LUHFT Life - April 2023

Welcome to our new chair

Our new Chair, David Flory CBE, started on 27 February 2023.

He has a track record of delivering healthcare services having previously served as interim Chair of Cheshire and Merseyside Health and Care Partnership, and brings experience and understanding of population health needs across Liverpool City Region.

James Sumner, Chief Executive said: “David’s extensive skills, knowledge and experience of the NHS, and understanding of healthcare in the Liverpool City Region will be critical to the next steps on our improvement journey to deliver the quality of care our

patients deserve, and to make LUHFT a great place to work for our colleagues.”

David has 22 years of board level experience as Chief Executive and Executive Director of NHS organisations in England and healthcare organisations internationally, including six years in the Department of Health for England.

David Flory, Chair, said: “I am looking forward to working together with colleagues and partners to deliver continued improvements in the quality of healthcare for the benefit of our patients and the communities we serve.”

LUHFT has started on an improvement journey to make the Trust a place where you want to work and thrive, while being supported by your managers, to deliver high quality patient care.

As part of our three to five-year improvement journey, one area of focus is to develop the leadership and governance, so there is a clear process for issues to be escalated and managed from ward to Board.

You will have seen a number of changes to our Executive Team and Board as part of this development.

Our improvement

We have embarked upon our improvement journey following feedback from patients, staff and regulators, which indicated that we aren’t getting things right in terms of patient care and staff experience.

Through our improvement plan, which focuses on leadership and governance, people and culture, quality and safety, clinical effectiveness, financial sustainability and operational performance, we have outlined what we need to achieve.

And now, we are empowering colleagues, putting them at the heart of LUHFT and its future, to work together to decide how we make those improvements.

To support the transformation that is required, we are introducing Hospital Management Boards at Aintree, the Royal, Broadgreen and Liverpool Clinical Laboratories (LCL). This will give each of our sites greater autonomy and the ability to have increased oversight of their opportunities, risks and issues.

James added: “This change enhances the arrangements that are already in place with our Hospital Leadership Teams. The new governance with provide strengthened control, with more decisions made at site level and less escalated at executive team level, which will enable more rapid decision making.

“Although this may feel like a step backwards, we will continue to operate as one organisation,

Board structure

Chief Officer

James Sumner, Chief Executive, said: “We know that the improvements that we need to make are within our control and that by listening to our staff, those who are closest to the delivery of care, we can do better for our patients.”

Chief Finance Officer / Deputy Chief Executive

Chief Medical Director Chief Officer Director of Communications and Marketing

Director of Strategy and Partnerships Director of Quality Improvement

Executive Managing

Director Nursing Director of Operations Medical Director

Trust

improvement journey

LUHFT to improvement

sharing the same vision and values. Our Board and Executive Team will continue to have oversight, making decisions that impact LUHFT at a Trust level, but Hospital Management Board will have devolved control of aspects that enable their effective running and ability to respond, such as workforce, finances and quality and safety.”

The Executive Managing Directors of each Hospital Management Board will be voting members of the Trust Board, which maintains the connectivity between the Board and each site. These changes will ensure that we have a clear vision of where we want to be, and the leadership capacity, capability and appropriate governance to get us there.

Chair Non-Executive Directors

Executive Officer

Chief People Officer Chief Operating Officer Chief Nursing Officer

Director of Corporate Affairs/ Company Secretary

Executive Managing Director (site)

Meet our new Executive Managing Directors

Natalie

Hudson,

Executive Managing Director for the Royal Liverpool

Natalie has a wealth of knowledge and experience in surgery, theatres, critical care and emergency medicine. She has also led on several large-scale initiatives to improve patient experience and flow. Natalie said: “I’m excited to be working alongside your leadership teams across the Royal as well as with colleagues throughout the Trust. I know there will be challenges ahead and I’ll be joining you on this improvement journey, to help make LUHFT a great place to work."

Executive Managing Director - Aintree

Executive Managing Director - Royal

Director of Nursing Director of Finance Director of People

Dr Peter Turkington, Executive Managing Director

for

Aintree Hospital

Peter will start with us in early May from Salford Care Organisation, which is part of The Northern Care Alliance, where he has been the Chief Officer and Medical Director since 2019. Peter said: “I am looking forward to beginning my new role at Aintree Hospital as the site undergoes several key developments. This exciting opportunity presents a new challenge as the Trust continues on its improvement journey and I’m committed to working with colleagues to realise the potential of LUHFT for the benefit of our patients.”

Robert Forster, Deputy Chief Executive, will have executive responsibility over LCL and Heather Barnett, Chief People Officer, will be responsible for Broadgreen.

Liverpool Clinical Laboratories (LCL) at the Royal Liverpool University Hospital site has fully relocated to the Clinical Support Services Building (CSSB), with some staff also based in the Linda McCartney Centre.

We spoke to Awtad Hassan, Medical Laboratory Assistant working in clinical trials at LCL to find out more about the move. Awtad joined LCL a year ago, so has experienced working in both the Duncan building and CSSB. We wanted to know how the move has improved things for patients and staff.

“Since moving to CSSB we now have updated analysers and pre analytics in Biochemistry. We use the Roche Cobas 8100 in the CSSB which is more efficient and requires less human intervention in comparison to the MPA (Modular Pre analytics) which was used in the Duncan building.

All the samples loaded are sent to the suitable analysers for testing, and samples that have no outstanding tests are sent automatically to the fridge. If the sample needs to be retrieved it can automatically be done so, rather than manually, which was the case in the Duncan.

Previously in the Duncan building we had three analysers whereas in the CSSB there is four, which allows for more sample testing, therefore increasing our turnaround time for patient results.

With the advanced technology in the new lab, there has been a big change in the turnaround times which are shorter and more efficient. Having all departments working close together allows for better communication/processing, overall providing a quality service for effective patient care.”

Awtad Hassan, taking one sample and dividing into three, then archiving

Team LUHFT get a visit from The Royal College of Surgeons

President of The Royal College of Surgeons, Professor Neil Mortensen, and Vice President, Mr Tim Mitchell, discovered more about our complex surgical work in a recent visit to the Royal and Aintree hospitals.

While at the Royal consultants discussed our new robotics programme in pancreatic surgery, the developments and challenges in centralising complex and cancer surgery as well as surgical training in Liverpool.

The Royal College of Surgeons’ (RCS) team then took a tour of the Royal to find out more about the new wards and how they work for patients, the new theatre spaces and patient recovery areas.

The following day they spent time at Aintree with a presentation reflecting on the 10 years as a Major Trauma Unit, the work of KnifeSavers, the regional delivery of Maxillofacial services and the LiVES vascular service.

The RCS team then spent time taking to staff in the Major Trauma Ward, ED – Resus, Maxillofacial lab and the Elective Care Centre.

Professor Neil Mortensen, President of the Royal College of Surgeons of England, said: “It has been an honour and a pleasure to visit LUHFT in person after a virtual visit in November 2021. The wait to move into the Royal has been worth all the challenges along the way. The building and clinical areas look stunning, and the specialist surgical teams are very special.

“On the Aintree site another group of outstanding surgeons are pushing the limits of trauma, head and neck, vascular, and emergency general surgery. All these brilliant people are collaborating to improve elective and emergency provision for the patients of Liverpool, Merseyside and beyond.”

Week beginning 12 March saw the Glaucoma Team at St Paul’s Eye Unit marking World Glaucoma Week with a series of events including display stands and interactive activities. Every year, the week aims to improve the understanding of glaucoma and its impact.

This year, the World Glaucoma Association’s (WGA) campaign was called “The world is bright, save your sight” - a global awareness initiative on glaucoma spanning across all continents.

Glaucoma is commonly known as the “sneak thief” of sight as it causes irreversible blindness, and the figures are staggering. One in 200 people, aged 40, has glaucoma, and the number rises to one in eight, aged 80. This number is forecasted to skyrocket in the coming years.

In conjunction with World Glaucoma Week, St Paul’s has also launched its own podcast, Eye on Liverpool, with the first episode being on the subject of glaucoma. You can listen to the episode on Spotify and other major download sites by searching ‘Eye on Liverpool.’

Marking World Glaucoma Week

Honouring a well-loved colleague

Colleagues in the Trust’s Colorectal Department organised an event in memory of a revered colleague, Colorectal Consultant, Andrew McAvoy, who passed away last year at the age of 38, following a battle with pancreatic cancer.

Andrew was described by his peers as being “kind, compassionate and caring” as well as a “talented surgeon, an astute clinician and an enthusiastic teacher.”

The event, that was held on 17 March at The Spine Building, was hosted by BBC Radio Merseyside’s Roger Phillips. Andrew’s department organised a reception inviting members of Merseyside’s surgical community, colleagues from the Trust and Andrew’s friends and family to celebrate his personal and professional life.

Ahsan Javed, Consultant Colorectal Surgeon at LUHFT, said:

The event will undoubtedly be a legacy for Andrew’s family, especially his children, with a clear message to the McAvoy’s that they will never walk alone!

Navigating young people away from violence

To help support young people who are experiencing violence, or are at risk of violence, when they attend our Emergency Departments, we now have specially trained Navigators on hand to engage with vulnerable 10 to 25-year-olds.

By working in partnership with Merseyside Youth Association (MYA), we now have youth workers working alongside our hospital staff to proactively identify vulnerable young people and help them to access the support they need to prevent any potential escalation of violence and reduce the risk of repeat victimisation or exploitation.

The abuse navigators are based in our A&E's and will co-ordinate support for young people attending our Emergency Departments right through to their discharge back into the community.

The team also work closely with our Safeguarding Team, Katherine Cline, MYA Navigator Coordinator, said: “Our Navigator service is a bespoke support offer for any young person aged 10-25 who has been impacted by violence, and our aim is to reduce numbers of young people returning back to hospital due to violence.

“Navigator support is offered both when young people are at hospital, and once they're back in their community. By building a rapport and becoming a trusted adult for the young person, through phone calls, meetings in the community and home visits, Navigators build a picture of a young person's life and identify any gaps of support, including mental health, housing, education or social aspects.

“Since the service began in February 2022, we have received 131 referrals across LUHFT, including young people who have been stabbed and shot. Often, these young people can receive no further contact once they leave hospital. It's important that we offer Navigator intervention as a support mechanism that can signpost and refer to the specialist support they require. We can help that individual to turn their lives around. One young person said that since working with a Navigator, he ''feels more confident and much safer''.

“As a staff member, when you refer into the Navigator service via the ADT Dashboard, you know that you will be giving that young person an opportunity to receive support, and that they have not been forgotten once they're back in the community.”

Showcasing therapies to Taiwanese nurses

Last month Team LUHFT welcomed nursing and therapy colleagues from Taiwan during their UK visit to explore the holistic and complementary therapies offered to patients and staff.

The delegation party led by Dr Shwu-Feng Tsay, Chief Nurse for Taiwan’s Ministry of Health and Welfare, visited the Health and Wellbeing Centre in the Linda McCartney building. They were hosted by Corporate Director of Nursing Fiona Murphy, as well as Health and Wellbeing colleagues and staff from Macmillan Cancer services.

During the visit, the party were particularly interested to understand how others deliver reflexology as well as sharing their own methods, approaches to training and regulation of reflexologists and the use of reflexology in healthcare.

The gift of giving blood

In February, Transfusion Practitioner, Jessica Bradbury, spoke to TV presenter Naga Munchetty on BBC 5Live for a special programme looking at the journey of blood donation.

Naga donated blood last year and she was notified by NHS Blood and Transplant that it was later used here at the Trust, potentially going on to help save the lives of our patients!

Jess, who is also a Red Cell Haematology Clinical Nurse Specialist, explained how after you’ve donated blood it’s split into three parts: red blood cells, plasma and platelets – meaning one donation could help up to three different patients.

Jess said: “Donating is a precious gift to give people who really need blood – it’s so important. As blood is split into three components, there’s a variety of different things it could help with. Donated blood could be used in theatres, when patients are having an operation, or when they have lost a lot of blood, in a trauma for example.

“It can also help patients with inherited blood disorders such as thalassemia, a rare anaemia, where patients need to have transfusions on a two to four week basis from birth, and sickle cell disease, where some patients have their red blood cells replaced every four to eight weeks.”

If you want to find out how you can donate blood, visit: www.blood.co.uk

PIFU service proves a success

Hundreds of ISS colleagues officially join Team LUHFT

We are delighted to officially welcome ISS colleagues to the Trust, as hotel services colleagues from our Royal and Broadgreen hospitals move in-house.

Hundreds of our colleagues in cleaning, catering and portering, can expect improved working terms and conditions and greater pay, as they move into NHS employment.

The Therapies Service has seen a big decrease in patients missing their appointments, which in-turn is reducing waiting lists, thanks to a process which allows patients more control over when they need to be seen.

As part of our Outpatient Transformation Programme, the Patient Initiated Follow-up (PIFU) process gives patients flexibility to arrange their follow-up appointments as and when they need them, based on their symptoms or any flare-ups they have with long or short-term conditions.

This has meant the service is more efficient as unnecessary patient attendances are avoided, plus DNAs (Did Not Attend) are reduced, so the team has more clinical time to see urgent cases and reduce waiting lists – ensuring it’s a better patient experience with improved outcomes.

Michelle Berrick, from Therapies said: “Initially some of the team were apprehensive about PIFU. There were concerns that patients could get ‘lost’ and care would be compromised. But clinicians discuss with patients when PIFU is an appropriate option. Transferring patients onto PIFU is done safely when patients are at a stage in their rehabilitation journey to take control of their own pathway. It also supports that important transition from regular attendance to discharge and self-management.”

The process allows clinicians to still book follow-up appointments when this is the best option for the patient, but it also benefits patients that don’t need to come back.

This change will also give us greater flexibility of how these services run and colleagues can expect to see improvements made to food and refreshments available on-site.

Heather Barnett, Chief People Officer, said: “It is fantastic that our colleagues, who play such valuable roles in our hospitals, can now benefit from the same conditions as their NHS counterparts.

“LUHFT is one of the largest employers in the region. We have a duty to invest in our workforce, and the decision to bring these roles in-house helps us deliver on our vision, to support communities to live healthier, happier, fairer lives.”

Joe Baldwin, Chair of UNISON Liverpool Hospitals Health Branch, said: “We welcome the decision to bring this service back into the NHS. We have been campaigning for a long time for these members to be afforded the same pay and conditions as those of us who work directly for the NHS. This is also about pensions and access to wider opportunities and staff benefits. We are ‘One NHS’ – and our members in this service are a vital part of our health service.”

Michelle added: “The digital Dr Doctor system we introduced, specifically the two-way text messaging, brought a significant change to our current processes. It enables patients to cancel and re-book appointments, as opposed to calling up, which frees up staff to help relieve some operational pressures.”

Leading Liverpool surgeon to spearhead major trial into cancer vaccine

Local people living with bowel cancer could soon benefit from potentially life-changing technology, thanks to a new global clinical trial into cancer vaccines.

Robert Jones, Consultant Hepatobiliary Surgeon at LUHFT has been appointed UK Chief Investigator for the trial exploring personalised tumour vaccines. The study will use messenger-ribonucleic-acid (mRNA) technology based on the genetic code from each patient’s cancer in order to tailor their treatments and tackle tumours.

Liverpool will be the central hub for the study, which is in partnership with German pharmaceutical company, BioNTech. Working alongside The Clatterbridge Cancer Centre NHS Foundation Trust and the University of Liverpool, the trial hopes to recruit the first local patients in April.

Robert said: “This is an incredible opportunity to change the face of cancer treatment. I’m delighted to help run this trial which we hope will mean more people are cured of colorectal cancer after surgery.

“Making vaccines for cancer has always been very difficult, because unlike other diseases, cancer has a unique appearance to the patient’s own immune system. Using new technology, we are now able to quickly and efficiently develop a vaccine that is specific to each individual’s cancer. The early results have been really encouraging, and we know these vaccines are very well tolerated with far less toxicity than chemotherapy."

Patients in the trial will have had surgery for colorectal cancer and been offered routine follow-on chemotherapy. They will be told by their surgeons about the trial and can then discuss with their oncologist if they would like to take part. Some patients will be offered additional vaccine treatment after their chemotherapy. Other patients with

more advanced cancers (metastatic disease) will be offered the vaccine with the hope that it might help to shrink and control it.

Dr Jim Gardner, Chief Medical Officer at LUHFT, said: “The prospect of changing how we treat cancer using vaccines is momentous. To have this trial based in Liverpool and led by Robert is a wonderful opportunity for our local patients to receive potentially life-changing, personalised care. It further bolsters how our region is becoming a leader in delivering innovative, healthcare research, and we look forward to seeing the results of this trial.”

This study builds on work that LUHFT has delivered over the last couple of years in collaboration with BioNTech and the University of Liverpool, and recognises the Trust as an organisation that places research at the front centre of routine clinical care.

Celebrating transformation

There has been a lot of positive work happening at the Aintree site. With various service improvements resulting in a better patient and staff experience, and ongoing redevelopment works to reconfigure the ‘front door ’ of our hospital to improve patient flow.

Dr Rebecca Hanlon, Medical Director at Aintree, said: “These improvements have had a positive impact, not only on patient experience, but also on staff wellbeing. Below are just a few examples of departments across Aintree who have implemented successful changes to support great care.”

The team on Ward 10 has seen a huge decrease in the amount of patient falls, with their lying and standing blood pressure compliance increasing from 50% in September 2022, to between 95-100% now. A drop in standing blood pressure can cause dizziness and fainting, leading to falls. By the team regularly monitoring medication and hydration of patients, they are providing the best care possible, and preventing longer stays in hospital.

Radiology

Aintree’s radiologists have introduced a Wellbeing Board in their department to improve staff morale and in turn help colleagues deliver the best care possible to our patients. Colleagues pin social suggestions, mental and physical wellbeing resources, and advertise on-site sessions hosted by partner organisations which promote team building.

As part of Aintree’s reconfiguration works to improve patient care and flow, the SAU, has been made a standalone service and relocated from Ward 29. The unit recently achieved Silver status in Liverpool University Hospitals’ Quality Assessment and Accreditation (LQA), which incorporates the CQC standards of care. Given the short period of time the unit has been functioning in its new home, and the large increase in new staff and new faces (Ward Manager, trainee advanced nurse practitioners, Band 6 nurses, ward clerks and housekeepers) this is a fantastic achievement.

Surgical Assessment Unit (SAU)

Ward 10 – Gastroenterology

transformation at Aintree

Hyper Acute Stroke Unit

A&E

Following the cross-city migration of Stroke services from the Royal Liverpool University Hospital, and Southport Hospital, Aintree is now the central site for Stroke services in the North Mersey Region. Early indications show a real improvement in care in the critical 72-hour period after a stroke occurs. More than 600 patients have been taken away from Emergency Departments, and patients are given access to hyper acute care in just four hours, which is above the national average. Stroke colleagues are helping deliver healthier, happier, fairer lives to our communities.

Acute Medical Unit

In recent weeks there have been several department moves, including Acute Medical Unit, Ambulatory Emergency Care, MAB/FAB, High Care, Frailty, Minors, GP Service and ID Medical. Improving access to these services will help enhance patient experience and reduce pressure in A&E. The goal is to see a reduction in admissions, and an increase in same-day care and discharge.

This will mean our patients can been seen by an appropriate clinician, first time, to either receive treatment or even be discharged on an ambulatory pathway.

Various improvements have been made through staff and patient focussed changes in A&E. These include the creation of staff led and designed models, such as triage, see, treat and refer (STaR) and rapid assessment models – empowering colleagues to make changes to improve how they work, and improved staffing levels within the departments.

Since November 2022, 90% of patients are now triaged within 15 minutes – which is an improvement of 10%, and double the number of patients are now seen by a clinician within one hour, rising from 30% to 60%. Ambulance handover times have also significantly improved from a 70 minute average to 20 minutes.

Pharmacy

The Pharmacy team has played a pivotal role in supporting reconfiguration and the improvement of patient care and flow at Aintree. The team has supported colleagues in the Emergency Village, ensuring correct medication stock lists were readily available for patients undergoing relocation, easing pressure on nursing staff. Pharmacy has also extended their weekday service to SAU providing pharmacist cover for an additional four hours, allowing patients to get the medication they require during evening hours.

LIVING OUR

Our values are 'the way we do things around here'. They are the very core of who we are, for every colleague, patient and individual who comes into contact with us. Our values enable us to work together more effectively and to deliver great patient care more consistently.

We see examples of our values in practice on a daily basis, and each month we will celebrate individuals or teams who are clearly caring, fair and innovative.

New

tool to improve pressure ulcer care

A new, mandatory skin assessment training programme developed by Critical Care Nurse Kamali Smith and the LUHFT Tissue Viability Team will teach caregivers to take skin tone into consideration when treating pressure ulcers.

Research has shown that people with darker skin tone are more likely to be diagnosed with a higher category pressure ulcer than people with a white skin tone, due to delayed or inaccurate identification of pressure ulcer risk. This is because a grade one pressure ulcer is defined as red and non-blanching on a patient with a white skin tone but may appear as discolouration on a darker skin tone, when compared with the surrounding area.

LUHFT are the first Trust in the North West to be collecting skin tone and pressure ulcer data and this innovative advancement in care will allow for improved treatment, better knowledge for our care providers and a more equitable service for our patients.

The ‘skin tone tool’ will be available in both wipeable and single use versions and skin assessment documents will be provided within end of bed charts to remind colleagues to note skin tone before issuing an appropriate treatment plan, allowing for a more tailored, individualised management of care.

Bed disco keeps patients active

The Therapy Team on Ward 11 at Broadgreen Hospital have held a number of bed and chair 'discos' for patients, to support their mobility, keeping them active and engaged whilst in hospital.

Individually tailored to each patient, the 50-minute activity encouraged them to do as much or as little as exercise they felt comfortable with.

Those taking part were able to request music and sang along whilst physiotherapists led on the exercises. Last month, the team hosted a St Patricks Day inspired disco for patients and even supplied non-alcoholic Guinness for those taking part!

Katie Linas, Clinical Specialist Physiotherapist, said: “We had great feedback from the patients and staff. It was fun and inclusive for all involved. Our patients said that it really cheered them up and we even got asked if we could do it more often!"

VALUES

Occupational Health and Wellbeing Team achieve national accreditation

LUHFT’s Occupational Health and Wellbeing Team has been accredited by the Safe Effective Quality Occupational Health Standards (SEQOHS).

As one of only 186 organisations accredited nationally, the standards show that the team understand what users expect of the service. The accreditation also highlights the team’s ability to be responsive to the needs of our staff, who in turn can continue to deliver great care to our patients.

Diane Haddock, Associate Director of People (Occupational Health and Wellbeing) said: "Against a backdrop of a phenomenally busy few years with merger, COVID and new hospital, the team have maintained a consistently high-quality, safe and effective service to support our valued workforce. I am so proud of the team’s achievements and this five year re-accreditation reinforces the efforts of this high functioning and proactive team.”

Audiology Team maintain high standards

Congratulations to our Audiology Team at Aintree who have maintained their UKAS IQIPS accreditation.

The Audiology Team were the first NHS Audiology service to achieve this accreditation in May 2013 and have worked continually in maintaining accreditation since this time.

Gaynor Chittick, Head of Audiology Services at Aintree, said: “I am very proud of the team’s achievement on maintaining their UKAS IQIPs accreditation. It provides a framework to benchmark our services and assures our patients that the diagnostic services we provide are at a continually high standard.

“The accreditation process requires excellent teamwork and all members of the team have had an active role in ensuring the department’s commitment to continual improvement and providing confidence to our patients using our service. This was obvious to the UKAS assessment team who commented that ‘staff are proactive, patient-centred and supportive of each other’.”

Life at LUHFT

Your staff support offer

Life at LUHFT is our promise to take great care of you, to allow you to take great care of yourself. Our priority at LUHFT is to provide you with access to the tools and resources which will allow you to live life well.

Your staff support offer includes information and resources in the below four sections: