Insight Bath Spring 2013

insight

Royal United Hospital Bath NHS Trust

Photo courtesy of Bath Chronicle

ISSUE 18 SPRING 2013

New test to rate our care Hospital stars Art on a big scale

Smallcombe House Smallcombe House is a purpose built Residential Care Home for the Elderly (registered by the Care Quality Commission).

The Home is situated on Bathwick Hill, Bath, all rooms are single en-suite with call-bell facilities, with views looking out across Smallcombe Woods.

The ethos of the Home is Christian and has a Chaplain who is an ordained minister.

For further information and a brochure please Tel: 01225 465694.

Smallcombe House, Oakwood Gardens, Bathwick Hill, Bath BA2 6EJ Non profit making organisation – part of the Salvation Army

Every possible care has been taken to ensure that the information given in this publication is accurate. Whilst the publisher would be grateful to learn of any errors, it cannot accept any liability over and above the cost of the advertisement for loss there by caused. No reproduction by any method whatsoever of any part of this publication is permitted without prior written consent of the copyright owners.

Octagon Design & Marketing Ltd. Š2013. Britannic Chambers, 8a Carlton Road, Worksop, Notts. S80 1PH. Tel: 01909 478822

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Welcome

inside this issue ...to the Spring edition of your hospital magazine.

Read about how we are helping children to prepare for their stay in hospital with the production of two films which explain what happens when a child needs an anaesthetic. We are hoping that these DVDs will go some way to making them feel safe and as relaxed A staff celebration… page 14 as they can be, and that they will answer some of the children’s questions which their parents are unable to answer.

insafehands In Life and Death......................................................4 Changes in the NHS..................................................5 Helping children understand.....................................6 Easing the pressure...................................................7 Coming into hospital?...............................................8 Prosecution supports ‘zero tolerance’ message..........9

inview Dementia funding...................................................10 Patients to rate RUH quality of care.........................11

We are delighted that an award of £453,000 will improve the experience of patients and carers affected by dementia. The investment will be used to reduce unnecessary time in hospital, involving carers and listening to their views, planning the discharge better and ensuring better support at home, so there will be fewer readmissions to hospital. Access to staff training will also be increased.

People moves..........................................................11

Our staff do extraordinary work every day and we were delighted to honour them for their contributions and achievements in health and patient care, at a special annual awards evening recently. The event, which took place at the Assembly Rooms, Bath, was a fantastic celebration and we are so very proud of them all.

Sharing the pain.....................................................16

Yours sincerely........................................................12 Emergency Department gets top marks...................13 Hospital stars..........................................................14 Our snow heroes....................................................15

Art on a big scale – celebrating our 80th year.........17

inaddition Art..........................................................................18 Mayor of Bath supports appeal...............................19

Anita Houlding Editor / Senior Communications Officer

Take away teddies...................................................19

Editorial dates 2013 You can send your articles for insight via email to anita.houlding@nhs.net or RUHcommunications@nhs.net Deadline for copy for next issue is 18 April for publication in May.

Giving a helping hand.............................................20 Changing lifestyles..................................................21

inyourowntime Take a break...........................................................24

Contributors

Dr Paul Hersch Consultant Anaesthetist

Mandy Rumble Assistant Director of Nursing (Acting)

Hetty Dupays Arts Programme Manager

Anaesthetic DVDs p6

ED gets top marks p13

Art on a big scale p17

www.ruh.nhs.uk

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In Life and Death Many of you expressed an interest in finding out more about the End of Life Care that we provide at the RUH, and so, at the first Caring for You event of 2013, over 75 Foundation Trust members talked with staff about the care we give to patients and their families, when a member of their family or close friend is nearing the end of their life.

End of Life Care is a vital part of the work of all our staff at the RUH. It is a difficult time for both patients and their loved ones, and our aim is to provide dignity and skill and the best quality care possible for those who are dying.

We are supported in this work by Dorothy House Hospice, with whom we have a very close partnership, working together to provide this important support for many of our patients. The role of our Clinical Nurse Specialist in Palliative Care, Rachel Davis, is partly funded by Dorothy House and their financial support has been enormously helpful in progressing the range and extent of Rachel’s work.

Rachel is currently working with staff across the Trust to help them enhance their skills in caring for patients at the end of life. She supports their training and education to ensure that end of life

“We encourage people to talk about their wishes towards the end of their lives, including where they want to die and their funeral plans with friends, family and loved ones. We need to make a ‘good death’ the norm.

“Talking about death doesn’t bring it closer. It’s about planning for life, making the most of the time that you have. Knowing loved ones have died where they wanted to be and had the funeral they would have wished can bring enormous comfort to those left behind.” issues are communicated sensitively with a patient and their family, and they also look at how they can support patients to express their preferences for where they would like to be cared for as they approach the end of their life – known as advance care planning – to help them achieve their wishes.

At the Caring for You event, there were some very interesting conversations around end of life and advance care planning, which is encouraging as Rachel says that talking about death is still a taboo: “As a society, we need to talk more about dying, death and bereavement.

As individuals, we need to talk with our loved ones about dying.

Dates for the diary Take a look at our future Caring for You events. Places must be booked in advance, so please contact the Membership Office.

Date

Time

Event topic

Monday 25 March

6:00pm Pain management

Monday 20 May

6:00pm Stroke

Monday 15 July

6:00pm Emergency Department

Wednesday 10 September

6:00pm Care of the elderly and dementia

Wednesday 27 November

6:00pm Eyes

All of our Caring for You events advertised will take place in the Post Graduate Medical Centre at the RUH, department B20.

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The overall feedback we received on the night highlighted that the standard of care was very good at the RUH. Mrs Cobb, an FT member from Bath, is a fan of the Caring for You events, she said: “Thank you for arranging these events which are an extra for the busy, professional working lives of staff, I appreciate the time they give.

The sessions are very interesting and informative for people like me who are not involved in health.”

Contact us Please contact us via any of the following numbers or addresses for more information: 01225 821299 RUHmembership@nhs.net www.ruh.nhs.uk/ foundationtrust FREEPOST RSLZ-GHKG-UKKL FT Membership Office, Royal United Hospital Bath NHS Trust, Combe Park, Bath BA1 3NG

Changes in the NHS

From 1st April 2013, Primary Care Trusts are being abolished and the planning and purchasing of local health services, called ‘commissioning’, will become the responsibility of Clinical Commissioning Groups. Based locally, the groups, comprised of GPs and clinicians, will be responsible for designing local health services In England. They will do this by commissioning or buying health and care services at a local level. The services they will be responsible for procuring include: • Elective hospital care • Rehabilitation care • Urgent and emergency care • Most community health services • Mental health and learning disability services.

Clinical Commissioning Groups will work with patients and healthcare

professionals and in partnership with local communities and local authorities.

On their governing body, Groups will have, in addition to GPs, a least one registered nurse and a doctor who is a secondary care specialist. Groups will have boundaries that will not normally cross those of local authorities.

Clinical Commissioning Groups will be responsible for arranging emergency and urgent care services within their boundaries, and for commissioning services for any unregistered patients who live in their area. Your GP practice will belong to a Clinical Commissioning Group.

The NHS Commissioning Board, accountable to the Department of Health, has the overarching responsibility for these Clinical Commissioning Groups.

As part of the changes, PCTs’ local public health functions will transfer to local authorities, giving councils formal

responsibility for health improvement activities, such as promoting healthier lifestyles, as well as protecting people from infectious diseases and environmental health. Councils will also be responsible for providing specialist public health advice to their local CCG, under the guidance of a local Director for Public Health, a role that will transfer from the PCTs. Who will commission services from the RUH? Two CCGs, one covering Bath and North East Somerset and the other Wiltshire, will be our main commissioners and that’s where the majority of our patients live. In addition, there are CCGs for Bristol, Gloucestershire, North Somerset and Somerset. The Somerset CCG is split into smaller areas or ‘federations’ and three of these, East Mendip, Central Mendip and West Mendip are expected to commission services from the RUH for patients in their areas. www.ruh.nhs.uk

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Helping children understand the anaesthetic process

Consultant Anaesthetist Paul Hersch with William and mum Kay

Coming into hospital for surgery is often a daunting prospect for our patients and perhaps especially so for parents and younger children.

Whether it’s for a simple procedure or more complex surgery, having an anaesthetic is often the part the children focus on and are most worried about.

Trying to understand the concept of being made to go to sleep and leaving behind mum or dad can be a very scarey prospect. For a parent, holding their child’s hand as they slip into unconsciousness is very distressing and the point at which the resolve of the most brave of parents gives way.

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To help alleviate some of this stress, Senior Registrar Beccy Leslie and Consultant Anaesthetists Rowan Hardy, Fiona Kelly, and Paul Hersch have worked with a video production company to produce two films to help guide children and parents through part of that process.

The films – one aimed at very young children, the other at school age – look at what happens when a child needs an anaesthetic, from the ‘magic cream’ on the back of the hand, through to being anaesthetised ahead of surgery.

Dr Paul Hersch says: “We are absolutely

delighted to have this resource available for our younger patients. It’s so important for them to feel safe and as relaxed as they can be and we hope these short films go some way to making that happen. Parents are also often very worried and may not know how to answer all their children’s questions so again we hope they will benefit from these films.”

The films are set in the hospital and feature our staff to add to the familiarity.

They are available to watch on our website and there are plans to make copies available to patients and parents ahead of having their surgery.

Easing the pressure We are in the process of creating a rapid assessment area within the Medical Assessment Unit (MAU), and we’re using the enhanced skills of our Medical Nurse Practitioners to help improve the flow of patients through the hospital and speed up their initial assessment.

These nurses have clinical skills to assess patients and order diagnostic tests, which will make the process more efficient and give you a better experience.

There are four new Medical Nurse Practitioners that will work within the rapid assessment area, making six in total working across MAU, Ambulatory Care and the Emergency Department, and there are more working across the rest of the hospital. All the Medical Nurse Practitioners have been given

a higher level of training so that they are qualified to physically examine you, make a diagnosis and prescribe medication if necessary.

The Medical Nurse Practitioner enhances the role of skilled nurses in hospitals by ensuring they are better qualified to assist doctors. They act as a lynch pin in this essential role, providing far greater continuity and a holistic approach to your care.

Emma McLaren who is a Junior Doctor at the RUH, says: “The medical nurse practitioners see patients as they come into the assessment areas of the hospital, this might be the Emergency Department, Ambulatory care or MAU, taking patient histories, examining and ordering the relevant ‘first line’ investigations; gathering the essential

information needed. This saves a great deal of time and allows an earlier review by a senior doctor, and assists in the planning of the next stage of a patient’s care.

“They have an excellent combination of skills and a great collective knowledge of the hospital, the people in it and how things work.

They are able to use this knowledge to liaise with the discharge team, or physiotherapy, or community services.

This speeds up referrals to these essential services and assists with discharge planning, which in turn improves flow through the hospital.

“As a doctor new to the department, I’m very grateful for their support and input. They are an essential and valuable part of the medical team.”

Three of the new Medical Nurse Practitioners who are working in Ambulatory Care; Junior Sister Dorothy Kumar, Sister Mieka Hamman and Sister Rachel Chesterton

www.ruh.nhs.uk

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Coming into hospital?

Bring your medication and repeat prescriptions with you Bringing your regular medication and repeat prescriptions with you into hospital sounds like common sense – it is – and we need more patients to do it.

A programme to raise awareness will begin in the next few weeks and will see posters in a range of locations across Bath & North East Somerset, including GP surgeries and pharmacies.

Regina Brophy, Chief Pharmacist at the RUH, says: “Encouraging patients to bring in their own medication information into hospital with them allows us to know exactly what they are taking. This will reduce the risk of a delay in giving a patient their medicines while we try to check the prescription with their GP. This is particularly important for critical medicines that should not be delayed such as those for Parkinson’s disease, diabetes and epilepsy.

“The scheme will bring a great many benefits, for example it will allow the prompt prescription of patients’ regular medications, reduce the risk of medicines being stopped or missed while checks are made, and continue the effective management of long term conditions.”

Dr Andrew Smith, a GP from Combe Down Surgery, says: “Although the hospital will provide any medicine you need while you are there, it is very helpful if you bring all your medicines and your repeat prescription with you when you are going into hospital. This helps staff know what medicines you are taking, how frequently you are taking them and they can then prescribe them for you without delay.

“You may find it helpful to keep 8

insight Spring 2013

GPs will be reminding patients who are on regular medication to bring it with them when they come into hospital

your repeat prescription in one place; for example, your purse or wallet, so that when you come into hospital, or if your hospital stay is unexpected, it is easy to bring it with you. It’s also a good idea if your partner, a family member or carer knows where to find your repeat prescription and medication.

Please look out for posters displayed in your GP surgery and in local

pharmacies, which will remind you that you need to bring your repeat prescription and all your own medicines, including tablets and capsules, liquids, creams and inhalers, when you come into hospital.

This project is part of a major ‘Safer Clinical Systems’ study at the RUH, funded by the Health Foundation, to ensure patients get their medicines on time in hospital.

Prosecution supports ’zero tolerance’ message A woman has been successfully prosecuted for being abusive and violent towards RUH staff on more than one occasion.

The 20 year old woman, from Peasedown St John in Bath, was convicted of using threatening words/ behaviour to cause alarm or distress and given a three month prison sentence.

Nicholas Reed, Security and Parking Manager (top right), is very clear that we need to exclude people who abuse NHS staff: “Violence towards staff, both physical and verbal, will not be tolerated.

“Staff have the right to be safe at work.

We have a range of sanctions available to us and if we need to pursue these through the courts to protect our staff we will do it.”

“Violent and aggressive behaviour causes severe distress to staff. We actively encourage staff to report such incidents so that we can take the action needed to ensure we continue to provide a safe environment.”

A number of measures exist in the Trust to reduce the risk of violence. This includes Conflict Resolution Training for frontline staff to help them deal with violence and aggression, aimed at staff working in areas where they may be vulnerable to aggressive behaviour.

Additional security measures exist in some areas, for example departments use access control systems at night which rely on close circuit televisions fitted to doors, and a panic button system, which enables staff to alert

hospital security if they encounter problems. Emergency Department staff also have personal attack alarms, which activate sensors in the ceiling, enabling security staff to locate them quickly.

www.ruh.nhs.uk

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Dementia funding “will make a tremendous difference”

Clinical Commissioning Group Clinical Director Dr Ruth Grabham, Consultant Geriatrician Chris Dyer, Karen John from Age UK Bath and North East Somerset and Neil Drinkwater from the Carers’ Centre

The RUH has been awarded almost half a million pounds to improve the experience of patients and carers affected by dementia.

We have received £453,000 as part of the Dementia Challenge Fund bid; £296,180 came from the NHS South Challenge Fund and £156,820 from the BaNES and Wiltshire Clinical Commissioning Groups.

The investment will be used to reduce unnecessary time in hospital, involving carers and listening to their views, planning the discharge better, and ensuring better support at home, so that there will be fewer readmissions to hospital. Access to staff training will also be dramatically increased.

Dr Chris Dyer, Consultant Geriatrician, explained that a new seven-day service would start in March with a much bigger mental health liaison service for older adults, and new dementia coordinators, who will help ensure the correct care processes and pathways are followed for patients with dementia.

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Four teams are focusing on what should happen throughout a patient’s hospital stay, what support is offered on discharge in both the BaNES and Wiltshire area, and how we will measure these improvements from a patient’s point of view.

Chris says: “We’ll be introducing care bundles which are key “must do’s” for every person, such as ensuring there is a discussion with carers about their loved one’s needs in hospital, and about any issues there are around discharge. We will ensure all patients have a ‘This is Me’ document so that staff understand their patients better.

“The funding also gives us more flexibility, allowing us to fund very short packages of care without necessarily involving a hospital social worker. For example, if a person was ready to leave hospital on a Friday, but could see a social worker at home on Monday, we could provide care for the first few days.

“We’ll also be looking at the use of Telecare to help support people at home,

in collaboration with the Bath Institute of Medical Engineering. Telecare is essentially the remote monitoring of a person at home to check, for example, that they haven’t fallen down or wandered outside. The plan is for this equipment to be demonstrated in the Atrium, so that carers, and indeed staff can see what is involved.

“I am hopeful that this funding will make a tremendous difference. My ambition is for the RUH to be recognised nationally as an exemplar of good practice for dementia care. I think we already provide good care as evidenced by the number of wards with charter marks. We now need to develop further our patient and carer partnerships.

Involving carers will drive up standards for these frail and vulnerable patients.”

Our bid for funding was supported by our partners, Research Institute for the Care of Older People, Bath Institute of Medical Engineering, Alzheimer’s Support and the Alzheimer’s Society as well as Sirona Care and Health and Wiltshire Council.

Patients to rate RUH quality of care An NHS-wide ‘Friends and Family’ test to improve patient care and identify the best performing hospitals in England begins from 1st April, and if you are an inpatient at the RUH, you will be asked to take part. As an inpatient, or if you attend the Emergency Department, you will be asked to rate us on the quality of the care you have received and whether or not you would recommend us to others.

At the point when you are discharged from a ward or the Emergency Department, you’ll be offered the opportunity to complete a very short questionnaire – either on a printed card (see below) or online via a laptop, PC or your mobile phone.

Put simply: each and every in-patient will be given the opportunity to share their views on their experiences as a patient. The expectation is that (with a few exceptions such as Intensive Care Units where it may be inappropriate to seek feedback from patients) the Friends and Family test will be implemented in all acute inpatient wards using the same question.

The current proposal is that the information

People moves Francesca Thompson

we collect will be published (again from April 2013) on a locally determined basis, probably online; from July 2013, the scores of all participating hospitals will be published nationally.

The purpose of the test is to gain information from you as patients about your experience. By asking the same patient groups the same questions in all acute care hospitals, the results, when published, will be comparable at a national level – hospitals can be compared side by side as well as comparing wards within a hospital to identify areas for improvement and to provide more information for patients when they are choosing where to be treated.

Many hospitals, including the RUH, already measure patient experience, and some do use this single question, but until now, there hasn’t been a standard approach about the questions asked, how responses compare, and what is done with the information. This new Friends and Family test is designed to address this and to provide a consistent measurement of how our patients feel about the care they receive at the RUH.

Congratulations to Francesca Thompson, who has been appointed as our new Chief Operating Officer.

Francesca has been Director of Nursing at the RUH since 2006.

She said she had enjoyed her nursing leadership role immensely. When she arrived at the RUH the rate of healthcare associated infections, such as MRSA and Clostridium difficile was amongst the highest in the country here, and now we are proud to say they are amongst the lowest.

Francesca says: “My admiration for the unstinting support, loyalty and hard work from my senior nursing team and dedicated staff has been so appreciated and I have been striving to see the RUH better recognised for all the high quality care and quality improvement work undertaken.

“This career opportunity for me is both personally and professionally exciting and I am delighted to be taking it on.”

Francesca’s former role of Director of Nursing will be filled on an acting basis by Assistant Director of Nursing (Medicine) Mary Lewis.

Mary Lewis

www.ruh.nhs.uk

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Yours sincerely It’s always pleasing to receive positive feedback from patients and their relatives for the support and care they receive from our staff and the Trust frequently receives letters of praise and thanks. Some also appear in the local press. Here are extracts from a few.

A woman from Westbury wrote to thank us for the care her daughter received recently. “I was impressed by the high standard of care she received throughout her two-day stay on the Paediatric ward. All the staff involved in her care were highly professional, kind to her and courteous to me. I would be most grateful if you could make sure that the medical staff involved in her care are made aware of my comments.”

We received a letter of thanks from a patient who lives in Corsham, who said: “During my stay on the Robin Smith ward I was treated by the surgeons, doctors and nurses with kindness, skill and understanding. I would like to give my most sincere thanks to all members of staff. May I state that the RUH is a hard act to follow and that the quality of work carried out by your staff is second to none – many, many thanks.”

A patient from Bath wr ote to say how very impressed he was with our Catheter Laborator y staff, they made him feel relaxe d and comfortable during tre atment.

“Whilst I was waiting to go back to the ward, two emerg encies came in, one via ambu lance and one via helicopter. I wa tched while they really went to work. I am sure two people’s live s were saved that morning tha nks to a wonderful team at the RUH Cath Lab. Superb.”

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A grateful patient from Peasedown addressed her letter of thanks to all the sta ff, doctors, nurses and everyone in the RUH: “You were all kindness itself.

Everything possible wa s done to make me comfortable.

I came in by ambulance and the crew and the medics were great, and the sister on duty worked tire lessly to care for me. I spent 10 days in the hospital and everyone was very kind and thoughtful an d put me at ease. I say thank god for the NHS, long may it reign.”

A man from Bristol wrote: “I would be extremely grateful if you could pass my sincere thanks to the doctors and nursing staff who handled my case recently. It was more than the exemplary clinical expertise shown by Dr Carson, Dr Birchell and Dr Lowe, and their supporting team, it was also the dedicated and superb nursing and pastoral care received from staff of the Coronary Care Unit. Through it all, the medical staff were at our side 24/7 to help us. I will never find enough words to express my gratitude. Please be very proud of them all.”

We also received a letter from a woman from Whitley in Wiltshire who wanted to convey her thanks and appreciation to the staff who cared for her son in the fracture clinic, and to highlight their excellence. “The receptionists were particularly helpful and went the extra mile to adjust appointment times and who kept us informed whilst we were in the waiting room. I particularly want to commend Sharon Parker, the orthopaedic technican who did an amazing job applying my son’s plaster. It was really professional and she is clearly an experienced practitioner. The entire department was clean and tidy and everyone seemed to work well together as a team. We appreciate all the care we received, the medical advice from Dr Oliver Bradford was informative and concise and really appropriate for my son to understand. I really commend all your staff and the experience we had.”

A man from Bath wrote to draw our attention to the excellence of a member of our staff, who cared for his elderly father who was treated in the fracture clinic: “Following a consultation with Otto von Arx, who was extremely helpful and obviously highly proficent. My father was then sen t for his arm to be plastered and he was dealt with by Tim Peterkin.

From the beginning, Tim dealt with me and my father in the most respectful, professional and compassionate way. I have much experience of dealing with the public in a variety of situations, I have never encoutered a better communicator or encountered better treatment. Tim was ably assisted by a trainee nurse and I was also able to witness him passing on his considerable skills.

I am sure you are already aware of the excellence of some of your staff and I am sure you will pass on my thanks to Tim and his team.”

Emergency Department gets top marks hospital. This compares with 66,228 attendances the previous year, and 25,110 admissions.

Picker carried out the survey on our behalf on a random sample of patients who attended the hospital in January 2012. The report also found that: • The courtesy of our ED reception staff was rated excellent, very good, or good by 91% of those responding • 95% of respondents said the Department was clean or very clean, while 87% felt the toilets were clean or very clean

Reception staff in the Emergency Department have been praised for their work to ensure the privacy of patients.

Sixty-four per cent of patients who responded to a survey felt they had been given enough privacy when discussing their condition with a receptionist on arrival at the Emergency Department (ED) – the highest response of any of the 66 trusts assessed by the Picker Institute Europe.

Patients were asked a series of questions relating to their arrival at the ED, waiting time, doctors and nurses, care and treatment, tests, pain, environment and facilities, leaving the ED, and an overall score for their experience.

Our performance was better in all of the areas when compared with the last time the survey was carried out in 2008. The RUH received an average overall score of 8.1 out of 10, compared to an average 7.6 for other

trusts who took part in the assessment.

Acting Assistant Director of Nursing Mandy Rumble says: “We are delighted with these results which reflect all of the hard work which goes into delivering emergency care.

It is particularly pleasing to see that we have improved the experience of patients during a time when we have seen year on year increases in the actual number of patients attending the ED. “We know that when patients visit the ED they may be worried, distressed, and in pain, and our receptionists, who are trained in customer service, deliver an excellent first impression of the hospital.”

Along with staff trained to deliver excellent customer service, the ED has booths to enable patients to discuss their condition privately.

In 2011/12, 69,508 patients attended the Emergency Department, with 26,968 being admitted to the

• Doctors and nurses were felt to be working well together – according to 89% of patients who responded • 86% of patients said they weren’t delayed when they were ready to leave the ED • 85% of respondents felt they had been treated with respect and dignity • half indicated this was their only visit to the ED in the previous year, 39% had been two or three times, with 7% coming four or more times • around one in three (34%) have previously been to the ED for the same condition or something related • 46% said they had a longstanding condition.

The full Accident and Emergency Department Survey 2012 is available on the NHS Surveys website at www.nhssurveys.org www.ruh.nhs.uk

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inview Team of the year

Most innovative team

Hospital stars

Hospital staff were honoured at a special annual awards evening for their contributions and achievements in health and patient care.

The event, which took place at the Assembly Rooms, Bath, symbolised the dedication and hard work of so many staff.

Staff on Midford Ward were voted Team of the Year in recognition of the care they give to patients with dementia. They were the first team to achieve a Gold Charter Mark, a scheme which has been developed by the RUH with Alzheimer’s Support, to challenge wards to meet high levels of care for their patients with dementia.

The Pulmonary Hypertension (PH) Specialist team won the Most Innovative Team Award. They’ve developed a ‘one stop’ pathway, which allows patients with

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Pulmonary Hypertension (a group of diseases in which the blood pressure within the lungs rises far above normal levels), to undergo non-invasive assessment in a single outpatient visit; massively improving the patient experience. They run a joint care service with two national centres for PH at Papworth and the Royal Free, and have been designated as part of a PH satellite centre.

Customer Care of the Year Award went to Amie Briggs, Ward Manager on Haygarth Ward in recognition of her outstanding professional care and her ward leadership.

The Stroke Team won the Research and Development Award, for their outstanding research work. Research is now integral to the Acute Stroke Unit and all patients admitted with stroke can be assured

they will receive care based on latest research, and if appropriate, be offered the opportunity to participate in a relevant research study.

Loyalty Awards were also given to staff in recognition of their long service, and the evening was another opportunity to acknowledge Anne Plaskitt, Senior Nurse for Quality Improvement, who won the Patient Safety Award earlier this year.

Staff who had been nominated as NHS Heroes, a nationwide recognition scheme, designed to celebrate the extraordinary work that staff in the NHS do each day, were also celebrated.

RUH Chairman Brian Stables says: “The awards are important as they give us a great opportunity to showcase the amazingly talented people we have at the RUH and it gives us a chance to thank the 4,322 staff who, day in day out, work incredibly hard caring for our patients. They are all stars and we are very proud of them.”

Research and development

Our snow heroes

We would like to say thank you to all of our staff who made such an effort to get in to work during the snowy and icy conditions in January.

Customer care of the year

Many staff made extraordinary efforts to get to the RUH, walking for miles in the snow, staying overnight on site, or locally, and often working longer or extra shifts to keep hospital services running.

… Steve Boxall, Head of Capital Projects, who drove miles out of his way to take home two members of the public who would otherwise have been stranded at the hospital late at night.

Good neighbours and friends helped battle the elements to make sure the care the RUH gave to patients continued as normal.

… Helen Murray in Anaesthesia, who’s car crashed on the way to work.

She asked the AA man to take her to the RUH so that she could do her shift, rather than taking her home!

We heard many stories about the lengths staff had gone through to get to work, and we are sure there are other stories that did not reach our ears.

Here are just a few – well done to everyone who went above and beyond to get to the RUH. Thanks to: … Mary Chapman, Health and Safety Manual Handling Advisor, who worked on the wards before sleeping on the floor in her office.

… Beth Gravell, David Minchin, and Andy Minchin who walked for three hours through a blizzard to get to work.

Thanks also to the staff who helped keep areas of the site clear of snow, and to colleagues at the education centre who helped accommodate staff by organising bedding, and refreshments.

… Mariska Oddy, Junior Sister, who worked a shift on her day off. She was one of a number of staff on Forrester Brown ward who completed extra shifts, or stayed over, in order to care for patients.

We received many more stories which we published on our intranet, but would also like to thank Debbie Grant and her colleagues in NICU, Helen Cain, Keiron Oglesby, Sarah Gouldson, Nina Habibi, Tim Howes, Pete Forster, Victoria Seelig, Debbie Crewe, James Minchin, Owen Margetts, Tim Evans and Tim Cook.

… Trevor Pringle, Site Manager, who ferried staff to and from the Frome area, which was particularly treacherous, in his 4x4.

We are all extremely grateful for your efforts and very proud of the level of commitment shown both to our patients and to the RUH.

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Sharing the pain A specialist physiotherapist from the RUH has returned from an eyeopening trip to Africa, where she worked with colleagues to promote good practice in pain management, through education and training.

Sarah Ferguson (pictured right in pink) travelled overseas with colleagues from the charity SPIN, Specialists in Pain International Network, and worked alongside staff in Africa to help them recognise the biopsychosocial factors associated with pain. It’s a model of care that assumes that biological, psychological (thoughts, emotions and behaviours), and social factors all play a significant role in illness. It’s an approach which is unfamiliar to them. rehabilitation, taking a holisitic approach to movement and function and helping the patients be more in control of their pain management.

Sarah explains: “At the RUH we take a far more holistic approach to how we treat patients with chronic pain.

We treat the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. We look at the impact of pain on different aspects of their life, like sleep, stress, work, and other personal issues.

“We encouraged the teams there to ask their patients different questions, for example how does your pain make you feel? In the clinics, we looked at the patients’ daily activities and helped them understand how this affects their pain system, for example, were they overdoing things, or taking too many rests. There are many factors to consider.”

Sarah works alongside our orthopaedic spinal consultants, assessing patients, and evaluating investigations. She explains the findings to patients and discusses treatment options with them, which may be pain clinic treatments or spinal surgery. Sarah also works as a Senior Phsyiotherapist in the pain clinic, alongside doctors, nurses and 16

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psychologists; they collectively advise, treat and manage patients with acute and chronic pain. She analyses the impact pain has on their ability to walk, sit or stand, as well as looking specifically at problems such as joint stiffness, or musle tensions and uses treatments, such as manipulation, to regain normal movement.

During her trips to Kigali in Rwanda, Nairobi in Kenya and Grand Cayman, Sarah also presented at two pain conferences, which focused on the training of staff working with acute and chronic pain patients.

“We discussed research-based treatments for back pain, for example exercise and the different types and possible benefits. We also promoted

“In a region with a population of 270 million, East Africa has only one hospital where pain management services exist.

There is a huge need to improve the general knowledge and awareness of good treatment procedures for acute and chronic pain management.

“It has been a fantastic experience to be involved in the SPIN charity, their work in East Africa over the last two years, has been invaluable in the training of staff and has had a big impact on ‘evidencebased’ treatment for patients.”

Therapy Services Manager, Maggie Depledge, is full of praise for Sarah’s work: “We are extremely proud of the work that Sarah has done with SPIN, and we are very fortunate to have such an international expert within our workforce. Sarah is keen to share her knowledge with colleagues locally and contributes a great deal to improving the care of patients with pain at home and abroad.”

Art on a big scale – celebrating our 80th year Local school children visted the RUH to unveil art on a grand scale which they have created in celebration of our 80th year.

St Mary’s Catholic Primary School and

Kier Construction (the company building our new Pathology Laboratory), kindly donated materials to allow the children to create ‘time’ panels to represent 80 years of great patient service and healthcare at the RUH. The panels will decorate the hoardings which surround the construction site.

year and a half.”

Arts Programme Manager Hetty Dupays said: “The art created by the children from Weston All Saints Primary School,

should all be very proud, and of course,

The Paragon Junior School will cheer up a functional, but not very attractive, building site at the hospital for at least a Gary Latham, Site Manager for Kier, came up with the idea for the art project: “The quality of the children’s artwork is superb, their ideas are amazing. Our external hoardings make a great viewing area where this creativity can be displayed for all to see. They their artwork cheers up my construction site no end!”

Many thanks to all the children who created the beautiful artwork, and to Shay Brennan of St Mary’s Catholic Primary School, Anne Bull of Weston All Saints Primary School and their art teacher Liz Bullock, Charlotte Thurz, Head of The Paragon School and their Art teacher Alex Hucks for their enthusiasm and involvement in the project. Thanks also to Country Cupcakes for supplying some delicious cakes enjoyed by the children at the ‘installation’ party.

The panels are on display to the public and are situated adjacent to Zone B18/19 and B21 Bath & Wessex House.

Local school children gathered to show off the art they created to celebrate our 80th year.

www.ruh.nhs.uk

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Art at the Heart of the RUH

New Beginnings Art at the Heart of the RUH presents a brand new programme of exhibitions in the hospital corridors.

On display is an exhibition by Georgie Meadows: ‘Stitched Drawings’ on tour from the Wellcome Collection in London. Ageing and dementia is perhaps not the most likely theme for art and yet this exhibition explores this very theme and may strike a chord with many of us.

and colourful exhibition which is brightening up the hospital corridors.

Tabitha Stewart has recently graduated from an MA in Textiles at Bath Spa University and is also a member of staff.

Tabitha uses a variety of media including drawing, watercolour, photography, textile prints and CAD, enabling her to indulge her love of textile prints, colour and texture.

Georgie Meadows, an artist and occupational therapist, brings together 20 affecting and compassionate portraits, translating line drawings of people she knows or has cared for, into stitched works.

The exhibition also includes work by MA students Bronwen Gwillim, Jessica Shoemack and Sammy-Jo Stephenson.

Showing alongside these graduates is Kim Francis who shows the intricate work that she makes using tissue paper, steel and fire.

Complimenting Georgie’s exhibition is ‘Drawn to Textiles’, an inspiring, intricate

Patients, staff and visitors can also enjoy ‘A Walk on the Wild Side’, by

Elephant by Tabitha Stewart: digital print on linen 18

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Man with two Ties by Georgie Meadows: stitched drawing

Madeleine Town and Sally Muir; a series of arresting and imaginative images to cheer, entertain and enliven. Madeleine’s paintings are neo-romantic, dreamlike landscapes which feature birds and wild animals. Sally‘s are large charcoal drawings of dogs on paper, some imagined, some real.

Exhibiting in the Art Sparks corridor, The Paragon School have chosen the theme of Love, to coincide with St Valentine’s Day. From March there will be a display of photographs by Bath Photographic Society and work by Tristram Tyler and Catherine Knight. Tristram produces enchanting and sensual landscapes and Catherine’s work is based on old family photographs that explore the theme of memory.

Love Heart by Maddie: Paragon School

Mayor of Bath supports appeal The Mayor of Bath, Councillor Andrew Furse, is lending his support to the RUH, by becoming a patron of the PET-CT Scanner Appeal; equipment which will benefit cancer patients at our hospital.

The campaign to raise £1.2m for the scanner, is being run by the Bath Cancer Unit Support Group. They contacted the Charter Trustees of the City of Bath to invite the Mayor of Bath to become a patron of the Appeal, and they are delighted that the invitation was accepted.

Chairman of Trustees of the Bath Cancer Unit Support Group, John Carter said: “The support which has been pledged by the Charter Trustees of the City of Bath to do all that they can to help raise the money required, clearly demonstrates how important the acquisition of this equipment is for the treatment of certain cancers at the Royal United Hospital.”

The Positron Emission TomographyComputerised Tomography scanner, or PET-CT scanner for short, will transform the treatment of certain cancers and the RUH will be the first district hospital to offer such scans.

Take away teddies Children who come into the fracture clinic and orthopaedic outpatients here at the RUH now have the lovely surprise of being offered a little knitted teddy bear to make them feel special, and to distract them from their injury.

The teddies, which the children take home with them, are knitted by staff members, friends, patients, the 44th Kingswood Brownie pack and the Mill Lane Independent Methodist Church, both located in Warmley, Bristol.

than just a sticker.” says Staff Nurse Pam Norman, “The idea, based on a previous Women’s Institute initiative, was reawakened at our Knit and Natter group in Larkhall Church. There has been such a good response to the appeal for them that we’ve enough to be able to share with the children’s ward, so more children have benefited.”

“It is great to see the children’s faces light up and to have more to give them

The teddies brought comfort to Isabelle from Trowbridge Wiltshire, pictured with her dad

The scanner appeal has already received support from The Somerset District Miners Welfare Charity, the Bath branch of Waitrose whose staff nominated the appeal to be one of three local charities to benefit from its community support programme, and a number of patients of the RUH cancer unit.

Mayor of Bath, Councillor Andrew Furse welcoming chairman of BCUSG Trustees John Carter to The Guidhall

www.ruh.nhs.uk

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Giving a helping hand Friends of the RUH Coffee shop We’re sure that many of you will be missing being able to pop into the Friends Coffee Shop for a cuppa and a cake these last few weeks.

you can still enjoy the warmth of the Friends hospitality at the Oasis Centre, on site at the RUH. Our volunteers will be serving up delicious lunch-time snacks, and although it is a little further to walk, the welcome will be worth it.

Unfortunately, the coffee shop had to close temporarily to enable some structural work to be carried out. This work is continuing but, in the meantime,

Please do continue to support the Friends of the RUH during their temporary relocation. They will be very pleased to see you.

Claire Adlan, Claire Chambers and Janet Norris

Cake sale The Friends of the RUH will host a cake sale on Thursday 14 March in the Oasis Centre to raise funds for the hospital. They will be selling homemade produce from 10am until 12pm.

Thank you

On the run Vicki Smith who works in the Friends office (and is also a volunteer) ran the Bath Half Marathon on Sunday 3 March to raise funds for the Friends of the RUH. Vicki says: “I enjoy my work in the Friends office very much. The volunteers are a fantastic, dedicated and sociable bunch who provide hundreds of hours of support to the

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RUH. Running the half marathon on their behalf was my way of saying thank you to them all for making my job so rewarding.”

Although Christmas is already a distant memory, we just want to say thank you to everyone who supported the Friends of the RUH Christmas fair last year, and to all the volunteers for their hard work to make the day a success. The event raised £2,663 which will go towards the provision of patient comforts and amenities. It was a cheery event and carols performed

by Weston All Saints Junior School Choir added to the ambience.

Changing lifestyles Due to the efforts of our staff on the respiratory ward and, in particular, three members of staff who trained as Level 2 Stop Smoking Advisors, Sirona Care and Health has seen a 200% increase in referrals to their Healthy Lifestyle Service.

Patients are asked about their lifestyle and if they would like help to change, they are referred to the Healthy Lifestyle Service. This could be for support to stop smoking, get more active or to eat more healthily. The trained advisors on the ward provide extra support for patients while they are still in hospital.

This is part of a new initiative and is a way of asking patients suffering from chronic obstructive pulmonary disease what help

Healthcare Assistants Tammi Musgrove and Gill Roberts, either side of Assistant Practitioner Gerri Peerman

they will need when they leave hospital.

coming back into hospital.”

Consultant Respiratory Physician Dr Jay Suntharalingam says: “This initiative is a way of proactively addressing patients’ needs to prevent them

Sirona offers advisors ongoing support through regular visits and mentoring, annual refresher training, and support with resources.

www.ruh.nhs.uk

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Forever Friends latest Walk of Life: Saturday 18 May 2013 Join in this beautiful walk along the Kennet and Avon canal and help raise funds towards the build of a pioneering new Cancer Centre for the RUH. You can choose to take on the full 21-mile challenge or just a part of it: • Full day – Devizes to Bradford-onAvon to Bath – 21 miles • Morning section – Devizes to Bradford-on-Avon – 12 miles • Afternoon section – Bradford-onAvon to Bath – 9 miles You need to be able to walk at least 3.5 miles per hour. The walk sets off in the morning from Devizes Wharf, passes through Bradford-onAvon and arrives in Sydney Gardens in Bath. There are marshals with refreshments at various points along the route, and a goody bag waiting for you at the end.

Help spread the word to your friends, family and colleagues and encourage them to walk with you. Entry is just £15 per person and we ask all our walkers to aim to raise as much as possible towards the suggested minimum sponsorship of £100 for the new Cancer Centre.

For an entry form call Jo on 01225 825823 or download it from the website www.foreverfriendsappeal.co.uk

Praise for the RUH Compassion, Care, Competence, Communication, Courage and Commitment; These six ‘big Cs’ is how the NHS looks to Geoff Hudd, and in particular relates to the care he has had from staff in both the Oncology and Urology departments, at the RUH. Geoff says: “After two years careful monitoring by staff in the Urology Department, I had a laparoscopic radical prostatectomy (my cancerous prostate gland removed). I was thoroughly impressed throughout by the professional and caring nursing of my consultant’s team, nurses and administrative staff. Two years later the Oncology Department team took me through six weeks of daily radiotherapy treatment, with the same quality of nursing and support.

“So, after four years I can say both Departments are brilliant, and talking to other cancer patients I know they feel the same. Is this your NHS, too? If so, please tell them so!”

Kumon’s maths and English study programmes work to build your child’s confidence and inspire a passion for learning.

Contact your local Instructor for a Free Assessment: Bath North Study Centre Caroline Barry 01453 521503 kumon.co.uk

Royal United Hospital Bath NHS Trust accepts no liability for work done or goods supplied by any advertiser. Nor does Royal United Hospital Bath NHS Trust endorse any of the products or services.

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insight Spring 2013

Social Care funding A new system is being introduced to determine funding amounts for adult social care The Council is reviewing its system for adult social care Personal Budgets, making it fairer and easier to understand. The plan is to introduce the national Common Resource Allocation System (RAS) now used by most councils to work out how much funding people receive for their social care needs The new system is fairer because it uses a consistent method of calculating funding for everyone with support needs. This makes it much simpler to understand why funding decisions have been taken.

most complex needs are allocated sufficient resources to meet their needs, whilst also ensuring a fairer distribution of resources overall.

People will be informed of the estimated amount of funding they may receive much sooner in the process. This means they can start planning their support as soon as possible, and can feel in control

of the process. The new system is much more streamlined and clients should feel more involved with the assessment and support planning process, as well as noticing a reduction in paperwork.

Flexibility and control More flexible options can be considered by people for meeting

their care and support needs, for example, by employing their own staff or by paying expenses for volunteers or purchasing equipment. The Council is also considering ways to make it easier for people to have more control over the funding they are allocated, so they can get on with deciding what is best for them without necessarily taking on all the responsibilities of managing the budget themselves.

How will this affect me?

All current adult social care Personal Budget holders will be contacted at their next review, when the funding for their support needs will be re-assessed using the new RAS. More information about the new system will also be made available later in the year. The changes will be rolled out on a phased basis from early 2013.

Social care needs The RAS is based on a short, easy to complete, needs assessment questionnaire that measures social care needs. This makes it easier for the Council to check that everybody is being treated equally and fairly. The new system will have a ‘support needs’ weighting to ensure that people with the

If you have any questions about this article, please contact our Information Officer by either email melanie_hodgson@bathnes.gov.uk or telephone 01225 477983. For further information see www.bathnes.gov.uk/adultsocialcare/personalbudgetchanges

Safeguarding Vulnerable Adults at Risk Bath and North East Somerset Council, Sirona Care and Health and the Avon and Wiltshire Mental Health Partnership Trust are the lead organisations with responsibility for protecting vulnerable adults within Bath and North East Somerset. We work closely with a variety of agencies including the Police, the Care Quality Commission and the Royal United Hospital to protect vulnerable adults from abuse.

An adult at risk is someone who may be in need of support because of a disability, illness (including mental illness), or their frailty and who is unable to take care of themselves or stop someone from harming or exploiting them.

Abuse of an adult at risk can take any form and includes sexual, physical, financial, emotional, neglect, and

discrimination. They can also suffer institutional abuse. This is when a setting or service i.e. a care home, a care agency, a hospital, undertakes care of a number of people in a way which causes harm or represents a lack of respect for their human rights.

Abusers could be anyone, including relatives, friends, neighbours, strangers, paid carers, or volunteers.

Abuse can happen anywhere, for instance in someone’s own home, a care home or a public place.

The effects of abuse can be extremely serious and long-lasting. It can often be hidden and secretive.

Adults at risk may need other people, members of the public as well as professionals, to help them put a stop to it.

contact Sirona If you are concerned that an adult at risk is, or could be being abused, or need danger te immedia in are they If .

396000 01225 on Health and Care at found be can ion informat urgent medical attention always dial 999. Further

www.bathnes.gov.uk/SafeguardingAdults

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Across 1 Bruce Bennett tracks down a gangster in this 1949 drama 14 “The ___ Limits” 15 Hometown of Hilary Swank 16 1999 comedy directed by Paul Weitz 17 “Monday Night Football” org.

18 “___ Day at a Time” 19 Comedy directed by Michael Schultz 21 “God’s Little ___” 22 He played Uncle Jesse in “The Dukes of Hazzard” 24 Movie with the tagline “They meet. They judge. They execute… All in the name of the law.”

27 “Open ___” Kevin Costner western 28 “___ the Sand Nor the Sea” 24

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30 “___ We Dance” 31 “Black ___” 1963 horror film 32 “The ___ Family Robinson” 33 “The Lords of Discipline” role 34 1947 movie about a comic strip used for criminal purposes 36 Star of several Emanuelle movies 38 Writer-star of “On the Outs” 41 “The Night of the ___ Day” 43 “MTV ___” MTV Europe show 44 1977 Catherine Deneuve movie 45 “Outlaws of the ___” The Durango Kid western 46 “American Splendour” director Shari Springer 48 She played Eugene Levy’s wife in “Waiting for Guffman” 51 “Deep Impact” actress Laura

53 Chingachgook portrayer in “The Last of the Mohicans” 55 He played Brando’s brother in “On the Waterfront” 57 “Alfie” writer Charles 58 “Eulogy” actress Kelly 59 “The ___ Fellow” Patrick McGoohan film 60 “Morvern Callar” writer-director 61 Quint’s boat in “Jaws” 63 “___ the Bee” 64 “Fargo” actor Steve 66 “___ and Away” 68 “___: A Dog” 69 Young actress on “Dr Quinn, Medicine Woman” 70 “Touched By ___” 72 He played Sparrow in “The Man with the Golden Arm” 73 1991 Wes Craven horror film

Down 1 “Don’t worry, we’ll think of a ___” 2 “Artifical Intelligence: AI” actor 3 “Lorenzo’s ___” 4 “Red ___” 1985 fantasy film 5 1933 Helen Hayes drama 6 He played Reverend Bemis on “Chico and the Man” 7 “Silk ___” 8 1971 Anne Baxter movie 9 1971 Max von Sydow movie, with “The” 10 “The Parent ___” 11 “Running on ___” 12 1968 Paul Newman movie 13 1970 sci-fi film about computers run wild 20 “Back ___” Sally Field movie 23 Member of “The Mod Squad” 25 “Dead ___” 2001 thriller 26 1973 mystery based on a comic 29 1949 Lloyd Bridges movie 35 “___ and Whispers” 37 “Manon of the Spring” star 38 “___ County Jail” 39 “Cat People” star 40 Bob Denver TV role 42 “___ to Drive” 47 Ethan Hawke has a crush on Teri Polo in this comedy 49 1989 James Cameron undersea film, with “The” 50 “Modern Times” actor Murdoch 52 Princess Kitana player in “Mortal Kombat” 53 1931 Lew Ayres comedy 54 Oscar-nominated screenwriter of “Houseboat” 56 “Deathtrap” costar (surname) 62 “Deathtrap” costar (surname) 65 “Heaven can wait” actress Hasso 66 “Under Two ___” 67 1995 David Caruso movie 71 “Live and ___ Die”

Take a break

Answers to last issue’s puzzles Christmas themed questions 1 Punch 2 Frankincense 3 Scrooge 4 Stocking 5 Spirit 6 Gold 7 Flock 8 Angel 9 Lord 10 Candle 11 Myrrh 12 Yule 13 Camel 14 Cranberry 15 Party 16 Inn 17 Jesus Christ 18 Holly 19 Merry 20 Bethlehem 21 Star 22 Tinsel 23 Holiday 24 Bell 25 Donkey 26 Snow 27 Present 28 Eggnog 29 Emmanuel 30 Turkey Who am I? Charles Dickens

Designed by: Octagon Design and Marketing Ltd, Britannic Chambers, 8a Carlton Road, Worksop, Notts S80 1PH. Tel: 01909 478822

Settle down with a cup of coffee and a biscuit, grab a pen and ponder over the answers to this ‘mega’ entertainment crossword for TV and movie lovers. The answers will appear in the next issue of insight.