Vital Signs Winter 2011 by Chris Davies

VitalSigns WINTER 2011 Cardiff and Vale University Health Board

Brighten the grey days with Vital Signs

As winter descends, we bring you the latest edition of Vital Signs. There’s a lot going on in the UHB at the moment, as we celebrate 40 years of UHW, we also gear up for another busy winter in our hospitals, GP clinics and visiting patients out in the community. Have you had your flu jab yet? You can read Nurse Louise Williams’ story on page 6. Louise didn’t get round to having her jab last year, and became seriously ill with flu. She talks to us about why it’s vital to get immunised. You can turn up and talk to the Occupational Health nurses at any vaccination clinic and they will listen to you, and answer your questions about the flu jab. L-R: First Minister Carwyn Jones, Dr Julia Sanders, Consultant Midwife, Health and Social Services Minister Lesley Griffiths We also visit West Quay GP surgery in Barry, and find out how Ear Nose and Throat patients are getting seen quicker in the community, and spend five minutes with Psychiatric Intensive Care Unit Ward Manager Mark Bates. Many of your colleagues across the organisation work without email, so please make sure as many people as possible get to see Vital Signs, by putting it on a notice board, or printing a copy and sharing it around in staff rooms. Have a merry Christmas, Marie Editor, Vital Signs

Big Money Debate

Contact me here: marie.concannon@wales.nhs.uk UHW (1872) 2406, externally on 029 2074 2406

An estimated 1000 staff members came along to the recent Big Money Debate meetings, to discuss how to address our financial challenges with members of the UHB Executive team. Many more sent their suggestions in via email. You may have seen the Turnaround to Transformation e-bulletins, which explain how we are looking at the suggestions and using them to kickstart more efficient ways of working and saving money across the UHB So far, more than 90 Fiver a Day ideas have been assessed, and 62 are being taken forward. These include energy reduction, including switching off the UHW fountain, stopping hospitality and cancelling departmental journal subscriptions. If you have suggestions, or even better, can tell the T2T team what you are doing to save money, get in touch: Fiveraday@wales.nhs.uk

First Minister honours Cardiff and Vale staff High-achieving staff members were honoured at a prestigious awards ceremony in Cardiff recently. The Recognising Achievement for Service to Wales Awards recognised people who have: • • •

demonstrated innovation in joint integrated health and social care that is delivering lasting results brought distinction to Wales locally, nationally or internationally given exceptional service

First Minister Carwyn Jones said: “There is an increasing pride in being Welsh and a desire for Wales to recognise and celebrate the good things that happen here. The individuals who I have presented these awards to make me proud of Wales and the recognition they receive is richly deserved.” UHB staff past and present who were honoured: Nicola Evans, for supporting joint working to improve the health and wellbeing of vulnerable groups John Fitzpatrick, who established the rapid response service within the South Wales wheelchair service Angela Gorman, who founded the charity Hope for Grace Kodindo, which makes safe for mothers in subSaharan Africa Professor Judith Hall, Professor in the Department of Anaesthetics, Intensive Care and Pain Management in the School of Medicine at Cardiff University

Professor Keith Harding, the first Director of Cardiff’s wound healing research unit Dr Huw Jenkins, National Director of Healthcare Services for Children for Wales Judyth Jenkins, who led the development and piloting of the All Wales Food Record Chart Consultant Midwife Karen Jewell, who developed a fast track clinic for newly arrived asylum seekers in Cardiff Dr Julia Sanders, Consultant Midwife, pivotal in developing women’s services within Cardiff and Vale Dr Kay Saunders MBE GP in Butetown, providing high quality care to many vulnerable patients Meena Upadhyaya, Professor of medical genetics at Cardiff University, gaining international recognition in several areas of research Dame Deirdre Hine DBE, for a varied career in both academic and NHS practice Andrew Lewis, Director of Innovation and Improvement said: “Staff from Cardiff and Vale UHB beat off stiff competition from colleagues across Wales. We are always developing the ways we work and it is an honour for staff to be recognised in this way.”

The project, run by the UHB in partnership with Age Concern Cardiff and Vale of Glamorgan and the Society of Chiropodists and Podiatrists, has been nominated in the Workforce Development Award category. A team led by Consultant Gynaecologist Richard Penketh picked up a HSJ Award nomination for Acute and Primary Care Innovation, for their work moving hysteroscopy procedures from theatres under general anaesthetic to an outpatient setting under local anaesthetic. They are also nominated for a Wales Innovation Award from the Wales Quality Centre. Mr Penketh said: “Previously, we used general anaesthetic for surgery to remove polyps for women with menstrual problems or post menopausal bleeding.

Nursing Assistant Ruth Farrant receives supervision in footcare for her patient from Specialist Podiatrist Maureen Hillier

Two innovation award nominations for Cardiff and Vale

“Clinical teams elsewhere have done this, using expensive, single use equipment that is slow, and less effective. We’ve gone about things differently. We have worked out how to use more conventional, reusable equipment, which can remove more tissue more effectively. The procedure is less invasive for the patient, and makes better use of our resources.

Two projects that help improve life for patients recently picked up nominations for prestigious national awards. Cardiff and Vale University Health Board was recognised in the Health Service Journal Awards with two nominations, more than any other Welsh health service.

“By freeing up space in theatre, we use this time more efficiently and are reducing waiting times for many patients. Feedback from patients is very positive, with a majority of those we surveyed agreeing that they would recommend the procedure in outpatients to a friend.

Chief Executive Jan Williams said: “The UHB is committed to providing safe, high quality patient care as efficiently as possible, so I’m delighted the awards, which celebrate innovation in healthcare, have recognised improvement projects developed by staff.” The two projects have already been praised for the impact they have made. One, a project aimed at keeping patients mobile and ensuring routine foot care prevents major problems later, scooped an NHS Wales Award this year. The other project, which has improved the way hysteroscopy procedures are carried out, received a SHINE award and funding from the Health Foundation. Theresa King, Strategic & Clinical Lead in Podiatry, explained how her project helped keep patients’ feet healthy:

“We wanted to carry out the procedure under local anaesthetic in an outpatient environment; it’s less invasive and involves a much shorter recovery time, which is much less stressful for the patient and her family.

“Many people have trouble caring for their feet, because of mobility, sight problems, or arthritis. But good foot care prevents problems later on, such as ingrown toenails, risk of infections and increased risk of falling. So it makes sense to train staff to help prevent problems for our patients early on. “We set up a training programme to ensure Health Care Support Workers and Nurses can identify low risk patients, have the skills to provide them with essential foot care and refer more patients with more complex needs to appropriate specialists in the podiatry team. We train Age Concern staff and staff from nursing and residential homes to carry out this assessment and foot care in the community, so that people who don’t necessarily come into contact with Cardiff and Vale UHB staff are also able to access the service.

"I'm delighted that the team has been recognised. It is an innovative service, and hopefully the Wales Quality Centre judges will agree."

National Appointment for Sue A Cardiff and Vale Physiotherapist is looking forward to representing her colleagues at a national level – as the first ever Vice Chair of the Council of the Chartered Society of Physiotherapy (CSP) from Wales. Sue Rees, Deputy Head of Physiotherapy Services, has been a CSP member since graduating, and has worked in Cardiff and Vale for 24 years. Sue explained: “It’s a privilege to be elected by my colleagues to this position. The Council is the decisionmaking body for the CSP in the UK, so it’s a great chance to represent my colleagues and work with the CSP’s senior management team in the interests of physiotherapists and their patients. “I enjoy my job, where I can make a difference to the physiotherapy services across the UHB, but I’m delighted to be working with my colleagues in the UHB and the CSP to make a difference to physiotherapy services across the UK.”

The hysteroscopy team in awards ceremony mode

Director of Therapies at Cardiff and Vale UHB Fiona Jenkins, added: “Sue’s appointment reflects the high calibre of clinical leaders we have within the UHB. I’m delighted to congratulate her on her appointment.”

‘Have the flu jab for your loved ones’ Contracting flu left a UHW nurse fighting for her life in the hospital's ITU. Louise tells her story. “I was just back to work after Christmas, but became unwell over the weekend with flu-like symptoms. I spoke to the GP on Monday, who took a swab and confirmed swine flu on Thursday. I took two doses of Tamiflu, but deteriorated quickly and was admitted to the Emergency Unit at UHW on Friday morning. I was moved to A1 for medical assessment and isolated. I was

achy, had a high temperature, and couldn’t breathe – my lungs were full of infection. I developed pneumonia and was admitted to ITU within hours. “I woke up four and a half weeks later. “It was a horrendous time for my family. I have three daughters and a husband, who were told I might not make it. The UHW Critical Care team were fantastic and did everything they could for me. “It was a battle to build myself up when I woke up. I couldn’t do anything for myself and had to learn to walk again. I recovered well on Ward A3 and got home three weeks later. “The Community Nurses and Community physio teams were brilliant as I recuperated, and I finally returned to work on September 12. I spent such a long time recovering, which was hard initially; I’d mentally recovered, and I missed my colleagues and my job. Having been a nurse all my adult life, suddenly being a dependent patient was so frustrating. “I’m a Nurse Advisor for Medicines Management. I do visit wards and work with nursing staff. I didn’t consciously not have the flu jab last year, I just never got around to it. I was always busy with other things. But it’s for yourself, your colleagues and your patients. For me this year it was for my family. I never want them to go through that experience again; sitting and watching me, not knowing if I’d pull through. “I didn’t think it was going to affect me. I’m not ‘very frontline’, I thought if I did get it I’d be off for a few days. So many dedicated Cardiff and Vale staff helped me, and I want to get the message out to all staff that getting the seasonal flu jab is so important.”

i 6

Get your vaccination: clinics (no appointment necessary) Denbigh House, UHW, Mon - Fri 9am - 4pm, Roseway Lodge, UHL: Mon – Thurs 9am - midday. Check the flu intranet page for outreach clinics.

Cardiac Rehabilitation Patients Give Back Big hearted cardiac rehabilitation patients and staff at UHW recently took part in a sponsored walk which raised more than £500 for the British Heart Foundation. The charity event, organised by specialist nurse Alison McCarthy, took place at Maindy Leisure Centre on a sunny afternoon. Supervised by cardiac rehabilitation and physiotherapy staff, as well as partnership staff from the leisure centre, 20 participants enjoyed a healthy walk around the Maindy track.

“I love it here, and I love my job.” Community Support Nurse Gill Green started work in Llanishen Clinic on October 1, 1991, and still enjoys her job. Gill is celebrating 20 years’ service, first at Llanishen Clinic, then at Roath Clinic.

Alison said: “The patients who came along have all had either a heart attack or heart surgery in recent months and have been involved in regular rehabilitation exercise classes. Cardiac Rehab nurses also provide guidance on appropriate diet and lifestyle changes.

My role in the Roath District Nurses involves caring for patients who are housebound and who require our nursing care and support. I support the qualified nursing staff with wound care, taking blood tests, identify potential risks and deliver sensitive and compassionate care to the terminally ill. We are all proud of the work we do.

“We find patients do appreciate the quality of the support we provide after their cardiac events, and they were all keen to give something back. The amount of money raised was tremendous. A big thank you and well done to everyone involved. Special thanks must go to Phase 4 instructor Rhian Penikett for all her help.”

“I also work in a wound healing clinic in Splott, seeing patients weekly. I get great satisfaction from caring for the patients and love to see good outcomes. Over the years I have established strong relationships with patients and can offer them support and advice. What I have learnt at this clinic also helps with my work at Roath.” The UHB recognises the experience and commitment of staff through the Long Service Awards.

To apply, complete an application form with your manager the month before your anniversary. Download this from the HR intranet pages or contact Victoria Hiscocks on (1872) 5700, externally on 029 20 74 5700.

Hear how we work better together Some patients who have chronic ear conditions may need to be reviewed on a long term basis. Previously these patients had to travel to the University Hospital of Wales every four months, to be seen by a consultant in a clinic. Thanks to funding from the Chair’s Innovation Fund, which provides investment where staff can make a case to improve patient care and use resources more efficiently, this is now happening closer to their homes. ENT Consultants have trained GP Dr Louise Jenkins and several nurses, who are now accredited to provide this specialist service locally. The UHB is piloting a clinic in West Quay GP Practice, Barry, for patients from West Quay and four other local surgeries, so these patients are seen by specially trained staff who can review and monitor their condition. This means these patients have shorter waits and receive their care locally, by staff working to the same national guidelines for high quality care. Consultants are freed up to see more new patients, and West Quay staff have gained new skills and are working more closely with UHW colleagues.

GP Louise Jenkins with an ENT patient

Patients with long term chronic ear conditions are getting the right treatment, closer to home thanks to an innovative new way of working, developed by the Ear Nose and Throat Department, in partnership with GP surgeries in the Vale of Glamorgan and supported by the UHB’s Innovation and Improvement Team.

Chris Absi from the Innovation and Improvement Team said: “Subject to funding and feedback from patients, we hope to continue the clinic beyond the pilot. In future, appropriate referrals for new patients may go directly to the clinic. Currently 7,000 patients across Cardiff and the Vale need long term follow up from the ENT team, so this initiative could deliver real benefits for patients and ensure primary and secondary clinical teams work together effectively.” Chair David Francis said: "The Chair's Fund provides support to frontline staff who have innovative ideas for improving quality, safety and patient care, and West Quay is a good example of what we can achieve.”

For more information on how to apply, email Maureen Fallon, Assistant Director, Innovation and Improvement: Maureen.fallon@wales.nhs.uk

Julien McDonald OBE meets former patient Suzanne Portlock

Breast Centre Opens in Style Glamour and style was brought to Cardiff on the eve of Bonfire Night and celebrations certainly went off with a bang! Julien Macdonald, Patron of Cardiff and Vale Breast Centre, officially opened the Centre on November 4 at University Hospital Llandough. Patients and staff were delighted to meet the world renowned fashion designer. Former patient Suzanne Portlock said, "It's a great honour to meet Julien, I was amazed at how down to earth he was. He will be a great ambassador for the charity and will help raise awareness for the breast centre." Julien Macdonald took time out of his busy schedule to spend the afternoon at the centre. "I am absolutely delighted to be the patron of the new Breast Centre at the University Hospital Llandough which will serve Cardiff, the Vale of Glamorgan and beyond. “Breast cancer affects so many people but thanks to this new facility, people from across Wales will get a worldclass service. The service provided is already fantastic, giving patients the very best treatment in the very best of surroundings, but I want to help make it even better. “Hopefully over the coming years, we can raise the profile of the incredible work being done here and, most importantly, try and raise £1m so we can keep investing

in state of the art equipment that will help us beat breast cancer.” Julien was guest of honour that evening at the Breast Centre’s first fundraising Gala Dinner at Cardiff City Hall. The team raised more than £10,000 and have already started planning next year’s celebration. Mr Sumit Goyal, Consultant Surgeon and Lead Clinician for Breast Services, said, "The first fundraiser night was a huge success. I congratulate the team for all their hard work and efforts to make it a night to remember. Julien being there and taking the time to speak to everyone really was the icing on the cake.” Julien concluded, “Most of us will know someone who has had breast cancer, whether it's your mother, sister, friend or simply someone you know. The disease can have devastating effects and that's why I really wanted to get involved and help support a centre which is making a real difference to patients.”

UHW@40

UHW turned 40 in November and the anniversary was used to honour the remarkable history of the hospital and the achievements of its staff through the years.

The Health Board worked with patients and staff, both past and present, to gather together memories of the opening by the Queen in 1971 and its 40 years of providing care to the people of Cardiff and the Vale of Glamorgan and from across Wales. Chair David Francis said the celebrations had gone well. He said: “This was a great opportunity for us to recognise the hard work of staff and the remarkable impact the University Hospital of Wales has had on the lives of people across Wales. “I was pleased to see patients coming forward with their memories of the hospital over its four decades and paying tribute to the staff who looked after them and thanking them for providing their care.”

Thanks to the efforts of staff and patients the UHB was able to compile a rich array of memories, pictures and videos looking back at the hospital’s development over the years, how it has changed and what the future could hold for it. The anniversary also coincided with a special tea party event for long servers that brought together some of those who have spent many years with the Health Board. The UHB worked with local media to highlight the anniversary and the kind words of patients about the care they received. The South Wales Echo featured double page spreads throughout the week on the anniversary and BBC marked the occasion with features on radio, online and on television. A micro-site drawing together the material gathered as part of the 40th anniversary is now available via this link

to the UHB’s website. A special digital edition of Vital Signs will also be available to download after Christmas. Mr Francis said: “The 40th anniversary of the opening of the University Hospital of Wales has been a great opportunity for us to look back at how it was born and grew and to praise all those that have played a part in its success. “It is a part of life in Cardiff and that has been shown by the heart-warming memories of patients and their desire to show their appreciation for the care they’ve received.

“I hope that the anniversary will help to inspire another 40 years of outstanding care and excellence at the hospital and across all the work the Health Board does.”

Community Directors help deliver care close to home Delivering the right care, at the right time, in the right place means more and more care provided by the UHB will be delivered closer to patients’ homes, where it is clinically appropriate. This will ensure patients who still need hospital care can see consultants sooner.

Neighbourhood leads Cardiff East/South Locality Manager Rachel Lewis Dr Liam Hannaway Dr Roger Morris Dr Sian Roberts

Cardiff SE Cardiff East City and South

Cardiff North/West Locality Manager Lynne Topham Dr Guy Marshall Dr Helen Lawton As part of this, the UHB has recruited a number of local GPs as Community Directors. Some are responsible for engaging with GPs in their neighbourhoods, and some lead specific programmes covering all neighbourhoods or lead on specific specialties. Some work across the UHB in service integration on developing and improving services. In addition, Community Resource Teams play a key role in providing individual care across the community. They are multidisciplinary teams working to ensure, where it is clinically appropriate, patients can be cared for at home. They work closely with both consultants and GPs to ensure patients receive continuity of care, seamless discharge from hospital to the community, and that the most vulnerable patients are closely monitored. The teams aim to detect medical problems and intervene as soon as necessary. One of the three teams is already in place covering the Vale locality and teams are currently being set up in Cardiff Central and North. A Community Directors’ forum is held every two months to co-ordinate their work, chaired by Dr Mark Smithies, Divisional Director, Primary and Community Care.

Cardiff North Cardiff West Cardiff South West (interim)

Vale Locality Manager Lance Carver Dr Christian Ogden Dr Rosemary Kavanagh Dr Ben Roper Dr Anna Kucynska

Eastern Vale Western Vale Central Vale (interim) Central Vale

Putting Personal Safety First The UHB recently held a roadshow in the Concourse at UHW to promote personal safety as part of the National Personal Safety Day led by the Suzy Lampugh Trust. This awareness day is held annually to raise awareness of simple and practical tips for staff to help minimise violence and aggression. The feedback from staff and patients was extremely positive and staff representatives have asked for another session to be held in University Hospital Llandough.

Case Manager Carl Ball, Policeman Stuart Bryant and Community Support Officer Laura Moore, EU Nurse James Hill, Jayne Matthews, Welsh Ambulance Trust and Nurse Wayne Parsons

UHB commits to being a Mindful Employer

Cardiff and District NHS Retirement Fellowship

Tracy Myhill, Director of Workforce and Organisational Development, has signed the 'Charter for Employers who are Positive about Mental Health' on behalf of the UHB.

The Fellowship not only helps people keep in touch with their colleagues and friends but also arranges many social and educational activities and events. This year these included a summer trip to London, visits to Buckingham Palace and the London Eye.

This Charter commits the UHB to the principles of reducing the stigma associated with mental ill health through the provision of information and training, and providing non-judgemental and proactive support to staff who experience mental health issues. For more information see www.mindfulemployer.net. and the Mindful Employer intranet page.

If you are approaching retirement and feel that filling the void without work may be problematic please get in touch for further information on what your local branch can offer by contacting by e-mail norman.bishop@sky.com or telephone 029 20752237

Specialty/Programme Leads Dr Andrew Dearden

Dermatology, Referral Management Dr Dominic McGovern Quality Outcomes Framework, Medicines Management Dr Sarah Morgan Heart Failure, Unscheduled Care Dr Julie Yapp Older Persons Services Dr Ben Roper IM & T, communications Dr Helen Lawton Chronic pain, Stroke, Neuro, Epilepsy, ERAS Dr Liam Hannaway Orthopaedics Dr Rebecca Walberg Women’s health, Mental Health Dr Guy Marshall Respiratory lead

UHB now available on your phone Cardiff and Vale University Health Board is now on Facebook and Twitter – with Chief Executive Jan Williams tweeting regularly. You can find important updates as well as the latest UHB news. Members of staff are unable to access the sites whilst in work, but can access them from home or via smart phones. The UHB Twitter feed is @CV_UHB and Jan Williams tweets at @Jan_CV_UHB. Here are the links:

www.twitter.com/CV_UHB www.twitter.com/Jan_CV_UHB www.facebook.com/cardiffandvaleuhb

H.A.T Hospital Acquired Thrombosis Dr Ben Roper using the new e-referral system in his GP surgery

“We are speeding up the referral process for patients” Family doctors at GP practices across Wales are switching to e-referrals to refer patients to consultants. Cardiff and Vale University Health Board has been a pilot site for the system, known as the Welsh Clinical Communications Gateway (WCCG), a project by the NHS Wales Informatics Services (NWIS). It allows messages to be sent quickly and securely from the GP to the consultant. Jo Brooks, NWIS Programme Manager at the UHB, explains: “All the GP surgeries in Cardiff and the Vale of Glamorgan will have access to the system by the end of the year. “The UHB’s Information Management and Technology Department has developed a system to receive the e-referrals which are processed by staff in the Clinical Referral Centre.” Sian Williams, Health Records Site Manager, explained:

Dr Ben Roper, GP at Ravenscourt Surgery, Barry and Community Director, Programme Lead for IM&T and Communications, said: “E-referrals mean information is sent quickly, securely, and is clear and consistent. It’s more cost effective, and most importantly, safer for patients.” Jo added: “The Cardiff and Vale IM&T team are managing this project on behalf of the NHS Wales Informatics Services (NWIS) and will ensure the system can be rolled out across Wales.

“It’s an instant transfer of information, more effective than waiting for a mail pouch delivered by the Welsh Ambulance Services Trust, saving time and money. The GP can create and send the e-referral using the referral template while the patient is still in the room. Most importantly, it standardises clinical and personal referral information, so it’s consistent.”

“Another pilot project is underway using the WCCG to send e-discharge notifications from hospitals back to GP practices, so that when a patient is discharged from hospital, their GP can immediately obtain the latest information about their stay, treatment and current medication.

The second phase will improve this further; the e-referrals will come to Sian’s team, who will forward them on to Consultants to prioritise and add to a waiting list. Currently the Referral Management team prints each referral for the Consultant to read and book the appointment.

“The IM&T team has a busy programme of ecommunications projects which will improve the way we deliver services in the coming years, and I’m delighted that e-referrals are working effectively. There’s much more to come.”

Have you assessed your patients? Hospitalisation increases the risk of venous thromboembolism. This risk varies according to the reason for admission, and the individual patient circumstances (age, underlying inflammatory conditions, if they are pregnant) – and both should be assessed when an adult is admitted to hospital. Consultant Haematologist, Dr Rachel Rayment, says: “The UHB is committed to safe, high quality care, and reducing hospital acquired thrombosis is a key to this. All staff involved in the care of adult in-patients should incorporate thrombosis risk assessment into their routine working practice. “Not all thromboses are preventable but staff should be confident that, if a patient returns with a hospital acquired thrombosis, they documented that appropriate measures were undertaken to attempt to prevent it whilst the patient was an in-patient.” You can find risk assessment tools on the intranet.

Nurse Racheal James explains Atrial Fibrilation in the Concourse

Know your pulse Arrhythmia Nurse Specialist Racheal James provides education and support to patients diagnosed with Atrial Fibrillation (AF) - irregular heart rhythm. “An episode of AF can last from a few minutes to weeks, and it’s progressive, so 50% of self-terminating cases will become permanent in ten years. The easiest way to detect AF is to feel the pulse. Earlier this year I held a ‘Know your pulse’ stand in the UHW Concourse, to raise awareness as part of ‘Heart Rhythm Week’ organised by Arrhythmia Alliance. “I offered simple pulse checks and explained to visitors if their pulse was fast, slow, regular or irregular. Encouraging patients to “know your pulse” promotes quick and effective diagnosis, and early diagnosis could improve a patient’s chances of finding successful treatment, and could save their life. “It’s my role, once patients are diagnosed with AF, to provide care and management of their symptoms with appropriate medication, education and advice prior to their surgical treatment options and to offer a direct contact for support to improve their quality of life.”

How much can you save?

Good to meet you:

Cardiff and Vale UHB is leading the way to a more environmentally friendly future. Staff have put a tremendous effort in to reduce our environmental impact, but there is more work to do.

British Association of Occupational Therapists (BAOT) Representative

The rising cost of energy means that more money has to be spent just to maintain our current consumption. However, the UHB must save £600,000 on its energy bills. This target is actually just the trigger; we need to start a major attitude change. Each of us must actively think about how to personally reduce our consumption. Although many people are conscious of their energy use, small acts such as simply remembering to turn off a light or switching off the photocopier each night add up across 14,000 staff. However this requires us all to change our daily habits and think about what we can do every working day to save energy. The minus 70ºC freezer project at Cardiff University is a great example. By running some laboratory freezers just a couple of degrees warmer, energy use is reduced but sample quality is unaffected. Better freezer maintenance and management, ensuring they are full, turning off those not in use, and ensuring they are de-iced and not located near heat sources is also making a huge difference.

Could your team do something similar?

Everyone in the UHB can help to save energy by adopting this approach:

Remove any old electrical equipment you no longer need: email scrapwaste.management@ wales.nhs.uk. Charge personal mobile phones at home, use a desk fan rather than the air conditioning. Many energy saving projects are underway to support staff efforts; reducing the use of the UHW fountain is one example, and the Energy Management Team is investigating replacing our hand driers with more efficient versions. During the recent mild weather, where possible the heating has been turned down by 3ºC, and the ‘on’ time reduced. Radiators in corridors and stairwells that don’t need to be on, have been turned off. If you want to turn radiators off but can’t, contact the Energy Management Team (details below). During a walk round at UHW in early November, more than 180 open windows were closed to save heat; please help to save energy.

Peter Hewin

You can’t always see these changes. The Estates Team is involved in a project to replace steam traps on the heating system and bag filters on the air handling equipment after they discovered that the old filters were costly to maintain and inefficient. The new steam traps and filters will improve efficiency and help reduce operating costs.

The Energy Management Team is evaluating how heat and power is provided at University Hospital Llandough and will be considering future options such as renewable energy. Help us to help the UHB, by identifying more energy efficient ways of working. The Environmental Management intranet page is being updated to include information about all the projects which are making a difference. The Energy Management Team will be holding several road shows and environmental events over the next year. The team is happy to consider all ideas however small, so please email Nicola.williams14@wales.nhs.uk, or post it in the internal mail to the Capital and Estate Management Team, FAO Nicola Williams

BAOT is affiliated to UNISON, and I am Vice Chair of Cardiff and Vale UNISON Branch, and also Lead Staff Representative for the UHB’s Mental Health Division. In 2009 I completed a three-year term of office as a Council Member for my professional body, the College of Occupational Therapists, including one year as Vice Chair of the College. I work as an Occupational Therapist Team Leader covering two Community Mental Health Teams, the Hamadryad and the Links. I have been an active representative of the British Association of Occupational Therapists for around 15 years.

How can you support staff? At every level, from individual casework, through directorate and divisional negotiations, to UHB-wide priorities (for example, as a member of the Employment Policies Group and Local Partnership Forums) and national campaigns such as the defence of our pension scheme.

What motivates you? I firmly support public services and the NHS in particular. I have a strong belief in occupational justice, for staff (fairness and respect in the workplace) and for service users (equal opportunities to participate in valued occupations).

What is your greatest achievement in the role? Last year I received a Merit Award from the College of Occupational Therapists, and was elected to represent BAOT at the NHS Staff Council (which negotiates national terms and conditions), both of which I consider a great honour.

To join BAOT: 020 7450 2348 http://www.cot.co.uk/join-baot/join-baot To join UNISON: 0845 355 0845 http://www.cavunison.co.uk/

Getting back to Basics at the Nursing Conference

Twenty years of looking after children’s hearts Welsh rugby was at the heart of the nation this autumn. Two players took time out from the game to celebrate twenty years of looking after children’s hearts. Former Wales International and most capped player, Martyn Williams, and team mate Matthew Rees joined in the celebrations to mark the 20th Anniversary of the Children’s Heart Unit in Cardiff. Martyn Williams said it was a privilege to attend: “I was delighted to meet families who have been affected with heart problems and hear about the treatment they received and how well they have recovered. “Rugby requires a particular strength but these families and patients are tremendously strong with incredible resilience to keep on going. It is inspiring to hear their stories.” The Children’s Heart Unit is based in the Children’s Hospital at the University Hospital of Wales and treats on average 300 inpatients and more than 4,000 outpatients a year. The Cardiac Unit delivers comprehensive cardiology care and has a strong partnership with Bristol Children’s Hospital, which provides surgical care. Claire Logan, Children’s Heart Nurse Specialist, has worked in the Unit since it opened and is still in contact with a large number of the patients. She said, “My job is highly rewarding and we end up becoming very close to the families. I still keep in touch with patients from 20 years ago”. Claire Dawson is testament to this; she has been treated at the Unit since 1992. Claire said, “I was born with a congenital heart condition and was treated as an outpatient following open heart surgery. I loved spending time in hospital, the nurses were so kind and friendly, they made the experience a pleasure. Lauren Skeet and Evan Price (front row) with Martyn Williams and Matthew Rees (back row)

Catherine are aged 11 now and luckily have healthy hearts whereas my heart issue will never be fully resolved. I am eternally grateful to the team for making my condition easier to live with, they are fantastic!” Dr Dirk G Wilson, Consultant Paediatric Cardiologist and Divisional Director for Women and Children Services, has worked in the Unit for the past 19 years. He said, “I have cared for babies who have been critically ill and seen them grow up into teenagers and then go on to have children of their own. I am grateful so many of our patients and families were able to attend the celebration event.” Peter Price, father of two year-old Evan Price praised the staff at the Unit after his son was diagnosed with Transposition of the Great Arteries (TGA). He added, “Evan was so unwell when he was born - he was diagnosed immediately and received expert lifesaving treatment locally before he was transferred to Bristol Children’s Hospital for his surgery. He was in Intensive Care for the 10 days that followed and has since made a good recovery. He will be monitored throughout his life with regular heart scans and there is a possibility he will require further treatment in the future. “Evan is doing very well and we owe everything to the staff at the Children’s Heart Unit at UHW. The doctors saved more than one life that day, they also saved me and my wife and we wouldn’t be here without them.”

Professionalism, quality, safety and achieving excellence were at the heart of the UHB Nursing and Midwifery Conference held at the All Nations Centre, Cardiff recently. Ruth Walker, Executive Director of Nursing said: “We need to remember what a privilege working in this profession is. We want to provide dignified care to patients whilst demonstrating this to each other, and look after the little things to bring health care ‘back to basics’. “I am delighted to work with you to deliver our services in a modern way. As guardians of care, you are responsible for your professional standards and the quality and safety of patients. “The UHB has achieved fantastic success over the past year, including the 37% reduction in c.difficile infection rates and winning national awards for initiatives such as the Acute Stroke Swallowing Screening training.” Chair David Francis said, “We have made it clear that dignity and respect, patient safety and a high quality of care are at the forefront of everything we do. There is a huge commitment and energy for this work, which is refreshing.” Ruth Walker concluded with how the UHB is changing the way we respond to patients’ needs: “Listening to and learning from patients, carers and staff telling their stories is how we can demonstrate that we are beginning to change the way we deliver patient care. “Patient safety, dignity and compassion are the standards we expect at this health board, standards I am confident that our staff deliver every day.”

“If I have any problems, they see me straight away and are always on the end of a phone to offer advice. Dr Wilson has treated me from child to adult life, even when I had an elective caesarean with twins. Keiron and

UHB’s growing support for campaign Movember, the month when men grow moustaches to fundraise for prostate and testicular cancer, was celebrated across the UHB, as you can see from these pictures L-R: Before Movember Michael Birdsall, Kevin Nicholls and Paul Gough tried to see how they could look with a moustache

Check out the UHB's Men of Movember Kevin, Contact Centre Manager for ALAC (Artificial Limb and Appliance Service), took up the challenge along with eight colleagues – around 30 UHB staff are thought to have taken part.

5 minutes with… Nurse Mark Bates Ward Manager East 3, Psychiatric Intensive Care Unit, Whitchurch Hospital.

Kevin said: “A few mates of mine did it last year in their football team and they had a great laugh and raised some cash. I found out too late to join so I was very eager to get involved this year. “I believe that there is a lack of focus on men’s health and want to help to raise awareness and cash.” Sharon Hopkins, the UHB’s Director of Public Health, welcomed staff efforts: “Movember is about fundraising for cancer charities, but it’s about more than that. Moustache-growing men like Kevin become walking billboards, raising awareness of prostate cancer issues. “Highlighting men’s health issues like this is key to our public health work, so I’m delighted to support these efforts.”

The Mo-ology team from Cellular Pathology.

To support Kevin and donate to Movember and check out more pictures of UHB Men of Movember, check out the UHB Movember 2011 internet page.

Quality Improvement Faculty Launches The UHB’s new Quality and Improvement Faculty launched recently, with an afternoon of inspirational speakers presenting their work to a large audience. David Francis, UHB Chairman said: “Patient safety and quality is core to everything we do. All our staff are fully behind us and there is a huge commitment and energy for this work which is really refreshing.” Assistant Director of Innovation and Improvement, Maureen Fallon added, “We are proud to be the first LHB in Wales to launch a Quality Improvement Faculty.

As public servants we have two jobs; to do our job and to improve it. By supporting and nurturing staff to be the best they can be we will ultimately improve quality for the betterment of citizen and patient care. “We want to promote and strengthen the Faculty to encourage networking through creating a physical space for staff to generate ideas and concepts. Collaboration will be key to its success and the Health Board will be utilising facilities in the new Cochrane building which is testament to the important working relationship with Cardiff University. “I look forward to working with colleagues across the UHB on this project”.

Who do you work with most within the UHB? Five inpatients, 28 ward staff, five adult mental health wards at Whitchurch and UHL and 14 consultants and their multi-disciplinary teams.

Who do you most admire (living or dead) and why? Billy Bragg for mixing pop and politics and some of the most poetic song lyrics you’re ever likely to hear.

What are your key responsibilities? The running of a busy and challenging ward, engaging with patients who are often behaviourally challenging, supporting them and their families through a very difficult time in their lives. Working with a skilled and dedicated staff team who can often be on the receiving end of abusive and aggressive behaviour. Liaising with other wards and professionals in order to provide the best possible care for our client group.

If you could live anywhere in the world, where would it be and why? Here will do for now, but a desert island would be nice.

What do you like most about your job? Seeing positive change. A patient’s average stay with us is usually between 7-10 days. Seeing the change in an individual’s mental health is rewarding for the whole team. What is your next big target or issue to tackle? Ongoing development of the unit ready for expansion in 2014. We are looking forward to increasing our bed capacity to 10 and developing the staff team in line with this. What are your hobbies outside of work? Two children under six, a dog and bad guitar playing. Where in the world would you most like to visit and why? Durban, South Africa – my sister and her family live there.

What was your first job? Kitchen-hand in the best fish and chip restaurant on the South East Coast. What’s your lifelong ambition? To reach retirement with a decent pension. What was your nickname at school? Norman If you or your loved ones have had to use our health services, what did you appreciate most about your experience? My wife was admitted to CCU at Llandough earlier this year, the nursing team there were fantastic, they were always professional, helpful and supportive. We can’t thank them enough. What is the best piece of advice you have ever received? “Enjoy yourself, it’s later than you think”.

Healthy snack team celebrate success UHB staff are celebrating having helped thousands of local pre-school children to make healthy snack choices. Community Dietitians from Cardiff and Vale University Health Board and Flying Start work together to run the Gold Standard Healthy Snack Award, a programme for pre-school childcare providers. Dietetic Support Worker Rebecca May explains: “We work with organisations that look after children before they go to school. This could be a nursery, or a childminder. They work towards achieving the award which is focused on promoting healthy snacks, in a hygienic and appropriate environment. “We work with child carers, encouraging them to replace crisps and biscuits with healthy snack choices like fruit, vegetables and toast. We encourage children to move from sitting on the floor, to sit on age appropriate chairs at a table, and teach them to eat and drink with cutlery and a proper cup. “A celebration evening was held recently for the childcare teams who have made such a difference to the diets of children in Cardiff. The evening was made possible through funding from Flying Start and the Health Partnership Team. In the four years we have been running the scheme, we have helped 125 groups. George Bailey gets stuck in to peeling and chopping.

“More than 1,000 children in Cardiff and the Vale of Glamorgan have been supported to choose healthier foods.”

Standards of behaviour what you need to know. As public sector workers we all have a duty to ensure that we do not misuse public funds or seek to gain personally from any contacts made through work The Board recently approved the Standards of Behaviour Framework Policy Incorporating Declarations of Interest, Gifts, Hospitality and Sponsorship. This applies to everyone working within the Health Board, including Board Members and those on Honorary Contracts. All Independent Members and staff are expected to practise high standards of corporate and personal conduct whilst acting in the public interest at all times. This means: •

More staff seeking help to quit smoking More NHS staff in Cardiff and the Vale of Glamorgan are seeking help to quit smoking, as the UHB continues to move towards a smoke free future. From November 1 staff, patients and visitors must use designated shelters if they wish to smoke.

CLEAN AIR ZONE

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• Executive Director of Public Health Dr Sharon Hopkins explains: “The UHB moved to a policy of smoke free entrances on May 1 this year. Between May and September, 44% more staff accessed smoking cessation services than during the same period last year. “We planned to become a smoke free organisation on November 1, this year. However, we’ve listened to feedback from staff and patients, and appreciate that a complete ban is very difficult, particularly for patients and visitors who have had bad news.

“We also recognise that this type of culture change takes place over time, and so we will continue to work towards a full ban, and review the situation in March 2012. We are asking staff, patients and visitors that if they want to smoke, they use our smoking shelters and do not smoke anywhere else on our hospital grounds. People come to our sites to get better, and it’s very important that we support this. “I’m delighted to say that since May 1, the numbers of people smoking outside our hospital entrances have reduced significantly, and I want to thank staff in particular for their support for the changes.”

• •

ensuring the interests of patients and the public remain paramount being impartial and honest in the conduct of official business using NHS resources to the best advantage of the service and the patients, always seeking to ensure value for money not abusing an official position for personal gain or to benefit family or friends not seeking advantage or to further private business or other interests in the course of official duties, and not seeking or knowingly accepting preferential rates or benefits in kind for private transactions carried out with companies with which they have had, or may have, official dealings on behalf of the UHB.

All staff are responsible for declaring any relevant interests. Some staff are required to complete a Declaration of Interest form every one to two years,

even if they have nothing to declare. If you receive this form from the Governance Division, please complete and return it promptly. The Standards of Behaviour intranet pages are being updated to include all relevant forms, a copy of the UHB Register of Interests and FAQs. Here are some things for all UHB staff to think about: • whilst it is still OK to accept sponsorship to attend conferences, this must be approved in advance by the appropriate Divisional/Executive Director • if accepting any hospitality e.g. lunch, consider whether it is OK under the Framework • under no circumstances should staff attend corporate/sporting events e.g. rugby matches as guests of our suppliers • staff can only accept gifts up to the value of £25 from patients and their relatives. Cash or personal cheques cannot be accepted • gifts from suppliers are not allowed unless they are of low intrinsic value e.g. pens, diaries

If you, colleagues or your manager require any further information, contact Alison Gerrard, Director of Governance on (01872) 5544 or externally on 029 20745544 or Melanie Westlake, Head of Corporate Risk and Governance on (01873) 6181 / 029 20336181.

What’s in the Christmas Stocking this year? As the official charity of the Children’s Hospital for Wales, the Noah’s Ark Appeal is often approached by supporters and well wishers who would like to make Christmas, a little more special for children at the hospital. However, it’s often difficult to decide which gifts are really needed or appropriate for sick children in a hospital environment; for example, soft toys cannot be used as they can carry infection very easily. So to make it easy to give to the children at the hospital this Christmas, the Noah’s Ark Christmas Stocking Appeal will raise money to buy a special wishlist of gifts drawn up by children and staff which includes toys, games and DVDs for the play rooms, as well as specialist items for the therapy rooms. The Christmas Stocking Appeal will also raise funds for a hydrotherapy pool, one of the key projects for which the Noah's Ark Appeal is currently fundraising. It comes at a cost of £500,000 and is a gift the Children’s Hospital for Wales really needs. A pool would mean many more children could have hydrotherapy treatment. The Christmas Stocking Appeal makes giving simple and makes sure the money donated by kind supporters will help buy gifts that are really needed. Supporting the Noah’s Ark Appeal this Christmas will help put smiles on young faces by making wishes come true and ensuring that the Children’s Hospital for Wales gets the best equipment possible to treat our young patients. We have lots more ways you can get involved with the Noah's Ark Appeal this Christmas, from requesting a Santa letter, to purchasing our Christmas cards, to signing up for a parachute jump or even trekking the Inca Trail in Peru.

To find out more about supporting the Noah’s Ark Appeal this Christmas, visit our website www.noahs-ark-appeal.org or call 029 2033 5016.

Text Santa Keep an eye out for the ITV Christmas Appeal this year, Text Santa. The Noah's Ark Appeal is one of nine charities across the UK that will benefit, and TV cameras from Daybreak visited the Children's Hospital for Wales recently with one happy family who came back to thank the staff that helped them.

Blood chilling challenge for staff Catherine Zeta Jones, Patron of the Noah's Ark Appeal, with patient Catrin Evans in the Children's Hospital for Wales last year

Early Christmas present for Children’s Hospital Health Minister Lesley Griffiths, pictured on the front cover with patient Emilia Fox, has just announced £63.8 million funding for a major expansion. Phase Two of the Children’s Hospital will create stateof-the-art wards, critical care facilities, four new operating theatres, a new outpatient department and dental suite, an assessment unit, a new critical care unit, parents’ accommodation and facilities, education and teaching facilities, and a dedicated radiology department. Visiting the hospital, Lesley Griffiths said: " The second phase will mean that all children and young people will receive their care in modern, purpose-built settings, enabling more services to be provided in Wales for the children of Wales.”

UHB staff took on a chilly challenge to help tackle homelessness in Cardiff recently. Chris Lee, from the Haematology Department at University Hospital of Wales, has braved the cold for 12 years to join dozens of others sleeping rough in Cardiff overnight and was joined by colleagues this year to help homeless support group Huggard. It provides help and support to the homeless through the Huggard Centre, based at the old Custom House. The group provides a variety of services to support the hundreds of people who are homeless in Cardiff. Chris said: “I have participated for about the last 12 years or so, and several of the folks from the labs have joined me over the last few years. “Usually there is anything from 30 to 70 people from various organisations and churches etc taking part. “I have always thought it to be a really worthwhile cause, and anybody who contributes can be assured that the money is spent on some of the most vulnerable right here in Cardiff. “It is an excellent cause and any donations will be gratefully accepted.”

To find out more or to make a donation visit www.huggard.org.uk or contact 029 2034 9980.

UHB Chair, David Francis, said: “The approval of the full business case marks the culmination of more than a decade of work by the UHB and its predecessor organisations, the Welsh Government and, significantly, the Noah’s Ark Appeal, without whose tireless support the first phase of the Children’s Hospital of Wales would not have come to fruition." Lyn Jones, Chairman of the Noah’s Ark Appeal, said: “With these vital funds we will ensure that children in Wales receive the very best healthcare possible. This is the best Christmas gift we could have asked for.”