A newsletter for the 2,500 people who work and volunteer at Noble’s Hospital and Ramsey Cottage Hospital in the Isle of Man - sharing information, marking achievements and awards, and highlighting strong teamwork Published by the Department of Health and Social Care Crookall House, Demesne Road, Douglas
Connections
Summer 2018
Hospital staff embrace emergency stress-test challenge
Major Incident Exercise At Noble’s Hospital By Marian Kenny Communications partner, DHSC A state-of-the-art training kit donated to Noble’s Hospital has been deployed by around 100 health care staff during a major incident exercise for the first time. The Emergo Training System provided by the Microgaming Health & Care Trust, was used in the second annual table-top exercise at Keyll Darree training centre, where hospital teams were presented with a series of
challenges to respond swiftly and professionally to a virtual crisis. The kit is designed to stress-test emergency services’ plans to deal with major incidents, and is widely used by organisations in the UK rehearsing their response to crises involving numbers of casualties, ranging from an epidemic to a train crash. The event on Friday 4 May was led by Dr Gareth Davies, Hospital Lead for Emergency Preparedness and follows a similar exercise last year. Turn to page 2
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Emergo’s numerous detailed components added a substantial extra dimension this year, with clinicians and nursing staff called on to plan their approach to the most complex range of injuries and logistical headaches to date. This year’s scenario was revealed at a pre-event staff briefing as a serious incident at the Ramsey Sprint during TT. The exercise saw key teams of clinicians, nurses and specialists demonstrate in real time how they would respond to the unfolding crisis, in line with the hospital’s emergency plans.
transform the way we simulate a worst-case scenario, and therefore enable us to push our staff further to develop key skills.’
Keyll Darree’s rooms were pressed into action for the afternoon, representing the emergency department, medical and surgical wards, operating theatres, the intensive care unit, X ray department, mortuary and strategic control centre. Hospital managers rehearsed logistical plans, responding to demands from relatives, the public and the media while keeping the hospital operationally safe. Porters, core services and communications staff also played a key role in the exercise.
A ‘hot’ debrief was held immediately after the event, where feedback was offered by each team. The new training system was widely welcomed as taking the exercise to a new level, offering scope for more engaging emergency incident simulations than in the past. Commenting on the donation, Chairman of Microgaming’s Health & Care Trust Dr Malcolm Clague said: ’The simulation system will help strengthen real world communication, teamwork, crisis management and resilience during critical events; we are delighted to invest in staff training at Noble’s Hospital, to help them continue to provide the best quality of care to the island.’
Dr Malcom Clague and Trustee Paul Novellie
Dr Davies, who planned the 2018 exercise over many months said: ‘We are extremely grateful to the Microgaming Health & Care Trust for the funding. They have given us an amazing piece of equipment to stress test our major incident plan, which can be used and reused by every department in the hospital year on year. He added: ‘The Emergo kit will greatly improve staff preparedness, ensure our action plans are up to date and
On a personal note, the exercise offered me a new challenge, as media liaison and hospital spokesperson. In such exercises during my previous career as a journalist, I have provided the challenge to authorities under pressure, to release as much information as possible to the public, as quickly as possible. Here, with responsibility to reflect a complex unfolding situation, I fielded questions from reporters – not all of which had an immediate answer. It was a fascinating reversal of roles!
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Digital Future: the story continues By Chris Holland Communications, GTS Since the last update on digital initiatives across the hospital and the wider health network, there’s been a lot happening as we move towards a more integrated, digitallyminded way of working. First of all, the programme of scanning all our medical and maternity records is now complete. The successful introduction of the Digital Health Records (DHR) programme, and the use of MediViewer to view these records, means that DHR is now up and running in all live clinical areas. The Forward Scanning Bureau now handles around 7000 sheets of paper every day.
There will be a series of upgrades to MediViewer as we move ahead, and we will keep everyone up to speed with developments. The Order Comms programme is also well into its delivery phase. It’s now deployed live across all Noble’s wards as well as in the Emergency Department, with other areas set to go live imminently. Looking at the Electronic Prescribing and Medicines Administration (EPMA) project, the first phase has seen the the delivery of Electronic Medicine Management (EMM), the further digitisation of the internal pharmacy order system to increase efficiency and safety. And we have started
the installation of lockable bedside medicine cabinets on the majority of wards. These will allow patients to bring their own medication with them, which will be more easily available for administration on the ward, reducing the need to order replacement supplies. The final step - Electronic Prescribing - is likely to go live later than we had originally anticipated. The Project Team is working with our supplier to agree development timescales. While the delay is disappointing, we have a detailed action plan to make sure we get an EPMA that is fit for purpose Testing of the upgraded Patientrack system has started, in preparation for the launch of electronic
Clinical Assessment and Noting. All being well we expect to see this roll-out later this year. And, finally, E-Discharge. This needs both Clinical Assessment and Noting and Electronic Prescribing to be fully up and running. Once this is the case E-Discharge will follow hot on their heels.
Above: Dr. Gregor Peden, Chief Clinical Information Officer
£710,000 was required to address this.
for closure and this was achieved in March 2018.
Due to the forecast financial deficit at the time along with a vacancy factor of 26.3 it was not thought appropriate to bid for funding for recruitment. This would have added to the vacancy issue and meant efficiencies would have to be found elsewhere. Instead, the findings of the Shelford assessment were applied to the current compliment of nurses, to ascertain the number of beds that could be safely staffed.
To help off-set the loss, 10 additional beds have been opened at Ramsey Cottage Hospital, providing a welcome opportunity for several staff to move north.
New era for Ward 5 Team spirit shone out as the staff of Ward 5 bade a fond farewell to their nursing base at Noble’s this spring. It was the end of an era for the established team of nurses and ancillary staff, many of whom have been based in the 21-bed mixed medical ward since the hospital opened 15 years ago. Friendships, shared experiences and the highs and lows of providing frontline health care have forged strong bonds among the team – which while supplanted, will survive. Individual members of staff have been met with to discuss their next step, with transfers and placements to other areas accommodated as far as possible for everyone.
A padlock on the door of a decommissioned ward may be an uneasy sight – but it won’t lie empty for long, as plans to transform the space into a chemotherapy day unit are progressing. While this may seem a straightforward change of use, the project is something of a jigsaw. So why did Ward 5 close, how has its capacity been absorbed and what happens next? A logistical answer rather than a quick fix was needed to address ongoing staffing headaches. In 2017 a review using the Shelford Safer Staffing Tool suggested there was a shortfall in the nursing establishment across the 194 acute medical and surgical beds of 22.56 (12.66 RN and 9.9 HCA). An investment of around
This exercise confirmed there were sufficient nurses in post to safely staff 174 acute beds – which meant Noble’s Hospital needed to reduce its overall acute bed ‘footprint’ by 20 beds, the equivalent of one ward. Ward 5 was identified
Noble’s first patient discharge lounge has increased patient flow and eased admission bottlenecks, freeing-up acute bed spaces sooner. Ward 5, once refurbished, will replace the current chemotherapy day unit, temporarily housed in Ward 20. We’ll report on how the refurbishment is progressing in future editions.
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Donation will help sepsis detection Equipment which will assist medical and nursing staff diagnose a potentially lifethreatening condition has been donated to the Manx Emergency Doctor Service (MEDS) by island charity Mannin Sepsis. The lactate monitor will be used to carry out a test
which can quickly assist in the diagnosis of sepsis. The monitors are already installed in ambulances and now thanks to the donation, staff at the outof-hours GP service are being trained to use theirs. Diagnosing patients with sepsis is challenging, as symptoms are not always specific. The device will help with onthe-spot diagnosis, to ensure patients are given immediate treatment and increasing their chances of a full recovery.
The Mannin Sepsis team is dedicated to raising awareness of the condition, and was set up in memory of Island teenager Ann Struthers, who died from sepsis in 2013 at the age of 18. Dee said: “We are very honoured on behalf of Mannin Sepsis Charity in memory of our daughter Ann, to be able to donate this piece of equipment. This monitor will assist in the early diagnosis of sepsis, a condition which requires effective treatment
here and now. Perhaps if Ann’s blood had been tested with such a monitor back in 2013, we would be sharing a different story today.”
Dee Struthers and Dr John Snelling, Clinical Lead at MEDS
New Head of Midwifery looks to future By Frances Butler Clinical Team Lead Children’s Therapy If you want something doing, ask a busy woman - or so the saying goes. Head of Nursing and Midwifery Frances Jones has hit the ground running since her move to the Island to take up the post last November. As a champion of the integrated model of care, she’s made a core pledge to increase the involvement of people who use our services in shaping them for the future. Frances has already delivered on an early aim to reintroduce home births, with attending their Noble’s midwives for almost two years, in May. It’s an
achievement she aims to build on, as she sets about modernising our midwifery service. A recent career break proved to be less about kicking back than stepping up, when three granddaughters arrived in the space of a year - at roughly the same time! It proved a pivotal moment to pause. Enjoying family life and reflecting on her next step, Frances saw the advert for the post at Noble’s. Leading the nursing and midwifery service for an Island nation offered a new direction and a fresh challenge. Ah well, a change is as good as a rest – or so they say! Beginning her career in Cheshire, Frances completed her midwifery training at Guy’s and
St Thomas’s hospitals in London. She spent more than 20 years at community-led maternity units in Bath and Wiltshire and more recently, she’s held posts in south Wales, London and Hertfordshire, assisting Trusts implement change in line with recommendations from the Care Quality Commission. It was a body she advised when it was as the Health Care Commission, so she’s seen from both sides how quality and safety problems are identified and addressed. An eight year spell on the Nursing and Midwifery Council participating in fitness to practice hearings has offered an insight into the difficulties faced by colleagues across the United Kingdom.
Elsewhere, Frances has been involved in gynaecological research seeking optimum treatments for miscarriage and in setting-up perinatal trials. She’s also played a role with Major Incident Planning for the London Olympics and the Ryder Cup in Wales, and who knows, after observing her first TT she may have input into future planning for our own major public event. Frances has high praise for antenatal care in the Island for mums and dads, our spacious facilities and up-to-date equipment. We extend a warm Manx welcome to Frances and her family and look forward to working with her. Below Frances Jones, Head Midwife.
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Retirement is latest project for long-serving scientist Cathie Robinson Secretary - Pathology If a member of staff was ever synonymous with his place of work, it is Paul Woods and the pathology department at Noble’s. But Chief Biomedical Scientist Paul bids farewell to his colleagues and career in June at the end of a career spanning almost 40 years. Paul joined the hospital, then in Westmoreland Road, in 1978 as a laboratory scientific officer on a three month trial – a post for which he was grilled by a 15-strong interview panel! A combination of practical work and study saw him qualify as a UK stateregistered scientific officer, before he went on to gain his Fellowship from the
Institute of Biomedical Sciences in 1990. He’s headed the Haematology department as Chief BMS since 1996, with the award of Chartered Scientist status in 2004 the pinnacle of his
career. Paul’s devoted tenure in pathology has seen Noble’s Haematology claim several lab ‘firsts’. It was the first UK lab to use a malaria lamp test in 2017 and led the way in deploying a new analyser to investigate abnormal haemoglobins such as sickle cell. In 2000 Paul went to Milan to provide feedback on
the prototype coagulation analyser and more recently, he introduced two stateof-the-art blood cell count analysers which will serve the Island for the next decade – an initiative which will achieve a cost saving of more than 10%. Outside work, a passion for hockey has seen Paul qualify as an England level 2 coach, a talent put to use with Vikings Men’s first team and the Island County Ladies’ team – until recently he also coached juniors. Paul has two grown-up boys, Jack who’s away at university and Harry, soon to start a course at Isle of Man College. As well as seeing more of his partner Karen, he’s looking forward to setting sail on reef and wreck fishing trips and in his lobster boat the Wanderer. The pace won’t
slow too much though as he also plans to put in plenty of time walking, kayaking and skiing. Paul will be greatly missed by colleagues and friends in the lab and across the hospital – and we wish him the very happiest retirement.
Consultant Microbiologist Dr Rizwan Khan is a dab hand with a brush!
Exam Success For David Watt!
precious down-time.
The secret lives of doctors: a passion to paint We’re willing to bet most of us have some sort of private passion outside
work - a pressure release valve in the form of a hobby or sport, be it weaving or wake boarding. Getting stuck into something you enjoy away from the daily grind can offer a much-needed change of focus and a chance to relax during that
Doctors are so often defined by their work. So we’re pleased to discard that one-dimensional view and report that Consultant Microbiologist and artist Dr Rizwan Khan kicks back with canvas, easel and paints. He’s been taking evening classes at University College Isle of Man for the past two years with tutor and well-known local artist Des Clague. Feast your eyes on one of Dr Khan’s water colours – and let us know how you choose to chill for the next edition of Connections.
Chief Biomedical Scientist Paul Woods steps down after almost 40 years’ service
David Watt passed his Institute of Biomedical Science registration portfolio with flying colours. Well done David!
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Noble’s provides perfect plot for state-of-the-art learning disabilities complex New day facilities for adults with learning disabilities are rapidly rising from the ground on the Noble’s Hospital estate. The £5.1 million project will replace units currently scattered on sites around Douglas. The complex will include a replacement Eastlciffe hub, a spacious new home for Greenfield Garden Centre, up-to-theminute craft and industrial workshops, a shop, café, meeting rooms. Phase 1 is due to be handed over by contractors Cedar in mid-July and is expected to open in the autumn. Service users have had a big say in shaping their new facilities,
inspiring contractors to build a facility which works for its future occupants. Contract and procurement manager Francis Johnson and his team have invited service users to inspect progress at every stage and listened to their views. Several keen to pitch in and get their hands dirty have gained invaluable skills working with the labouring team. It’s a unique collaboration which has had a profound effect on all involved. Describing the project as ‘just wonderful’ Francis admits he’s ‘humbled’ to be dealing with it - echoing the sentiments of Cedar’s hard hat site team - and he’s planning to volunteer once
the facilities are up and running. A revamped Greenfield social firm tied to the day service workplace will optimise output from equipment soon to be installed - from weaving looms to wood working jigs. Products from the workshops and produce from the garden centre (which includes an upmarket chicken run) will be on sale in a shop partly fitted-out by service users, who recycled pallets into stylish panelling. They’ll also be preparing and serving light lunches, tea and cakes at the on-site coffee shop, likely to prove popular in the summer, as the outdoor seating overlooks a bucolic Manx
backdrop. It all adds up to increased opportunities for adults with learning disabilities to enjoy a range of activities at bespoke facilities in a carefully designed environment - gaining life and employment skills which for some, will be a bridge to the workplace. Watch this space for more news on the opening – and here’s to a great future at the Noble’s Complex!
Liz Lillis-Ingram, Thie Bee Commercial liz.lillis@gov.im Leslie Murphy, Midwife leslie.murphy@nobles.dhss.gov.im
Want to get involved?
Editorial board Mike Quinn, Director of Hospitals mike.quinn@nobles.dhss.gov.im Chukwuka Anaziah, Doctor chukwuka.anaziah@nobles. dhss.gov.im Amy Hamm, Doctor amy.hamm@nobles.dhss.gov.im Janet Austin, Systems Administrator janet.austin@nobles.dhss.gov.im
Diane Batty, Recovery Nurse diane.batty@nobles.dhss.gov.im Frances Butler, Children’s Therapy frances.butler@gov.im Gill Horsey, Stroke Nurse gillian.horsey@nobles.dhss.gov.im Anna Featherstone, Cancer Services Team anna.featherstone@nobles. dhss.gov.im
Cathie Robinson, Personal Secretary, Pathology cathie.robinson@gov.im Marian Kenny Communications Officer marian.kenny@gov.im
If you have an idea and want to contribute please get in touch, email -
editorialboard@ nobles.dhss.gov.im
Connections Summer 2018
Noble’s is the place to Air Ambulance Bee for loyal worker Pat! staff receive special This is one woman and flowers. helicopter training who does not want to Pat recalls when she stop working. Thie Bee catering assistant Pat Hogg retired in 2008 but missed her job and came back to work on bank. At the age of 75, she’s showing no signs of wanting to ease up and if she has her way, will keep on going! Pat’s celebrated a few milestones during her 30 years in catering and it was service as usual on her 75th birthday, when friends and colleagues at Noble’s staff restaurant presented her with a cake
started doing the job ‘computers hadn’t been invented, the internet was something fish did when they were being caught and flexi-time meant deciding whether you wanted 25 minutes or half an hour to eat your cheese sandwich’. Pat loves working at Thie Bee and is respected by customers and colleagues alike. Just a tip: when you see her, don’t mention the ‘R’ word. What an appetite for work!
Pat’s back at it again! Ten years after her first retirement and there’s still no sign of Pat slowing down.
Pat’s first attempt at retirement didn’t seem to go down well with her back in 2008...
A team from the Island’s Air Ambulance service travelled to Caernarfon in North Wales recently for special training on the helicopter used in bad weather emergencies.
In normal conditions Air Ambulance uses a dedicated fixed-wing aircraft operating out of Ronaldsway, but in poor weather conditions such as very high winds and fog these aircraft are unable to fly. That’s where the specialised Sikorsky S-92 helicopters operated by the UK’s Search and Rescue team come into action, taking emergency patients to Liverpool Airport and then on to a range of specialist hospitals. When needed, the helicopter can be requested at any time of the day or night and will be at the Noble’s Hospital helipad within 60 minutes, assisted by the Isle of Man Coastguard which acts as the local ground team. The team of nine doctors and nurses visited the Welsh Search and rescue base – one of 10 across the UK - for a special briefing covering
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on-board orientation, safety, communications and service logistics. The training was led by search and rescue paramedic, Chris Bradshaw, along with a number of his colleagues at Caernarfon. Speaking after attending the training, consultant anaesthetist and medical lead for the Air Ambulance team, Dr Kate Teare, said: “Although we only make use of the helicopter when we have a patient who needs urgent life-saving treatment, and the weather makes other aircraft unusable, it’s vital that the team are fully trained and ready to go. ‘Working in one of these aircraft is completely different to any other environment. It’s very noisy, often turbulent and with engines running and rotors still turning, so we need to make sure that all the medical and nursing team are comfortable working in these kind of conditions. We don’t use the emergency helicopter service that often, but whenever we do we can be sure that the team all know their jobs and can focus on delivering the highest standard of patient care.’
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Taste of success for Thie Bee Mouth-watering figures from Thie Bee restaurant and coffee shop at Noble’s this month.
Henry Bloom Noble Healthcare Trust donates £41,000 for hospital Radiology Unit equipment The Henry Bloom Noble Healthcare Trust has donated £41,000 for the purchase of new equipment at Noble’s Hospital Radiology Department. The money has paid for a specialist MRI-compatible anaesthetic machine, to improve care for patients, including children, with serious and life-threatening conditions, and portable screens to give patients enhanced privacy. The Trust was originally established in 1888 by the Island’s greatest benefactor, Henry Bloom Noble, in memory of his wife. It was dedicated to improving healthcare in the Isle of Man and today, thanks to generous public donations and bequests, the Trust continues that work by funding the provision of new equipment, training and education, research and measures to improve conditions. Consultant Anaesthetist Dr Adrian Dashfield explained: ‘The new MRI compatible anaesthetic machine is made by the
same manufacturer that supplies the present conventional anaesthetic machines to the hospital. Functionally it is identical to the existing machines, meaning that staff will be familiar with its workings, but where possible materials other than ferrous metals have been used in its construction. Oxygen cylinders are firmly secured to the machine and it has powerful brakes to prevent it being drawn towards the
magnet.’ Dr Dashfield added: ‘Provision of this machine will improve the care of some patients at Noble’s Hospital with serious, lifethreatening conditions and could obviate the need of children to have to travel off-Island for their MRI scans.’ The Trust has also paid for five patient privacy
screens for use in the Radiology Department. Growing demand has seen the department capacity increase, but the space for patient privacy is limited. The new portable Kwickscreen units will offer additional privacy in the two CT scanner rooms and Ultrasound room, as well as to patients awaiting scans outside the rooms. Trust chairman Terry Groves said: ‘The Trust exists to help improve healthcare provision in the Isle of Man, this is clearly a step forward for patient treatment in the Island. Also of great importance to the Trust is the care given to patients, and privacy, such as during and while awaiting procedures like CT and MRI scans, is essential.’ The Henry Bloom Noble Healthcare Trust relies on donations and bequests from the public. If you would like to support the Trust, visit the website www. hbnhealthcaretrust. org.im, email info@ hbnhealthcaretrust.org. im or call 616108.
Over the past 12 months, the coffee shop has served up 143,590 hot drinks, including a staggering 91,000 cups of coffee
More than 550,000 customers have used the facility since it opened in October 2012
Around 1.65 million customers have been served in the restaurant since July 2003.
An average 122,266 patient meals and 46,800 sandwiches are prepared each year at the central production unit – now that really takes the biscuit!
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The Manx Swallows Support Group By John Beckett Head and Neck Cancer Patient The Manx Swallows is the Manx patient-led group with professional support that provides advice, support and realism to the 140 Head and Neck Cancer patients, families and carers in the Isle of Man. The target groups are patients with mouth, throat, tonsillar, oropharyngeal or similar cancers. The support group was launched in 2013 by ENT Specialist Nurse Doreen Wilkinson and tonsillar head and neck cancer (H&NC) patient John Beckett, having been given the green light by ENT consultant Richard Hogg. Our quarterly Manx Swallows meetings at
The Sefton Hotel are attended by a mix of regulars, new patients, medical professionals, families and friends, with everyone encouraged to participate and socialise. We’re a friendly informal group, who clearly fulfil a need. In truth, we do little more than get together to learn and meet each other, but the format gives confidence to this patientfamily-carer group to face up to the realities of head and neck cancers in public, deal with their treatment issues and understand they are not alone. The number of H&NC patients in the Isle of Man will grow as diagnosis improves and treatments become increasingly successful, leading to more long-term survivors. Many will have a range of medical needs and support for the rest of
their lives. Knowing this IOM group exists is proving a psychological boost to patients and their families, even though not all attend in person. We de-mystify the frightening unknowns and facilitate practical advice on a host of subjects from patient transfers and extended treatment at UK hospitals to on-going medical support and review. Increasingly, we’re making contact with patients soon after diagnosis, which opens the door to active mentoring during the treatment and recovery phases. We encourage patients to think positively, whilst being realistic. We cannot emphasise enough how tough, painful and difficult these treatments over many months can be. To achieve our ambitions we network strongly, maintain a high confidentiality ethic and carefully plan our meetings to ensure they address the group’s needs. But
above all, by listening and quietly communicating, we deliver knowledge, advice and compassion to H&NC patients, their families and carers. As Doreen Wilkinson puts it, “sometimes the best medicine doesn’t just come from the pharmacy or a doctor. It comes in the form of attention, conversation and connection to other people who have experienced the same challenges.”
Dates for your diary Our meetings are held at the Sefton Hotel Cowell Suite on Thursday afternoons at 1.30pm. Remaining dates in 2018: 19 July and 25 October In 2019 it’s the same venue, same day of the week and same time! Do join us on: 24 January 11 April 18 July 24 October 2019.
Prized machine advances diagnostic pace By Dr Rizwan Khan Consultant Microbiologist A new piece of equipment recently delivered to the microbiology department at Noble’s will provide faster, effective patient diagnosis, as the lab takes another step towards automation. The latest tool for the study of microorganisms does what it says on the tin. It is a Biomerieux Matrix Assisted Laser Desorption Ionisation
- Time of Flight mass spectrometry – or MALDITOF for short. For the last almost 100 years, diagnostic microbiology has utilised biochemical and sugar reactions to identify species and subspecies of microorganisms, which can be a time consuming process. The new piece of kit transforms this process, enabling identification and taxonomic classification of organisms direct from culture plates without the need for further incubation or biochemical tests. Proteomic fingerprints
are compared with reference spectra in the MALDI-TOF library and the instrument provides a result in less time than conventional biochemical profiling – which is great news for patients. The MALDI-TOF is a powerful tool for identifying not only routine bacterial identification but also rare bacterial species implicated in human infectious diseases. So it is likely staff will come across some new and different names they may not be previously familiar with. Staff in Microbiology have
been busy validating the instrument and everyone involved feels this is an exciting and innovative step forward for the Department.
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RCH overhaul optimises elderly care Integrated care model beds-in at northern hospital hub The reorganisation of Ramsey Cottage Hospital is helping transform care for some of the most vulnerable people in our society – while easing pressure on Noble’s at the same time. The 10 additional beds opened in Martin Ward this spring combined with greater occupancy have provided an enhanced rehabilitation facility for the whole Island. Designed as a steppingstone between hospital and home, Ramsey’s 31-bed ward receives elderly patients from Noble’s who no longer need acute hospital care. Under the direction of Consultant Geriatrician Dr Tim Petterson, patients’ additional medical needs are catered for while plans are made for their ongoing care at home. It is a joined-up approach in which Dr Petterson, Associate Specialists Dr Tariq Anwar and Dr Julie Keeling, nurses, therapists, social workers and healthcare assistants are all involved. ‘We’ve created a really exciting community hub and rehabilitation unit,
providing continuing care for frail older people throughout the Island,’ said Dr Petterson. ‘After their stay with us, most patients return to their own homes, with support tailored to their needs. The feedback we get from patients and their families is excellent.’ Logistical approach drives transformation The changes at Ramsey, where medical care was previously overseen by local GPs, have been rapid. Making best use of the hospital has not only created a thriving hub for rehab but freed-up acute beds at Noble’s. It has been a complex logistical exercise. Timing, planning and attention to detail are vital to ensure optimal use of hospital services at Noble’s and in the north. Dr Petterson divides his time between the two sites - at Noble’s he selects patients who will benefit from the focus on social needs at Ramsey, paving the way for transfer when the time is right. ‘We want to ensure people come here for the right reasons at the right time,’ said Dr Petterson. ‘Improved patient flow
at Noble’s is intimately dependent on Ramsey, and our model - offering high quality care for a vulnerable group of people who no longer need acute medical interventions - is delivering positive results all round.’ The transfer of the Dermatology Service to Ramsey has expanded hospital activity in Ramsey further and including the Minor Injuries Unit, Community Therapy and Wound Management services, the hub now employs 89 people. Care without walls ‘The multi-disciplinary team at Ramsey aims to do something for every person, every day,’ said Dr Keeling. ‘As our patients are medically fit, we want to make sure something happens towards their discharge every day.’ A morning ‘board round’ sees the team set goals for each patient’s progress, while doctors complete a full ward round three times a week. Assessment of ongoing needs involves close liaison with patients, their families and carers. Home visits by occupational therapists ensure everything is
Left - Multidisciplinary team at Ramsey Hospital Right - Outside and Garden area at Ramsey.
in place for a return to everyday life and individual care plans follow patients into their homes. The commitment of nursing staff to the transformation has been key to its success. Team work and settled shift patterns mean nurses get to know patients well, providing continuity of care and an understanding of wider needs and expectations Dr Petterson says fully integrated care is the norm at Ramsey. ‘This shows how the individual can be put at the centre of the system and their needs met without any barriers between health and social care. We provide individualistic support without boundaries for patients and their families.’ Ramsey Cottage Hospital has been serving the Island for well over a century and has seen much change in recent decades. The lasting benefits of the new set-up will unfold over time – but its potential to serve the Island’s growing elderly population is clear.
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Writing on the wall for ED project For many parents, keeping the kids occupied is the key to coping with hospital waits. So when Noble’s Emergency Department staff decided a blackboard would be perfect in the play area, they turned to the hospital’s Friends at Noble’s Hospital for help. The charity uses its funds to purchase patient
comforts wherever they’re needed and makes numerous generous donations large and small, year-round. Only a bespoke blackboard would fit the bill, so who better to turn out a top- notch job than the willing workforce at ERIC - Eastcliffe Recycling and Industrial Centre, a day facility for adults with learning disabilities based on the Noble’s site.
Service users chalked up a success in their workshop, cutting and decorating a frame, painting the board and putting it all together to a robust spec. It’s the latest product from the team at ERIC known for its planters, wishing wells and outdoor ornaments, often made from pallet wood recycled from hospital stores. Support worker Caroline
O’Connor says the team was delighted to help out as they use hospital facilities daily. ’We wanted to give back to the hospital and to the Friends, as they support us,’ she said. ‘It was a perfect project for our users who enjoyed the whole process and learned a lot from it’. Below - Service user Scott Schofield and Chairman of Friends of Noble’s Hospital Chris Kelly
Eye lamp donation brings new out of hours capability A piece of equipment donated to Emergency Department by the Friends of Noble’s Hospital has been welcomed by clinicians as a great addition which has brought immediate improvements to patient care.
The Friends have funded a slit lamp which allows doctors to examine the surface of the eye in detail to find and remove foreign bodies, offering swift relief for patients presenting out of hours. In the past, patients arriving at ED with eye problems were referred to the Eye Clinic and would
have to wait until the next day at the earliest to see the Ophthalmologist, adding to the clinic’s workload. Now, most patients can have their eye problem resolved in less than an hour. The lamp, which will help doctors diagnose and treat other minor eye problems, has been installed in a new
side room and is in regular use, after senior members of the ED team trained colleagues in its use. The cost of the lamp has been assisted through a donation to the charity by the Scheinberg family, whose generosity is greatly appreciated.
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Employee of the month January: Elizabeth Llewellyn Jones, Speech and Language Therapst Liz has shown outstanding dedication to the service over the years. This was highlighted recently when she presented a set of talking mats resources, which were very specific for use with non-verbal patients or those with information processing difficulties. Liz took the time to fund and make all of the resources in her own free time. It has helped a patient make a difficult decision, allowing him some degree of autonomy, with his mother requesting personal thanks on her behalf. March: David Parker, Radiographer A colleague has said of Dave: “He went above and beyond, as he has done on multiple occasions previously, during a serious paediatric trauma Dave arranged, transferred and returned all patients he possibly could on his own without the need to tie up ED staff unless necessary. This was invaluable given the circumstances and is at least the third time he has done so where I have been present”.
February: Sharon Murray, Clinical Audit Facilitator A colleague has said Sharon is the unseen hero, helping to ensure that audits we conduct are formatted in a way that they can help to make a difference at ward level. She is cheerful, supportive and always able to provide appropriate advice, a joy to liaise with. Sharon goes the extra mile to help turn around information in a timely manner.
April: Liz Parrington, Secretary, Core Services A colleague said “In a corridor of six secretaries, five have been away from the office at the same time, due to unforeseen circumstances or sickness. When the going gets tough, the tough get going! Liz has stepped in without hesitation to support three specialities, to ensure patients receive the level of support they should. She’s remained cheerful, organised and professional throughout”.
Paper copies of the nomination forms are distributed around the hospital and they can also be downloaded from the DHSC intranet. Once completed, either email employeeofthemonth.nobles@gov.im or send to Employee of the Month Nominations, Management Suite, Noble’s Hospital. The winner is chosen by the Operations Management Team. All the Employees of the Month will be invited to a celebration next April – when one will win a trip for two to Madeira.