your hospitals, your health, our priority
Public and Staff Governor Election News
The Challenges Ahead
Text Message Appointment Reminder Service
Living Healthier Longer
Unnecessary A&E Visits
Our Hospitals Charity Has a New Name
Listening into Action
Catering ‘A Recipe for Success’
Service and Site Investment
Recognising Excellence Awards 2012
17 ‘Green Medication Bag’ Scheme 18
Successful Elimination of Mixed Sex Accommodation
Equality Delivery System
Blood Test (Phlebotomy) Becoming a Member
Front page photo: Janet Irvine, WWL Lead Cancer Nurse, Kris Radlinski, Rugby General Manager at Wigan Warriors, and Roberto Martinez, Manager of Wigan Athletic.
Issue 7 _ 3
Welcome to Our Latest Magazine
Since our last magazine, we have held our 2012 election for Governors. You can read more about this on page four. I am delighted to be taking on the role of Lead Governor after Tom Frost completed his term of office. On behalf of all the Governors, I would like to express our thanks to Tom. The leadership and commitment he gave to this role during his time as Lead Governor is very much appreciated. I look forward to the role of Lead Governor. I will be communicating with all the Governors to establish their thoughts on their roles, and the way forward to deliver the best health care to the borough and the patients in our care. It has been another busy few months at Wrightington Wigan and Leigh NHS Foundation Trust, especially during this time of significant challenge for the NHS. On page six, Andrew Foster gives his view, as Chief Executive, on the challenges we face. I hope you enjoy reading about some of our recent successes and our fantastic site development progress. As always we welcome your feedback to help us ensure that we provide information that is of interest to our members. May I take this opportunity to thank you all for your continued support and commitment to the Trust.
Gordon Jackson Lead Governor
4 _ Issue 7
Public and Staff
Governor Election News 2012
Welcome to New Governors
We are pleased to announce the results of the latest elections to our Foundation Trust Council of Governors. Following closure of the recent Elections on 10 September 2012, we were delighted to welcome back:
We said farewell to Mrs Pauline Gregory (Public, Wigan) and Miss Kate Fussell, (Public, Makerfield) who did not seek re-election following completion of their term of office. We would like to give our thanks to Pauline and Kate for their tireless efforts during their time as Governors. They represented the views of members and provided invaluable advice and input into our service planning and delivery.
Mr Bill Greenwood – Public, Wigan Ms Anne Vernengo – Public, Leigh Ms Margaret Hughes – Public, Makerfield Mr Vincent France – Public, Rest of England and Wales Mr Tom Frost – Public, Rest of England and Wales Mrs Chris Swann – Staff, All other staff We are also pleased that Mr Fred Lever (public, Makerfield) has returned as a Governor following a year’s absence.
Growing our Membership Stephen, our Membership and Engagement Manager, supported by Governors, has been to events across the Borough. They have been actively encouraging members of the public and patients to join as members and take advantage of the opportunities the Trust promotes for them.
New members to join the Council of Governors are: Mrs Maggie Skilling – Public, Wigan Mrs Sandra Morrow – Public, Rest of England and Wales Dr Nick Flatt – Staff, Medical and Dental Mrs Julie Cook – Staff, Nursing and Midwifery All the Governors – newly elected and re-elected – wish to thank all the members for taking part and voting.
Photos left to right: Fred Lever, Maggie Skilling, Sandra Morrow, Nick Flatt and Julie Cook.
If you have friends or family who are not members, please encourage them to join us. There are several ways to sign up and it is completely free; you just need to be 16 years of age or over. Website: www.wwl.nhs.uk Freephone: 0800 073 1477 Email: firstname.lastname@example.org
Issue 7 _ 5
Listening to You
Dates for Your Diary
Governors are the voice of both our public and staff members and the local community. They want to hear from you about ways you think our hospitals could change for the better.
The Council of Governors hold meetings in public and you are very welcome to attend. The next meeting is on 19 December 2012, in the Trust Board Room, Royal Albert Edward Infirmary at 6pm.
You can get in touch with the Governors, in your local area, by calling the Membership Office on freephone 0800 073 1477 or by emailing email@example.com. To find out more information about your Governors go onto our website at www.wwl.nhs.uk. Address Change If you are moving house don’t forget to add us to the list of organisations you need to notify. Your address determines the constituency that you belong to. It is important during Public Governor Elections that all our Public Members are registered under the correct constituency. If there is more than one Public Member in your household, let us know if you would prefer to receive more than one copy of our Newsletter. Also, if your details have changed, please call the Membership Office on 0800 073 1477. Benefits We should like to remind Public Members with internet access that you can now enjoy the same national and local benefits as our Staff Members. NHS Discounts This is a special website with discounts from high street brands. Visit www.nhsdiscounts.com and complete the simple registration form. Membership will give you access to more than 100 companies offering great discounts. Once you have set up a username, members of your family will also be able to benefit.
Real Time Patient Experience Dignity and respect Pain control Involved in decisions Communication: Worries and fears Catering Cleanliness Communication: Questions answered Recommend this hospital Average Benchmark
Please contact the Membership Office if you would like to attend a forthcoming meeting. Real Time Patient Experience Goes Green The Membership and Engagement Department, together with the support of volunteers and Governors, have continued to engage with patients on the wards during their stay. This is to find out what their experience is like whilst staying in our hospitals. Our target is to achieve 90% overall patient satisfaction. Over the past 12 months we have seen improvements in all of the areas we assess. However, two areas have been more of a challenge. These are ‘the opportunity for patients to discuss their worries and fears’ and also ‘pain relief’. Following the introduction of a new initiative by nurses called “Hourly Rounding”, we have now turned these indicators green for three consecutive months, which has exceeded our benchmark of over 90% of a positive patient experience (see chart below). Pauline Jones said: “We have outstanding staff here at WWL, and this initiative has been embraced because it gives our nurses a way of guaranteeing our patients are being seen and cared for appropriately. “By putting patients at the heart of everything we do and providing dedicated care to our patients, they feel able to discuss their worries and concerns openly. This is reflected in the fantastic results in our patient satisfaction scores.”
98.2% 87.2% 93.5% 79.73% 91.4% 99.76% 96.93% 97.46% 93% 90%
97.83% 96.56% 97% 95.56% 96.1% 99.56% 97.8% 95.9% 96% 90%
6 _ Issue 7
The Challenges Ahead
The NHS has always faced a multitude of challenges, but as I have been asked to write only a short piece, I will restrict myself to the two biggest facing our local hospitals. Firstly, in this period of economic austerity, we are required to make savings of 5% per year against a long term trend of demand for hospital services growing at around 4% per year. And we have to meet these challenges without any increase in waiting times, without compromising patient safety or the quality of our services, and without making life impossible for our wonderful staff. So how are we doing after the first 18 months of this austerity? The answer is “so far, so good”. At present we have one of the best performing A&E Department in the whole North West, with over 96% of patients being treated in less than four hours. We have gone over six months without a single MRSA infection and have had just 19 cases of Clostridium difficile. Our Hospital Standardised Mortality Ratio (HSMR) is 94 and this is one of the best scores in the North West. Financially we are on track to make a respectable surplus this year which will contribute to our £70m programme of investment in our hospitals. The big challenge though, is that we have to keep on finding these efficiency savings indefinitely, and this is a truly daunting prospect.
By Andrew Foster, Chief Executive
services might be affected in future and our plan isto work in partnership with our neighbouring Trusts in Bolton and Salford. Between us we have a population of one million, so by developing shared services we hope to be able to retain as much as we can in our local hospitals. These are daunting challenges but we have excellent staff, a good track record and very good relationships with our partners elsewhere in the NHS, particularly local GPs, local Government and Social Care. There is a strong ethic of ‘partnership working’ in Wigan and I am confident that by working together, we will come through these major challenges.
Secondly, there is a national move to re-organise hospitals in a way that will centralise some services currently provided in smaller hospitals. In Wigan and Leigh we serve a population of 320,000 and, in the long run, this may be too small a population to justify provision of the more specialised services. Of course this is nothing new and local residents have long accepted the wisdom that many cancer patients should go to the Christie Hospital, heart surgery to Wythenshawe and spinal and neuro-surgery to Hope Hospital. It is too soon to say what Photo: Andrew Foster presenting at a recent event.
Issue 7 _ 7
Missed Appointments and
Text Message Reminder Service
During 2011/12 the NHS carried out nearly 53 million out-patient appointments. But unfortunately 5.5 million of these appointments were missed, meaning that one in ten appointments related to patients who did not attend.
If you are unable to make an appointment telephone 0300 555 4567 and speak to our Patient Appointment Centre. You can also visit our website at www.wwl.nhs.uk and complete our online cancellation form.
Last year there were 39,728 missed appointments at the Trust, which equates to 8.4% of hospital attendances. Missed appointments affect the Trust and its patients in a number of ways, including increased waiting times and loss of revenue. This year, to try to reduce the number of missed appointments, we have introduced a new text messaging appointment reminder service. It has been rolled out for the vast majority of appropriate hospital services.
The Trust appreciates our patients continued support in helping us make the most of our valuable resources to improve patient services.
This service sends out reminders to patients about the date and time of their next appointment or planned hospital admission. The reminder also includes the necessary information for patients to cancel their appointment should they be unable to attend. There is no cost to the patient to receive the reminders. It is possible, in the case of children, to send reminders to their parent/guardian and for vulnerable patients, their designated carer. When you attend the Out-patient Department, our receptionists will ask if you have a mobile telephone number to receive future text reminders. If you do not wish to receive the text reminders, there is the facility for you to opt out. Since the introduction of the text reminder services we have noticed the number of appointments cancelled by patients has increased, which is a positive indication the text reminders are having an effect. It also means that because an appointment has been cancelled it can be offered to another patient. By offering cancelled appointments to someone else we are also reducing our waiting times and providing a more efficient service.
8 _ Issue 7
Living Healthier Longer
Diabetes, asthma, coronary heart disease, stroke, dementia and arthritis. These conditions are often incurable but managed through medication/therapy. They are some of the most common ‘long term conditions’. Currently, around 15 million people in England live with at least one. Over the next few years, it is anticipated that there will be a 60% increase in the number of people with more than one long term condition. This is in addition to a predicted rise in numbers of all long term condition patients, over the next decade.
In the Wigan Borough, over 96,000 people are living with long term conditions and there is a growing number who will develop further conditions as they get older. Most people over 65 have two or more long term conditions, whilst the majority of over-75s have three or more. It is recognised that people living with long term conditions do not want to spend time in hospital. Additionally, they would like more say in the care they get and the way it is delivered. The increase in these conditions is adding to an already strained NHS, which has to make savings of more than £15 billion over the next three years. That is why the Trust and other health and social care providers in Wigan Borough, are jointly looking at ways to create better, more efficient, ways of caring for people with long term conditions. Living Healthier Longer is a joint programme which promotes greater self-care by patients, together with more shared decision-making between patients and clinicians. The Trust is looking at how we deliver services to our patients, achieve savings, whilst also making sure we maintain and improve the quality of care we provide. We also need to help to change the culture of how people expect to receive their healthcare, focusing more intensely on prevention. It’s vital that action is taken now for the sustainability of the NHS and our health care across the borough. Shared Decision Making Not being properly told about their illness and the options for treatment is the most common cause of patient dissatisfaction. Most patients nowadays want more information and a greater say in decisions about how they will be treated. In Shared Decision Making, patients are involved as active partners with the clinician, in clarifying acceptable medical options and choosing a preferred course of clinical care. To fully achieve Shared Decision Making with our patients, we are working closely with our GP colleagues.
Issue 7 _ 9
If you have any questions, would like any further information or would like to become involved please email: firstname.lastname@example.org Public and Stakeholder Events The Trust has held two successful events over the year. The first event was aimed at a Professional audience; clinicians, GPs, healthcare professionals, charities and self help groups. Over 250 people attended the Leigh Sports village and listened to guest speakers from all the local health Trusts. The topics included GP Consultations, chronic care delivery and how to provide co-ordinated, high quality health and social care.
Living Healthier Longer Website The Living Healthier Longer team are currently looking at developing a new, interactive website and we want you - our members - to help us to do this. By answering the following two simple questions, you can support the creation of a website that suits everyone’s needs - both personally and professionally - when managing long term conditions. 1. What would you like to see on the website? 2. What would help you best manage your condition from a website perspective? Please send your answers or any other comments to:
The second event, held at the DW stadium, Wigan, was well attended and aimed primarily at the public. Patient representatives, as well as charity and self help representatives also attended. The guest speakers, from across the local health Trusts, talked at length about patients with long term conditions and how they can be better supported in their own homes. During the day a table exercise was carried out to answer the question “What is most important for you in managing your health”.
Free Post Business Reply Services Licence Number SWB50013 Membership and Engagement Office, Royal Albert Edward Infirmary, Wigan Lane, Wigan, WN1 1XZ
Further events are being planned for patients, visitors, carers and staff, over the coming months.
Photos: At the recent ‘Living Healthier Longer’ events there were information stalls, free health checks and presentations.
10 _ Issue 7
Unnecessary A&E Visits A&E or 999 Choking, chest pain, black outs, blood loss.
Walk-in-Centre With 12 per cent of people admitting to have used A&E when they knew they didn’t need to, WWL hospital doctors and nurses are asking the public to think twice before they dial 999 this winter. A&E attendance across the UK from June 2011 to May 2012 was over 17. 6 million – so that’s a staggering 2,112,000 attendances that were “wasted”.
Cuts, itches, sprains.
Dr Tim Dalton, local GP and Chair of Wigan Borough Clinical Commissioning Group (WBCCG) said:
“We know that over the winter, the number of serious and life-threatening cases will go up if temperatures fall below 12 degrees Celsius. That’s people with breathing problems, strokes and heart-attacks caused by the cold weather. What we don’t need at such a busy time, are people calling 999, turning up at A&E or going to their GP when they don’t need to be there.
GP Vomiting, ear pain, back ache.
Pharmacist Upset stomach, runny nose, headache. Unwell? Unsure? Need Help?
Self Care Hangover, grazed knee, sore throat, cough.
“It’s not just A&E and 999 teams who feel the pressure over winter. GPs and community nursing teams are a vital part of the care needed by people who return home after having suffering a life-threatening emergency.”
“The NHS carried out a quick on-line survey over the summer and 94 per cent of those who answered said that people should do more to self-care for common complaints, such as coughs, colds and so on.
The Choose Well campaign aims to educate and inform people about the different NHS services available to them. It promotes self-care and the use of local high-street pharmacy for common complaints such as coughs and colds, flu, stomach upsets and general aches and pains. The campaign has been developed by NHS teams and has been growing in the past couple of years. Over the winter months information will be distributed by NHS teams throughout the community and promoted via Twitter and Facebook.
“We are kicking off a winter campaign and are working with the National Self Care Forum, the Royal College of GPs and the National Pharmacy Association to try and get this important message across”.
Dr Dalton continues: “Most common complaints will begin to get better within a couple of days. We know that people can sometimes get confused about which NHS service to use. But going to A&E because your toe-nails need cutting, calling 999 because of period pain or going to your GP with a common cold is a huge drain on NHS resources.
Advice and information about a range of common winter health complaints, including how long symptoms will last and how to relieve symptoms is available from NHS Choices at www.nhs.uk. This is were you’ll find an easy to use symptom checker, can search for your local services and use the interactive First Aid toolkit.
Issue 7 _ 11
Our Hospital’s Charity Has a New Name
The community of Wigan and Leigh have really got behind the campaign to give Wrightington, Wigan and Leigh’s Health Services Charity a new name. Hundreds of people voted in the campaign and Elizabeth Titley, Fundraising Officer for the Charity, recently announced that the new name would be ‘Three Wishes’. Elizabeth said: “We really want to say a big thank you to all of those people who took the time to vote. We can now move forward with a fabulous new name and identity. ‘Three Wishes’ really captures the meaning behind what the Hospital’s Charity is trying to achieve: we have three main hospital sites and our three main wishes are to improve our sites and environment, provide better patient care and improve patient quality with many ‘wishes’ of what the Charity can provide in future years”.
The Charity will now seek to have a more prominent presence in the area, with the launch of a fantastic fundraising event at Christmas. Wigan will have its own ‘Reindeer Run’ which will be held at the DW Stadium on 16 December 2012. The Fun Run is an all inclusive event. We are encouraging novice and experienced runners, as well as walkers, to join in and raise sponsorship for Wigan’s new Cancer Care Centre. Les Higgins, Chairman of the Trust and the Charity said: “We would love the community to become involved in this wonderful event. Anyone who has cancer or had a loved one suffer from the disease, will know how difficult their journey to recovery can be. We want the unit to be as comfortable for patients as can be, and this event, along with support from colleagues and stakeholders, will go a long way to making this happen!” For more information about the Reindeer Run, to download your entry form, or to watch the Reindeer Run video simply visit www.wwl.nhs.uk/reindeerrun.
Photos, top to bottom: Janet Irvine, Lead Cancer Nurse at WWL with Roberto Martinez, Manager of Wigan Athletic, Sue France and Andy Birch from the DW Stadium with WWL’s Fundaising Officer, Elizabeth Titley.
12 _ Issue 7
Listening into Action
Listening into Action (LiA) is a new programme which gives NHS staff, our staff, the power to transform their workplace. The aim of LiA is to empower our staff to drive the changes they want to see. These changes are not only for the benefit of their patients but also the workforce as a whole. Ownership lays firmly in their hands, with the backing of the Trust’s leadership and management teams helping to unblock the way. Chief Executive, Andrew Foster is fully committed to this new staff engagement approach. He is delighted that we are one of ten NHS organisations who have been selected to be a national pioneering site. No one can argue that happier, motivated staff have a directly positive impact on the quality of care patients and service users receive. In June over 1,100 staff completed a survey and more than 300 attended the five listening events that took place in July. The honest views, opinions and suggestions were essential to supporting the move towards this new way of working. In August Andrew Foster announced a series of actions which the Trust would be taking in an attempt to help address some of the comments and concerns raised by staff at the July Listening events.
Actions taken to date: • Top 10 Eyesores – David Evans, Associate Director of Estates and Facilities, led a process where staff voted for the worst sights in the Trust, which would then be put right or removed. This started in September. A survey was conducted throughout September asking staff to submit feedback on what they considered to be their Top Three Eyesores. A significant number of staff responded and these results are currently being analysed. • Protected time for training – Jon Lenney, Director of Human Resources and Organisational Development, led the development of a new policy to give all staff, who currently have no protected learning time, at least one day per year. This will allow them to participate in learning and development activities. A policy has now been written and has been endorsed by Staff Side chair. The policy will be communicated to staff once it has been formally ratified and uploaded on to the Policy Library. The key to the policy is for staff to negotiated with their line managers for the additional protected day (pro rata) through the PDR process. • Staff suggestion scheme – Michelle Cloney, Listening Into Action Lead, has overseen the creation of an electronic and paper-based staff suggestion scheme. This sits alongside the Fact or Fiction Board. The LiA Team launched the ‘Ideas into Action’ intranet site on 4 October 2012. A series of communications regarding the site were made throughout October and will continue as appropriate.
Photos: Staff participating in the Listening into Action events.
Issue 7 _ 13
No one can argue that happier, motivated staff have a directly positive impact on the quality of care patients and service users receive.
In addition to the Rapid Responses outlined, the Trust also agreed to five system change projects, with a deadline of 14 January 2013 for completion. They are: • • • • •
IT Recruitment Mandatory Training Values and behaviours Leadership
Each of these work streams has now started and is making good progress. Finally, 10 local teams were selected to adopt the LiA methodology. This was to support them to make changes in their areas of work. All teams are well underway with their project work. This includes conducting a local staff survey called a Staff Pulse Check and holding a local Listening event for the team.
An Illustrator was on hand at each of the five listening events to caputure key themes.
14 _ Issue 7
Catering ‘A Recipe for Success’ By Gillian Lyon, Facilities Manager
I give no apologies for stealing the ‘tag line’ used by our Nutrition and Hydration team when re-launching protected meal times. The recipe for success is a poster detailing a number of key steps ward staff should follow to make mealtime a pleasurable experience for patients. It can be seen displayed on wards and accessed through the Trust’s nutrition website. Meal Service for patients has never been just about delivering nutritious, safe food. It requires a whole approach from everyone concerned, and the Catering Team along with our colleagues, have worked tirelessly to improve the patient experience. Caroline Lecko from the National Patient Safety Agency visiting the Trust earlier this year commented “I have spoken on many occasions to my Catering and Nursing colleagues about working together - such as recognising wards as restaurants and caterers as your best friend - and during my visit to WWL I actually saw this happening”. This has been the cornerstone to improving services.
“I would like to congratulate you on your menu, it is tastier and much more enjoyable.” A patient comment.
However, Catering have also been busy behind the scenes: We have introduced a ‘one pot’ hot choice at lunchtime, such as hotpot, chicken casserole and beef stew. In addition to offering our famous home-made soups, a choice of two sandwiches, on brown or white bread, has also been included. This was trialed extensively on wards prior to its introduction in September, and designed to coincide with the re-launch of protected mealtimes. Catering Staff visit the wards to take meal orders prior to lunch and evening meal. This helps to better capture ‘right meal, right patient’ and to assist in reducing waste. A new Children’s menu was introduced on Rainbow Ward, with the collaboration of the ward staff, dieticians, patients and their parents. This has been very well received and includes ‘healthier versions’ of favourites like burger buns, breaded chicken fillets and pizzas on wholemeal bases. Paul Riley, our Hotel Services Manager, was awarded Employee of the Year for his work in implementing this. Fruity Friday was launched on Rainbow ward two years ago on the back of a dental awareness campaign to encourage children to eat more fruit. This initiative is still going strong today. We have changed from Butter to Flora, reducing the saturated fat in our recipes. In fact, the Trust will reduce its saturated fat consumption by over one ton in the next 12 months. Our work with the Improving Working Lives team saw the Trust achieve Commitment Standard this year. We are now working hard towards achieving the Excellence Standard. Our Health Trainers also display poster information in Dining Rooms advising on appropriate portion sizes. Additionally, nutrition tips are displayed in Dining Rooms each month.
Photo: Ward and Catering staff on Rainbow Ward.
Issue 7 _ 15
Service and Site Investment
The Trust has agreed an eight-year investment plan that will run beyond 2020. This £70 million investment, in our hospital facilities and services, will significantly enhance the quality of care and experience for our patients and visitors. Enabling projects are already underway. We are working with our construction partners, Integrated Health Projects, to finalise the plans for our major builds, due to start in 2013. Below are some of the major projects taking place across our main hospital sites.
Improving Your hospitals
Royal Albert Edward Infirmary Projects • Refurbishment and enhancement of the Education Centre • Relocation of Ophthalmology services to Wigan Health Centre (Boston House) • Moving Children’s Outpatients to the Thomas Linacre Centre • Building a new Essential Services Laboratory and new Oncology Unit • Building a large Surgical Centre to house new state of the art theatres • Creation of new office buildings for clinical teams • Modernisation of wards
Wrightington Hospital Projects Leigh Infirmary Project • Upgrading the site’s electrical infra structure to support the new building work • Refurbishment of the Conference Centre • Developing a brand new surgical centre complete with new ‘barn’ style theatres and wards
• £6.8 million investment in the refurbishment of the Hanover Building • A new Outpatient Department and treatment facilities to include: – – – –
A Gastroenterology Unit A Urology Investigation Unit A Women‘s Healthcare Facility A Scope Decontamination Facility
This investment in major building works marks a very exciting chapter in the Trust’s history. They will transform the experience of our patients and the working environment for our staff. The new buildings, modernisations and re-developments will complement and enhance our current facilities.
Photos, clockwise from top: Inside a ‘barn’ theatre, an artist’s impression of the new Cancer Care Centre and an artist’s impression of the Hanover new build at Leigh.
16 _ Issue 7 The winners of the Foundation Trust Award – Angels Pockets.
Recognising Excellence Awards 2012
High performing individuals and teams from Wrightington, Wigan and Leigh NHS Foundation Trust were honoured by their colleagues at the sixth annual Recognising Excellence awards ceremony. The DW Stadium was the venue for a rather special night of celebration and entertainment, with over 350 staff in attendance. The Awards ceremony gave staff the opportunity to showcase areas of good practice. Andrew Foster, Chief Executive said: ‘We recognise that staff are our greatest asset in delivering high quality services. Each of the awards is given in recognition of an outstanding contribution towards delivering safe, effective and quality care. Each year the bar is raised, which is testament to our staff for their innovative work, outstanding achievements and commitment to patient care.” The event celebrated staff from across the organisation for the excellence they have achieved in their daily work. The Trust recognises the commitment and dedication of staff to ensure all our patients receive the best possible care every day. This year saw a record number of nominations for the five categories; safe, effective, caring, innovation and supporting staff and colleagues. This year’s winners were: Safe Tracheostomy Management in the Community Training Primary Care Trust staff on the management of tracheostomy patients. The training supports seamless continuity of safe care when patients are discharged. Effective Angiogram/Angioplasty Pre-op Clinic The development by the Surgical Admissions Lounge of a service which enables patients requiring angiogram/ angioplasty, to attend a pre-operative clinic preventing the need for an overnight stay in hospital, enhancing the patient’s experience.
Caring Angels Pockets Designed and created by the Linen Services Department, these are embroidered and trimmed cotton pockets in which early demise and premature birth babies are placed. Bereaved families have been comforted knowing that their baby had been placed in a pretty pouch. It demonstrates a sympathetic and caring touch at a very sad time. Innovation/Service Transformation Pharmacy Services Realignment A major change to the Pharmacy Service to a full, seven day service, including the introduction of Pharmacist on-call. This improved service also covers weekends and bank holidays. The changes have enabled 100% of acute patients to be seen by pharmacy staff within 24 hours of admission. No other Trust in the UK offers a seven day Pharmacy service of this magnitude; a great example of successful service transformation. Supporting Staff and Colleagues Intensive Care Unit Working Pattern The radical change to the consultant’s working pattern was from a different consultant present each day, to the same consultant present each day - usually 7 consecutive days. The change has lead to improved consistency in decisionmaking, better care given to patients by the consultants and improved communication both within the team and with patients and relatives. Consultants have reported that the change has benefitted patient care overall, with increased familiarity of patients and improved efficiency of ward rounds. This year’s Chairman’s Employee of the Year Award was presented to Paul Riley for his fantastic work developing a new children’s menu. The Foundation Trust Award, which was presented to the overall winner from the initial five category winners was scooped up by Linen Services and their Angels Pockets.
Issue 7 _ 17
When you visit hospital, you can take your medication with you You can pick up your own Green Medication Bag from your local GP surgery, or hospital Pharmacy
your hospitals, your health, our priority
18 _ Issue 7
“Have you had any problems with your memory in the past 12 months which have affected your everyday life?”
Improving the care of our patients who suffer from Dementia In 2009, the Government published the National Dementia Strategy. This document focused on improvements to the care of dementia suffers. Within acute hospitals, the main areas for improvement are: • Skilled and knowledgeable workforce • Early identification and diagnosis of patients who have memory problems • Early identification of patients who suffer from dementia or memory loss • Person centred care • Involvement of carers/families • Reduction in antipsychotic prescribing
The Trust is absolutely committed to improving the care of patients within the Borough. We work in partnership with Wigan and Leigh Hospice, Wigan Borough Council, 5 Boroughs Trust, Alzheimers Society, Carers Support, Age UK and Wigan Link. Essential to the work we are doing is the participation of carers, who have been involved in the development of the strategy. We are also one of the acute Trusts who are part of the Advancing Quality Alliance (Aqua) dementia community. This vital work with our partners has assisted in the development of our dementia strategy. To support this strategy, we are launching the Forget-Me-Not campaign to improve the care of patients and their carers/ families. Dementia Champions Each clinical area will have a dedicated Dementia Champion, identifiable by their Forget-Me-Not lapel badges. The champions will be responsible for: • • • • •
Leading changes to improve the quality of care Providing a resource area for staff members Providing a resource area for patients and their carers Be an ‘expert’ resource Attending regular training and education sessions which will enable them to implement the latest research.
Issue 7 _ 19
The symbol for the campaign is a Forget-Me-Not flower.
Education and Training A four tier education and training strategy has been developed within the Trust. The strategy outlines that it is now essential that all staff have a basic awareness of dementia. Having this significant plan in place will continue to support and maintain staff’s dementia knowledge and understanding. As part of the strategy it is necessary that all patients over the age of 75 will be asked a question regarding their memory. This will happen within 72 hours of their admission. The question asked is called the ‘Single Question to Identify Dementia’ (SQID). “Have you had any problems with your memory in the past 12 months, which have affected your everyday life?” Staff will become familiar with the documentation and assessment processes through their Champion. Further assessments and referrals will be carried out, if and when necessary. This process will ensure the many, currently undiagnosed patients get the correct diagnosis and the most appropriate level of support. Know the Patient – Know the Person If we are to provide person centred care, it is crucial to get to know the patient. The family/carer obviously knows the patient – we don’t. But, by working together with the family/carer, we can gain this essential information. We will ask the family/carer to complete a Carer’s Passport. This is an information booklet that provides a ‘snapshot’ of the patient’s life. It enables our staff to treat each person as an individual, and helps to reduce any potential distress for both the patient and their family/carer.
The information forms the basis of the patient’s nursing care plan. It details the patient’s likes, dislikes, how they may react to pain and what they can and can’t do in their daily life. Knowing these will allow our nursing staff to support, and as much as possible, continue the patient’s normal routine. Another key aspect of improving dementia care is having the right environment. This will reduce stress and anxiety in the person who suffers from dementia. We are working hard to develop the right standards of environment within the Trust. This includes: • • • •
Brightly coloured bathroom doors with better signage Enhanced lighting Improved flooring Appropriate artwork
The work around dementia is immense and, unfortunately, long overdue, but much of the current work includes long term goals. In the short term, the Dementia Champions are working to emphasise that one person can make a significant change to improving the care of a patient with dementia. This can be achieved by simply treating them with the respect and dignity they deserve. The Dementia Champions encourage our nurses to make eye contact, to explain what they are going to do and why - several times if necessary - and, most importantly, to see them as a person who has sadly developed this terrible disease. If someone has lived a life as a child, parent, grandparent or worker for seventy years prior to developing this illness, surely it is that which defines the person, not the diagnosis of dementia. We believe each person is a unique individual and should be treated as such – not as a dementia patient.
20 _ Issue 7
Successful Elimination of Mixed Sex Accommodation
The Trust is committed to deliver care in a way that respects and protects the privacy and dignity of our patients. One of the ways we are achieving this is through the elimination of mixed sex accommodation. This means that we do not ask our patients to share sleeping accommodation or bathroom facilities on our wards with members of the opposite sex unless there is clear clinical justification. This may be because they are in intensive care or very close observation is needed. Some of our wards care only for patients of one sex, whilst other are mixed sex wards, meaning patients of either sex are cared for in different bays. These are rooms, with up to 10 beds with designated bathroom facilities, or single rooms with en suite facilities. A policy is in place to make sure all of our staff know their responsibilities to guarantee our standards are maintained. It also safeguards that they take appropriate action if they think there is a risk of the standards being breached. We inspect our wards regularly to test that the right measures are in place, and we undertake surveys each month to check that our patients feel that the standards are being maintained. A monthly report is provided to our commissioners and the Department of Health, detailing whether any patients have been exposed to mixed sex accommodation. This includes whether or not cases are clinically justifiable as described previously. The Trust is proud that there have been no clinically unjustified breaches at WWL since February 2012. More than 98% of patients have consistently reported that this reflects their experience.
Trust members will already be aware of the plans in place to develop the Trustâ€™s hospitals in the coming years. Improving the standard of privacy and dignity, according to our patients, is a key consideration in the design of new facilities, including smaller bays and more single rooms - all with en-suite bathroom facilities. Should you have any suggestions about ways in which we could do more to improve privacy and dignity at WWL, please contact Linda Smyth, Head of Quality Improvement, on 01942 773338 or via email at email@example.com.
Issue 7 _ 21
Improvements have been made in visitor and staff car parking at Wigan.
Equality Delivery System ‘Have your say on equality in the NHS’ – Survey Results Over the past 18 months, we have been working hard to implement the NHS Equality Delivery System (EDS) - a new framework for Equality and Human Rights in the NHS. The EDS requires all NHS Organisations to engage with local communities to understand whether they are treating everyone in a good and fair way and making sure everyone has a say.
Recommendations based on the survey results are: 1. To continue to engage with local people about access to services, provision of information and communication issues. 2. To engage with groups of people who are seldom heard.
At the beginning of the year, a survey was sent to over 600 of our members. This was to gather their views on a number of aspects including access to services, provision of information and communication issues. Of the 231 members who responded to the survey, the majority were aged 50 or over and of British Ethnicity with a similar number of males and females. Of the total number of respondents, half of them considered themselves to have a disability, the majority of which were of a physical disability, followed by a sensory impairment. Twenty-two percent of respondents declared that they were providing support to a partner or relative. Overall respondents felt that their health needs were appropriately assessed, changes to services were communicated and information and support was provided. The majority of respondents agreed that patient safety should be a priority for the Trust and that overall privacy and dignity be maintained.
3. To continue to promote and make sure patients are aware about patient choice and what information is available to them. 4. To continue to communicate and raise awareness about what initiatives are in place to make certain that patient safety, privacy and dignity are maintained. 5. To continue to promote and raise awareness about changes to services and to implement new initiatives and facilities. These recommendations have been incorporated within the Trusts EDS action plan, and work is currently taking place to ensure all actions are achieved. For further information on how we have embraced the EDS, or for details of who we have involved and what improvements we have put in place, please visit the Trust’s website: www.wwl.nhs.uk/equality/equality_delivery_system.asp
Although the majority of respondents felt that the services the Trust provided were accessible, 17% did feel that services were not easily accessible. The majority of feedback received related to poor parking facilities and transport issues. A majority felt that comments and complaints were addressed with respect with 13% reporting that they did not feel confident that complaints were addressed with respect and would reach a satisfactory outcome.
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Janet Duffy is the Trust’s Patient Information Administrator. She would like to thank the members of the Lay Reading Team for their continued help and support. They provide an invaluable service to the Trust. Who are Lay Readers?
Interesting in Lay Reading?
Lay readers are WWL Trust members who expressed an interest in assessing patient information leaflets.
If you would like to become a Lay Reader, why not contact Janet Duffy on 01942 773106 or email firstname.lastname@example.org. It is a great way to help improve our hospital publications.
What do Lay Readers do? When a new patient information leaflet is developed, a copy is issued to our Lay Readers. It is their job to critically assess the information, make sure it is easily understood, jargon free and of a high quality. But above all, that the information within the leaflet is “patient friendly”. Their comments and observations are then forwarded to the author of the leaflet. The author then makes the appropriate changes, if necessary. A recent example of how Lay Readers work was regarding a leaflet entitled “Caring in the Last Hours of Life”. The Lay Readers felt that the content needed clarity. The leaflet was firstly addressing the dying patient and then later on addressed the relative/carer; which was very confusing. A discussion was held with the author where the content was re-examined. It was decided that it would be more appropriate for the leaflet to be aimed at the relative/carer. All the necessary amendments were made and the leaflet was agreed. All WWL’s patient information leaflets are available in audio, Braille, other languages and large print format.
Photo: Janet Duffy, Patient Information Administrator.
Issue 7 _ 23
Blood Test (Phlebotomy)
Becoming a Member
Patients who have their blood tests taken at Leigh Infirmary will do so in a fantastic new department. Work has commenced to create a new Blood Test Department, and the modern, purpose built facility will open in early 2013.
Do you have friends or relatives who would like to become members?
Focus groups were held with patients who currently use the service. They were encouraged to share their thoughts, ideas and suggestions to improve and enhance the service, many of which will be adopted in the new department.
If you know someone who may like to join our membership, receive information, invitations to events and become involved with the Trust – please ask them to complete the below form and return it to the free post address detailed below.
The Blood Test Department will be located nearer to the main Outpatient Department it serves. The new department will provide a much needed modern environment, as well as support facilities for both staff and patients. These include three separate clinical blood testing rooms, with greater disabled access, and also a much larger improved waiting area. The patient experience will be greatly improved with reduced waiting times and increased clinical services, all contained within the new contemporary design.
This work forms part of the £70million investment plan detailed in the Service and Site Investment article on page 15.
Address: ...................................................................................................................... ......................................................................................................................
Telephone number: ......................................................................................................................
If you have any questions or would like further information about the opportunities and benefits available to members, please don’t hesitate to contact our membership office on 0800 073 1477 or via email at email@example.com
Above: Technical drawings of the floor plan of the new Blood Test Department and the proposed colour scheme.
Free Post Business Reply Services Licence Number SWB50013 Membership and Engagement Office, Royal Albert Edward Infirmary, Wigan Lane, Wigan, WN1 1XZ
Issue 7 The Magazine for WWL Members
Contact Us Switchboard T: 01942 244000 Appointment Centre T: 0300 555 4567 Engagement Department T: 0800 073 1477 E: firstname.lastname@example.org www.wwl.nhs.uk
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