GPLink Issue 3
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elcome to our winter edition of GP Link, the newsletter where we keep you up-to-date with information on new services, how we are performing and where we are making improvements.
Have you heard about our digital hearing aids?
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emand for audiology services is growing with more than 40% of over 50 year olds and 70% of over 70s having some level of hearing loss. The NNUH provides an expert service for adult hearing loss. In addition we also provide hearing assessment and rehabilitation of babies, children and teenagers from 0 18 years, vestibular assessment and rehabilitation for those with dizziness and Hearing Therapy services for the management of tinnitus, hyperacusis and emotional support for living with hearing loss. The Audiology department has a strong link with the Ear, Nose and Throat department at the hospital, allowing them to provide advanced diagnostic assessment as well as maintaining the ear health of patients. Technology For patients with hearing loss, the hearing aids available from the Audiology department are small and discreet, but have all of the features to help patients hear better, whatever their lifestyle. The hearing aids are digital
hearing aids are also a thing of the past. With adaptive feedback management systems built in, hearing aids detect feedback and eliminate whistling before it has even been heard.
with up to 16 channels, which means that they can be programmed to closely match patients’ hearing levels across different pitches of sound. They can also have up to four programmes or additional settings added to tailor the hearing aid to meet patients’ lifestyle needs. The hearing aids have front and back-facing microphones. Twin microphones allow hearing aids to focus on conversational voice whilst reducing background noise, making conversation in noisy places easier to follow. Whistling
Waiting times It is even quicker now for patients to receive hearing aids. From receipt of referral, patients will be seen for their hearing aid assessment appointment within three weeks. At this appointment, the Audiologist and patient will discuss their hearing needs, test the patients’ hearing and work with the patient and their family to plan the best future management for them. Their next appointment to be fitted with a hearing aid will then be within four weeks of the first appointment– only six weeks from start to finish.
In this issue: • Dietary advice for patients • Saturday service for cancer investigations • Improved ambulance turnaround times • Stem cell treatment acclaim • New cardiology clinics • NIHR Clinical Research Network comes to NNUH
New Saturday service for specialist cancer investigations
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service offering a minimally invasive procedure to help diagnose lung cancer and tailor treatment plans is now available on Saturdays at NNUH. Patients have an investigation for a endobronchial ultrasound (EBUS) bronchoscope. The investigation takes about 30 minutes and is carried out as a day procedure. Dr. Ajay Kamath, Consultant Physician in Respiratory Medicine at NNUH, said: “We have been using this technique for about two years and see about four patients a week on a dedicated EBUS list. The procedure is delivered by an experienced bronchoscopy team, working closely with radiologists and pathologists”. LOCAL TREATMENT Previously, patients would have had to travel to Cambridge for the procedure or have faced an invasive surgical operation under general anaesthetic, followed by a hospital stay. The Saturday procedure list expands capacity and offers patients more choice about appointment times. The results of the EBUS help to pinpoint and assess spread of cancer enabling cancer specialists and surgeons to deliver tailored treatment programmes. The NNUH team also provides the EBUS service for patients across Norfolk and Waveney, including those from the James Paget University Hospital and the Queen Elizabeth Hospital at King’s Lynn.
Dietary advice for patients
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he community dietetic team provides a range of support for GP practices, including individual dietary advice for patients, group sessions and training for practice nurses. The first step towards referring patients is to complete the referral form on the Knowledge Management system at: http://nww.knowledgeanglia.nhs.uk/forms/referral/nnuh/dietetics_ adult_nnuh.doc The clinics cover conditions such as allergies and irritable bowel syndrome. There are also group sessions for patients needing dietary advice for diabetes, cardiac rehabilitation and Parkinson’s disease. The diabetes course is a single two-hour session which covers diet and lifestyle issues, plus healthy eating with an emphasis on weight reduction for those who are overweight. Patients also learn about target values for HbA1c, cholesterol and blood pressure. The courses take place in Norwich, Attleborough, Cromer, Dereham, Diss, Kelling and Wroxham.
These courses are aimed at newly diagnosed patients with diabetes and are in addition to the work undertaken with patients who are insulin dependent and under the care of the NNUH Elsie Bertram Diabetes Centre who are seen by the hospital dietitians. The team also has a dietitian who specialises in learning disabilities and provides advice on dealing with challenging behaviour relating to eating and swallowing difficulties. In some cases, the team undertakes home visits for housebound patients who are at risk of malnutrition. They also work in community hospitals with nursing and residential homes on the Malnutrition Universal Screening Tool (MUST) which identifies patient at risk of malnutrition. There is also an enteral feeds team who support tube fed patients and their carers to live in their own homes or in a nursing home. There are 250 adults on home feeds and 108 children managed by the paediatric home feeds team. The 15-strong community dietetic team covers central Norfolk and is based at NNUH. It is supported by the specialist hospital dietetics team which covers in-patient care.
Older People’s Medicine (OPM) Consultant Phoneline It is a well known fact that older patients do not like to come into hospital and if given a choice would chose to stay at home The OPM directorate’s, aim is to only admit those patients who really need in-patient treatment. To help in achieving this the hospital provides a direct phone contact with an OPM consultant. You can contact an OPM Consultant daily, from Monday to Friday on extension 6509, via the hospital’s dedicated GP line - on 01603 286666. This service is available from 09.00 – 17.00hrs You can discuss your patient’s clinical condition and current treatment, get advice regarding potential changes to treatment and or arrange an urgent review in our out-patient facility if required. Patients wanted for bronchiectasis study Primary care patients may be interested in a novel self-management plan for bronchiectasis called BET which has been developed at NNUH and Norwich Medical School. Self-management plans improve the quality of life and daily functioning of patients with chronic diseases by advising patients what to do if they have a problem with their condition. This plan is to support people who have the respiratory condition bronchiectasis, it is designed to help maintain the best lung health. Please help us test whether it works. This involves completing questionnaires every three months for a year. For enquiries please call NNUH Researcher Claire Brockwell on 07766 858911 or leave a message on 01603 289876.
Improved ambulance turnaround times
A new Immediate Assessment Unit (IAU) has been established at A&E to improve patient handover times from ambulance to A&E staff. Only one ambulance has waited more than an hour outside A&E during the operational hours for IAU since it was established in June, despite a 20 per cent increase in ambulance arrivals and a 7 per cent overall increase in attendances in the first half of 2013/14. A new Clinical Decision Unit (CDU) and co-ordinated out-patient service has been introduced in the Acute Medical Unit with a view to preventing unncesssary patient admissions and reducing length of stay. Additional staff have been recruited to the emergency areas of the hospital to allow the new services to operate seven days per week. Working with the Clinical Commissioning Groups, the NNUH has conducted small-scale pilots to see how pressure can be alleviated on the central Norfolk urgent care system. Over the course of three days in October and December there were community NHS staff working closely with the A&E department. Some patients who did not need to be admitted to A&E were treated by the nurse/GP team.
Stem cell treatment receives international acclaim The stem cell transplant service for cancer patients at NNUH has gained centre of excellence status. Director of the Stem Cell Transplant Service, Dr Matthew Lawes, said: “This is a fantastic achievement and something the team has been working towards for six years. It means we are providing a high standard of care for stem cell transplant patients in Norfolk. “The accreditation is very important because it demonstrates that we are now internationally recognised as a centre of excellence in the field
of haematopoietic stem cell transplantation, previously known as bone marrow transplantation.” The service which treats patients from NNUH and the James Paget University Hospital, has been given international accreditation by the Joint Accreditation Committee-ISCT Europe & EBMT (JACIE). JACIE's primary aim is to promote high quality patient care and laboratory performance through an internationally recognised system of accreditation.
Expansion of Delivery Suite official opening
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he Delivery Suite reopened in October after undergoing a three month refurbishment and redesign. The redesign was possible after the Trust was successful in gaining £272,000 of funding from the Department of Health to improve the environment for patients. This resource was used to create en-suite facilities for all birthing rooms and increase the recovery area from one bed to two. The redesign also means that the hospital has been able to increase the overall capacity of the Delivery Suite by adding three new delivery rooms bringing the total to 15 rooms,
which will help the service to cope with the predicted increase in birth rate over the next 5 years. NNUH Head of Midwifery Glynis Moore, said: "These improvements to the Delivery Suite will benefit our patients and boost our capacity for dealing with the increasing birth rate. We're delighted that the extra funding has enabled us to provide more en-suite facilities so that our patients will have more privacy and a better experience when they give birth." The birth rate has increased from 4929 births in 2003 to 6352 births in 2012.
New Cardiology clinics at Cromer
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new out-patient clinic and additional echocardiography clinics have commenced at Cromer Hospital. The new fortnightly cardiology out-patient clinic aimed at patients who have been referred to a hospital specialist by their GP for further investigations and for patients who require follow-up appointments after they have had treatment or a procedure for cardiac problems. The additional echocardiography clinics led by Charles Graham mean patients from North Norfolk referred from their GP for ultrasound scans of the heart can be seen at Cromer. Patients who need more complex investigations and procedures such as angiograms and angioplasties will continue to be seen at the NNUH. In addition to these cardiology clinics, Cromer Hospital also offers a pre-assessment clinic for patients who are due to have a routine or elective cardiac procedures, a pacemaker clinic and a rehabilitation clinic for patients who are recovering after treatment.
NNUH appointed to host NIHR Clinical Research Network
NNUH has been selected as one of the 15 Trusts nationally to run the National Institute of Health Research (NIHR) Clinical Research Network in the region. The NIHR Clinical Research Network is the clinical research delivery arm of the NHS. It provides funding to hospitals and surgeries to pay for research nurses, scans, x-rays and other costs associated with carrying out clinical research in the NHS. NNUH Chief Executive Anna Dugdale said: “Our focus will be to support clinical teams across the region in increasing the number of patients who have access to clinical trials, thereby giving patients access to cutting edge clinical care.” The Network helps to increase the opportunities for the Eastern region’s patients to take part in clinical research, ensures that studies are carried out efficiently, and supports the Government’s Strategy for UK Life Sciences by helping companies to carry out vital clinical research into potential life-saving new treatments and improved ways to diagnose illnesses in the NHS. GP LINK Produced by the NNUH Communications Team. If you have any feedback on this newsletter, please contact us at: Email: gplink@nnuh.nhs.uk Telephone: 01603 287634