Improving Together - August 2019

Improving Together

Improving Together Issue #5 - August 2019

ENGAGEMENT CHAMPION Question and Answer

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Our Quality Improvement journey to delivering great care Caring | Well-Led | Responsive | Effective | Safer

T AS A RESULRVE Y OF S TAFF SUACK FEEDB

2 | Improving Together

CQC inspection The Care Quality Commission (CQC) this month

The CQC report also highlighted areas of improvement:

published its reports into ‘focussed inspections’

• Junior doctors spoke positively about working in the ED and said

it carried out in our two Emergency

Consultants were supportive and always accessible

Departments back in April.

• An increase of Band Six nursing staff and the appointment of four

The CQC highlighted a number of areas which needed improving, and our teams took immediate action to address these concerns.

• Staff reported morale improving and described an “appetite for

Some of this work is ongoing and we expect to see further improvements over the coming months.

This work includes:

substantive Consultants were considered as positive by staff change” • Staff felt supported and were encouraged to be open and transparent • Staff from all disciplines said they could raise concerns without fear • Staff had access to a Sepsis trolley which had step-by-step guidance and equipment needed for dealing with suspected

• Approving spending of over £1 million on additional staffing for our EDs with a clear recruitment drive for additional nursing staff

Sepsis patients, with a doctor identified daily to carry a dedicated Sepsis bleep to respond quickly to suspected cases.

worked into our workforce plan • Carrying out significant work with NHS Improvement and NHS England and with Health Education England on recruitment • Joining the NHS Improvement Retention Programme.

• Recruiting additional nurses to ensure children our seen in our Emergency Departments within 15 minutes of arrival • Employing four new paediatric nurses with two more due to start in September • Undertaking a Value Stream as part of our Transforming Care programme to improve patient flow for minor injuries • Appointing 13 registered nurses in our EDs with an additional 13 newly qualified nurses due to start in September • Introducing an induction pack for agency staff

Barbara Beal, Interim Director of Nursing, Midwifery and Quality, said: “We are continuing to work hard to not only implement improvements, but to ensure they become embedded.

“There have been some significant changes to strengthen the Executive and Senior Leadership teams since this inspection was carried out and we are focussed on making SaTH the best it can be for patients, visitors and staff.

“Our workforce remains a major issue for us, but we are making some progress in this area. We have recently secured an additional 50 nurses across all departments in our hospitals and interviewed a further 90 last week.

“Although we have also improved recruitment in our EDs, this is an area that remains fragile, particularly in respect of Middle-tier doctors and is an area which we will continue to focus on.”

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Having been inspected by the Care Quality Commission (CQC) back in August and September last year, we are preparing for a re-inspection, which we expect to be around November this year.

Bev Tabernacle, Interim Deputy Chief Executive, said:

“The results of the last inspection were hugely disappointing for everyone connected with SaTH. No matter where we work within the Trust, we all have our part to play in making this a great place to have treatment and a great place to work; so to receive the feedback that we did can't have failed to have had an impact on each of you.

“We know that the prospect of a CQC inspection can be daunting enough at the best of times; and it may feel even more so given the results of that last inspection. We have listened to feedback from staff and, as a result, we have created a new guide on what to expect when the CQC come to see us.

“This is not us dictating what colleagues should and shouldn't say, but what we hope is a useful guide to what the inspectors will be looking for when they come and the sort of thing they are likely to ask if they speak to you.”

The guide can be found on the staff intranet at intranet/cqc.

We have also set up a dedicated email address for anyone who has any questions about anything in the booklet, which is sath.askcqc@nhs.net

Bev Tabernacle Interim Deputy Chief Executive

4 | Improving Together

Improvements this month Scheduled Care During the last CQC inspection, a total of 15 ‘Must Do’ findings were found in Scheduled Care with a further 33 ‘Should Do’ findings. The Care Group has made excellent progress on the Must Do and Should Do findings and are now on cycle 12 of the plan – meaning more time is now being freed up to conduct regular Quality And Safety Walks across our hospitals to maintain the impetus.

and knowledge to build resilience in themselves and their teams.

Improvements in Surgery include: • Controlled drugs standard operating procedure

As a result of the improvement work, lockable trolleys or storage facilities are now in place on every wards with a new standard operating procedure in place.

audited and evidenced • Sepsis control and management improved

The Workforce Transformation Team organised a workshop on 5 August with Paul McGee (better known as ‘The Sumo Guy’). This was very well attended by around 160 staff. Feedback from attendees is that many are already using his tools to good effect in work and at home. Demand for another workshop has resulted in one being organised for March 2020 for staff who were unable to attend and details will be published soon.

• Sepsis awareness improved • Demand and capacity modelling in place • Infection Prevention and Control standardised Improvements in Critical Care include: • Tailored Deprivation of Liberty Safeguards flowchart created • Behind the beds checklist review at handovers • Checklists and audits in place • Dedicated Operational Group set up • Awareness of national standards improved • National Guidelines on display

Improvements in End of Life Care include: • Dedicated Datix section for End of Life Care • Syringe driver storage and return protocols in place • Swan Rooms prioritised • Electronic record storage plan in place • Medical examiners recruited • PSAG icon space provided • End of Life Care training plan rolled out for Junior Doctors

Workforce As a result of a lot of hard work and staff commitment, the Trust’s Statutory and Mandatory training rate continues to rise steadily and on 1 August we reached the highest ever rate in the Trust’s history - 85% against a Trust target of 90%. This has risen from 76% in the past 12 months.

Many staff are reporting that the ability to complete some subjects for refresher by e-learning that can be accessed from anywhere (such as Safeguarding Adults Level 2 and MCA and DOLS) suits them and fits in better with their work patterns. Work is continuing to reach and sustain the 90% training target that helps us keep our patients, our colleagues and ourselves safe.

Under the Well-Led banner, the importance was recognised of staff having the skills

As a result of the focus in our action plan on the importance of therapeutic care for patients, we are welcoming new therapy staff in a number of areas. In addition to our 11 newly qualified Band 5 Physiotherapists (starting between June and September) we are also welcoming Band 6 staff for Occupational Therapy and Physio over the next two months, with some of these starting as a result of the successful critical care business case and we are substantively recruiting for the additional Wards 27 and 17 Supported Discharge.

Mandy Taylor, Head of Physiotherapy and Inpatient Therapy Lead, has also reported that from November 2019 the Trust will have a Therapy-Led ward. This innovation will be a 13-bedded area with a Therapist as a Ward Manager for the first time in the Trust’s history and with Occupational Therapy and Physio support available seven-days-a-week from 7.30am until 7.30pm.

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Women and Children’s Quality Improvement Information Boards have been introduced to all Maternity Services areas.

The department will aim to update these every six weeks and will be asking staff what else they would like to see on the Board.

Feedback has been excellent so far, with staff appreciating the effective communication tool that allows them to be kept updated and involved in the improvement work.

We recently produced a training video about the importance of using the S.B.A.R acronym during handovers. S.B.A.R stands for Situation, Background, Assessment and Recommendation and the video explains how using the acronym during handovers will ensure all members of staff are fully briefed about every patient.

The video was produced by the Communications Team and features Dr Olusegun Ilesanmil, who has worked at SaTH for more than seven years.

All line managers have received support packages to help their teams with regards to health and wellbeing. Staff who feel stressed are encouraged to contact their line manager for support.

Unscheduled Care The Emergency Department at RSH has created a new People Link Board.

A video that demonstrates how a People Link Board can be used to enhance the sharing of information with your teams can be viewed on our YouTube channel here https://www.youtube.com/watch?v=v9C27KXNBhs

6 | Improving Together

Improving the way we deliver cancer services

Breast imaging department re-locates to improve patient care The Breast Imaging Department at PRH has moved to a new, dedicated location to improve care for patients.

The new department brings breast imaging services at PRH into one location which includes a new private waiting area and changing cubicles as well as a new mammography suite.

The aim is to help streamline the breast cancer care patient pathway at PRH, and also give patients much more privacy – improving their hospital journey.

The department covers four dedicated breast clinics each week, as well as performing breast biopsies, pre-theatre interventional procedures and mammograms. Breast Imaging services are also provided RSH. Rachel Hammond, Senior Breast Mammographer at SaTH, said: “Previously ladies were sat within an open waiting area off the main x-ray corridor at PRH which is very busy. They would be required to cross the corridor if they needed an ultrasound following their mammogram whilst dressed in a hospital cape.

“The new department has addressed this issue, and we now have a dedicated breast department that is only accessible to patients requiring breast imaging either for breast screening or as part of the symptomatic pathway.”

IT revamp will improve care for radiotherapy patients A £150,000 investment is being made in new IT infrastructure which will help improve care for radiotherapy patients at SaTH. New server hardware, computers and up-to-date software is currently being installed in the Radiotherapy department. This will streamline the service and benefit patients undergoing radiotherapy as part of their treatment for cancer at The Royal Shrewsbury Hospital.

Paul Evans, Consultant Clinical Scientist and Head of Radiotherapy Physics at SaTH, said: “We have been planning and working on this project to upgrade the software and servers in Radiotherapy for the last two years, and it has finally come to fruition, which is great news for both our patients and our staff.

“This means that we can now remotely access scans and complex treatment plans for our patients from any location.

Until now, everyone in the Multi-Disciplinary Team had to be in the same room, looking at the same screen.

This will benefit patients as it means that there will be fewer delays to starting their treatment. It also means that our staff will have a more flexible and rewarding way of working.”

“This upgrade has been made possible by redeploying existing radiotherapy funds, which is fantastic news as it means that we haven’t incurred the Trust any additional costs.”

“During the planning of this project we have been able to make savings by, for example, better procurement with our external suppliers. Some equipment maintenance contracts formerly held with the manufacturer have been brought in-house with considerable cost savings and no reduction in machine reliability.

“We have then been allowed to ring fence those savings to re-invest back into the department for this project and hence improve the quality of radiotherapy.”

The radiotherapy department, which is based in the Lingen Davies Centre at RSH, houses three state-of-the-art Linear Accelerators and a wide bore CT scanner. Radiotherapy is used to treat many forms of cancer including skin, prostate, breast, colorectal, head and neck, lung and gynaecological tumours.

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Going note-free

Living Well and Beyond

SaTH’s Cancer Multi-Disciplinary Teams (MDT) are moving swiftly towards becoming note free.

It is a cause for celebration that more people than ever are living longer after a cancer diagnosis, but we know the impact of cancer doesn’t suddenly stop when treatment is over and that many people have ongoing needs and long term side effects.

It follows a successful RPIW at the end of April this year and the excellent work completed in the Colorectal MDT. The Gynae and Breast teams are the next to introduce the use of Ipads to support their patient discussions and remove the need to request and prepare patient records to review during the meetings.

It is recognised the MDT members can become more engaged in the patient discussion and the recording of outcomes of higher quality as a result.

We are working in partnership with Macmillan Cancer Support to help improve the experience of people living with and beyond cancer.

The focus at SaTH is on addressing what matters most to the patient using a person-centred approach and supporting people to safely self-manage.

The programme consists of five main interventions:

Outside of the MDT meeting, may hours are allocated to requesting and preparing patient notes for the meetings in the MDT office. Going note free will enable the Cancer Pathway Co-ordinators to track patients more frequently, supporting SaTH’s improvement trajectory against the Cancer Waiting Times targets.

1. Holistic Needs Assessment and Care Plan 2. Treatment Summaries 3. Living Well Offer 4. Cancer Care Review (by your GP) 5. Person-Centred Follow-Up

It is hoped that all MDTs will be note free by the autumn.

The work done so far includes:

Two-week wait Four new Two Week Wait booking clerks have been recruited to improve care for patients with suspected cancer. It brings the number of booking clerks in the department to seven, helping to speed up the booking process for patients.

The extra capacity also means that staff will be able to call patients to make sure they are able to attend – reducing non-attendance and rebooking – and give them time to answer any additional questions that patients may have about the clinic they are attending.

• More than 140 people have attended five community-based ‘Living Well’ sessions that focus on fatigue, emotional health and wellbeing, physical activity and nutrition. This pilot of 12 sessions will end in December 2019 and a business case will be prepared by September for a range of potential providers and commissioners to ensure the continuation of this service.

• A Living Well video is being created to provide an opportunity for patients to hear from other patients so they can reflect on their experience and learn what ‘living well’ means to them. The filming is expected to be completed in September.

• Our LWBC team are piloting and testing the benefits of using

Quality award

a Treatment Summary, which help patients to safely

The Macmillan Cancer Information and Support Centre at SaTH has achieved Level 4 across all quality areas of MQuISS Macmillan’s quality standard for information and support services.

to them while also helping GPs to improve continuity and

self-manage and take more control over what is happening coordination of care. There has been fantastic early engagement in this process with 63 patients, 17 Consultants and GPs completing an online survey telling the team how important treatment summaries are.

This is the level that Macmillan requires all Cancer Information and Support Services to achieve. In recognition of the continuous quality improvement and hard work that has gone into achieving this standard, Macmillan has issued a certificate to the service manager, Jessica Brindley.

• A LWBC Advisors Network is currently being established to provide opportunities for people living with and beyond cancer. More than 100 people living with and beyond cancer have agreed to be involved in the programme

8 | Improving Together

Improving the culture of our organisation When morale is down, standards follow and ultimately the standards we walk past are the standards we start to accept.

Feedback from our patients, the CQC and the NHS Staff Survey tells us that the culture of our organisation is not where we want it to be.

There are many challenges ahead but our Organisational Development team have developed some initial areas of focus through the Leadership Academy to support an open and honest workplace culture and to deliver improved behaviours among leaders and managers at all levels.

Culture of openness Freedom to Speak Up – We now have three Freedom to Speak Up Guardians, who are supported by a network of more than 20 Freedom to Speak Up Advocates.

Peer-to-Peer – This volunteer listening service, which provides a confidential ear and acts as a point of triage for staff, has been piloted small with just 10 participants. Initial feedback has been successful and it will soon be rolled out with further information.

Talk Safe – This is another pilot area but so far some of the qualitative feedback has already been instrumental in driving changes.

Regular surveys – Every two months we undertake a short survey with you to ask how it feels to work at SaTH. The data is collected and analysed so improvements can be made based on your feedback.

Training Coaching - We are developing our coaching culture as we believe this will be pivotal to our success as we move forward. Through the Leadership Academy you can book onto a Coaching Skills for Leaders workshop, via the intranet Training Diary.

ThinkOn – This programme of work, done in partnership with Go Make a Difference Thinking, is about how we spread more purposeful conversations throughout SaTH. It also giving managers and leaders a toolkit to notice where their own thinking is and where their team’s thinking is. You can book onto one of the sessions via the Leadership Academy on the intranet Training Diary.

Strength Deployment Inventory – This course helps you understand your motives and the motives of others. The course provides an easy way to see your core and the core of others from the perspective of motives. It provides a valid and reliable measurement of core personality, and the strengths that people use

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Our Values Values-based conversations – Our Values are really important to us and we know that, while our staff know our Values, we have work to do to ensure you see them lived every day. This is why we provide Values-based conversations courses through our Leadership Academy, available to book via the intranet Training Diary.

Health and Wellbeing

ensure a pot of additional money is available to further improve your working environment. Most recently the Fund paid for fridges, microwaves and picnic benches. To make a bid please visit http://intranet/Charity/lottery.asp The panel will next meet on 3 September to read through all the latest bids.

Staff recognition Annual Values in Practice (VIP) Awards - This year we had more than 720 award nominations.

Resilience - As part of leadership development we have focussed on resilience and how we can build resilience as an individual and as a team. On August 5, Paul McGee (AKA the Sumo Guy) gave a masterclass to around 160 members of staff on how to build team resilience.

Monthly VIP Awards – We have a VIP Award winners each month and our Chair Ben Reid visits the celebrants within their workplace where he takes time to understand and learn from their nomination success.

Learning from Excellence – By capturing episodes of

Mental wellbeing – We have invested in Mental Health First Aid Champions and increased our Stress Risk Assessment. We also offer stress awareness sessions for managers.

Employee Assistance Programme – This will be implemented as of next month, giving any member of our staff in difficulty support via the telephone 24/7.

excellence we can learn from events and use the learning to improve practice and the quality and safety of the care we provide.

Communications – The Organisational Development team works closely with the Communications team to celebrate staff achievements in internal and external publications.

Small Things Makes A Big Difference – This was created to

Learning from complaints Complaint: Confusion over cancelled appointments.

Cause: Patient had two referrals in same specialty.

Action taken: Ensure that before logging a new referral that all staff check that this not already a referral recorded to the same speciality.

Complaint: Delay in treatment Cause: Correct process not followed to add patient to waiting list Action taken: Consultant has shared experience with the team and reiterated the importance of ensuring that forms are completed and sent to the Waiting List office in line with internal procedures.

Complaint: Concerns regarding care of patient who had an emergency admission Cause: Staff not aware of blue cards Action taken: Training for staff on blue cards

10 | Improving Together

Junior Docs

More than 150 new junior doctors have joined SaTH to continue their training, where they will work across a wide range of specialties, including: Medicine, Surgery and Women and Children’s Services.

Dr Jenni Rowlands, Director of Postgraduate Education at SaTH, said: “The trainees range from straight out of University, to final year before becoming a Consultant. We have also welcomed many trainees from overseas to continue their learning in the NHS.” Senior clinicians at the Trust delivered an induction programme to the junior doctors covering a number of important medical topics, including; Sepsis awareness, Infection Control and Antibiotic Therapy, Resuscitation and End of Life Care. The junior doctors will now move on to practical/ward based learning which, supported with an extensive teaching programme, will help them to progress in their chosen field of medicine.

Improving the way we care for patients living with dementia A bus stop is a surprise new addition to a corridor at the Royal Shrewsbury Hospital.The bus stop outside Ward 21 and Ward 22 is an innovative solution to patients living with dementia wandering off the wards.

Many of their patients on these two wards are elderly and living with forms of dementia, so therefore staff at SaTH have come up with the unusual solution of a bus stop mural at the entranceway. The hope is to prove a familiar scene which will encourage confused patients to stop and wait, giving staff time to come and collect them.

Karen Breese, Dementia Clinical Specialist at SaTH, said: “When patients living with dementia become confused and agitated they tend to walk off the wards and will often look for something which looks familiar. The bus stop is just that. “It can also be a great place for patients to escape the noise of the ward for a few moments and where they can sit and talk in environment with other patients or their families.”

Gary Francis, Ward Manager on Ward 21, said: “The work that we have been doing has been a huge team effort and has already made huge improvements to the way that we operate and the care that we can give to our patients. It is really encouraging to see the staff proactively volunteering to lead improvements and own projects – everyone is playing a part and together we are making a difference.

“These interventions are proven to prevent emotional escalation, and reduce anxiety, and are a great example of adapting what we do to meet the holistic needs of our patients.”

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Strengthening our Senior Leadership Team We have strengthened our Senior Leadership Team with a number of high profile arrivals in key areas of the Trust.

The appointments follow six major changes to our Board of Directors – including that of Paula Clark as our new Interim Chief Executive, two Deputy Directors of Nursing and a Deputy Workforce Director.

Kara Blackwell and Clair Hobbs will join SaTH on 2 September as Deputy Directors of Nursing.

Kara joins us from Walsall Healthcare NHS Trust was she was the Deputy Director of Nursing and led on quality, safety and patient experience.

She has 30 years’ experience as a registered nurse having specialised in haematology, cancer and palliative care. She has held senior nursing roles in London Teaching Hospitals and in the West Midlands in both acute and integrated Trusts.

Clair Hobbs Clair joins us from The Royal Wolverhampton NHS Trust where she was the Head of Nursing for Surgery, Speciality Services, Outpatients, Theatres and Critical Care. Most recently she has completed her Masters in Healthcare Leadership.

Clair qualified as a Registered Nurse in 2000 and started her nursing career within the specialty of Cardiology. She joined Wolverhampton Primary Care Trust in 2008 as a Community Matron to extend her clinical knowledge and skill base. Here she gained a Diploma in COPD management and non-medical prescribing. She later moved into the Senior Matron role for Adult Community Services before taking on her current role.

Rhia Boyode joined SaTH recently as Deputy Workforce Director. She possesses a wealth of experience as a senior leader, helping to shape, implement and drive transformational people agendas.

During the first 10 years of her career she worked for an organisational development consultancy and spent a lot of time working in partnership with Primary Care Trusts, such as The Christies. The past seven years of her career she has been deputising for HR Directors within large global organisations as part of their Senior Leadership Team.

Other senior appointments include Janet Budd, who is the Programme Director for our Hospital Transformation Programme, and Kathleen Rose who will join the Trust in October as the Associate Director of Service Transformation.

Rhia Boyode

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News in Brief Award-winning improvement initiative Two teams at SaTH have scooped a national award which recognises excellence in palliative care provision.

The Dundas Medal was awarded to the End of Life Care (EOLC) and Speech and Language Therapy teams at SaTH for the work done to change the culture of nil-by-mouth for end of life patients through the introduction of Taste for Pleasure.

Therefore a tailored system has therefore been developed to provide counselling and more information prior to discharge. A training session has been created for all pharmacy staff to raise awareness, while an information leaflet to help when counselling patients has also been developed.

Improved patient experience

Around 80% of hospital patients will have swallowing difficulties in the last 72 hours of life, so SaTH has implemented an alternative to nil-by-mouth called Taste for Pleasure. The idea came from Jules Lock, End of Life Care Lead Volunteer, and aims to improve patient experience and allow loved ones to be involved in their relative’s care.

The Trust has a well-established system for providing patients on older anticoagulants, such as warfarin, but the new anticoagulants, while effective and much easier to monitoe require patients to be very watchful of any side effects and warnings.

The NHS Long Term Plan was published in January 2019, setting out the vision for improving health and care over the next 10 years. Over the coming months, our STP will be developing and implementing a five year strategy to take forward these ambitions.

To have your say, please download a feedback form from the SaTH intranet (search Long Term Plan).

Stoma-friendly toilets Every single accessible toilet at SaTH is now stoma friendly.

SaTH has introducing yellow name badges for its staff to improve patient experience and address barriers and inequalities for patients with visual and cognitive impairments.

Pharmacy have taken steps to provide patients with tailored advice for a new range of oral anticoagulants (DOACs).

Shropshire, Telford & Wrekin Sustainability and Transformation Partnership (STP) is developing a local long term plan and needs your help.

Engaging with our staff is important to determine what the NHS Long Term Plan means to you and how local services could improve.

Taste for Pleasure means that when receiving end of life mouth care (cleaning and hydrating the mouth), hospital staff can use the patient’s favourite flavours to provide moisture. These flavours can be anything from blackcurrant squash and tea to whisky and Prosecco.

Giving patients more advice

Shape the local long term plan

The new standard name badge for all staff consists of bold black text on a yellow background and incorporates the #hellomynameis logo to remind healthcare staff of the importance of introductions in a healthcare setting.

Having a coloured background to text increases contrast, which can support patients with both cognitive and vision impairment when reading information.

Yellow has been chosen as it helps people with a cognitive impairment to process information quicker making it easier to read.

Yellow can also stimulate people’s minds as it activates the left side of the brain, awakening greater confidence and optimism.

People with stomas have additional needs when they use the toilet, and the provision of hook, shelf, mirror and disposal bin in every accessible toilet will help to meet these needs and make a great difference to people with stomas who are patients or visitors to the hospitals.

SaTH has worked closely with Colostomy UK to roll out the improvements at both hospitals.

Irene Constable, Patient Representative for Colostomy UK, said: “We are delighted that SaTH has now made these additions to their disabled access toilets to help those living with a stoma.”

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Freedom to Speak Up SaTH has strengthened its Freedom To Speak Up (FTSU) team, which now extends to three Guardians and 24 Advocates.

FTSU Guardians act in an independent capacity to make hospitals safer for patients and staff by encouraging a more honest environment where all staff, volunteers and students feel able to raise any issues or concerns and know that they will be addressed confidentially, swiftly, and in line with good practice.

The Trust’s three FTSU Guardians are Kate Adney, Chan Kaur and Teresa Carrington. The Executive Lead for Freedom to Speak Up is Dr Arne Rose, SaTH’s Medical Director. In addition to the Guardians, there are also 24 FTSU Advocates who work on a voluntary basis and can provide informal and confidential guidance on how to raise a concern.

Same day surgery

The FTSU team has been strengthened following NHS Staff Survey feedback that colleagues made about being able to raise issues regarding unsafe clinical practice, and to ensure that these issues are always addressed.

Total laparoscopic hysterectomies can now be done as outpatient surgery at PRH. Women who come to PRH for a major surgical procedure which involves removing the uterus and the cervix using keyhole surgery can now go home the same day.

Prior to this surgical technique patients would routinely stay in hospital for up to five days.

Susan Dawson, of Telford, underwent the procedure recently, said: “I arrived at hospital at 7.30am and within 12 hours I was back home with my feet up watching a film and eating a slice of toast. I tried to take the next few days sensibly but it was surreal as I was in no pain at all. I had undergone major surgery yet I was in no pain at all and was able to get on with my life as normal.

Dr Sahu, Consultant in Obstetrics and Gynaecology at SaTH, said: “With correct patient selection, day case total laparoscopic hysterectomy offers many advantages. This includes early mobilisation, reduced recovery time, less need for pain relief and helps get ladies home sooner.”

Breast cancer studies SaTH were in the top 10 recruiting hospitals for the recent Persephone study that looked at improving the treatment for patients with HER2 positive early-stage breast cancer. People diagnosed with breast cancer that produces high levels of a protein called HER2 are traditionally offered a 12 month course of a drug called Trastuzumab. The drug is taken intravenously every three weeks for a year.

But during the 10-year national study, more than 4,000 women and men – 60 of whom came from SaTH - looked at whether a six month period is the equivalent of taking the drug for 12 months. The results showed that 89.4% of trial participants who had a six month course of the drug and 89.8% who had 12 months were free of breast cancer four years after their initial diagnosis. The results also showed that 4% receiving six months compared to 8% receiving 12 months had to stop early due to heart problems.

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Every member of staff can get access to an NHS Mail Information from our Engagement Champions - who were recruited on the back of Staff Survey Feedback that told us that staff want to be better engaged and involved with what’s happening at SaTH – suggested that not everyone was aware that they could now have access to NHS email. Since we moved over to nhs.net it is now possible for every member of staff to have an NHS email – and access it from wherever they are.

Staff can apply for a nhs.net email by filling in a password request form, which can be found on the intranet here: http://intranet/Library_Intranet/documents/informa tics/SaTH_Password_Request_Form_v18.pdf For more information, staff can contact IT directly on ext.2522.

Staff can also access the latest messages and newsletters by downloading the new staff app, where access to NHS mail is also available.

For instructions on how to download the new staff app please visit http://intranet.sath.nhs.uk/communications/app.asp Other issues that have been raised, and are being considered, by Engagement Champions include: • A review of iPad, iPhone allocation to improve access to VitalPac • Improvements to ward/staff toilets at RSH • Introducing adult changing rooms for visitors on both sites

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Please provide an update on what progress is being made to introduce flexible shifts for nurses as many people find the current 12-hour shifts difficult to juggle alongside a young family?

There is a robust flexible working policy, however a newly-formed retention group are looking into this.

Where are we at with plans to make all of our hospital sites ‘smoke-free’?

Our Smoking Policy was updated last year and recommends that we make our hospitals smoke-free.

However, there is currently no capacity to drive the plan forward so any recommendation would need to include a view on what department should lead the plans.

How do you order the new yellow badges?

To place the order: 1) Access the Oracle App from the main intranet homepage.

2) Click on the name badge icon as below (this is an example of the layout).

3) Select the style (either pin or magnet).

4) Add your first name only along with your Job title, and follow the above example (first letter is a capital letter followed by lower case). If you have a double barrelled first name please add these two names such as Mary-Ann with a hyphen and ensure you start each name with a capital letter.

5) Once your order is placed and approved, delivery will be 2- 3 weeks from date of placing order.

Does the Trust feedback on unsuccessful Small Things Makes Big Difference bids?

We respond to everyone a letter of acceptance or decline. There is currently a back log of requests and the team are reviewing the current process as there can sometimes be a delay if the panel choose to gather further information.

We are one of only a few Trusts to charge staff for DBS checks. Are there any plans to changes this?

The recruitment and retention group are looking at the DBS issue as they recognise the impact.

Can Champions have update on NHS Future Fit at next session?

Yes, this has been organised.

What is the peer-to-peer support service we are introducing and who is a supporter?

The peer to peer volunteer service is a listening service for staff who need a confidential ear. They act as a sounding bar or a point of triage for staff to access. The volunteers have been trained in the local offer at SaTH and will be able to suggest other support required.

We only have a pilot of 10 peer-to-peer volunteers at present, with another cohort being trained in October.

Any member of staff can access a peer-to-peer volunteer via email sath.p2p@nhs.net. Their contact details can be found from that inbox once you email.

Is there a list of ThinkOn Master Coaches on the intranet?

ThinkON Master Coaches are currently going through their accreditation and therefore we are not in a position to promote them widely just yet. However, an intranet page is being developed in the background and will be published once ready.

Do we have fast-track options (besides physio) for staff who are off sick and waiting for specialist referral?

Not at the moment but this is something we have started to look in to and are contacting other NHS Trusts to find out what fast track options they are offering staff. We will need to explore whether there is a need and what options are available and share this with the Workforce Committee.

Are there any plans to give staff access to Mental Health First Aid training?

We have Mental Health Aid champions across the Trust who are identifiable by their lanyard. The purpose of the champions is to spot signs within their colleagues and signpost where appropriate. They are not required to do specific interventions or to step in. We have also increased sessions on stress and mental health awareness by offering half-day courses throughout the year. These can be found on the Intranet’s training diary. There is a significant cost to introducing Mental Health First Aiders, and therefore we would need to assess the specific need for introducing these and the expectations from the staff of what the first aiders will do, in addition to the offer currently provided.

Improving Together

Spotlight on...

Expectant mums opting for a birth at the Wrekin Midwife Led Unit will be cared for by small teams of named midwives to improve their maternity journey.

Midwives at the unit, which is based at PRH, have introduced Continuity of Carer for their mums-to-be. It means that they will have the same people looking after them before, during and after the birth of their baby.

The consistency will enable the midwives and the mums they are looking after to build up a trusting relationship. It has been proven to lead to better outcomes, and also helps mums-to-be to have a more positive and personal experience.

Becky Havvas, Wrekin Community Manager, said: “Continuity of Carer means that our mums will be cared for by a team of six to eight midwives, including community and ward based midwives, from the start of their pregnancy to the finish. It means that the mum-to-be will be booked to see someone that she knows. The midwives are working hard to improve teams also being present to provide care through labour for families in our care.

“The midwives in the team are able to build up a relationship with the mum-to-be during her journey which is so important as it builds up trust and confidence.

“They will be aware of her history and the choices she has made for her and her baby, so she doesn’t have to keep repeating it at every appointment. There may also be mums who have the ‘blues’ after having their baby, and they might feel they can open up more to a midwife that they have built up a relationship with. It is also a rewarding experience for our midwives too.

“The aim is to improve outcomes and the experience for our mums-to-be. We have only just introduced this but we are definitely starting to hear positive feedback from our mums.”

The introduction of Continuity of Carer at Wrekin MLU, which also involved the Shropshire and Telford & Wrekin Local Maternity System, follows a Better Birth’s report which set out a vision for maternity services in England that are safe and personalised, and which found that Continuity of Carer was the single biggest request from women.

Planning is now under way to introduce Continuity of Carer for mums-to-be opting for home births, and it is hoped to roll it out in January 2020.

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