, and clinical risk modelling.

Your vital support will now enable the project to progress, so that it can be scaled up and mobilised across the trust as early as this spring to shorten the time patients spend waiting for treatment.

Both the scope of the solution, and its rapid delivery, are only possible as a result of your generous support. Your investment in innovative ideas like this transforms the hospital experience for patients and families, enabling them to receive the best possible care when they need it most.

A portion of the Breaking Point funding will be used to fund our ongoing core work to support patients and staff across our hospitals. This includes stepping up our suite of vital services, delivered directly by the charity across our three hospitals.

These are: •

Our professionally accredited volunteer programme;

•

Our patient support hub; and

•

Our complementary therapy service for both staff and patients.

From dementia companionship to music on the wards, welfare benefits advice to therapeutic massage, our services make an invaluable difference to patients. They humanise the hospital experience, helping people to navigate the complex emotions they face throughout their treatment journey. This can range from providing companionship to those in hospital without family or visitors, to securing vital support for people facing a life-changing diagnosis.

Your generosity makes these extraordinary acts of everyday compassion possible.

In addition to running these services, core funding enables us to invest in building a sustainable charity that can attract the best staff, engage deeply with our community, and ultimately go on to raise further investment in the future.

Two crucial initiatives to boost staff wellbeing Funding awarded: £113,000

A cutting-edge virtual reality project to help staff unwind Boosting the emotional and mental wellbeing of staff across the Royal Free London has been a key priority for us as a charity throughout the Covid-19 crisis.

Over the course of the pandemic, our supporters have walked side by side with our hospital teams through some of life’s most challenging moments. More than 800 members of staff have accessed peer support through trained Mental Health First Aiders and SISOS (Serious Incident Supporting Our Staff) teams, with the majority approaching the service for help surrounding bereavement and emotional health. Moreover, there have been over 1,300 one-to-one contacts with psychologists providing clinical psychological support between June 2021 and February 2022.

Both of these services were funded through the generous response of our supporters to our Covid-19 Emergency Appeal in 2020, demonstrating the invaluable difference our donors make to staff across our hospitals.

We are now investing a further £63,000 in a highly innovative pilot to explore the use of virtual reality (VR) headsets to expand the range of support available, providing an exciting and sustainable

health and wellbeing option accessible to an even greater number of staff.

VR immerses the user in a fully digital environment through a computer generated or filmed 360-degree video.

From beach walks to ocean diving, a stroll in the snow to going on safari, the different experiences all offer a moment of escapism. This has a powerful, and clear, application in a hospital context, enabling the user to take a short break from the stress and noise of the ward and return to work refreshed.

VR offers a more flexible approach to wellbeing than more traditional interventions because it is accessible to a wide audience. It takes less time out of the working day for busy staff, and can be used either in a therapeutic setting or be brought to staff wherever they are working, making it much easier to access support.

It is therefore unsurprising that the idea of using VR to promote wellbeing is gaining traction across the healthcare sector. A number of studies in NHS settings have linked VR to a reduction in stress and an increased ability to cope with work-related pressures.

Left A member of staff tries the VR headset at Chase Farm Hospital Right ICU nurses in a ‘wobble zone’ room at the Royal Free Hospital

Supported by funding from the Breaking Point appeal, the Innovation and Intelligent Automation Team (IIA) at the Royal Free London are working closely with staff across our hospitals to deliver a series of virtual reality wellbeing workshops to assess whether a similar scheme could help support staff across the trust.

The first workshop took place on 22 March at Chase Farm Hospital. Our incredible volunteers helped to facilitate the workshop, welcoming staff and collating invaluable feedback to support the IIA Team. The response to the VR headsets was extremely positive. Staff told us that they provided “well-needed rest and relaxation time” during a busy day.

As one member of the endoscopy team explained:

“It calmed me down stress wise, I wasn’t so tense. We’d had a difficult patient before, so it was nice to have that to level my stress a bit more.”

Funds will allow the workshops to be expanded to Barnet and the Royal Free hospitals until the end of June.

Feedback from the pilots will inform the development of a trust-wide strategy to integrate VR into staff health and wellbeing from September onwards, ready to help our hospital teams through the difficult winter. The majority of the grant will be invested in the headsets, so that they can be pressed into service rapidly to provide a sustainable, longterm option for continuing health and wellbeing provision.

Investment in rest areas across our hospitals to give staff space to recharge Following the 2020 Covid-19 Emergency Appeal, where we were able to invest in improvements to a small number of staff rest spaces, staff surveys have highlighted an acute need for more and better rest spaces across our hospitals where individuals and teams can recuperate between challenging shifts.

Whether providing the opportunity to speak in confidence to an empathetic colleague, or somewhere private and restful to eat, these spaces make a tangible difference to the wellbeing of our staff. As one of the ICU nurses at the Royal Free Hospital explains, rest spaces “help [staff] to take a breath” away from the constant noise and stress of the ward.

We have therefore invested £50,000 to refurbish key areas, including wellbeing spaces for specific departments, and the creation of ‘wobble rooms’ where staff who have been emotionally affected by a traumatic incident can decompress alone or with a trusted colleague. The scale of the need, combined with the complexity of our existing hospital architecture, and a sharp spike in the cost of construction mean that this programme of refurbishment and renovation is a long-term priority for us. Consequently, we are continuing to fundraise for this crucial work.

Breaking Point appeal: breakdown of total investment (to the nearest £100) Long Covid research £125,700

Recruitment and staffing of research team for 18 months

£136,100

Testing, analysis, and research and development support

A digital approach to reducing waiting times for people undergoing vital treatment £19,900

Innovation team time

£12,900

Clinical staff time

£90,000

Development of robotic automation

£5,000

Training to enable staff to use the platform

£5,000

Software licence

£12,900

Project support

Virtual Reality wellbeing for staff £30,000

60 VR headsets distributed equally across Barnet, Chase Farm, and the Royal Free hospitals

£3,000

5-7 immersive experiences per headset

£30,000

Innovation team time

Rest spaces for staff £50,000

Furniture, lighting, and refurbishment costs

Core funding £181,000

Funding to support our vital services and facilitate the delivery of our work

“We are immensely grateful to all our supporters for their continued commitment to staff and patients across the Royal Free London. The success of the Breaking Point appeal is testament to the incredible power of community, and to the ambitious work we can deliver when we work together.

To all who supported us, gave us their time, or amplified our voice: thank you.

We look forward to continuing to keep you updated on the impact of your wonderful generosity.”

Jon Spiers, chief executive of the Royal Free Charity.

Phone: 020 7317 7772

Email: fundraising@royalfreecharity.org

Charity number 1165672.

Company limited by guarantee number 09987907.