Update GP
Issue Number 2 Summer 2009
NEWS FROM
Infection rates at record low INFECTION RATES at the Norfolk and Norwich University Hospitals NHS Foundation Trust have fallen to a record low. In the financial year 2008/09, there were 15 cases of MRSA infection (down from 33 the year before) and 139 of C difficile (down from 326 the year before). Five of the MRSA patients had acquired the infection in the community before being admitted to hospital. The Trust has now expanded its current MRSA screening programme for all patients having elective surgery. Those colonised by MRSA are offered a special antibacterial skin wash and cream for the nostrils which helps to clear the bacteria prior to hospital admission. The reduction in C diff infection has been achieved with the help of changes to antibiotic prescribing, the use of isolation rooms, and deep cleaning of infected areas, as well as scrupulous hand hygiene.
F
ollowing publication of the Darzi report last year, patient safety has rightly become the major area of focus in attempts to improve clinical quality. The Trust is totally committed to this issue and has embarked on a series of initiatives to ensure that patients are safe in our hands. Every year we will focus on specific areas of risk and commit further resources to improving patient care in those areas. During 2009/10 we are targeting medication prescribing errors and hospital acquired infections. Medication errors account for nearly half of all serious adverse events in hospitals and are a major source of patient harm. We aim to reduce our error rate by 50 per cent within the next year. Last year saw a drop of over 50 per cent in our MRSA and C difficile rates at NNUH, making us one of the best performing Trusts in the East of England. As well as further reducing these infection rates, we are committed to achieving similar reductions in central line and surgical site infections. In April the Trust appointed Dr Debbie Browne, consultant anaesthetist, as Director for Patient Safety and she will chair a new Patient Safety Committee made up largely of experienced clinicians. This committee will monitor all aspects of patient mortality and safety and produce regular reports for staff and the public. We would appreciate any information or ideas you may have to help us provide our patients with totally safe care.
Krishna Sethia, Medical Director, Norfolk and Norwich University Hospitals NHS Foundation Trust
Stroke services are changing FAST NNUH IS working in partnership with Norfolk Community Health and Care to develop a seamless approach to specialist stroke care in central Norfolk. With the help of the ambulance trust, social services and the voluntary sector, the aim is to achieve improvements along the entire patient pathway. Coinciding with the Government’s TV advertising campaign to help people recognise stroke symptoms and seek help FAST (the intials stand for Facial weakness, Arm and leg weakness, Speech problems, Time to call 999), NNUH now provides clotbusting thrombolysis 24 hours a day, 7 days
a week. Additional medical, nursing and therapeutic staff have been recruited to ensure rapid assessment of patients (including CT scanning) and hyperacute care immediately following stroke. Specialist rehabilitation will be provided in a dedicated 24-bed unit which is currently being built at the Norwich Community Hospital, in the same complex as another ~ 24-bed rehabilitation ward. An early supported discharge team is being established with the recruitment of 30 staff including nurses, therapists, social workers and rehabilitation assistants. The team will provide specialist stroke care in
patients’ own homes and will be a model that we hope to replicate across central Norfolk. For the first time there will also be a clinical psychologist employed in the stroke service to help patients and their families come to terms with the life changes brought about by having a stroke. Stroke is the third largest cause of death in England and is the single largest cause of adult disability. These new developments commissioned by NHS Norfolk will have a significant impact on stroke services, ensuring patients and their families receive high quality specialist stroke care to enable best possible recovery.
KEY CONTACTS Norfolk and Norwich University Hospital Colney Lane Norfolk NR4 7UY Website: www.nnuh.nhs.uk On-call: For emergencies tel: 01603 286286 and ask to be transferred to the on-call SpR. (bleep 0080). There is also an on-call general (GI) and vascular consultant available via the switchboard.
Norwich Community Hospital Bowthorpe Road Norwich NR2 3TU Tel: 01603 776776 (Also Breast Screening, Pain Management)
Norwich Central Family Planning Clinic Grove Road Norwich NR1 3RH Tel: 01603 287345
Pharmacy Medicines information line: 01603 287139
Pathology Clinical Biochemistry and Haematology 01603 286929 / 286932 / 286959 Microbiology 01603 288587 / 288588 Knowledge Norfolk website: http://nww.eastern.nhs.uk/scripts/index.as p?pid=73450&id=95975
SUMMARY FORMS REDESIGNED From your feedback on the content and layout of our Electronic Discharge Summaries we are keen to have a summary which better reflects the needs of GP practices. We have now set up a group to review and redesign the summary with the help of a representative from primary care. We are grateful for all your comments and we look forward to working together to improve the form. We will keep you informed of our progress later in the year
GP UPDATE SUMMER 2009
New vascular theatre opens NNUH IS expanding its theatre capacity with the opening of a £1.5 million theatre designed for specialist vascular surgery. It will be the focus for complex aneurysm repairs, as well as more routine operations. New techniques make use of X-ray guidance to insert stents into the affected arteries without the need for open surgery. At NNUH more than 170 aneurysm repairs were carried out last year, of which 53 involved the stenting procedure. The Department of Health published data that showed the Trust had the best mortality rates nationally for emergency AAA (abdominal aorta aneurysm) repair. The new theatre has been built within the main theatre complex, bringing the total number of theatres at NNUH to 29. It is the first to be fully equipped with audio visual
links to beam live images to the education centre for training purposes. TV sports presenter Kevin Piper officially opened the new theatre in March. He commented: “It’s great to see the people of Norfolk being offered such cutting edge treatment and facilities and I’m delighted to be involved in the opening of this new theatre.”
NEWS IN BRIEF REFERRAL BETWEEN CONSULTANTS We are aware that consultant-toconsultant referral can be confusing. The rules currently are: if another opinion relating to the same condition is needed then internal referral is appropriate. This would include, for example, a referral from rheumatology to orthopaedics for a joint problem, or a cardiological or anaesthetic assessment prior to surgery. If, however, the patient raises another complaint then the consultant is obliged to refer back to the GP who can decide if another referral is necessary. DO YOUR GPS HAVE QUESTIONS FOR DIFFERENT SPECIALITIES? When the Medical Director, Krishna Sethia and I visit practices some of the questions often refer to different specialities within the hospital. If your practice would like a visit from a Consultant from a specific hospital area please contact me and I will arrange at a mutually convenient time. ROADSHOWS WILL GO ON The second GP IT Roadshow took place on the 26 March and was well attended.
It is my intention for us to continue with the roadshows as feedback has indicated that they are very worthwhile, allowing information to be exchanged and information shared. Let me know if you have any thoughts on topics for an autumn roadshow. HELP PATIENTS TO BE PREPARED Please ensure that all patients who report to us for blood tests arrive with a valid request form (preferably computerised). as we cannot print or raise forms in our phlebotomy department. Glucose Tolerance Tests (GIT) are by appointment only and unfortunately we cannot accommodate people who have fasted but turn up without a pre-booked appointment. GP UPDATE GP Update is edited by Rebecca Perry and produced by the NNUH Communications team If you have any questions, comments or contributions please contact Rebecca on 01603 289989 or by email: rebecca.perry@nnuh.nhs.uk