Annual Report 2014/2015 - NHS Forth Valley · Improving Quality and Safety 7 Technological Advances...

Annual Report2014/2015

Celebrating our Staff and Volunteers

10

Identity variants

2 NHS Forth Valley

Chief Executive’s Foreword 3

Service Developments 4

Improving Quality and Safety 7

Technological Advances and Innovations 11

Improving Health 13

Fundraising and Volunteering 16

Our People 20

At a Glance – the year in pictures 24

Your Feedback 28

Key Performance and Activity 31

Board Members 35

Contents

32014-15 Annual Report

In June 2014, we joined in the celebrations for the Commonwealth Games when we welcomed the baton to two of our hospitals. Later in the year we presented our first NHS Forth Valley Staff Awards to recognise the efforts of staff and volunteers across the organisation. We also reinstated long service awards to acknowledge the contribution made by staff during NHS careers spanning 20, 30 and 40 years.

The hard work of staff to improve inpatient wards and create a safe, clean and pleasant environment for patients, staff and visitors at Falkirk Community Hospital was recognised in July 2014 following a visit by the Healthcare Environment Inspectorate. Their report described the inspection as exemplary and it was the first announced hospital inspection in Scotland which resulted in no requirements or recommendations.

Like many NHS Boards across Scotland, we faced challenges in meeting waiting times targets within our Emergency Department during the busy winter period. I am pleased to say that our performance has improved in recent months but there is no room for complacency and work continues to ensure we meet this target consistently over the coming year. Waiting times for the majority of planned medical and surgical procedures also significantly improved over the last 12 months,

but we recognise there is still more to be done, particularly to reduce waiting times for children and young people with mental illness and people who require psychological therapy. A number of additional specialist staff have recently been recruited to help increase capacity in this important area.

Throughout the year, we continued to work closely with our three local authority partners to progress plans to integrate a wide range of local health and social care services. It has been agreed that there will two new Health and Social Care Partnerships in the Forth Valley area – one covering Falkirk and one covering Clackmannanshire and Stirling. These important new Partnerships will be responsible for ensuring that local people get more seamless care to help them live independently in their own homes for as long as possible.

I would like to thank local staff and primary care colleagues across Forth Valley for their ongoing support over the last year and I look forward to continuing to work with staff and our many partners to further improve the quality, safety and effectiveness of the services we provide over the next 12 months.

Jane Grant Chief Executive

This has been a busy 12 month period which has seen a number of important developments. In October 2014 we launched a major review of our clinical services to help develop a new healthcare strategy. Work started on a new Maggie’s Forth Valley centre and work continued on plans to development a new care village on the Stirling Community Hospital site. We also embarked on a major programme to vaccinate thousands of children across Forth Valley as part of the roll-out of the national flu immunisation programme.

Chief Executive’s Foreword

4 NHS Forth Valley

Throughout the year, NHS Forth Valley continued to develop and improve a wide range of services for patients and their families. This section highlights a number of the key developments taken forward across the organisation during 2014/15.

At the end of 2014 a major review of health services was launched across Forth Valley to help develop a new healthcare strategy for the next five years. Eight working groups were established to review the wide range of clinical services currently provided and look at ways these could be designed and delivered in the future to meet the needs of local people, keep pace with rising demand and deliver the Scottish Government’s 2020 Vision for healthcare.

The Review is taking into account national policies, trends and best practice, as well as looking at innovative ways of working across the UK and beyond. An important part of this work has been gathering feedback from frontline staff, patients, and the general public on what they think about existing health services and how they would like to see them developed in the future. Hundreds of patients and staff have completed an online survey, attended public meetings or returned a

short leaflet questionnaire which was widely distributed across the organisation. All of this feedback is now being carefully considered to help identify key themes, priorities and recommendations. These will then be combined with the recommendations from each of the working groups to help develop a draft healthcare strategy which will be subject to further consultation and engagement.

Over the last 12 months we have worked closely with our council partners on plans to integrate a wide range of local health and social care services for adults. Good progress has been made and we have developed integration schemes which set out how the two new Health and Social Care Partnerships in Forth Valley will be established and managed. Work is now being taken forward to identify local plans and priorities for each Partnership to help ensure care is better co-ordinated, more joined-up and easier for patients to access.

Planning for the future

Service Developments

A new outpatient facility for children and young people opened at Stirling Community Hospital


Plans to invest in a number of new facilities and equipment were also highlighted during the period. These included proposals to build a new larger, purpose-built health centre in Doune, capable of delivering a wider range of local health and social care services. The development of a new centre is a key priority as the current facility is overcrowded, requires considerable maintenance and is too small to accommodate the future needs of the growing local population. Detailed plans for the new centre are being taken forward. In the meantime, additional temporary buildings have been erected at the existing health centre to create more accommodation.

Initial outline proposals to create an innovative new care village in the grounds of Stirling Community Hospital were formally approved by the Scottish Government in March 2015.

The new Care Village would bring together a wide range of health and social care provided by Stirling Council and NHS Forth Valley. These include services for older people who require additional short-term care, an assessment or rehabilitation following an illness, an operation or an acute hospital admission. It would also provide specialist support for patients with dementia and those who require palliative and end of life care. Services would be delivered in a modern, purpose-built facility with more than 100 short-stay care beds. This would provide a comfortable homely environment for older people to help them recover, regain their independence and, in the majority of cases, return to their own homes.

The plans would also see the creation of new facilities to house a number of existing health services on the site including minor injuries, X-ray and GP out-of-hours services, along with medical services provided by a number of local GP practices which are keen to be part of the new development. These include Viewfi eld, Park Avenue, Park Terrace and Wallace Medical Practices in Stirling.

There would also be the potential to develop a range of onsite recreational facilities such as a café and a hair salon where people could socialise and meet up with friends

and family. In addition, the Scottish Ambulance Service plan to relocate their existing ambulance station in the Riverside area of Stirling to a new facility on the Stirling Community Hospital site and Forth Valley College are interested in exploring opportunities to offer training and work experience to local young people interested in a career in the health or social care sector. Work is now underway to develop more detailed plans.

Construction work on the new Maggie’s Centre, which is being built in the grounds of Forth Valley Royal Hospital, began in March 2015. The new Forth Valley Centre has been funded by a £3m donation from cancer charity Walk the Walk who organise The Moonwalk Scotland. It is due to open in 2016 and will provide a wide range of information, services and support to thousands of cancer patients and their families across Forth Valley by helping to reduce anxiety, fear and isolation.

Almost £1m was spent during 2014/15 to create a new hub for children and young people’s services at Stirling Community Hospital. The project involved a major refurbishment of a number of existing outpatient areas to create a light, bright and airy environment for both patients and staff. Services provided from the new hub include physiotherapy, occupational therapy, speech and language therapy and paediatric clinics. Also housed in the new hub are Child and Adolescent Mental Health Services (CAMHS), group and individual therapy rooms, a specifi c space for orthotics (which ensures that all their equipment is stored in one place) and dedicated gyms for physiotherapy and occupational therapy.

In addition to local service improvements, patients across Forth Valley also benefi ted from the development of a number of regional facilities. These include a new Regional Endoscopy Unit at the Queen Margaret Hospital in Dunfermline , which opened in July 2014, and the construction of the new Lanarkshire Beatson which is due to open later in 2015.

Investing in new facilities

Artist’s impression of the proposed new Stirling Care Village - Primary and Urgent Care Centre

6 NHS Forth Valley

As well as investing in new facilities, NHS Forth Valley set aside £2.75m during 2014/15 to purchase a wide range of state-of-the-art medical equipment. This included ultrasound scanners for cardiology, anaesthetic machines in theatres, a major upgrade of equipment in the audiology department and a range of specialist equipment to support the early detection and treatment of patients with cancer. A fi broscan machine was purchased for Stirling Community Hospital to help detect and monitor liver fi brosis, avoiding

the need for liver biopsies, and a slit lamp, which is used to shine a thin sheet of light into the eye, was purchased for the ophthalmology clinic rooms at Falkirk Community Hospital. Additional equipment was also purchased for Clackmannanshire Community Healthcare Centre to support increased outpatient activity and a new tracking system was introduced at Forth Valley Royal Hospital to help protect and locate equipment quickly.

During the year funding was secured to continue to provide information and support to local cancer patients and their families. The one-to-one support service, which is funded by Macmillan Cancer Support, helps patients following treatment and NHS Forth Valley was the fi rst NHS Board in Scotland to trial the new scheme. It sees Macmillan Community Care Nurses visit patients at home to discuss concerns and provide assistance to help deal with any fi nancial, emotional or health issues they may have. Nurses are also able to signpost patients to other services and organisations who can provide support and advice. Macmillan Healthcare Support Workers help answer calls in the oncology department at Forth Valley Royal Hospital and are now handling telephone triaging. In addition, the service organises a range of local events including coffee ‘drop in’ sessions which encourage patients and their carers to come together for an informal chat and company.

Staff from NHS Forth Valley worked with colleagues at Falkirk Council to develop and pilot a new service in Bo’ness to help support people to remain well at home. The service consists of a round the clock advice line known as ALFY – Advice Line for You - and is available to anyone aged 65 and over, their family and other people who may care for them. The dedicated phone line is operated by experienced nurses who listen to callers’ concerns, and ensure they receive the right help and support. This could range from offering general reassurance and advice, to signposting callers to relevant social work, health or voluntary services. Staff are able to book appointments to attend a rapid access frailty clinic for a specialist review or arrange for a nurse to visit day or night. Alongside ALFY, older people are also being encouraged to develop a personal care plan known as Your Plan and share this with their family as well as health and care professionals. Regular education sessions are being held in the Bo’ness area for anyone wanting to learn more about the service and speak directly with health and care professionals. If successful, the aim is to extend the service across the entire Falkirk Council area and into Stirling and Clackmannanshire.

A new email service was introduced for pregnant women to make their fi rst appointment directly with a midwife as soon as they have a positive pregnancy test. The service, which runs alongside the existing telephone booking line, aims to offer women greater choice and make it easier and more convenient to arrange an initial appointment.

Investing in new equipment

Developing new services


Delivering high quality care which meets the needs of individual patients and their families continued to be a high priority and during 2014/15 we took forward a number of important initiatives to further improve the quality of safety of services across the organisation. These build on the wide range of systems and checks already in place to improve outcomes for patients.

NHS Forth Valley is one of four NHS Boards in Scotland working with the Boston-based Institute for Healthcare Optimization (IHO) to improve the flow of patients thorough our inpatient wards. A pilot project is underway in Ward B32, a general medical and gastrointestinal ward at Forth Valley Royal Hospital, to look at ways of improving our discharge arrangements. These include daily multidisciplinary team meetings, which bring key staff together including AHPs, senior nurses and clinicians to discuss and review treatment and discharge plans for each individual patient. These are held early in the morning and patients who are medically fit to go home are seen first by doctors. This allows the discharge process to begin as soon as possible.

Plans are also being developed to delegate responsibility for

discharging patients to a junior clinician or nurse within the

ward so that they will be able, in certain circumstances, to

discharge patients without the need for them to be reviewed

by a consultant. This will be supported through the use of

standardised admission and discharge criteria which have

been developed to help inform decisions about when patients

are clinically well enough to go home. Ensuring that all staff

use the same criteria to admit and discharge patients will also

help reduce variation and ensure a consistent approach across

the hospital.

Further work will be taken forward over the next year to help

increase capacity by reducing delays for patients at each stage

of their journey during their stay in hospital.

Improving patient flow

Improving Quality and Safety

Staff in Ward B32 at Forth Valley Royal Hospital are involved in a new pilot project to improve discharge arrangements

8 NHS Forth Valley

Work continued across the organisation to improve the safety of the care and treatment we provide as part of the wider implementation of the Scottish Patient Safety Programme (SPSP). This important national initiative aims to improve the safety and reliability of healthcare and reduce harm across the country. Locally in NHS Forth Valley it has led to several signifi cant improvements and results.

These include a 20% reduction in hospital mortality rates which was achieved in December 2014 (one year ahead of the national target), a 12% reduction in deaths for patients diagnosed with sepsis, an ongoing reduction in the rate of adverse events and fewer falls in wards caring for elderly patients. There has been a sustained reduction in the number of patients experiencing pressure injuries, ventilator associated pneumonia and central line bloodstream infections as well as an ongoing fall in the number of cardiac arrests in our acute admission unit. Learning is also shared across the theatre teams and regular de-briefs take place as part of the ongoing work to reduce potential harm to patients undergoing operations.

While much of the initial work of the SPSP has focused on improving safety within hospitals, it has also expanded to cover care delivered in the community and mental health services. As a result, all GP practices in Forth Valley are participating in a new initiative to help reduce medication errors or medication-related harm. This includes work to check the medication which patients are currently taking and compare this with medicines previously prescribed, documented allergies and adverse drug reactions to identify any potential issues. The vast majority of GP practices also participated on a safety climate survey and undertook reviews of their medical records to identify potential safety issues and areas for improvement. Over 250 GP practice staff supported Forth Valley Patient Safety Protected Learning Time sessions throughout the year and the Primary Care Quality Improvement Group continued to work closely with local practices to provide ongoing information and support.

Increasing safety


A new Care Assurance Framework has been introduced within NHS Forth Valley as part of our ongoing commitment to improve the experience of patients who use our services. This involves dedicated visits to all wards to review key areas such as falls, pressure area care, eating, drinking and respect and dignity. During these visits reviewers talk to patients, observe care and check key documentation. Any issues identifi ed are fed back to the senior charge nurse at the time of the visit.

During the year a number of staff within our community hospitals were involved in piloting the Playlist for Life initiative. This national project aims to improve the wellbeing of people with dementia by giving them access to personally meaningful music that can help to evoke precious memories. Whilst the project is still in its infancy, the initial fi ndings have been very encouraging with noticeable improvements in the level of social interaction. We also actively encourage patients, carers and their families to share their stories with us using a range of methods. These stories are shared with staff at a number of key meetings and events to raise awareness of feedback and act as a powerful reminder of how things feel from a patient’s perspective.

Patient stories are also used in staff training and development to help drive forward changes and improvements.

These initiatives form part of the wider Person Centred Care work being taken forward across the organisation to deliver care and treatment which is focussed on the individual needs of patients and is of the same high standard we would wish for our families, friends and colleagues. A new Forth Valley Person Centred Care Strategy is also being developed which will be supported by a Person Centred Steering Group. The Group will oversee and co-ordinate improvements in a number of key areas including communications and fi rst impressions, care of older people in hospital and end of life care.

A wide range of policies and procedures are in place to improve cleanliness and help prevent the spread of infection. Checks are carried out every month to monitor compliance and all acute and community hospital wards are visited by the infection control team on a weekly basis. Any issues identifi ed are recorded and closely monitored by the team and results are shared with relevant staff. Ward staff also perform monthly infection control audits and share the results with local teams to identify any areas for improvement. Hand hygiene is monitored continually by ward staff and there are now more than 200 hand hygiene trainers across NHS Forth Valley to maximise hand hygiene compliance and help prevent the potential spread of infections.

Falkirk Community Hospital was the fi rst hospital in Scotland to have no requirements or recommendations following an announced visit from the Healthcare Environment Inspectorate in May 2014. The report, which described the inspection as exemplary, highlighted a comprehensive and effective range of infection control systems in place, helping to minimise the risk of infection to patients, visitors and staff. Staff compliance with hand hygiene was excellent and patients highly commended the standard of cleanliness within the hospital. Ward staff were knowledgeable and confi dent

when describing their roles and responsibilities for infection prevention and control, and all wards inspected were clean and well maintained.

The report refl ects the hard work carried out by staff over the last year to improve the inpatient wards and create a safe, clean and pleasant environment for patients, staff and visitors. Feedback from patients interviewed during the inspection was also very positive with many highlighting the rigorous approach to cleaning and complimenting staff on their professional and courteous approach. Whilst we welcome this report, we recognise there is no room for complacency and work will continue to ensure we maintain consistently high standards of cleanliness and infection control in all healthcare facilities across Forth Valley.

Focusing on patient care

Reducing the spread of infections

10 NHS Forth Valley

A new centralised booking system was introduced during the year for all physiotherapy sites that deal with muscles and joints. Known as the Musculoskeletal (MSK) Hub, the centralised team of administrators deal with referrals and self referrals initiated through GP practices, book appointments and deal with queries. The development of the Hub is part of a wider MSK redesign project which aims to improve access, efficiency, quality and patient experience. It also forms part of the Scottish Government’s initiative to transform outpatient services by making sure that patients are seen by the right person at the right time and in the right place. In addition, new clinical pathways have been produced for the treatment of a wide range of hand, hip, shoulder, knee, foot and ankle injuries to help reduce delays and ensure patients get access to the right treatment and support as early as possible.

Around 90% of patient contacts occur in the community. For most people their first and perhaps only, ongoing contact with the NHS is with their local medical practice and staff working within community health services are increasingly involved in managing the care of patients with very complex healthcare needs. Initiatives such as the Rapid Access Frailty Unit at Forth Valley Royal Hospital and the ALFY project on Bo’ness have shown that providing dedicated advice and support can help prevent hospital admissions and enable people to recover at home. Developing and agreeing care plans in advance can also help people to maintain their independence at home and ensure that everyone involved

in caring for them are aware of their wishes if their health changes or deteriorates. Work is therefore underway to develop Anticipatory Care Plans (ACP) for all vulnerable patients and those with the most complex needs. Key information from the plans is also summarised and recorded electronically so that it can be shared with other parts of the healthcare system. NHS Forth Valley was an early adopter of the Key Information Summary (KIS) and the success of this initiative has only been possible through the involvement and ongoing support of GP practices across Forth Valley. In June 2014, 8,135 individuals in NHS Forth Valley had an ACP in place recorded using KIS. This rose to 12,117 in June 2015 which accounts for almost 4% of our population.

During 2014/15 a number of medical practices in Forth Valley experienced difficulties in recruiting GPs to replace doctors who had either left or retired. This is not a local issue as many other practices across Scotland are experiencing similar difficulties in recruiting and retaining GPs. In order to maintain access to local services, NHS Forth Valley took over responsibility the management of the Westburn Medical Practice in Falkirk in February 2015. This Practice has now returned to be independently managed by GPs. However, in May 2015, NHS Forth Valley took over responsibility for the management of Bannockburn and Kersiebank Medical Practices. Since then a range of additional services have been put in place to provide support to a team of salaried and locum GPs now working at the Practices. This includes nursing, pharmacy, physiotherapy and mental health services.

Improving appointment systems

Supporting patients in the community


During 2014/15, NHS Forth Valley continued to improve the use of new technology across the organisation.

This included work to introduce new clinical systems, implement the use of electronic patient records and enable staff and GPs to order tests electronically.

A new Clinical Portal is being introduced across the organisation to make it easier for staff to access patient information and test results. The portal pulls in information from a wide range of electronic systems and allows staff to access this using a single username and password rather than having to log on to a number of separate accounts.

Online test requesting is now in place in all GP practices. Around half of the monthly 49,000 test request samples received by our laboratories in March 2015 were processed using the new OrderComms system – compared to just 6% in June 2014. The aim is to roll the system out across NHS Forth Valley by the end of 2015, for laboratory, radiology and cardiology tests. This is a significant development which will help increase patient safety and enable faster, more accurate recording, reporting and tracking of results.

Fourteen GP practices are now receiving Emergency Department discharge letters electronically as part of a pilot project. This has proved successful and is about to be rolled out to all GP practices in the Forth Valley area. A pilot is also underway to send electronic letters from the GP Out-of-Hours service.

A new tracking system, which was developed internally, was introduced to improve the way cancer patients are

tracked. The CATs (Cancer Audit Tracking System) facilitates the tracking of test results, audit and reporting. Improved communication between the Scottish Bowel Screening Programme and primary care has also ensured that local GPs are now able to see bowel screening results electronically. In the past, doctors received paper copies of positive results but no information about patients who tested negative, or those who failed to respond to screening invitations. Now details are delivered directly into the patient’s clinical record in the GP system and gives family doctors the ability to send follow-up requests to non-responders and emphasise the benefits of early cancer detection.

The use of iPads, tablets and other mobile devices continued to be trialled in a number of areas across NHS Forth Valley to provide an easy and quick way for clinical staff to access and record a wide range of information. Staff working in adult mental health services are using iPads as this allows them to assess and arrange care plans with patients in a range of more relaxed and informal settings. Dietitians are also testing the use of iPads for AHPs working in the community

Technological Advances and Innovations

All GP practices can now order a range of tests electronically

12 NHS Forth Valley

which is helping staff to plan and manage their caseload more effectively as well as respond to priority emails between home visits.

Patients who have undergone hip and knee surgery are now being asked to complete a new online questionnaire on an iPad to help chart their progress before and after surgery.

Research continued to play a key role in the development of innovative new treatments and throughout the year hundreds of local patients participated in a range of clinical trials, both within Scotland and the UK. These included haematology, breast, urology, lung and colorectal cancer trials. Since January 2014, more than 240 patients have consented to take part in a genetics study on colorectal cancer, making NHS Forth Valley the top recruiting centre in the West of Scotland. The Stroke Service remained active in stroke clinical research

with the assistance of the Scottish Stroke Research Network and is currently involved in two trials relating to acute haemorrhagic strokes. The AVERT (A Very Early Rehabilitation Trial) was completed in 2014 and NHS Forth Valley was one of the largest recruiters in the UK for this important international rehabilitation trial. We are very grateful to all the patients taking part in these important studies which help drive forward advances in care and treatment.

Patients across Forth Valley are benefiting from new ways of working which have seen NHS Forth Valley drivers becoming multi-skilled. The streamlined service, which has also received a prestigious national award, has resulted in additional specimen uplifts at 51 health centres and the delivery of pharmaceutical supplies within Forth Valley Royal Hospital at weekends. This has improved existing services and helped free up clinical staff. The changes have been made under a programme ‘The Generic Worker: The Drivers Journey’ which won the NHS Scotland 2014 Facilities Innovation Award.

All NHS Forth Valley drivers are now equipped with tracking systems and routes have been re-drawn to maximise

efficiency. The new ways of working have also substantially reduced the use of external transport providers as NHS Forth Valley drivers now take pharmaceutical supplies to community hospitals at weekends and transport health records between sites. In addition, health records are delivered direct to the Acute Assessment Unit at Forth Valley Royal Hospital, ensuring that the most urgent case notes are in the right place at the right time for the right patient. These new ways of working are not only delivering a better service but are also benefiting the environment as the redesigned routes have reduced fuel consumption and carbon dioxide emissions from the fleet of around 60 vans and lorries.

New ways of working


A new Family Nurse Partnership was launched in Forth Valley in April 2014. This national initiative aims to help first-time parents aged 19 and under give their babies a healthier start in life with the support of a team of specially-trained nurses.

The US inspired scheme offers expectant mums a pattern of weekly and fortnightly visits which begin in pregnancy and continue until the child’s second birthday. Using programme guidelines, materials and practical activities, the nurses work with the mother on understanding their baby, making changes to improve overall wellbeing, support emotional development and build on strengths which encourage positive relationships. Where possible, the nurses also work with the baby’s father and wider family members and offer advice on diet, education and employment.

The Forth Valley team comprises four family nurses, a supervisor and a data manager. Staff who are already highly trained in nursing and midwifery have undergone 15 months of intensive tuition. This has covered pregnancy, infancy and toddler training and communication skills. Around 120 babies are born to teenage mums every year in Forth Valley and since the project started, the new team has provided support and advice to more than 100 young women.

A new local weight loss programme for patients with diabetes has proved successful. The pilot project, which is run by community dietitians, has resulted in some patients losing up to three stones in weight. This has helped stabilise their blood glucose levels and reduced the amount of medication they require to take. It also offers a safer, more cost-effective remedy than gastric band surgery. Our dietitians believe the secret of their success is providing ongoing support to people for up to a year after their initial weight loss as many patients find it hard to keep the weight off.

The abdominal aortic aneurism (AAA) screening programme celebrated its first anniversary in October 2014 after achieving one of the highest uptake levels in Scotland. Almost 3,000 men in Forth Valley, 83% of those invited, took up the offer of a male-only scan in the first year of operation. This resulted in five men being referred for vascular surgery and 39 undergoing regular monitoring. Men aged 65 across Forth Valley continue to be invited to weekly screening sessions in community hospitals in Falkirk, Stirling and Clackmannanshire as part of a rolling programme across the area.

Supporting young mums

Supporting weight loss

Improving Health

The flu vaccine was offered to around 18,000 school pupils across Forth Valley

14 NHS Forth Valley

To tie in with relaunch of the NHS Forth Valley Stop Smoking

Service, giant inflatable ‘Mega lungs’ were installed in the

atrium of Forth Valley Royal Hospital to help draw attention to

the perils of smoking. Staff encouraged patients, local school

children and visitors to step inside the lungs to see examples

of respiratory trauma and disease and find out more about

the latest medical treatments.

During the year, NHS Forth Valley supported a national

campaign launched by the Scottish Government to help

prevent children from being exposed to second-hand smoke

by their parents. A number of events were organised locally to support national No Smoking Day on 12 March 2014. These included case studies of local Forth Valley residents who had recently given up smoking and the announcement of plans to appoint a new tobacco control officer to help discourage people from lighting up outside our hospitals. Staff from our stop smoking service took to Twitter to answer questions and post information and advice.

NHS Forth Valley continued to support the national Detect Cancer Early initiative and staff attended an event in February 2015 to mark the three year anniversary of this important work which aims to improve the detection and treatment of cancer across Scotland. Funding provided by the Scottish Government has been used to recruit additional specialist staff, run more one-stop clinics and work with local communities across Forth Valley to raise awareness of the signs and symptoms of breast, bowel and lung cancer. This work is making a real difference with many more

people being referred by local GPs for investigations and an increase in the number of requests for home test kits which can detect early signs of bowel cancer.

Highlighting the dangers of smoking

Detecting cancer early


Continued efforts were made to encourage people to take up the offer of a number of key vaccinations during the year. This included supporting the national roll-out of the flu vaccination programme which has been extended to cover all children aged between 2 and 11 years.

The 2014 campaign involved almost 120 schools in Stirlingshire, Clackmannanshire and Falkirk and targeted around 18,000 pupils. The majority of clinics were held in schools at weekends, following a successful pilot last year which saw a 65% uptake. In more rural primary schools, staff from the local GP practice administered the vaccine. The programme was also extended to children not yet at school, who were offered vaccination by nasal spray at their local GP practice.

The roll-out of the childhood flu immunisation programme is an extension of the existing annual flu vaccination programme which targets people over 65 years, or those under 65 years with chronic illnesses which can make flu much more dangerous. These include people with heart disease, chest complaints such as bronchitis, emphysema or asthma, chronic kidney failure, cystic fibrosis, lowered immunity due to disease or treatment, diabetes or liver problems. Pregnant women, NHS staff and unpaid carers are also eligible for free flu vaccines.

Public health experts continued to provide expert advice and guidance on a wide range of illnesses including cases of tuberculosis, scarlet fever, meningitis and legionnaires disease. They also worked with local media to highlight the risk of catching salmonella from pet reptiles, following a number of cases where local owners in Forth Valley had fallen ill.

Preventing ill health

16 NHS Forth Valley

Volunteers make a huge difference to the lives of our patients. Not only do they support people when they are ill or receiving treatment, but they also provide valuable feedback and suggestions to help improve patient care. We are extremely grateful for the support provided by more than 200 volunteers and fundraisers across Forth Valley. This section highlights just a few examples of their wonderful work and the important contribution they made to local healthcare during 2014/15.

The Patient Public Panel (PPP) celebrated their 10th Birthday in December 2014 and they continue to go from strength to strength. The contribution made by members over the last ten years is greatly valued and they are involved in a wide range of activities. As well as representing the views of patients and the general public at meetings and events across NHS Forth Valley, they help improve transparency through involvement in activities such as domestic monitoring audits which help maintain high standards of cleanliness. They also work on improving patient information and recently helped develop a new questionnaire for theatre patients.

The Public Partnership Forums within Clackmannanshire, Falkirk and Stirling Community Health Partnerships (CHPs) continued to engage and consult with patients and the wider public on a wide range of issues, including the Clinical Services Review and a number of patient care pathways. They worked closely with a number of key partner organisations to raise awareness of local services and organised a number of evening educational events on a range of health topics including equality, mental health and NHS 24.

The Friends of Forth Valley Royal Hospital – a group of local volunteers who dedicate their time and energy to raising funds for the benefi t of patients throughout the hospital - supported a wide range of initiatives during 2014/15. This included donating a number of Christmas trees and decorations for public areas throughout the hospital over the festive period. A Roll of Honour was displayed at each

Christmas tree to highlight the names of more than 200 members of the public who gave donations to help

buy the decorations. The Friends also organised a Christmas light switch on with live entertainment.

Thanks to the hard work of staff across the organisation, NHS Forth Valley successfully retained its Investing in Volunteers Quality

Award, which recognises our ongoing commitment to developing and supporting

the work of volunteers across the organisation. Investing in Volunteers (IiV) is the UK quality standard for all organisations which involve volunteers in their work. The Investing in Volunteers Award is held for three years and then re-assessed; the Award was fi rst achieved by NHS Forth Valley in 2011.

Celebrating our volunteers

Fundraising and Volunteering

NHS Forth Valley’s Chairman Alex Linkston joined members of the Patient Public Panel to celebrate their 10th birthday

Christmas tree to highlight the names of more than 200


Throughout the year, a number of local fundraisers, charities and supporters continued to come up with ever more ingenious ways of raising money for local services, wards and departments.

Staff from our Health Records Department paid tribute to their pop idols to help raise money for Children in Need. ZZ Top, Sonny and Cher, Sporty Spice, Adam Ant, Kenny Rogers and Dolly Parton were just a few of the look-alikes who helped raise a total of £1,278. This was the fourth year the Department had taken part in the Children in Need appeal, and so far they have raised more than £4,000.

Two local charities, So Precious and Water Babies (Central Scotland), teamed up recently to raise £11,000 for a special incubator for the neonatal unit at Forth Valley Royal Hospital. Known as a BabyTherm it is used by both premature and full-term babies and offers a range of treatments. The open-topped incubator can cool babies down as well as keeping them warm. The money for the BabyTherm was raised through a number of donations with the largest of just over £8,000 coming from a sponsored swim event held by Water Babies.

So Precious also donated £9,000 to buy new specialist equipment for the maternity unit at Forth Valley Royal Hospital. Known as fetal pillows, these silicon devices are designed to make caesarean deliveries easier, quicker and less traumatic by helping to elevate the baby’s head from the pelvis if it has become impacted. The money was raised through a number of donations, including £900 from the Larbert Round Table.

Babies in the neonatal unit at Forth Valley Royal Hospital can now get used to travelling in a car before they leave hospital, thanks to Jan Stewart Pram and Nursery in Falkirk who donated a Mamaroo. This special chair simulates the movement of a vehicle and plays sounds similar to those babies hear in the womb.

The Unit also took delivery of a special star projector from Greig Melville HR which lights up the ceiling with a shower of stars and shimmering clouds. This helps calm, soothe and entertain newborn babies during their stay in hospital.

Meet our fabulous fundraisers

18 NHS Forth Valley

Staff from the Clinical and Acute Assessment Units held a charity fundraising evening to raise money for F.E.A.T – a charity which works to fund research and raise awareness of sepsis. Local businesses also helped by donating prizes for a raffle which, along with ticket sales, helped raise over £1500.

As well as receiving support from local charities and businesses, NHS Forth Valley also received support from many individual patients and their families during 2014/15. These included Ian and Gayle McMeechan from Fallin who raised more than £2,500 in memory of their baby girl, Katie Gayle McMeechan, who was sadly stillborn at 38 weeks. Some of the money, which was donated at Katie’s funeral instead of flowers and also raised through a sponsored walk, was used to purchase a new bed for a specially designated room in the maternity unit. This allows families to spend more time with their baby before finally saying goodbye. The couple, who have also donated Moses baskets, cot sheets and nappies to the Unit, were spurred on to start fundraising as they wanted to give something back to the Unit and help

other parents who may experience similar losses in the future.

The children’s ward at Forth Valley Royal Hospital received a number of donations throughout the year including Christmas gifts from students and staff at Forth Valley College. A number of Easter eggs were also donated to the ward including a bumper donation from ASDA which ensured that every child in the ward received a special present from the Easter Bunny.

Customers using the restaurant at Forth Valley Royal Hospital over the last year helped raise money for charity, by popping their loose change into collecting boxes at the main tills. The money collected has benefited a number of intiatives including teacher Lissie Faulks who received a cheque for £267 to help provide more technology for pupils in the children’s ward at Forth Valley Royal Hospital.


NHS Forth Valley’s arts strategy aims to involve patients, service users, staff and artists in a wide range of arts projects. This includes creating artworks for a number of areas within local hospitals and health centres and developing a programme of arts exhibitions and events with a range of partner organisations such as Creative Scotland and Artlink Central.

During the year, a new-look children’s ward was unveiled following a makeover by a team of artists. The new design includes bird boxes for children to peer into and hear the sound of birdsong. Hidden nests have also been painted along corridor walls to help distract children en-route to theatre.

New wall panels have also been installed in the 16 birthing rooms at Forth Valley Royal Hospital to make the labour suite brighter and more welcoming. The vinyl panels were designed by Ava Blitz, a visual artist whose commissions include a huge mosaic wall panel at Philadelphia International Airport. The wall panels can be easily cleaned to ensure they comply with strict infection control standards. Feedback from women has been very positive with many commenting on the difference the new artwork has made to their surroundings.

To coincide with World Stroke Day on 29th October 2014, giant images were projected onto the wall of Forth Valley Royal Hospital to help raise awareness of the signs and symptoms of a stroke. The outdoor screening was a great success and work is underway to develop a programme of images which can be used to promote key health messages and campaigns.

Art advances

20 NHS Forth Valley

The dedication, commitment and expertise of staff across the organisation were recognised throughout the year with a number of key national awards. It is not possible to mention them all but a few highlights from 2014/15 are outlined below.

In July 2014, NHS Forth Valley launched a new Staff Award scheme to recognise the hard work, care and commitment of NHS staff, Serco staff and volunteers.

The scheme is part of a wider staff recognition programme to celebrate the work and achievements of staff across the organisation. The Awards applaud excellence and innovation, outstanding care and celebrate exceptional achievements during the year. There are six award categories to recognise the work of individuals, services or team and the inaugural

awards attracted hundreds of nominations from patients, members of the public and staff across the organisation.

The feedback from the fi rst winners and runners up has been really positive with many commenting on how good it felt to be recognised and appreciated by colleagues and patients.

The Theatre Team, Winner of the 2014 Innovation Award said: “We were absolutely elated that our new and creative ways of working to enhance and support patient care was recognised, not only in our own department but also by the wider organisation.”

Jane Kaney, winner of the 2014 Unsung Hero Award said: “I felt very humbled to be nominated and then to win the award was a very pleasant experience. It was, and still is, a great honour. There are a lot of unsung heroes working within NHS Forth Valley. If you know one or work beside one please nominate them.”

Our People

Two NHS Forth Valley healthcare workers scooped top awards at the 2014 Scottish Healthcare Awards (Catherine Mondoa and Babs McCool are pictured 2nd and 4th from right respectively)


Long services awards were also reintroduced in 2014/15 and more than 200 members of staff from across NHS Forth Valley, with a total of 4,380 years service between them, attended award ceremonies to celebrate their long careers working for the NHS. Short films highlighting the careers of a number of staff with 20, 30 and 40 years service were shown at the events which were hosted by the Chairman, Alex Linkston and Chief Executive, Jane Grant.

Two NHS Forth Valley healthcare workers scooped top awards at the Scottish Health Awards 2014 in recognition of their invaluable contribution to Scottish healthcare. Babs McCool, Charitable Arts and Wellbeing Coordinator, was awarded the Support Worker Award for her work at Forth Valley Royal Hospital. Babs has managed to secure significant external funding and the services of internationally renowned artists from as far afield as the USA. Catherine Mondoa, Consultant Nurse at Forth Valley Royal Hospital, was awarded the Healthier Lifestyle Award for her work as part of the cardiac rehabilitation team and for her voluntary role as President of the Healthy Hearts Club. Catherine was also awarded a British Empire Medal for services to nursing and the Forth Valley Healthy Hearts Club in The Queen’s 2014 Birthday Honours 2014.

The Women and Children’s Unit celebrated in December 2014 after it was confirmed that the Unit had successfully retained its UNICEF Baby Friendly Award. The Baby Friendly Initiative is a worldwide programme administered by UNICEF and the World Health Organisation, which was introduced to address a global decline in breastfeeding. Forth Valley Royal Hospital was first awarded full accreditation in 2012.

The Award recognises the high-quality support provided by health professionals to support successful breastfeeding. It was given following an assessment by a UNICEF team, which involved interviews with clinical staff and with mothers themselves to determine how effectively the standards are being implemented. The accreditation is hard to achieve and requires a tremendous amount of work and effort over a long period. Many of the mothers interviewed– in fact 93% of them – were delighted with the information and care they received and this is a testament to the standard of care provided by all of the staff involved.

Carol Whitfield, a maternity support worker at Forth Valley Royal Hospital, won the 2015 Royal College of Midwives (RCM) Maternity Support Worker of the Year award. This prestigious national award aims to reward, celebrate and share outstanding achievement in midwifery across the UK. The Maternity Support Worker of the Year award also recognises the importance of the Maternity Support Worker in providing holistic care to women and their families, supporting midwives and improving practice.

22 NHS Forth Valley

Two NHS Forth Valley dietitians were honoured by the British Dietetic Association at their 2014 annual awards ceremony in Birmingham. Nicola Henderson and Caroline Ritchie, who work at Forth Valley Royal Hospital, were awarded the BDA Dame Barbara Clayton Award for 2014 for their development of an electronic database which has increased the time dietitians are able to spend with patients on dialysis. This unique award is given to an individual, team or department who demonstrate innovation and new ways of working within the dietetic profession. In addition, Nicola is the Chair of the BDA Specialist Group NAGE (Nutrition Advisory Group for Older People) and received the BDA Specialist Group of the Year 2014 award.

Five members of staff from NHS Forth Valley were among the latest health and social services professionals to graduate as Dementia Champions. The national programme, which is funded by the Scottish Government, has been developed by the University of the West of Scotland and Alzheimer Scotland to improve care for older people in hospital, including those with dementia.

The Practice Pilot Prescribing Project (PPPP) team won the award for Innovation in Prescribing Quality at the Scottish Pharmacy Awards 2014. The team was developed to support the delivery of prescribing improvements in local GP practices in Forth Valley which have higher than average prescribing costs per patient. It aims to improve quality and safety for patients as well as generating savings for the practices through effective, fair and equitable prescribing.

Sandra Campbell, NHS Forth Valley’s Nurse Consultant for Cancer and Palliative Care, was recognised for her work with prisoners in Forth Valley with a Fellowship from the Royal College of Nursing (RCN). The Fellowship is one of the highest awards the RCN can bestow and is awarded to registered UK nurses who have made exceptional contributions to nursing and healthcare, through clinical innovation, leadership, research or practice development.

NHS Forth Valley Associate Audiologist Louise Whitelaw received a ‘Rising Star’ award at the 2014 Advancing Healthcare Awards. These UK-wide awards recognise and reward projects and professionals that lead innovative healthcare practice and make a real difference to patients’ lives in the healthcare science and allied health professions. They also cover a wide range of professional and specialist groups whose achievements often go unnoticed and the ‘Rising Star’ award aims to highlight people within fi ve years of qualifying who have already made their mark.


* This table shows the total number of staff employed in each category however, as some staff work part-time, the corresponding number of full-time (or whole time equivalent WTE) posts is also shown for comparison

Staff numbers

The number of staff employed by NHS Forth Valley in 2014/15 increased by 130 from the previous year and we continue to review our skill-mix and numbers to ensure we have the right staff with the right skills, in the right locations to meet the needs of local patients.

Acute Community Services Corporate NHS

Forth Valley

Job Family Number of Staff WTE* Number

of staff WTE* Number of Staff WTE* Total

Number WTE*

Admin Services & Managers 519 427.59 194 149.21 374 344.73 1086 921.53

Allied Health Professions 283 227.74 285 218.54 2 1.67 570 447.94

Health Science Services 179 153.40 9 4.80 13 13.00 201 171.20

Medical & Dental 440 407.09 107 77.58 16 10.83 563 495.50

Medical & Dental Support 45 39.58 60 47.18 0 0.00 104 86.76

Nursing & Midwifery 1349 1175.16 753 656.65 62 54.33 2164 1886.14

Nursing & Midwifery (Unqualified) 593 506.18 302 259.08 3 1.60 899 766.86

Other Therapeutic 6 4.09 51 37.36 135 115.49 193 156.94

Personal & Social Care 0 0.00 5 3.23 8 5.40 13 8.63

Support Services 34 21.29 7 4.91 348 230.09 389 256.29

Total 3449 2962.13 1773 1458.52 960 777.14 6182 5197.79

24 NHS Forth Valley

People across Forth Valley were urged to take a fresh look at the medicines they take as part of a new campaign to make sure they are getting the best possible care.

The ‘Let’s Talk Medicines’ initiative encouraged people on repeat prescriptions to look again at the medicines they take and speak to their pharmacist or GP if they have any questions or concerns. It also urged people who had been taking the same repeat prescription for a while to check if the medicines were still required.

The new campaign, which was developed by West of Scotland NHS Boards, featured posters which were displayed in community pharmacies across Scotland and supported by a six week press and radio advertising campaign.

Staff and patients at the Oncology Department in Forth Valley Royal Hospital celebrated after receiving a prestigious national award.

The Macmillan Quality Environment Mark recognises and rewards good practice and high standards within the physical environment of a cancer care building. NHS Forth Valley’s Oncology Unit is among only 20 sites in Scotland to be given the award, which has been developed in collaboration with people living with cancer.

Two Forth Valley hospitals were chosen as part of the route for the Queen’s Baton Relay as part of the 2014 Commonwealth Games. Hundreds of people, including patients from the children’s ward, watched as Amanda Rutherford, the founder of the Tiny Tabitha Fund, carried the baton through the atrium at Forth Valley Royal Hospital.

The following day it was the turn of patients and staff at Clackmannanshire Community Healthcare Centre to see the baton being carried. Several patients, including 99 year old Annie Morton, were able to outside to watch local resident Mitchell Graham pass the baton to Rose McLellan-Dally.

At a glance – The year in pictures

April 2014

May 2014

June 2014


A major advertising campaign on buses, posters and local radio was launched urging anyone who thinks they may have been at risk of contracting Hep C to get tested as around 1500 people in the Forth Valley area are thought to be living with Hepatitis C without knowing it.

The campaign was launched to coincide with World Hepatitis Day. To help raise awareness, a number of people from across Forth Valley affected by Hepatitis C told their own personal stories in a series of radio adverts.

Hundreds of brightly-coloured posters were distributed across Forth Valley including schools, health centres, community pharmacies and libraries, to highlight the start of the 2014 childhood flu immunisation campaign.

The local poster campaign was also backed by a national TV, radio and press campaign which ran for several weeks across the country.

During 2014/15 NHS Forth Valley targeted a total of 33,000 children in GP surgeries and more than 120 primary schools across the health board area as part of an extended national child flu immunisation programme.

A room at Falkirk Community Hospital was decorated to give patients with dementia the chance to step back in time. Staff decided to redecorate the room with items from the past in a bid to spark patients’ interest, help them feel more comfortable in their surroundings and encourage greater social interaction. The design was the brainchild of former Year 6 pupils from the Art Department at Falkirk High School who chose the words of famous songs as their theme. Song lyrics are featured on a new mural which the teenagers painted on one of the walls in the newly decorated room. In addition, the room contains a range of memorabilia such as retro luggage, wedding dresses and kitchen equipment to help older people re-live their memories. An appeal has also been launched to collect more items, including clothing from the 1960s, 70s and 80s.

July 2014

August 2014

September 2014

26 NHS Forth Valley

A new campaign was launched in Forth Valley to help people recognise the signs of stroke and react quickly.

The ThinkFAST campaign, which was organised in partnership with Chest, Heart & Stroke Scotland (CHSS), is designed to raise awareness of the signs of stroke and emphasise the need to act quickly to improve the chances of survival.

A national survey of stroke patients following a previous campaign showed that recognition of symptoms increased from 35% to 49% and those seeking help immediately rose from 46% to 62%. The campaign also received a boost from a new advert which featured some of the cast of the popular TV comedy programme Still Game.

An NHS Forth Valley Consultant in Emergency Medicine set off for Sierra Leone as part of the UK’s efforts to tackle the Ebola outbreak.

Dr Roger Alcock, who works at Forth Valley Royal Hospital in Larbert, joined other medics from across the UK who volunteered to assist in Britain’s £125m aid package to help combat the deadly virus.

Staff, visitors and patients from across Forth Valley joined in the countdown to switch on the Christmas tree lights in the atrium at Forth Valley Royal Hospital.

The tree was kindly donated by the Friends of Forth Valley Royal Hospital, who also donated ten other trees which were displayed in public areas throughout the hospital. A Roll of Honour was displayed at each tree to highlight the names of more than 200 members of the public who gave donations to help buy decorations for the trees.

October 2014

November 2014

December 2014

At a Glance – The Year in Pictures


Forth Valley Giving, the registered charity of NHS Forth Valley, presented Maggie’s with a cheque for £11,358 during a visit to their Lanarkshire centre at Monklands Hospital in Airdrie.

The donation, raised through a prize draw and donations from patients, will go towards the running costs of the new Maggie’s Forth Valley Centre which is being built in the grounds of Forth Valley Royal Hospital in Larbert.

January 2015

February 2015

March 2015

A new campaign was launched to encourage people from across Forth Valley to make use of the Minor Injuries Unit (MIU) at Stirling Community Hospital. The Unit, which is open 7 days a week, is staffed by emergency nurse practitioners who can prescribe medication and treatment for a wide range of injuries and arrange X-rays.

Construction work started on the new Maggie’s Centre in the grounds of Forth Valley Royal Hospital. Due for completion in 2016, the Centre will provide free practical, emotional and social support for anyone affected by cancer.

28 NHS Forth Valley

NHS Forth Valley gathers feedback and suggestions from patients and service users using a wide variety of methods. These include regular inpatient surveys which are carried out to fi nd out the views of hospital patients on a wide range of issues, patient stories, complaints, online feedback received via emails, social media, our website and Patient Opinion (www.patientopinion.org.uk) – an independent website where patients can share their experiences of healthcare and health services. Feedback from all sources is shared with relevant staff and used to inform the design and development of new and existing services. Examples of changes made as a result of feedback from patients is also shared in wards and departments via ‘You Said, We Did’ posters and displays.

During the year a total of 1016 complaints were received - a slight decrease on the 2013/14 total of 1080. Just over 96%

of these were acknowledged within 3 working days and 86% received a response within 20 days. This is a signifi cant improvement on the previous year and work continues to reduce the overall number of complaints and further improve response times. Each complaint is thoroughly investigated and action is taken, where appropriate, to address any issues identifi ed and ensure lessons are learned. The issues and themes raised are also monitored to identify any patterns, trends or areas of potential concern. Frontline staff are closely involved in the complaints process and the outcome of any investigations are shared with them to support ongoing education, learning and development. In addition, feedback and learning from complaints is shared with senior staff and discussed at a number of key meetings and committees across the organisation.

The latest National Better Together results were made available in August 2014. The survey, which is organised by the Scottish Government as part of the Scottish Experience Survey Programme, aims to use the public’s experiences of health services to help improve future care. A total of 417 people who had stayed overnight in an NHS Forth Valley hospital responded to the survey which asked questions on a range of topics including the hospital ward and environment, care and treatment, staff and care after leaving hospital. Respondents from NHS Forth Valley were signifi cantly more likely to report a positive experience in a number of areas such as waiting time to see a nurse or doctor, feeling safe in A&E, meals, privacy and communication.

The results for NHS Forth Valley also showed the highest overall improvement in Scotland from the previous year.

In addition to the national patient experience survey, NHS Forth Valley also carries out a number of local surveys to capture feedback and suggestions from local patients. The questionnaire, which has been revised to include the ‘fi ve must do’s’, is now used in all of our inpatient areas including community hospitals and inpatient mental health wards. Our senior charge nurses use the feedback to identify areas for improvement and this information is displayed in clinical areas so that patients and the public can view local progress.

Your Feedback

Feedback from a wide range of sources is shared with staff to inform the development of new and existing services

Patient Experience Surveys


Whilst we fully recognise that we don’t always get things right, the vast majority of our patients have a positive experience of using local health services and this is reflected in the feedback we receive.

This section highlights a selection of the comments received from patients and their families during 2014/15 via email, our website and social media. You can read more feedback by visiting www.patientopinion.org, twitter @nhsforthvalley or facebook www.facebook.com/nhsforthvalley

“Attention to detail and thoughtfulness”

I spent five days in Forth Valley Royal Hospital and to be honest I couldn’t have been treated better. I was upset and the domestic held my hand and helped me through a difficult time. I felt obliged to write this to thank all the nurses, domestics, doctors and porters that made a difficult few days easier to manage. One thing that really struck me was the attention to detail and thoughtfulness. I had to get blood taken at 6am and the nurse always had a cup of tea for me when she came. I told her on admission that I only took milk and she always remembered.

Posted by Terry R (via Patient Opinion)

“Not sure if the doctors are supposed to tell the nurses when they leave instructions”

Once in A&E the service I received was fine. The doctors and nurses were very helpful and well informed. The only slight criticism is that after the doctor had been to see me I waited for 20-30 minutes for further information. In the end I asked the nurses at the desk, explaining I had come on public transport and would need to leave in time to get the last bus back. When they checked the pigeon hole they could see the doctor’s instructions had been left – the nurses were very apologetic and were very prompt in treating me after this so that I was able to leave. Not sure if the doctors are supposed to tell the nurses when they leave instructions or if the nurses are meant to keep checking.

Posted by Flop 475 (via Patient Opinion)

“A wonderful team of doctors and nurses”

Unfortunately my husband had to have a big operation and had to have further care in ITU, but fortunately for us he was treated by a wonderful team of doctors and nursing staff. Their care of my husband has been wonderful. They all went beyond the call of duty, by explaining my husband’s care and condition which, at a very stressful time, was comforting and reassuring. The nurses and doctors who choose to work in this department are very special and well suited to the job they do.

Linda Hannah, Grangemouth

“Sadly no bedside manner from one nurse”

I’m a HUGE NHS fan. Just been in to visit my niece at FVRH - hospital is spotless. Sadly no bedside manner from one nurse

Posted by @mezzocheryl (via twitter)

“Hugely impressed by the patience, compassion and understanding”

I have to stress that I am extremely grateful for, and appreciative of the care I received. I was hugely impressed by the patience, compassion, understanding, concern and the sheer workload of all the staff; the staff nurses, students, nursing auxiliaries and not least the Serco ‘girls’. I can name many of them, but not all, and therefore it would not be fair to single out individuals.

Thankfully I continue to make slow steady progress towards a full recovery following surgery which I am sure was stimulated by the encouragement and care I experienced, and for which, the least I can do, is to repeat a very grateful THANK YOU all the staff.

Brian, Callander

30 NHS Forth Valley

“As always with hospitals the one thing I would complain about was the wait to get a bed”

I had to go into hospital to have a piece of metal removed from my index finger as infection had set in causing swelling. From start to finish the staff in the A&E and day surgery were great, very friendly, professional, kept me informed as to what was happening and when it was likely to happen. As always with hospitals the one thing that I would complain about was the wait to get a bed. I was in A&E at 9am and didn’t get a bed until 4.30pm. I realise it’s not the staff’s fault as there are never enough beds in a hospital, but the afternoon dragged on.

Posted by Ham58 (via Patient Opinion)

“Wonderful care and kindness”

I’d like to pass on my warmest thanks to the nurses and ancillary staff in Unit 4, Falkirk Community Hospital for the wonderful care and kindness they gave to my mum before she went into her nursing home.

Elaine Mackie, Stenhousemuir

“A better experience at Forth Valley Royal Hospital”

Possibly I should consider changing my user name from “Annoyed Husband” to “Happier Husband” as my wife had a visit to Forth Valley Royal Hospital on Friday which was in complete contrast to her last one. This was a day’s stay for a biopsy and was a 100% positive experience. Everyone, from the cheerful lady on reception dispensing a parking permit, through to all the medical staff, did their best to make the experience as pleasant as anything like this can be. My wife was in the Day Medicine Unit prior to her biopsy and again for her subsequent recovery period. The unit seemed to be very busy, but all the staff were efficient and caring and could not be faulted in any way. Many thanks to everyone involved. I just wish that it could always be like this.

Posted by Annoyed Husband (via Patient Opinion)

“1st class service from nurses”

1st class service from nurses. Mobbed with patients today but nursing staff, as always, caring and competent. Thank you.

Posted by @catintosh (viaTwitter)

“A mention too for the cleaning staff whose efforts are clearly evident”

On a recent holiday in Stirlingshire my wife took ill and she was taken to Forth Valley Royal Hospital. I wish to thank all the staff for the treatment that was accorded to her. The doctors and nursing staff including the MacMillan palliative care nurse could not have been any more attentive and we were kept well informed of her condition, treatment and progress throughout her stay. The cheerfulness of the porters and ancillary staff kept her spirits up. I would like to mention the cleaning staff whose efforts are clearly evident, which is reassuring to both patients and relatives.

David, Renfrewshire

“I have nothing but admiration for the way they cope”

My wife has been admitted into Forth Valley Hospital 12 times during 2014. Without exception and on every occasion the staff have been very hard working, caring and very helpful. Having been able to watch the staff so often, I have nothing but admiration for the way they cope while obviously working under extreme pressure. My only worry is how long these dedicated people can continue. They need all our support.

Mr A Dunn


This section highlights our performance against a number of key targets during 2014/15. More detailed information on our performance across a wide range of health related activities can be found in the Board Executive Performance Reports which are published on our website www.nhsforthvalley.com and discussed at every Board meeting.

The Scottish Government aims to improve maternal and infant nutrition, support breast-feeding and reduce harm from smoking, alcohol and drugs. To help achieve this a target has been set to ensure that at least 80% of pregnant women will have booked for antenatal care by the 12th week of pregnancy by March 2015. Initial data shows that NHS Forth Valley is performing well against this target with around 82.2% of pregnant women booked at 12 weeks compared with a national average of 74.4%.

Good hand hygiene is a key way to prevent the spread of infections and all NHS Boards are required to monitor their performance and tackle non-compliance amongst staff, patients and visitors. In March 2015 NHS Forth Valley achieved a 99% compliance rate for hand hygiene opportunities against a target of 95%.

Giving up smoking is one of the most important things you can do to improve your health and work continued throughout the year to support local people across Forth Valley to stop smoking. The target for 2014/15 was to deliver 607 quits with 40% of these in the most deprived areas. Although we were only able to deliver 297 quits just under 50% of these (147) were achieved in deprived areas. Significant efforts are being made to improve our

performance in this area which includes work with local prisons and large workplaces. All pregnant women who have a high carbon monoxide reading taken by midwives at booking clinics are now automatically referred to their local stop smoking service.

NHS Forth Valley delivered a total of 10,591 Alcohol Brief Interventions (ABI) during 2014/15, exceeding the planned annual target of 3676. These important conversations help identify potential problems at an early stage and help people access specialist advice and support, if required.

The Child Healthy Weight Programme known as ‘Max in the Middle’ continued to be delivered in 30 primary schools across Forth Valley achieving a 100% uptake from the classes involved.

Key Performance and Activity

Improving Health

Cowie Primary School is one of 30 local schools taking part in the child health weight programme ‘Max in the Middle’

32 NHS Forth Valley

Significant progress has been made throughout the year to improve performance against several key waiting times targets. However, there continued to be challenges in a number of areas including child and adolescent mental health services, psychological therapies, ophthalmology and gastroenterology.

During 2014/15 NHS Forth Valley treated 13,927 inpatients and day cases of which only 19 breached the 12 week Treatment Time Guarantee. This is a compliance level of 99.86% and continued efforts are being made to ensure we maintain this position on an ongoing basis.

At the end March 2015 there were 517 patients exceeding the 12 week wait from referral to a first outpatient appointment, a notable improvement from March 2014.

At the end of March 2015, 93.6% of patients attending the Emergency Department at Forth Valley Royal Hospital were treated, discharged or admitted within four hours. While performance improved during the year, work continues to meet the 95% interim national target on a consistent basis.

The 18 week Referral to Treatment (RTT) position to the end of March 2015 was 89.8% just below the 90% target. While we met the target waiting time for many key specialities we continued to face challenges in a number of areas including ophthalmology, gastroenterology and orthopaedics. Plans have been developed to address this along with work to reduce waiting times for child mental health services and psychological therapies. This is a key priority for the Board and a number of staff were appointed during the year to fill vacancies within these services. Two new intensive treatment nurses were also appointed in 2014 to provide support to children and young people in crisis. In addition, children who require urgent mental health assessment or treatment are prioritised to ensure they are seen quickly. We recognise that there is still more to do to improve performance and work is ongoing to develop sustainable services which are able to meet both current and future demand.

As a result of increased awareness and better detection, increasing numbers of patients are being referred for cancer investigations and treatment in Forth Valley. To help address this, a detailed review of our cancer pathways has been carried out to streamline services and reduce delays. This has helped improve performance and in the last quarter of 2014/15, 98% of patients with cancer were treated within 31 days of the decision to treat, exceeding the national target of 95%. During the same period 91.2% of patients with a suspicion of cancer began treatment within 62 days of receipt of referral and work continues to meet or exceed the 95% target to ensure all patients are treated as quickly as possible. In addition, a review is undertaken of the small number of cases where we haven’t met these targets and learning is shared with the relevant care teams to identify areas for improvement.

Delayed discharges continued to present challenges throughout the year and we worked closely with our three local authority partners to improve arrangements for patients who were ready to leave hospital but required to be assessed for additional social care and support at home or transferred to a care home. A discharge hub at Falkirk Community Hospital has also been created which brings health and social work staff together to plan and manage discharges and provide greater support to care homes to help prevent avoidable hospital admissions.

Since August 2014 no patients waited for MRI, CT, ultrasound or barium studies longer than the waiting time target of 42 days. At the end of March 2015, 54 patients waited longer than 42 days for an upper or lower endoscopy. This is a significant improvement on the position at 30th of April 2014 when the number waiting over 42 days was 410.

A survey carried out in 2014 found that 91% of patients across Forth Valley were able to access a member of the GP Practice Team within 48 hours, and 80% of patients were able to obtain a GP consultation more than 48 hours in advance.

Providing timely treatment


At the end of March 2015, NHS Forth Valley performed well against the key quality standards for falls prevention, pressure area care and nutrition, exceeding the national target of 95%.

Work continued throughout the year to improve the care and treatment of patients who had experienced a stroke. Performance against a number of key standards continued to be closely monitored. These include ensuring patients received a MRI/CT scan within 24 hours and are admitted to a stroke ward within one day. Our aim was to meet these standards for 80% of all stroke patients and, whilst we met this for 6 months during 2014/15, this target has proved challenging to maintain. A number of actions have been taken to address this including setting aside a dedicated bed in the stroke unit each day and improving systems to help identify potential stroke patients at an early stage across our hospitals. The outpatient rapid access TIA clinic continued to perform well and NHS Forth Valley saw the largest proportion of patients assessed on

the same day of receipt of referral or the day after (60%) across all Scottish Health Boards. Overall 91% were seen within 4 days against a national standard of 80%.

Whilst we managed to meet one of the key national targets (which aims to ensure 90% of patients receive a MRI/CT scan within 24 hours), further work

is required to ensure we meet the other 4 key standards for stroke care on a consistent basis.

Reducing mortality rates in hospitals by 20% is a key goal within the Scottish Patient Safety Programme and NHS Forth Valley achieved this in December 2014, ahead of the December 2015 target.

Improving quality and safety

Delivering effective and efficient services

Achieving the national absence management target of 4% continued to be challenging with a March 2015 position of 5.15%. However, good progress has been made during the first half of 2015 and we will continue to build on this work going forward.

The ‘Did Not Attend’ (DNA) rate for new outpatient appointments at the end of March 2015 was just over 9% - a slight increase on the previous year. Work continues to improve performance in this area in line with our local access policy and we are exploring options to introduce new patient reminder systems as well as offering more flexible booking arrangements.

Focussed work with our GP partners across Forth Valley helped reduce our prescribing costs per patient during 2014/15 - bringing them just below the national average of £184.

34 NHS Forth Valley

During 2014/15 there were more than 221,000 outpatient appointments in our hospitals, almost 60,000 inpatient or daycase procedures and more than 78,000 attendances at our Emergency Department. During the year our staff delivered 3,182 babies and tested more than 588,000 samples in our laboratories.

The vast majority (around 90%) of patient contacts take place within the community. This includes more than 1.5m GP and practice nurse consultations, 450,000 community nursing contacts, 300,000 contacts with Allied Health Professionals, 650,000 dental appointments and 1.5m contacts with community pharmacists who dispensed more than 5.6 million items.

Notes: Source ISD publications and datasets *Provisional

Activity

2013/14 2014/15*

New Outpatient Attendances (all specialties except A&E) 68,986 73,276

Return Outpatient Attendances (all specialties except A&E) 150,587 148,467

Total Outpatient Attendances 219,573 221,743

Total Inpatient Discharges (acute specialties) 49,272 50,375

Total Day Case Discharges (acute specialties) 9,585 9,334

Total Inpatient/Day Case Discharges 58,857 59,709

Emergency Department Attendances 76,830 78,645

Number of Births 3,220 3,182

Nurse-led clinic attendances 99,222 100,959

Allied Health Professionals – outpatient attendances 293,739 309,853

GP out-of-hours attendances 21,070 23,296

Financial Performance We met all of our financial targets for 2014/15, including the delivery of an organisational-wide savings programme. As a result, we were able to deliver a balanced budget at the end of March 2015. The Capital Plan was also updated during the year to reflect local priorities including improvements to community healthcare facilities, purchasing new medical equipment and investing in Information Technology.

Annual accounts for 2014/15 will be published on the financial information section of our website http://nhsforthvalley.com/publications/financial-information after they have been laid before parliament in Autumn 2015.

Looking ForwardThis has been a busy year which has seen a number of key developments, including the launch of a major review of clinical services across the organisation. During 2014/15 we also make significant progress in meeting a number of key local and national targets, however, there is still more to do to further reduce waiting times, improve access and increase capacity in a number of areas. Looking ahead, over the next 12 months we will continue work to develop and consult on our new healthcare strategy and take forward plans to integrate local health and social care services, working closely with frontline staff, service users and the voluntary sector.


Board Members 2014/15

Mr Alex LinkstonChairman

Mr James KingVice-Chair

(From 1st May 2014)

Mrs Jane GrantChief Executive

Dr Stuart Cumming Chairman CHP

Professional Committee

Dr Graham FosterDirector of Public Health

and Planning

Miss Tracey Gillies Medical Director

(from 15th September 2014)

Dr Allan BridgesChairman Area Clinician Forum

Mr Tom HartEmployee Director

Mrs Helen KellyDirector of Human

Resources

Mrs Fiona RamsayDirector of Finance

Prof Angela WallaceDirector of Nursing

36 NHS Forth Valley

During 2014/15 we welcomed a number of new Board members and sadly said farewell to Charlie Forbes who passed away in June 2015 following a long illness. Charlie had been a non-executive Board member for many years and his enthusiasm, commitment and humour will be much missed by colleagues across the organisation.

Mr Charles Forbes Non Executive Board

Member

Mr John FordNon-Executive Member(From 1st May 2014)

Ms Fiona GavineNon-Executive Board

Member

Mrs Julia SwanNon-Executive Board

Member

Cllr Linda GowLocal Authority

Non-Executive Board Member

Dr Peter Murdoch Interim Medical Director (until 14th September

2014)

Cllr Corrie McChordLocal Authority


Cllr Gary WomersleyLocal Authority


(until 17th December 2014)

Cllr Les SharpLocal Authority

Non-Executive Board Member (From 18th

December 2014)

Dr Vicki Nash Vice-Chair

(until 30th April 2014)

Carseview House, Castle Business Park, Stirling, FK9 4SW. Tel: 01786 457243.

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