RD&E Express Spring 2012

www.rdehospital.nhs.uk

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

RD&Express

Patients will be welcomed and settled in on our wards by

our new Ward Housekeepers.

The pride Suat Erton radiates on his first day as Ward

Housekeeper on Taw Ward reflects the focus of this new

role to improve the experience of our patients and their

visitors.

The recent introduction of the Ward Housekeepers, in

their distinctive waist coated uniforms, follows a review

of non-clinical support services on Wonford hospital

wards. Key aspects of their work includes meeting and

greeting patients and showing them the facilities; and

focussing on cleaning, food and hydration of patients,

and the maintenance and presentation of the general

ward environment.

They will deliberately not have the same set hours each

day to ensure a real understanding and measure of what

is happening at different times on the ward. Other new

roles developed by the review include Domestic and

Catering Assistants.

Here to help

Spring 2012

Insiden Our 100 day discharge challenge page 2

n Getting the RD&E ‘Fit For the Future’ 3

n Right care quicker for stroke patients 5

n Membership events 11

n Want to be a Governor? 14

Improving patient experience2

We have created a new information guide for our patients and their

carers/relatives which sets out the planning we do with them to prepare for

leaving hospital.

Patient representatives were involved in this work. The guide explains what patients

and their families can expect from us and what we need them to do to avoid

unnecessary delays in discharge from hospital. It includes a useful checklist for the

family of tasks they may need to do as part of the preparations.

When our patients are ready to leave hospital we want there to be no delaysand for them to have the right information and the right care in the rightplace in the community for their onward recovery and support.

To achieve this we have set ourselves a challenge to achieve within 100 daysa plan for how we want RD&E hospital discharge to work and a timetable to

deliver the actions. At the heart of this work is our aim to improve patient careand experience, but it should also make more efficient use of NHS and social

care services.

We have been testing new ideas and approaches with theinvolvement of our Patient Engagement Group. Of course theRD&E cannot achieve this on its own so we are activelyworking with health and social care organisations locally toimprove co-ordination and management of care in thecommunity.

Examples of what we have done include:

➢ Testing an improved referral process for patients needingOnward Care when they leave the RD&E. In response tofeedback from colleagues that the current Health NeedsAssessment form is lengthy and time consuming, and at times,an unreliable referral process, a new electronic process hasbeen introduced.

➢ We have merged the teams looking after patients comingin and leaving our hospital so there is now a single point ofcontact called the Onward Care Team.

➢ We are introducing a Risk Assessment & Prediction Tool – to identify patient need for early therapysupport.

➢ We are exploring volunteer presence on wards to assist clinical teams, families and carers to plandischarge and a follow up telephone support hotline service for vulnerable patients.


3


Dear Members,Now is a useful time, at the end of the 2011/12 financial year,

to update you on progress achieved with our ‘Fit For The

Future’ programme.

Our staff have risen to the challenge of maintaining ‘business

as usual’ for our patients whilst, behind the scenes, we have

been reviewing what we do and how we do it; and

introducing new and sometimes radically different ways of

working. For example the introduction of a specialist

rehabilitation ward at Wonford hospital which has increased

the number of older patients leaving us and going straight

home with on going support, instead of a community hospital as an interim arrangement.

Improving patient experience and care lies at the heart of these changes and developing efficient

and innovative ways of working are directly contributing to that end. We are confident that we

will reach our target of £17 million savings for 2011/12 and we have taken stock on what we

need to focus on for 2012/2013.

What will continue is our commitment to providing the safest and best patient care and it is

testimony to the professionalism and hard work of our staff that in a year of uncertainty and

change, the RD&E has been ranked in the top 20% in patient satisfaction surveys and we were

one of only four hospital trusts in the country to be named Dr Foster Hospital of the Year.

We recognised from the outset of the ‘Fit For The Future’ programme, that the innovation and

flexibility of all of our staff would be essential if we wanted to strengthen our position as a

healthcare provider and centre for research and education. They have not let us down on that

score. Staff have been thinking outside the box and adopting an entrepreneurial spirit to how

we can improve patient experience and the quality of our services. This fantastic work is

happening right across the hospital, including pharmacy, theatres, wards, I&MT and

procurement.

‘Fit For The Future’ gives us the licence to iron out longstanding frustrations which historically

have got in the way of providing a smooth, clear and seamless healthcare experience for our

patients.

Finally on behalf of the Trust Board I would like to thank you, our members, for continuing to

work with us and share your ideas and experiences which contribute to the improvements and

inform our planning of future services.

Angela Pedder OBEChief Executive

Getting the RD&E ‘Fit For the Future’

Technology & research4


An exciting new chapter isbeginning at the RD&E whichis set to revolutionise patientcare and our management ofpatient records.

Our modernisation of patientrecord management will beachieved with eNotes. Infuture hospital health recordsand notes will be digitised andheld electronically. This willenable clinical decisions at thepoint of patient care to besupported by easy, prompt access to historic and current patient information. The electronic recordscan be updated directly and paper notes can be scanned and added. eNotes will dovetail in withother clinical tools used at our hospital.

The first services to adopt eNotes will be Orthodontics, Oral Surgery and Paediatric Cystic Fibrosisthis September.

Joint Medical Director Dr Vaughan Lewis and e-notes champion, said: “We believe this technologywill improve the security, access and management of hospital health records and should make ourpatient care

safer and efficient.”

eNotes

We have replaced rdeft email addresses for hospital staff and services with a new email system. Rdeft

email accounts have been replaced with an nhs.net email address which stays with the employee

throughout their NHS career and enables email correspondence to be viewed securely from any location.

Right care quicker for stroke patients 5

Our stroke service has been at the forefront of a research study to reduce the time it takes for patientsto receive vital clot-busting treatment.

The study is investigating the whole process of emergency treatment when a person suffers an acute stroke

from a blocked artery in the brain. For most patients in this situation, the earliest possible administration

(thrombolysis) of a clot-busting drug can greatly improve their chances of recovery. The drug is currently

licensed for delivery up to three hours from the onset of a stroke, but in that time the patient needs to call

an ambulance, get to hospital, have a brain scan, and be assessed by specialists before receiving the

treatment.

Our acute stroke team, radiology department and Emergency

Department colleagues have been working with researchers on this

from the University of Exeter, Peninsula College of Medicine and

Dentistry (PCMD), and the ambulance service.

The research team is currently evaluating the pilot scheme.

Dr Martin James, RD&E

Consultant Physician and

Lead Clinician for Stroke,

said: “This is a great

example of NHS

collaboration with

university academic

researchers to improve

patient care. Using the

simulation has enabled us

to identify and unblock

the bottlenecks in getting

the treatment to patients

much more quickly than

we could in the past.”

Dr James, pictured at

work on Clyst ward, said

the simulation can accomplish in an afternoon what used to take

months or even years of trial and error so research findings can be

applied to patient care much quicker and reduce the misery of

disability after a stroke.


We have been holding An Hour toRemember sessions for our staff toraise awareness, understandingand respect of the needs of aperson with dementia.

Year on year we are looking aftermore patients diagnosed withdementia - a physical conditionwhich comes from the progressivedeterioration of the brain tissueand its functions. These sessionsare open to all staff because, ifnot directly related to theirworking roles, they may be carersor have relatives with dementia.

Global impact of research6


Groundbreaking research at the RD&E has been

recognised with the University of Exeter

Outstanding International Impact Award for

transforming the lives of children born with

diabetes.

The award winning team, pictured, includes Professor

Sian Ellard, Head of Molecular Genetics and Professor

Andrew Hattersley, Consultant Diabetologist and

Research & Development Director and Peninsula

Medical School colleagues Dr Maggie Shepherd and Dr

Sarah Flanagan.

Their remarkable work involved the study of children

diagnosed with diabetes within the first six months of

their lives. This is a rare genetic form of diabetes, and

by identifying the genes that cause the condition they

were able to prove that the two commonest types are

better treated with tablets rather than insulin

RD&E Clinical Biochemist Dr Tim McDonald was also nominated in the Student Impact category, which

recognises students or alumni who have already demonstrated significant societal or economic impact

either through research or entrepreneurial activities.

Only three years into his research career, Tim McDonald

has increased the accuracy of diabetes diagnoses in

the UK.

Tim, pictured, developed a urine test to identify

sufferers of monogenic diabetes, who are often

misdiagnosed with more common type 1

or type 2 diabetes. His research has

already directly improved patient care

and the test is now used routinely across

this Trust and samples received for

testing from 40 others.

injections. What they have achieved has

revolutionised the diagnosis and care of these

patients, who now have a normal life on tablets when

previously they would have expected to be on insulin

for the rest of their lives. The tablets also cost less,

providing savings for the NHS and global significance in

countries where insulin affordability is an issue.

Innovation 7


The RD&E has played a central role in promising

research which has found that trainee surgeons can

learn their skills more quickly if they are taught

how to use the same eye movements as those of

more experienced surgeons.

Research led by the University of Exeter shows that

‘gaze training’ helps new surgeons learn technical

skills quicker and deal better the stress of working in

an operating theatre. They found that proficient

surgeons ‘locked’ their eyes to a critical location

whilst using surgical instruments with more accuracy

and without distraction from normal theatre activity

around them. This work has involved the RD&E, the

University of Hong Kong and a training centre in

Torbay and is applying science-based principles used

by sports people to improve their performance.

➢ Pictured is new surgeon Mr Tom Dutton wearing

headset which is used for gaze training.

Sights on safer surgery

A yawning space has appeared onthe Wonford hospital site with thedemolition of the PostgraduateEducation Centre.

Over 90% of the dismantled structureof the building will be recycled – themajority being used for road buildingaggregate. The disappearance of theformer education centre is a strongvisual milestone in the creation of anew Research, Innovation, Learningand Development (RILD) Centre whichwill bring together skills, educationand medical research on the hospital site.

The RILD project is a partnership between the Royal Devon & Exeter NHS Foundation Trust, PeninsulaCollege of Medicine and Dentistry and the University of Exeter.

➢ Pictured is Joint Medical Director Dr Vaughan Lewis during a site visit.

News in brief8


We have trialled a zero-emissions

van with the aim of reducing the

carbon footprint of our hospital

courier and car park patrol service.

In the week leading up to NHS

Sustainability Day - on 28th March -

our transport service manager Dave

Searle test drove an electric

powered van for regular courier and

patrol activity between the

Wonford and Heavitree hospital

sites in Exeter.

Dave said: “There is potential for a zero emission vehicle for this regular courier and patrol work

instead of the 1.6 diesel vehicle we currently use. We have used an electric-powered van kindly

loaned to us by Bristol Street Renault garage to see how it would best serve the operational needs

of the RD&E. If we invested in this technology it would certainly be a cleaner, greener way of

doing our business. Re-charging the power is simple enough, it just takes getting used to driving

without hearing any engine noise.”

The RD&E is playing its part in a world first charity bid to find a cure for Parkinson’s.

The charity Parkinson’s UK is investing over £1.6 million into the biggest ever in-depth research study tracking

people with the neurological condition. The study aims to unlock secrets about the condition and boost the

chances of finding a cure.

Our Movement Disorder Team at the RD&E Wonford hospital is a key centre taking part in this research led by

Consultant Physician Dr Ray Sheridan.

To qualify as a volunteer for ‘Tracking Parkinson’s’ at one of the UK centres, people need to have been

diagnosed under the age of 50 or have been diagnosed with Parkinson’s within the last three years (from the

date they register for the study). Brothers or sisters of either set of participants are also invited to take part.

To find out more about how to take part in Tracking Parkinson’s call the freephone helpline 0808 800 0303, or

visit www.parkinsons.org.uk/tracking for full details and links to other Parkinson’s UK funded research.

➢ Members will have an opportunity to hear more about treatment for Parkinson’s when Dr Sheridan presents

a lecture at our Members’ Say event in May.

9


News in brief

Wonford hospital has been designated a Trauma

Unit as part of a new regional NHS network

providing emergency care to patients with life

threatening illness or injury.

Our Emergency Department, which responded to

96,437 attendances last year, is part of a specialist

trauma network in the NHS South region. Patients

with specific specialist needs will be treated at

Trauma Centres in Plymouth Derriford hospital (for

head injuries) and Bristol Frenchay hospital (for

burns).

At the RD&E we will clinically assess the needs of

our patients and draw on the wealth of skills and

technology available to us in our local Trauma

Centres to give patients every chance of survival

and recovery.

We promoted hand hygiene on 3rd May in support of

the World Health Organisation 2012 campaign ‘Save

Lives: Clean your hands.’Our Infection Prevention and

Control Team hosted activities and events and staff

signed up to a hand hygiene pledge commitment to

comply with the good practice, challenge

noncompliant colleagues and be ‘bare below the

elbows’ to make it easier to clean their hands whilst

on duty.

The achievements and star qualities of our staff

were celebrated at a special annual awards event.

The Chairman’s Awards gives us an opportunity

tonominate colleagues we believe go ‘above and

beyond’ what is expected of them for this formal

recognition. Eleven individuals and two teams from

a range of professional roles and services received

awards.

Our members told us they like

hearing about our

achievements in the

newsletter but think we

should also do this in

the hospital so we

have put up a board of

the staff winners of

our Chairman’s Awards

this year and our Dr Foster

Hospital of the Year Award in

the Wonford reception area.

Our Chairman Angela Ballatti stands down at the

end of April after serving on the Trust Board for six

years. She will be succeeded by James Brent from

May 1st.

Mr Brent was an investment banker for 25 years

and established Akkeron Group LLP which has key

business activities in hotels, urban generation and

large scale agriculture. Mr Brent is Chairman of

Plymouth Argyle football club and he owns a

controlling stake in the Devon-based surfwear

brand Saltrock. Some of our Governors were

involved in the recruitment of our new chairman.

Improvements planned for Thoracic Surgery10


We are planning some improvements to thoracic surgery provision to ensure thatit continues to be safe, clinically effective and sustainable.

In order to maintain the quality of our services on thoracic surgery, it is absolutely vital that oursurgeons are able to treat sufficient numbers of people every year. In order to ensure thecontinuation of a high quality local service we are proposing linking our services with UniversityHospitals Bristol Foundation Trust (UHB). In considering these different options, we identified somekey principles to help guide our decisions:

• Patients will be treated locally when it is clinically appropriate to do so

• Routine and intermediate outpatient and thoracic surgery will be maintained in Exeter

• Outpatient services provided inNorth Devon will be maintained

• The entire pathway, with theexception of the major surgery willbe managed in Exeter – this willinclude pre-operative workup andstaging, and all subsequent adjuvanttreatments

• The continuation of a thoracicsurgical service in Exeter whichsupports other specialty areas such asrespiratory medicine, oncology, trauma, Intensive Therapy Unit and other surgery.

UHB would provide major elective surgery and receive non-elective thoracic admissions within 24hours of referral for our catchment population. This would be supported through 24/7 on-callconsultants. Local outpatient services, minor and intermediate surgical activity andmultidisciplinary team support would continue to be provided in Exeter and North Devon.

It is important to ensure that in making these changes we take into account the views of patientsthat may be affected and our team is already involved in consulting our existing patients.

We also intend to discuss these issues, and the rationale for aiming the changes outlined above,at our next Members’ Say meeting in May. If you have any views on this issue then pleaseemail: [email protected]

Website discounts offer 11


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Via the benefits web site, you can shop online, print out vouchers, get advice from confidential, free help line services and book holidays; all in the knowledge that you’ll be saving money.

There is even an exclusive range of financial products such as bank accounts, loans and insurance as well as mortgage services each supporting reduced fees or cash incentives.

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Tick the newsletter option to receive email alerts on latest benefits. Your registration will take about 48 hours to validate and then you will be sent membership confirmation.

Benefitsnow available toFoundation Members

Membership events12


Events for Members

Council of Governors Meeting

Wednesday 11 July 2012, 2pm - 4.30pm

Venue details are to be confirmed. If you would like to attend, contact Bernadette Coatesin the Foundation Trust Office on 01392 403977 or email [email protected]

Members Say!

Our next Members Say! event takes place at the RD&E Wonford hospital site onSaturday 26 May, 10.30am – 3.30pm.

Our limited spaces are being offered on a first come, first serve basis. To book a place at thisevent ring the dedicated Members Say! hotline on 01392 404060. This is a message-onlyservice and you will be asked to leave your name and contact details.

Increasing day casesurgery in communitytheatresWe have stepped up our ‘best keptsecret’ promotion of day caseorthopaedic surgery services weprovide in community hospitals inTiverton, Sidmouth and Exmouth.We want more of this activity totake place in these theatres toensure efficient use of our resourcesand free up the main Wonfordhospital theatres for complex andemergency surgery.

Meet a Governor 13


In this feature we will meet one of ourGovernors each edition to find out a bit more about them and their role.

I was born and bred in Devon, before training as a nurse

and midwife in the South East. I returned to the county

in 1990 as Director of Midwifery at the old RD&E

Maternity Unit on the Heavitree site – it was a very

exciting time in midwifery, with a real focus on links

into the community, and I was very proud to be a part

of if.

I retired from the RD&E in 2002, and after several years

as Non Executive Director of Exeter Primary Care Trust,

I became a Governor. In my spare time I also am

involved in giving money to the disadvantaged in the

area, through my role as Chairman of Exeter Municipal

Charities, and also to the Trust as Treasurer for the

RD&E branch of the League of Friends.

I am also a keen Bowls player, and Captain of the

Outdoor Exonian Bowling Club.

Why did you become a Governor?

I became a Governor really to keep my hand in with the

RD&E and the local community, which has played a big

part in my life. My father actually laid one of the

foundation stones of the previous hospital and was

involved in the transition to this site, so it is really part

of my history. Hopefully my experience and knowledge

from working in healthcare also means I can give

something back.

What do you see a central part of your role?

As an elected Governor I feel I must honour those votes

through my commitment to the role. I feel that my job

is to be a representative of my area. I think you have to

be yourself as a Governor, but by listening you can be

the vehicle for passing on and sharing the views of your

community.

What do you enjoy about being a Governor?

I actually really love being a Governor. I am involved in

many of the sub-committees that have specific

responsibilities, for example the Nominations

Committee, who are currently involved in the

recruitment of the new Chairman, the Non-Executive

Director Remuneration Committee as well as giving

support to the Board’s Audit Committee. These are all

roles that I have carried out in the past, when I was

heavily involved with the Royal College of Midwives, and

I think that my familiarity to these subjects is an

advantage. I really enjoy the lively discussions we have

had as a group in formulating the Council of Governors

and coming to agree on our role within the organisation.

Is there anything you would change about being a

Governor?

It can be difficult getting all the Governors together in

the room at the same time because we have other

commitments but I think this is when I feel we are at

our most effective.

You are welcome to get in touch with Kate, or anyof the other Governors, via the Foundation Trustoffice, either by calling Bernadette Coates on 01392403977 or email [email protected]

Kate Caldwell, Exeter & South Devon,Governor since 2007

Would you like to have a real influence over thefuture of the Trust? Are you interested inbecoming a Governor?

We are looking for members interested in puttingtheir names forward in elections to our Council ofGovernors. The elections will be held during thesummer and our 20,000 members will be castingtheir votes for new Governors.

If you are interested in taking part in the importantwork of our Council of Governors, you are invited tocome along to one of our ‘prospective governormeetings’, where you can hear more about the rolefrom current governors and Trust staff. We arelooking for people who are committed to the NHS,who are keen to support us, and who have skills thatwill add real value to our Council.

Our Governors have an important role: as well ascollectively holding the Directors accountable forour performance, they also ensure that the interestsof the Trust’s members are taken into account. Thenew Health & Social Care Act gives Governors morepowers so that Foundations Trust – such as the RD&Ebecome ever more accountable to the localcommunity we serve. Our Governors have shown

fantastic commitment in representing the views oflocal people and helping the RD&E to shape its plansfor the future.

For details of the venue and to book your place,contact Bernadette Coates in the Foundation TrustOffice on 01392 403977 or email:[email protected]

The meetings will give you information on the role ofa Governor, on the commitment you will need tomake and what is involved. This will help you decidewhether the role of a Governor is for you.

If you are not able to attend, you can still put yourname forward to join the Council of Governors, butwe would encourage you to get in touch with us sothat we can talk to you about the role and thecommitment required.

You can also attend the Council of Governorsmeeting on 11 July in order to see the Council atwork.

Interested in being a Governor? 14


The Prospective Governor Meetings will be held on:

4 July from 2.30pm to 4pm5 July from 5.30pm to 7pm

Our patients rate RD&E outpatient clinic services andstandard of care highly – placing us in the top 20% of bestperforming NHS trusts in the country.

The independent healthcare regulator, the Care QualityCommission, carried out its fourth survey on patientsatisfaction with adult outpatient services in 2011. TheEmergency Department (A&E) and fracture clinics wereamong the hospital departments where patients aged 16

➢ RD&Express readers who attended our last Members’ Say event will know that we want our outpatient clinicservices to be even better so we asked what worked well and what could we improve? Your feedback was passedon to the review project team. We will let you know the outcome.

years or older were asked to share their views abouttheir hospital experience.

Patients gave their feedback on questions aboutappointments, waiting times in clinic, cleanliness,test, treatment and medication information, care andcommunications with doctors and other healthcareprofessionals, privacy, dignity, correspondence for GPsand who to contact after discharge if worried abouttheir condition.

Interested in being a Governor? 15


“Governors at the RD&E provide avital contribution to the Trust inrepresenting members, communitiesand the public. Governors havestatutory responsibilities for holdingthe Board of Directors to account forthe well running of the hospital andfeeding back the views of themembers it serves. This requires acommitment to engage in Council ofGovernors meetings, committees anddevelopment days throughout theyear, where the unique contribution ofgovernors influences strategy, forwardplanning and governance.

Under the requirements of the New Health and Social Care Act. Governors will have an enhanced roledeveloped with a new national training programme and with the support of the Foundation TrustGovernors Association.”

Dianah Pritchett-Farrell, Public Governor

Patients rate our hospital care highlyRoyal Devon & Exeter adult inpatients have rated highly their experience of hospital care in the2011 Care Quality Commission satisfaction survey.

The commission sent a questionnaire to inpatients at Wonford hospital between October 2011 andJanuary 2012 to check we met government set standards and 561 responses were returned.

Patients were asked to score their experience out of 10 on a range of standards including:

n Emergency Department – overall score for questions 7.9 out of 10n Waiting lists and planned admission – 6.5n Waiting to get a bed on a ward – 8.3n Hospital ward and environment including meals – 8.3n Care by doctors and nurses - 8.7 eachn Care and treatment – 7.6n Surgery and procedures – 8.3n Leaving hospital – 7.0n Overall patient experience – 8.2 (respect and dignity 9.2; health professionals working together 8.1)

Director of Nursing & Patient Care Em Wilkinson-Brice said: “The results of the CQC adult inpatientsurvey confirms that overall our patients have confidence and trust in our staff and feel respectedand informed throughout their care. There are, however, always areas where we can respondpositively to feedback and make improvements. The national survey results will continue to influenceour improvement programme for the forthcoming year. These results are testament to the sustaineddedication and commitment of our staff who strive to put patients and families first.”

Email address

How to get to the RD&EVisitors to the RD&E are encouraged to use our dedicatedPark & Ride service. It runs to Wonford Hospital fromDigby (near Tesco and J30 of the M5), Monday to Friday(excluding Bank Holidays) and costs £1.30 return.

The Park & Ride service also serves the Heavitree Hospital

site.

However, please note that as of 30 December 2011, the

Heavitree service will no longer operate. A new timetable

for Digby to Wonford will come into operation on 3rd

January 2012.

Stagecoach bus service H runs to Wonford Hospital every

fifteen minutes or so from the High Street in the Buses from

Keep in touch16

Have you recently moved house or changed your contact details? Let us know so you can continue to receive information from us.

The Foundation Trust membership office can be contacted by telephoning 01392 403977, by [email protected] or by writing to: RD&E NHS Foundation Trust Office, Room E219,RD&E Hospital, Barrack Road, Exeter, EX2 5DW.

For more information about the Foundation Trust visit the RD&E website: www.rdehospital.nhs.uk

We can arrange language translation if you do not speak English. We can arrangeBritish Sign Language interpretation, and also give you this information in largertext. Please ask us on (01392) 403977.

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Recruit a friendThank you to everyone who responded to our call torecruit a friend in the last edition of the newsletter.

We are always looking to recruit more Members andif you have a friend, colleague or family membersyou think might like to become a Member please fillin this coupon and send it to us at:

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RD&E Express Spring 2012

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Transcript of RD&E Express Spring 2012