Update GP
Issue Number 5 Summer 2010
NEWS FROM
Laboratory medicine under the spotlight THERE WAS a great deal of interest in our laboratory open day in April, when GPs and their colleagues were invited to come and see recent developments in laboratory medicine. Pathology services are widely recognised as being central to modern medicine, with over 70 per cent of patient diagnoses based on laboratory test results. The service plays a key role in meeting waiting time targets, including A&E turnaround times, oncology services, clinics, theatres and requests from GPs. We have introduced a number of changes to manage our ever increasing workload, including automation to help speed up our service. In the vast majority of cases, reports are now returned electronically to requesters before the start of the next working day, allowing early decisions on patient treatment and follow up. For anyone who missed the open day and would like another opportunity to see the lab, please contact service manager Dianne Gibson on 01603 286936 (email Dianne.gibson@nnuh.nhs.uk) to arrange a convenient date.
STEPPING UP OUR SCIENTIFIC RESEARCH
O
ne of the great strengths of the city of Norwich is the high level of scientific expertise available on the Research Park. Over the past 18 months we have been developing a joint strategy with the University of East Anglia to work collaboratively with the Institute of Food Research, the John Innes Centre and the new Genome Centre to attract high-quality clinical academics. So far we have appointed two outstanding leaders for this research initiative. Andrew Coats, former Dean of Sydney Medical School and an internationally known cardiologist and scientist, will develop the overall clinical research agenda. He will work closely with Alastair Watson, who joins us from Liverpool as Professor of Translational Medicine. Andrew’s expertise in gastroenterology should enable us to build up one of the premier gut and nutrition research facilities in the world. We are now looking to make more appointments, especially in the fields of microbiology, and to promote the locally and nationally important goals of healthy ageing. Complementing this scientific activity – and hugely important to ongoing clinical research projects – we have spent nine months improving the Clinical Trials Unit and we have now appointed a new Director of the Unit, Laurence Skillern, who is both medically-qualified and has extensive experience of the pharmaceutical industry. The Trials Unit is available for primary and secondary care clinicians who wish to engage in research involving patients and we hope that it will now flourish. Krishna Sethia, Medical Director, Norfolk and Norwich University Hospitals NHS Foundation Trust
Microbiology move will affect patients delivering samples AS YOU MAY be aware, the Microbiology laboratory is moving to the Norwich Research Park in August. There will be no facility for patients or individuals to drop off specimens or mail at the new site. Instead, from 9 August these will need to be delivered to Pathology Reception at NNUH for onward transportation to Microbiology. Time-sensitive fertility tests will be
available Monday to Thursday inclusive, with samples being picked up and transported to the new Microbiology Laboratory at around 2pm. It is therefore essential that seminal fluids required for tests are produced between 12 noon and 2pm to meet the necessary two-hour window for testing. Please note, it is vital that patients record the date and time on the sample container and request form to allow accurate interpretation
of the results. Our User Manual will be updated with these revised arrangements ready for the move on 9 August. The laboratory fax number, 01603 620190, remains unchanged. If you have any questions or queries regarding the move please contact the Laboratory Manager on 01603 611816 or email peter.coe@nnuh.nhs.uk.
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 appropriate on-call teams: • Surgical: SpR. (bleep 0080) • Medical: via the Emergency Assessment Unit (EAU) on bleep 0002 • Medicine for the Elderly: ext. 6509 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.a sp?pid=73450&id=95975
GP UPDATE GP Update is edited by Rebecca Perry and produced by the NNUH Communications team Rebecca will be on maternity leave from mid-August until March 2011. In her absence please contact krishna.sethia @nnuh.nhs.uk with clinical issues or anne.osborn@ nnuh.nhs.uk with Trust matters.
GP UPDATE SUMMER 2010
Patients go walkabout on day of op NEW TECHNIQUES in pain relief, coupled with a team approach, are helping to get patients back on their feet faster than ever before. “We decided to run a pilot ‘enhanced recovery’ programme at NNUH and the results from a study of 30 patients have been very impressive,” says orthopaedic surgeon Jim Wimhurst. “It seems that targeted pain relief, plus early intervention from physiotherapists and occupational therapists, can have a very positive impact on patients both physically and mentally.” Of the first 30 patients surveyed, 100 per cent agreed that their pain had been well managed and 93 per cent were happy with the speed of their recovery. Although currently limited to hip and knee replacements, the enhanced recovery programme could potentially be extended to shoulder surgery and bowel surgery. The new techniques involve an injection of local anaesthetic straight into the joint,
Annie Bennet, from Postwick, was “delighted” to be up and about within hours of having a hip replacement at NNUH followed by a “cocktail” of painkillers taken orally. Previously, patients were injected with an epidural into the spine which meant they were numb from the waist down. Consultant anaesthetist Dr Lindsay Barker says a series of small changes, rather than one big change, have made the difference for patients. Denton ward sister Kay Marrison commented: “With this new technique patients are far less dependent and anxious and it’s very clear that ‘mind over matter’ plays a very big part in their recovery.” The average length of stay for a traditional hip replacement was 7.5 days, compared to 3.6 days for the first 30 patients surveyed as part of the pilot project.
A&E will be ‘front door’ for suspected stroke FOLLOWING the introduction of stroke thrombolysis 24/7 last year we are continuing to redesign our stroke and TIA services to achieve a better service for patients. On weekdays high-risk TIA patients can now be seen in clinic within a day of referral – a new referral form designed to guide GPs through the risk rating is available on Knowledge Norfolk (http://nww.knowledge norfolk.nhs.uk/cardiology.htm). The new referral form should be faxed immediately for all stroke patients as we aim
to see all high risk patients within 24 hours of their contact with a GP, and all low risk patients within seven days. From mid July the ‘front door’ for stroke will be A&E All suspected stroke patients will be diverted to A&E, including GP referrals, to ensure a direct pathway of care to the stroke unit. For any suspected stroke patient call 999. If you would like to discuss a case with a stroke specialist nurse we have a stroke alert nurse available 24/7. They can be contacted through hospital switchboard on ext: 6588.
A WORD IN YOUR EAR
HELPLINE IS A HIT
THE CROMER Aural Care Service (COTEX) is now up and running, offering patients who have problems with ear wax, foreign bodies in the ear canal or acute otitis externa the chance to have their ears cleaned by one of our trained nurses under clinician supervision. The service can be accessed via Choose and Book or by fax using the proforma available on the Knowledge website.
THE WOMEN’S Health Physiotherapy Team runs a telephone helpline for women suffering pelvic girdle or lower back pain during pregnancy. Women can call the helpline direct for advice or a prompt appointment, if appropriate. Leaflets can be found on the NNUH website and details of the service can also be found on the Heron website. The helpline number is 01603 287130