Insight Royal Liverpool - July 2016

July 2016

Exclusive:

1000 Voices

Hundreds of staff come together to improve patient experience

www.rlbuht.nhs.uk

International Nurses’ Day 2016 Latest RLB programme graduates celebrate at St George’s Hall

Transplant Games Find out where you can catch the action

Clinical trials ‘Help give someone more time with their loved ones’

2 Exceptional patient experience

Thank you We have all been working through an extremely challenging period and I wanted to thank you all for your hard work.

I would also like to thank you for your support during the recent Care Quality Commission (CQC) visit. It made me very proud that the visiting inspectors were able to see first-hand the passion, innovation and dedication that I see on a daily basis.

Before leaving our Trust, inspectors commented on how astonishingly well motivated staff were as well as how well you work during escalation periods. They also noted the hospitality, friendliness and engaging nature of staff.

Our AGM will take place 28 September 2016 in the Royal’s Lecture Theatre.

This is a great opportunity to find out how the Trust has performed over the last year and to hear about our achievements and future plans.

Finally, congratulations to our winners at the Make a Difference Awards, to those who were shortlisted and everyone who got involved in what was a fantastic night.

Aidan Kehoe, chief executive

How are we performing?

We, along with all other NHS Trusts, continuously monitor our progress against a series of targets that are set both nationally and locally.

This allows us to monitor the delivery of

our key corporate objectives of patient experience and quality of care, patient safety, productivity, people and financial health.

Below is an overview summary of some of our key performance indicators.

Overview to May 2016 Patient Experience and Quality All Cancers: 31-day wait Diagnosis to first treatment All Cancers: 31-day Surgery wait for second or Anti cancer drug treatments subsequent treatment All Cancers: 62-day wait Urgent GP referral to treatment for first treatment Screening service referral Referral to treatment Admitted waiting times Non-admitted Incomplete Cancer: two week waits Urgent suspected cancer referrals Breast symptomatic (not suspected cancer) Accident & Emergency % patients waited over 4 hours Patient Surveys To increase the number of patients who rate their experience as good or excellent Patient Safety MRSA and Clostridium Difficile Clostridium Difficile MRSA Venous Thromboembolism (VTE) VTE Assessments Mortality Hospital Standardised Mortality Ratio (HSMR) Risk adjusted mortality - all diagnoses Falls Reduction in falls Pressure ulcers Grade 2 or above pressure ulcers rate Grade 3 or above pressure ulcers rate Productivity Productivity indicators Daycase Rate Average Length of Spell (Elective) Average Length of Spell (Non Elective) New to Follow Up Ratio Did Not Attend Rates People Sickness absence Sickness absence rate (Apr-14) Finance Financial Performance Financial Risk Rating

Employee of the month and Staff Star awards ‘Employee of the Month’ (EOM) has recently been re-branded as ‘Staff Star of the Month’ linked to Trust Values.

The latest winners presented with their certificate are: November employee of the month: Daniel James

January staff star (patient centred): Michelle Guy

March staff star (patient centred): Denise Griffin

December staff star (patient centred): David Lindale

February staff star (creative): Steven Almond

March staff star (professional): Salihu Samos

December staff star (collaborative): Julie Clough

February staff star (patient centred): Margaret Styles

March staff star (open and engaged): Gary Thomas

3

Developing a sustainable health system

Staff share ideas on improving patient flow Hundreds of staff came together to share ideas on how to improve patient flow across our hospitals.

are affecting the experience our patients have when they come into our hospitals and the morale of staff when they come to work.

The 1000 Voices event called for staff from all departments to think of new ways of ensuring a patient’s journey through our hospitals is as streamlined as possible.

“The unprecedented 1000 Voices event provides an opportunity for staff from every corner of the Trust to put forward improvement ideas and play a part in transforming the way patients flow through our hospitals.”

Challenging circumstances, which have affected trusts across the country, have meant we regularly have more than 20 patients waiting for speciality beds and more than 60 patients waiting in our Emergency Department.

A group, led by the chief executive, will now look at how to use some of the changes that were suggested at the event and in the build-up.

Chief executive Aidan Kehoe called on staff to suggest changes – big or small – that could improve how we deal with these challenges.

Staff were able to talk about what challenges they face on their own wards and use their own experiences to suggest how things can change.

Aidan Kehoe said before the event: “We’re working in very challenging circumstances.

The problems associated with patient flow

Before and during the event, staff took to the Trust’s Padlet page to share their views and ideas. Posts covered topics

such as a specialised ambulance for AMU discharges.

Ideas that came from the event included: • Improve ambulatory care •M aking the most of IT to help patient flow •M aking use of diagnostics in the community •R educing duplication of requests for information on wards • P roactive staffing - right resource at the right time • I mproving bed allocation for vulnerable patients • Owning community beds • Palliative care outreach model •R emodelling the discharge lounge to take bedded and seated patients

Progressing big impact changes now Our staff want to carry out real time ward rounds and get the most out of our ADT whiteboards by using them to highlight vulnerable patients to ensure they are identified as early as possible – thank you to Emma Caton from the Emergency Department for moving this forward. Other big impact changes suggested by staff included: • Redesign of our ambulatory care model

•C onducting real-time ward rounds where outcomes (TTO’s, discharge letters, referrals, etc) are actioned immediately •M aximising use of ADT whiteboards to communicate bed state and other key information to patient flow, releasing nursing time to care • I mprove the functionality of discharge lounge by enabling bedded patients to be accommodated

•M aximise the provision of community services such as diagnostics and beds • E nsure that vulnerable patients are placed into the right bed at the right time •D evelopment of a Palliative Care outreach model •O ptimise how we communicate best practise across the Trust

4

Developing a sustainable health system

Showcasing sustainability We recently launched our Sustainability Plan for 2016 – 2017.

For the first time, the plan showcases some of the fantastic work being carried out by staff and community partners over the last year.

Highlights include the Royal becoming City Bike terminal, and the availability electric vehicle charging at both hospitals.

Ian Stenton, head of sustainability, said: “Playing a lead role in the development of a sustainable health system for the communities we serve is one of the Trust’s strategic themes.

“It’s great to be able to highlight the sustainability work that has taken place over the last year – from the installation of electric vehicle charging points to the new Warp-it system to the lasting legacy being created by the Liverpool Community Fund and the new Royal project.”

To find out more about the great work being done and to read the plan in full visit www.rlbuht.nhs.uk

Swapping pens for PENS Clinicians have been using the new Patient Electronic Notes System to record patient information as the Trust moves towards paper-free working.

Photo courtesy of James Maloney, Liverpool Echo

New Royal update Work on the new Royal is now beginning to move inside as work continues on the internal fit out.

Mock ups of the single bedrooms, nurse’s stations, critical care bedrooms and theatre suite with recovery bay are all being launched to allow staff to see where and how they will work in the new Royal.

All staff are welcome to book a visit to the new hospital – just email Charlotte.Griffiths-Wyness@rlbuht.nhs.uk.

Clinical data capture is one of the transformational projects working towards achieving a paper-free health records in the Trust.

A typical hospital has around 45million paper record documents which all need to be stored and archived in warehouses. There can be 50,000 paper case notes being used across the Trust at any one time.

The new Royal has been designed to operate within a paperless environment, meaning there will be no facility to store health records.

The new system enables staff to capture clinical data electronically at the point of care meaning writing, storing, and locating records becomes much easier and will eventually remove the need for case notes.

What are staff saying?

“PENS is excellent” – Sharon Twist, sister – Cardiac Rehabilitation “PENS collaborates the medical and nursing notes which makes patient information centralised and more accessible by everyone.

Floorwalkers have been amazing” – Rachel Piggott, staff nurse (HEC) “PENS means all medical and nursing notes are legible, FINALLY!” – Fiona Collins staff nurse (HEC)

5

Developing a sustainable health system

Teams find new ways to improve quality Teams across the Trust have been coming up with innovative ways to improve patient care in their departments as part of the recent QEP Week.

The Quality and Efficiency Programme – or QEP finds ways to improve quality of patient care by improving efficiency throughout our hospitals.

QEP Week, which took place 22-29 June, gave staff the chance to attend master classes in business intelligence, finance and procurement as well as listen to case studies from the NHS Institute for Innovation and Improvement AQuA, 2Bio and The Health Foundation.

During the week, staff pitched ideas to a panel made up of executive and non-executive directors, patients and members of the public.

One team to get involved with QEP is the Liverpool Angina Management Programme (LAMP). The service combines pain medicine and cardiology expertise for patients with chronic angina.

The team of consultant cardiologists, consultants in pain medicine, clinical scientists, clinical ethicists and clerical staff, made adjustments

to consultation times and introduced a triage process that tailors the service to individual patients’ needs.

When you focus on cutting costs, you automatically reduce quality, but when you focus on increasing quality, you almost always reduce cost

As a result of the QEP project referrals to LAMP significantly reduce the number and duration of patients’ unplanned hospital admissions.

Hoo Tsang, from the LAMP team, said: “We put a focus on maintaining the collaboration between pain medicine and cardiology, emphasising individual and group education, with interventional treatment options when needed. It’s really important that we all look at how we are working within the increasingly challenging health economy.”

Lean practitioner Alex McCrudden added: “The QEP programme is important as it looks at how we can

Physiotherapists Sarah Dyson (middle) and Laura Jennions (right) pitched their ‘Move to Improve’ idea

The Liverpool Angina Management Programme continue to deliver the highest standards of care to our patients when across the country there is less money to spend on healthcare. It’s fantastic to see teams across the Trust are finding innovative ways to work more efficiently.

“William R Brody, president of Johns Hopkins University said ‘when you focus on cutting costs, you automatically reduce quality, but when you focus on increasing quality, you almost always reduce cost’, it’s essential that we keep this in mind.”

To hear about other teams that have found innovative ways of improving efficiency and watch podcasts from QEP

Teams were on hand to support throughout QEP Week

Week head to the Staff Hub via the Staff Intranet.

You can sign up to receive regular QEP updates by emailing qep@rlbuht.nhs.uk

Idea Street Since the recent re-launch of Idea Street there have been 100 ideas submitted on Idea Street. There is now a section which has a range of helpful resources form external partnerships an overview of the ideas that have been used so far.

Find out more at sharepoint/ IdeaSt/SitePages/Home

Paul Evans, project manager, IM&T, presented a successful pitch around centralised printing

6

Exceptional patient experience

Patient food on show for international conference Hospital caterers and dieticians from around the world recently visited the Royal to find out more about the food on offer to our patients.

Delegates flew in from Sweden, Norway, Holland, America and even Australia to see the work being done to ensure patients’ dietary needs are met.

The visit was organised as part of the National Hospital Caterers Forum which was taking place at the Liverpool ACC. Hospital caterers ISS and the Trust’s Quality team have been working towards initiatives introduced by the Health Caterers Association which puts emphasis on complimentary disciplines working together to improve patient experience and improve nutritional outcomes.

Marianne Backrud-Hagberg visited from Swedish hospital caterers Kost and Naring.

She said: “We were impressed by the work on the food that is happening in the hospital. It was also very interesting to see your menus and the variety you offer patients. There are similarities but quite large differences from the Swedish hospital food.”

Our visitors were also able to sample patient meals from our new oriental menu which launched in October.

Bernadette Ratcliffe, contract monitoring and liaison officer, said: “It was a privilege for all of us involved with the nutrition of our patients in the Trust, be it our caterers ISS, our quality matron, dieticians, patient experience manager

and Patients Council members to host this visit. We were all very proud to be able to demonstrate all the good work we have achieved by working in collaboration to improve our patients overall catering experience.”

AMU success helps improve patient journey Staff and patients from the Acute Medical Unit (AMU) at the Royal have won funding for a recall device to improve patient care.

AMU health care professionals set up a focus group to look at the patients’ journey within the AMU, in order to improve their overall experience.

The group developed an idea using recall devices to allow suitable patients to leave the AMU to go to other areas of the hospital, rather than have to stay in AMU whilst waiting for test results.

The group submitted their ideas to a North West regional competition. Medical student Emma Aspinall and junior doctor Rachel Heath, presented the group’s idea to a panel, making it down to the final four and securing £1000 to implement devices on the unit.

Recall devices are now in the process of being implemented on AMU following the team’s success.

Vicky Price, AMU consultant said: “This funding has provided us with a great opportunity to make our patients’ stay a little easier.

“Recall devices should help to reduce patients’ anxiety and make their waiting more tolerable. It will also help patients that are unable to leave AMU by reducing the amount of people in the department.

“We’d like to thank Rachel, Emma and the whole focus group for helping to secure this grant and ultimately improving the experience of our patients.”

7

World class workforce

Bowel cancer experts offer advice to local patients Specialist nursing teams from the Royal took to Twitter to promote bowel cancer awareness during April.

The public were able to tweet in any questions they had around the illness during the bowel cancer team’s ‘Ask the Expert’ Tweetchat.

Bowel cancer is the fourth most common cancer in the UK and the second most common cause of cancer deaths. In Merseyside and Cheshire, death rates from bowel cancer are higher than the national average, with more than 570 people dying from it each year.

Bowel Cancer Awareness Month aims to highlight the importance of the bowel cancer screening kit for 60 - 74 year olds, and to encourage more people to

The bowel cancer awareness sessions are a fantastic way for us to speak to patients about how they can look after their bowel health

complete the simple test kit when it is mailed to them. This little kit could save someone’s life.

Staff from the specialist nursing team were also on hand in the foyers at the Royal and Broadgreen to answer any questions around bowel cancer screening.

Geoff Fitzgerald, from the Liverpool Bowel Cancer Screening Programme at the Royal, said: “The bowel cancer awareness sessions are a fantastic way for us to speak to patients about how they can look after their bowel health. The sessions are a great opportunity for us to answer any questions they may have around the bowel cancer screening programme.

“Last year alone we saw 632 patients and removed polyps from over 63% of them.

Polyps, which are small growths on the inner lining of the bowel, can lead to bowel cancer so removing them early can save lives.”

For more information visit Cancer Research UK’s website: www.cruk.org/bowelscreening.

Latest treatments for prostate cancer patients Our patients will be the first outside London to receive cutting edge prostate cancer diagnostic services.

We are the first and only site in the country outside London to provide the ground breaking new Prostate Specific Membrane Antigen (PSMA) test using their positron emission tomographycomputed tomography scanner.

Nuclear medicine specialists are working with the highly specialised radiopharmacy staff as well as consultants from Urology, Oncology and Radiology.

The test is based on a completely new method for spotting the early signs of a returning prostate cancer.

It aims to increase life-expectancy for patients with a variety of long term conditions including cancer and heart disease and to address the complex health needs of some groups of patients.

Radioactive material is injected into a vein and can be viewed on the PET/ CT scanner. The scans can potentially identify cancer cells that have spread beyond the prostate gland.

This also means that if treatment is required it can begin sooner, and for those patients who don’t need treatment can be reassured.

Professor Vinjamuri, lead consultant in nuclear medicine said: “The launch of this test in Liverpool ahead of other bigger cancer centres has been made possible because of our unique and specialist expertise in the fields of radiopharmacy, nuclear medicine and medical imaging.

Bowel cancer specialists were on hand in the foyer to give advice

“The PSMA test is part of a programme of continuous research and development into diagnostic tests which brings us another step closer to providing the best care possible to our patients.”

8

World class workforce

Royal consultant joins Zika fight A consultant at the Royal has joined a team leading the global fight against the Zika virus.

Dr Tom Blanchard, consultant in infectious diseases, will work alongside local health partners and neighbouring universities to provide expert knowledge and support work in developing a Zika vaccine candidate.

The vaccine candidate will be based on a safe quantity of the smallpox vaccine, which was used in the only successful campaign to date to bring about the global eradication of an infectious disease.

Lucy spent a week in Nagpur performing cleft lip and palate corrective surgery

Life-changing Lucy brings smiles back to Nagpur children An operating department practitioner has spoken about her pride in helping underprivileged children in India after volunteering with the Northern Cleft Foundation.

Theatres staff member Lucy Pilkington spent a week in Nagpur performing cleft lip and palate corrective surgery on 110 children with the Northern Cleft Foundation.

A cleft is a split in the upper lip or the roof of the mouth. It occurs when separate areas of the face do not join together properly when a baby is developing during pregnancy.

Lucy has fond memories of the warm welcome that greeted the visiting clinicians.

She said: “The local newspapers must have been told because when we arrived it was like the paparazzi had arrived.

“They greeted us with flowers which they placed around our neck and if we were walking around Nagpur people would always wave to us. It was a great feeling to be able to travel there to help so many children.”

In India, 35,000 babies are born each year with a cleft lip, while one million cases go untreated in India.

Each year the Northern Cleft Foundation travels to Indian hospitals providing cleft surgery to children whose families are unable to afford treatment.

“There are a lot of children who don’t have access to the help they need. Cleft lips can mean children are unable to eat or speak properly. Being born with a cleft lip can have an enormous impact on a child’s physical, psychological and social wellbeing.”

Lucy, from Chorley, raised £1500 through various events to raise the funds in order to travel to India.

The Zika virus is a mosquito-borne infection, which isn’t harmful in most cases. However, there are concerns for pregnant women travelling to the Pacific region, South and Central America, the Caribbean, and the Cape Verde Islands off West Africa as contracting the virus has been linked to birth defects – specifically, abnormally small heads (microcephaly).

It was first detected in the Zika forest of Uganda in 1947, and has circulated in Africa and South and South East Asia without many documented outbreaks reported.

In the last few years, Zika outbreaks have been reported in the Pacific region, and the virus has now spread to South and Central America, and the Caribbean.

Dr Tom Blanchard said: “The infection can be pretty mild and people can catch it without realising. Signs and symptoms to be aware of can include an unusual rash, joint pain, itchy eyes and a temperature. If left untreated, the infection will usually clear within a couple of days.

“However the risks to pregnant women are much more serious, as the virus can lead to birth defects. This also means that male partners returning from affected areas should use condoms for 28 days to avoid unwittingly transmitting the virus, given that there is a small but definite risk of sexual transmission, and for six months if they experience symptomatic Zika.”

Detailed travel health advice for your destination is also available from the National Travel Health Network and Centre (NaTHNaC) website or the Scottish travel health service fitfortravel.

The operating department practitioner admits that she didn’t get time to see the sights of the north-eastern Indian city due to the heavy workload.

“We arrived Thursday night and started work first thing on Friday morning, then completed our work shortly before travelling back. I don’t mind though, I didn’t go for sightseeing.

“I feel really proud to have been able to offer my support to such a worthy cause. I would definitely like to take part in a similar project if I ever had the opportunity to.”

Dr Tom Blanchard has joined the fight against the Zika virus

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World class workforce

Unsung hero: house keeper We caught up with house keeper Agnes Dickinson as part of our unsung hero campaign which takes a look at some of the lesser known roles in our hospitals.

Agnes, who has worked at the Royal for 38 years, is based on Ward 8X and is responsible for ensuring the ward remains clean and tidy and safe for patients. Agnes, however, will go wherever she is needed.

“I arrive at around 6.20am and top up the fridges with nutritional drinks for the patients. I’ll start cleaning then say good morning to our patients and see if there’s anything I can help with.

“I’ll also work with the dieticians to make sure patients are eating – our patients have just been through major trauma so can’t

always stomach certain foods. I’ll make jelly and ice lollies so they can have something without being sick.”

Agnes says a big part of her role is being there for the patients and visitors when they need someone to talk to.

“I’ve got a broad shoulder; I don’t mind it getting wet. I love working with patients and getting to know them. There’s no better feeling than when someone comes in who is really ill and you see them leave fit and healthy – it’s like winning the lottery.

“We do deal with some sad times, obviously, but it’s important to be there for patients and visitors so they never feel alone. We have a great team here on 8X, which is why it works so well.”

Agnes has worked at the Trust for 38 years

New therapy for patients

Valuable CCTV footage was gathered which led to an arrest and conviction

Quick response leads to safe outcome The Trust’s head of security has praised staff after a person who was suspected of starting a fire in the Emergency Department was sentenced to a two year suspended sentence.

Ian Wright said the successful outcome was down to the fire team, which includes security staff, responding quickly and working closely with Merseyside Police and the Fire Service to gather vital evidence including valuable CCTV footage of the suspect which led to an arrest and conviction.

The fire was started in the ladies’ toilets in the Emergency Department’s waiting room and caused considerable damage, resulting in a full refurbishment.

The suspect was arrested and charged with arson.

Ian said: “An evacuation of parts of the Emergency Department was carried out and command and control of the incident was maintained by security staff. Through their actions and quick response, a more serious incident was averted.”

We are proud to be the first hospital in the North West, and second in the country to provide Stretta® Therapy for NHS patients suffering from Gastro-Oesophageal Reflux Disease (GORD).

Stretta® Therapy is carried out by Consultant Gastroenterologist, Dr Howard Smart and is a safe and effective treatment for chronic GORD patients who are not responding to medications and wishing to avoid surgery.

GORD is a common condition resulting from a weakened muscle ring or valve located at the bottom of the gullet. This weakness causes the stomach acid to leak up into the gullet producing symptoms such as heartburn, acid reflux and an unpleasant taste in the back of the mouth.

The procedure enables patients to return home on the same day and allows them to return to work the day after treatment scar free.

Dr Howard Smart, said: “The Stretta® procedure has been used extensively in Europe and North America to improve patient’s GORD symptoms and quality of life. A long-term follow up study reveals that after eight to ten years symptom improvement is maintained and approximately two-thirds of patients require no regular acidreducing medication for their condition. Stretta® Therapy increases the treatment options available for patients with GORD, filling the gap between tablets and surgery.”

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World class research

‘Help give someone more time with their loved ones, like someone did for us’ A woman whose husband was given 12 more years of life thanks to treatment made available after clinical testing is encouraging more people to volunteer for medical research.

Roy Pegg was given less than 24 months to live when he was diagnosed with kidney cancer; however the availability of a trial immunotherapy treatment gave him 12 more years to be with his family and friends. Roy sadly died in August 2012.

Now his wife Trish, who took part in a breast cancer study after being diagnosed with breast cancer, is encouraging more people to help develop lifesaving treatments.

Trish, 53, from Neston, said: “When I was asked if I would be willing to consider taking part in a clinical trial, after being given detailed information about the trial from the hospital, I said yes. It’s my way of saying thank you to the people who have said yes in the past and helped to give Roy more time.

I’ll never know who they are, but they gave up their time to help.

“Roy’s cancer was at an advanced stage when he was diagnosed. As a family we benefitted – we spent more time together, we were able to go on lots of holidays, and Roy was able to attend his younger daughter’s 21st birthday party, and be at both his daughters’ weddings, which was a big thing for him.”

Clinical trials are used to test the latest drugs and technologies in order to develop lifesaving treatments for a wide range of illnesses.

Trish, who works at the University of Liverpool, remembers her husband’s attitude to being diagnosed with cancer.

“Roy was extremely positive. I always thought I completely understood him, but it wasn’t until I was diagnosed with cancer that I realised just how strong he was. He is my role model and he – together with the brilliant support from my friends, colleagues and family – helped me through my treatment.

“Many of the common treatments that we are all familiar with today will have been as a result of a clinical trial.”

“By being part of the research, I wanted other families to benefit like ours did. We all know someone who has been affected by cancer.

As well as saying thank you, this was an opportunity to give something back and be part of the work that goes into finding a life changing treatment for the illness.”

Trish took part in a five-day trial to reduce the growth of cancer cells before she had an operation to remove the breast cancer in October 2015. The test involved taking medication under supervision in the Royal’s clinical research unit on Monday and Friday and taking it unsupervised at home in between.

“I was given very detailed information about the purpose of the trial, what it involved, and any potential side effects - which in this case were minimal. Importantly, I was able to ask questions at any time. During the days in the

Trish is encouraging more people to help develop lifesaving treatments hospital as part of the trial, I was able to work on my iPad and read because it was so quiet.”

Louise Markinson, senior early phase trials scientific co-ordinator, said: “Volunteering for a health study helps to develop lifesaving treatments. Many of the common treatments that we are all familiar with today will have been as a result of a clinical trial.

“If you want to help shape the future of healthcare, ask the person treating you if you can get involved in research – this could be your GP, consultant, surgeon, nurse or therapist or call us on 0151 706 4863.”

The breast research team are based at the Linda McCartney centre. Patients who are eligible for trials are given the opportunity to discuss their involvement when they attend clinic appointments.

Breast cancer research nurses work closely with the wider breast cancer team to ensure patients feel supported through their diagnosis and cancer pathway and to provide them with a point of contact for their research appointments.

To find out more about clinical trials visit www.clinicalresearchliverpool. nhs.uk or www.nihr.ac.uk.

To find out more about breast cancer research opportunities, call the breast care research team on 0151 706 4027.

Record number join Liverpool diabetic eye disease trial A record number of people have volunteered to join a clinical trial aiming to help transform early detection of diabetic eye disease.

4541 people with diabetes in Liverpool signed up for the Individualised Screening for Diabetic Retinopathy trial, one of the largest clinical trial of its kind.

Usually people with diabetes have had their eyes screened every year for the prevention of diabetic retinopathy. As a result of the trial patients at lower risk could only require

tests every two years and those at higher risk can be checked up to twice a year.

By basing the timing of the eye screening on the amount of retinopathy, duration of diabetes, and the level of control of blood sugar, blood pressure and cholesterol, experts can accurately calculate risk of disease for each patient, tailoring diagnosis and treatment to the individual rather than applying a ‘blanket’ approach to all.

Professor Simon Harding, from the University’s Institute of Ageing and Chronic Disease, and consultant at St Paul’s Eye

Clinic at the Royal Liverpool University Hospital, said: “Liverpool has been leading research into screening since 1991 and many of the techniques used for screening worldwide have been developed here. The people of Liverpool have a great track record of contributing to ground breaking research and this is a fantastic example.”

The National Institute for Health Research funded trial will take a further two years to complete and, if successful, will be rolled out into screening programmes around the world.

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Improving the quality of lives of our patients

“My father’s death certificate saved my own life” A patient at the Royal wants men over the age of 65 to take part in a routine abdominal test that could potentially save their lives.

Healthy 76-year-old Barry Black, a retired mechanic from Rainhill, never expected to be diagnosed with an Abdominal Aortic Aneurysm (AAA), but after hearing a call for people over 65 to attend AAA screenings on a local radio station, he decided to go along for peace of mind.

reinforce the aneurysm and reduce the risk of a potentially fatal rupture.

An Abdominal Aortic Aneurysm is a swelling of the aorta – the largest blood vessel in the body that provides blood to the lower body.

The aorta is typically two centimetres wide, but a swelling can cause it to swell to over five centimetres.

“The choice to have surgery was a tough one. I could have gone through life without any problems. But with one rupture I could drop dead. There was no plan B.

Barry said: “My daughter was a registrar at the time and her husband’s family are all involved in healthcare – so I asked them, and my consultant, for some advice.

If an aneurysm bursts, it causes huge internal bleeding and 80% of people who suffer a ruptured AAA die before reaching hospital.

An AAA is largely symptomless.

“I didn’t want to worry about dropping dead at any minute. Since my diagnosis and operation I’ve been able to celebrate my granddaughter Sophia’s first birthday and the birth of another grandchild, Samuel.

Abdominal aortic aneurysms are most common in men aged 65 and over. Now Barry is urging others to take up the offer of screenings to help save more lives.

“I’m so grateful to the surgeons, medical staff and screening programme for giving me the opportunity to celebrate my grandson’s birth with the people I love.”

Barry said: “I was listening to the radio when I heard about screening for men over the age of 65. My dad died quite suddenly at the age of 59. On his death certificate and it confirmed he’d died of an aneurysm. In a way his death saved my own life.”

AAA screening is offered to all men registered with a GP during the year they turn 65. Men over 65 who have not been

People are at a higher risk if they smoke or were former smokers, have high blood pressure or have a close family member (parent or sibling) who has or has had an AAA. Barry went along to his appointment and following a quick scan, was called into the Royal for further tests. It was there that doctors told him he had a 5.5 centimetre aneurysm.

“After being told I had an aneurysm that could kill me, I wanted to know what and how much I could do. I didn’t really have any idea what an aneurysm even was.”

After speaking to his family, Barry decided to undergo an operation to

Barry Black wants people aged 65 and older to take part in AAA screening screened can self-refer by contacting their local screening programme directly.

“If anyone has any concerns about going along, the chances are there will be nothing to worry about. It takes ten minutes and is a simple scan on your body.

“Following my diagnosis, I told all my friends who were eligible to go along and they told their friends and not one of them was diagnosed with an AAA. As with any scan, there is calculated risk, but AAA is a silent killer.

To find out more about our AAA Screening Programme, call 0151 706 4767 or go to www.nhs.uk/aaa to find out more about AAA screening programmes near you.

Behind the camera Local video production company ZUT Media have been working with us to tell patient and staff stories over the past 12-months.

After telling Barry’s story in a recent film, director Mark Hancock said: “All the team at ZUT consider it a very special privilege to come in and film in the hospital. We have met and told the stories of some truly inspirational staff members. Witnessing their compassion and dedication to patients first hand has been a very humbling experience.”

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Improving quality of lives of our patients

Art provides creative relief for patients at the Royal Dementia and stroke patients have been given the opportunity to create their own works of art as part of a creative art programme.

The six-week ‘Making a Difference’ project is a partnership between the Royal and The Bluecoat Display Centre.

Funded through the Arts Council’s ‘Grants for the Arts’ programme and other charitable foundations, the project provides dementia and stroke patients with a stimulating activity to concentrate on for a short period while being treated in hospital.

Rachael Howard, the artist commissioned to take part in the project, wanted patients to focus on their art rather than the time they were spending in hospital.

Rachael said: “We want the work they do to empower patients with a small project they can be proud of. Patients become engrossed in the work they’re doing. It has been lovely to see the joy on their faces and the interaction their art has encouraged between patients, relatives and staff.”

Maureen Bampton, director of the Bluecoat Display Centre, said: “The project was designed to be an immersive experience between patients and carefully selected leading contemporary craft makers, who appeared to really benefit from the contact and exploration seen within the residencies.”

Patients are given a copy of their art to display proudly on their ward.

Patients work with artist Rachael Howard on their own pieces of art Shaun Lever, dementia practitioner for the Trust, said: “Giving dementia patients stimulating activities during their stay in hospital is a real benefit to the patient.

Taking some time to concentrate on their own artwork gives patients the opportunity to express themselves in a different way.”

British Transplant Games just around the corner The British Transplant Games will see hundreds of transplant recipients take part in a wide range of sporting events in venues across the city on 28– 31 July.

Figures show that 82% of the population want to donate or would consider donating, yet only 50% have discussed it with their families.

Participants can take part in a range of events including basketball, badminton, tennis and 5-a-side football.

There are currently 111 people in need of a transplant across the Merseyside area. The British Transplant Games aim to encourage more people to sign up to the organ donation register.

Each year, we carry out around 100 kidney transplants for patients across the North-West including Merseyside, North Wales and the Isle of Man.

Peter Brown, critical care audit lead nurse, is playing 5-a-side football at the games. He said: “I recently received a kidney from my younger

brother. Not only has it changed my life but lengthened it, it is a gift that I will be eternally grateful for. If more people could see how patients with organ failure benefit from this amazing gift then I think more people would donated their organs without hesitation.

“I can’t wait for the Transplant Games. I can’t wait to compete and to mix with other families who are involved with transplantation but to promote organ donation and how this gift of life can literally be life changing.”

Last year the games were held Newcastle, but organisers are confident of making this year’s games even bigger.

Lynne Holt, co-ordinator at Transplant Sport who organise the Games, said: “Over 900 people have registered to take part in this year’s British Transplant Games taking place in Liverpool. It is always very moving to see so many people whose lives have been saved thanks to organ and tissue transplants.

“It is also a chance for us to invite the general public along to take part and help spread the message about signing the Organ Donor Register, and most importantly, letting family know your wishes.”

To find out more about the British Transplant Games and see where and when you can watch each sport, visit www.brittishtransplantgames.co.uk.

To sign up to the organ donation register visit www.organdonation.nhs.uk or see Paul Dixon in the Royal’s main entrance on Thursdays between 9am and 5pm.

13

Improving the quality of lives of patients

‘I was back to smoking outside in the wind but I was no longer cool’ A member of staff at the Royal has taken to the internet to write about giving up smoking.

with a box of Swan matches, I lit my first fag. It was absolutely disgusting but this was time for a bit of character building.

‘Persevere, Ged, and I did’.

Ged Simpson from Fundraising quit smoking in March and has been writing about the highs and lows on his blog – www.gedgivingup.wordpress.com.

“Fast forward 40 years and I start work at the Royal. I had progressed to rollups and fumbling with a lighter. I was back to smoking outside in the wind, but I was no longer cool.

After a few fumbles with a box of Swan matches, I lit my first fag. It was absolutely disgusting. But this was time for a bit of character building.

‘Persevere, Ged, and I did.’

In his blog, Ged, recalls his first cigarette: “I was 13 and, boy, I was cool. I went down by the river and after a few fumbles

“I consulted our Stop Smoking service through a colleague a few weeks ago and was prescribed a course of treatment that would help me give up.

My missus, who had never seen me give up anything, was sceptical. So was I to be honest.

Ged has been blogging about giving up smoking

“Where am I now? Well, I gave up on 11 March and have had not had a cigarette since. Not a drag. What has it been like?

I’ll tell you in next instalment.”

George returns to open new theatre One of the first patients to be operated on by the new hybrid theatre returned to the Royal to perform the official ribbon cutting.

The £3.7million hybrid theatre gives surgeons access to ultra-high definition imaging during surgery on serious conditions such as abdominal aortic aneurysms (AAA).

To find out more about the Trust’s AAA Screening Programme, call 0151 706 4767

or go to www.nhs.uk/aaa to find out more about AAA screening programmes near you.

George Hasset, 74, underwent surgery on a complex aortic aneurysm.

George, from Broadgreen, said: “As with most procedures, you’re not aware of your surroundings. When I found out my procedure took place in this high-tech theatre, I was blown away.

“These surgeons saved my life and without them I wouldn’t be here to cut this ribbon.

I just want to say thank you. It’s an honour to be able to open this theatre and thank the whole team for what they did for me.”

The Royal provides vascular services as part of the Liverpool Vascular and Endovascular Services (LiVES) which connects the Trust with neighbouring hospitals across Merseyside.

George was one of the first patients to be operated on using the new hybrid theatre

14

Developing a world class workforce

National recognition for RLB Programme The RLB Programme became the first of its kind in the UK to gain national endorsement from the National Institute for Health and Care Excellence (NICE).

The programme encourages nurses to build a competency-based portfolio to evidence their clinical skills. It also includes a one-day study day marked by

a graduation style event to reward those on completion of the programme.

The programme was launched in November 2014 - since then 437 nurses have graduated as RLB nurses.

Nurses who have completed the RLB Programme explain how it helps them in a special video on our YouTube channel.

Joselito Marinas, head of professional & practice development said: “We are currently recruiting more nurses to our hospital teams and the RLB nurse programme helps with recruitment and retention as guarantees nurses at least two years of continuous professional development – the first year being the preceptorship programme followed by the RLB nurse programme.”

Celebrating International Nurses’ Day More than 250 nurses celebrated completing the RLB programme by graduating at St George’s Hall in an event that also marked International Nurses’ Day.

“I really look forward to celebrating the achievements of our nurses graduating as part of the RLB Programme.“

International Nurses’ Day celebrates the hard work and commitment of nurses across the world.

Nurses took to social media to share their graduation selfies with friends and family while patients and members of the public thanked our staff for their hard work.

Lisa Grant, chief nurse said: “International Nurses’ Day is a very special day to recognise the hard work and dedication of nurses and to celebrate the nursing profession.

“I really look forward to celebrating the achievements of our nurses graduating as part of the RLB Programme.

The programme aims to demonstrate the care and compassion provided by our nurses further develop them as professionals.

“I want patients to feel reassured that when they are visiting our hospitals they are provided with the best possible care. I also want to make sure our nurses feel proud of where they train and work.”

15

Developing a world class workforce

The show must go on We are a Category one responder for any major incidents that happen in and around the city, but what does that mean? Insight caught up with Head of Emergency Preparedness Craig Jones, to find out.

As an Acute Trust, we must have robust plans in place to enable us to respond

effectively to any number of incidents both internal and external.

The term ‘major incident’ refers to any incident which requires multiple organisations to co-ordinated a response to an incident which may range from a major transport incident to a terrorist attack. This may overwhelm an organisation’s ability

“Closing the front door is not an option; we need to carry delivering our services”

to deal with it using normal day to-day resources and may require special arrangements to be made by the Emergency Services and local hospitals.

As a Category one responder, we’re at the core of a response to a major incident.

If disruption should happen – whether that’s a technology or utility failure or a surge in demand to an incident where there are lots of casualties – the services we deliver to patients would be threatened so we must have wellrehearsed plans in place. Closing the front door is not an option; we need to carry delivering our services.

The Emergency Preparedness department provides advice and support to the Trust in the design and implementation of incident management plans, ensuring that the Trust meets its statutory and nonstatutory obligations.”

We are a Category one responder to major incidents

You can find plans on the Staff Intranet EQMS system or Staff Hub.

Share and Learn events provide opportunity to celebrate staff achievements Staff have been given the opportunity to share thoughts and ideas at special Share and Learn events organised by the Trust.

Share and Learn events are held every three months and give staff an opportunity to talk about the work they have done to improve patient care. Sessions are aimed at divisions and corporate teams.

Staff are also acknowledged with a mini award ceremony, celebrating work they have done for the Trust.

Staff star of the month awards, long service awards, retirement awards and special Trust qualifications celebrating leadership, apprenticeships, professional development, coaching, care certificates and health and safety are all presented at the event.

Rhonda Hughes, operational service manager for HR and organisational development and learning said: “To date we have run four events and over 200 staff have been recognised for their fantastic achievements.

“Events are open for anyone to attend and we would welcome any individuals, teams, departments to take part to recognise the fantastic work we know goes on around our hospitals.”

For more information and to discuss Share and Learn events, please email staffengagement@rlbuht.nhs.uk.

16

Fundraising

Born to do this Four brave members of staff are preparing to swap the corridors of the Royal for the tropical climates of the Borneo rainforest.

Laura Perry and Ricky Lacey will team up with chief executive Aidan Kehoe and consultant, general medicine Julian Hobbs to tackle the 10-day trek through the Kinabalu Rainforest south-east Asia, to raise vital funds for R Charity’s £10million Appeal.

The Borneo rainforest covers around 165,100 square miles.

Aidan Kehoe, chief executive, said: “This is going to be a fantastic experience and a great way to raise money for R Charity’s £10million Appeal for the new hospital.

The money we raise will help to buy the most advanced technologies and patient comforts. The trek will be a serious physical challenge so the training starts now!!”

R Charity offered two free spaces to staff members who submitted the best fundraising plan – each entry had to promise to raise more than £2500.

Specialist pharmacist Laura Perry and 18-Week Trainer Ricky Lacey were selected and can’t wait swap their lanyards for backpacks.

Laura said: “It has always been a dream of mine to visit Borneo and the opportunity to do so was presented

The Borneo rainforest covers around 165,100 square miles (Photo courtesy of Bernard Dupont, Flickr) to me at a time when I was ready for a personal challenge!

“The combination of completing such a demanding trek and raising funds for R charity appeals to both to my adventurous nature and my desire to contribute to the future of the Royal.”

Ricky added: “When I found out I had been selected my head was filled

with mixed emotions, uncontrollable excitement, anticipation but also nervousness and a little bit of fear; I quickly googled all poisonous and deadly animals that Borneo has to offer.”

To find out how you can raise money for R Charity email fundraising@rlbuht.nhs.uk or call 0151 706 3150. You can also call into the Fundraising office behind reception in the Royal’s foyer.

Meet the expedition

www.justgiving.com/profile/ lauraperry2016

www.justgiving.com/rickylacy

www.justgiving.com/ fundraising/Aidan-Kehoe2

www.justgiving.com/ fundraising/Julian-Hobbs4

New Breast Unit appeal launches R Charity has launched its appeal to buy the latest breast diagnostic and screening technology in the new Breast Unit as part of its £10million Appeal for the new Royal. £750,000 of the £10million Appeal will pay for three new lifesaving mammography machines Margie Shields was diagnosed with breast cancer in 2002 after being referred to the Royal by her GP. She said: “When the results from my mammogram came back, my specialist said I needed a biopsy. The doctors gave me the news. The results showed that I had breast cancer.

“If I had all the money in the world I’d still choose to be treated here – the staff are all so compassionate and kind. I couldn’t have hoped for better treatment.

People think cancer is the end, but I’m proof that with the right treatment you can live for a long time and can make the most of your life. That’s why I’m supporting R Charity’s new Breast Unit Appeal.”

You can support R Breast Appeal by holding a Pink Party during October – Breast Cancer Awareness Month. Contact Angela McShane on 0151 706 3172 or email fundraising@rlbuht.nhs.uk to pick up your free party pack. Packs include posters, invites, balloons, games and bunting.

New leaflets which explain the importance of the new mammography machines have been produced

17

Fundraising

Thanks to R supporters

Thanks to Steve Walls for raising over £10,000 for us by cycling all over the UK. Steve’s most recent trip from Liverpool to London has raised over £4,000 pounds up to now

All for One fundraising committee’s Pink Party raised £3,500 towards breast cancer services in the new Royal

Hazel Gearing’s amazing Ceilidh in St Michaels Irish Centre and raised a massive £3,296.53 – thanks Hazel!

A huge congratulations to Gary Jackson whose charity walk from Crosby to the Royal raised an amazing £4,336

A massive thank you to Tracy who raised £4328.52 for running the London Marathon

Thanks to all the staff and customers of One Stop Shop, Prescot Street. The shop nominated R Charity as their chosen charity for the 5p carrier bag charge and raised £1,000!

Thank you to Paul Daley for taking part in the Italian Alps cycle challenge and raising over £2,000

Thanks to Steve Doyle and Getrang Ford, Halewood for choosing R Charity as their charity of the year and raising £600

18

Exceptional patient experience

Patient thanks Royal Liverpool University Hospital I came to A&E on 20 March with a severe headache that I later found out was a brain haemorrhage. All of the staff on duty from front desk, triage, the doctors, nursing staff and radiologists were all fantastic and really looked after me until I was transferred to the Esau ward late at night. While I was waiting (12hrs before I could have a lumbar puncture) I could hear how efficiently and professionally everyone in the A&E dept was looking after other patients and managing bed space- despite challenging patients. In the Esau ward I was looked after incredibly well by the night staff who monitored my symptoms, pain relief and were wonderful when I was worried and upset. The day staff for 21 March were also fabulous and everyone- nursing staff, orderlies, doctors, medical student and the consultant I saw were great and I felt went out of their way to put me at ease and explain what was happening, and what was going to happen next. I think that the Dr who performed my lumbar puncture should be singled out for praise as I was

dreading it and they did a great job.

The member of staff who brought around the tea and coffee was also just lovely

as well. The ward was clean and it was cleaned throughout my stay. Thank you to everyone.

Broadgreen Hospital I recently underwent a shoulder arthroscopy at Broad Green Hospital and wanted to convey my sincerest thanks and compliments to all the staff involved in my care.

As a paraplegic I was a little anxious about the surgery, even though it was only a day case.

However, I needn’t have worried as I felt like I was in a well-oiled machine - everything occurred as and when I was told it would and I felt completely secure in the hands of all the staff I came into contact with, from SEAL unit to theatre to Ward1.

Everyone was friendly, efficient, competent and professional. Well done!

Dental Hospital I had an appointment today I have been extremely nervous about it for several weeks , the staff and students were amazing , made me feel so comfortable , very professional and caring right through the procedure , wish I could go here for all my dentistry appointments brilliant all round thank you.

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