NNUH AGM 2017 by Norfolk and Norwich University Hospitals NHS Foundation Trust

NNUH AGM 2017 Issue Number 68 Spring 2014

Some of the NNUH cancer care team

AGM 2017

Welcome to the Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) 2017 Annual General Meeting. This year our AGM is focusing on our cancer strategy and an update on Cromer Hospital. In this booklet you can also read about our NNUH Inspirational Fundraising Awards. In addition, we have included a review of the year looking back at the highlights of 2016-2017 and a summary of our quality report, which showcases our quality strategy and priorities and how we have been performing.

Contents • NNUH Inspirational Fundraising Awards p. 2-3 • The NNUH Cancer Strategy p. 4-5 • Celebrating 150 years of Cromer Hospital p. 6 • Review of the year p. 7-9 • Quality Report p. 10-11

Date for your diary NNUH Christmas Fayre - Thursday 7th December 2017 4pm-8pm East Atrium

If you would like to support the hospital charity then please contact NNUH Fundraising Manager, Louise Cook on 01603 287107 or email fundraising@nnuh.nhs.uk The Pulse is funded entirely from charitable donations and not from NHS funds. Norfolk and Norwich University Hospitals NHS Foundation Trust Charitable Fund. Registered charity number 1048170.

NNUH AGM 2017

NNUH Inspirational Fundraising Awards Our hospital charity is supported by staff, patients and the wider community. This year the annual Inspirational Fundraising Awards recognise and honour just some of the amazing people who have helped the charity.

Inspirational Young Fundraiser of the Year 2017

Recognising the achievements of an individual or groups of people aged up to16 years •‌ Perry Cooke ‌• Georgia Stallard

Inspirational Fundraiser of the Year 2017

Recognising the achievements of an individual who has gone beyond all expectations to raise money for our charity •‌ Philip and Christine Greenacre ‌• Andrew McCullough ‌• Mike Wallace ‌• Veronica Rose

Inspirational Fundraising Team of the Year 2017

Recognising the achievements of a team/group which has gone beyond all expectations to raise money for our charity ‌ • White Horse Pub in Cromer ‌• Julie Sapey (B&B Ball) ‌• Norwich High School ‌• Onesie Walk

Inspirational Fundraising Company of the Year 2017

Recognising the achievements of a Company / Organisation which has gone beyond all expectations to raise money/gifts in kind/ support for our charity ‌ • Marks and Spencer at Longwater ‌• Brandbank ‌• Grant Thornton

Inspirational NNUH Staff Fundraiser of the Year 2017

Recognising the achievements of a staff member/team at NNUH who has gone beyond all expectations to raise money for our hospital charity ‌ • Hilary Turnbull, Consultant in Gynaecology Oncology ‌• Head and Neck Cancer Team for HANC ‌• Waldemar Bartosik, Consultant in Thoracic Surgery ‌• Cromer Hospital Crest Cycle

FUNDRAISING AWARDS

NNUH AGM 2017

CANCER STRATEGY

NNUH Cancer Strategy The Norfolk and Norwich University Hospital is one of the largest cancer centres in England for numbers of treatments delivered, which is based on 62-day statistics from NHS England. This makes a huge difference for people in East Anglia having this expertise on their doorstep, and highlights just how much is going on at NNUH in terms of cancer care. As such a large cancer care centre, teams at NNUH saw the importance of establishing a strategy on how the delivery of cancer care should look over the next five years, and at the beginning of July 2017 the trust published its Cancer Strategy - a detailed plan on how it will develop and deliver cancer services over the next five years.

What is the Cancer Strategy? The Cancer Strategy is made up of six objectives, which reflects the pathway of a cancer patient at NNUH, and highlights what the trust plans to achieve and establish over the next five years. The strategy was worked on by a multi-disciplinary team, an operational team and the ‘Together Against Cancer’ patient participant group. Jo Richardson, Senior Nurse in Oncology and Haematology and Lead Cancer Nurse at NNUH said: “Enhancing patient experience was at the forefront of our minds when planning the strategy, and having the input from our patient group, as well as views from the multi-disciplinary and operational teams was important to ensure that all points of cancer care were covered in the strategy. Our cancer patients have the right to receive treatment with the best support and in the most comfortable environment and we believe the strategy will ensure this.” The Cancer Strategy was also worked on with the Big C and Macmillan Cancer Support to ensure patient experience is on a par with clinical effectiveness and safety.

NNUH AGM 2017

Why do we need the Cancer Strategy?

increase the amount of treatments we can deliver to our local population.”

The Cancer Strategy was worked on for three key reasons. The first was in response to the National Cancer Strategy. Vivekanandan Kumar, Consultant Urological Surgeon and Cancer Clinical Lead explains: “Our NNUH Cancer Strategy supports, and is in line with the National Cancer Strategy which has additional areas of focus beyond diagnosis and treatment. These include preventing cancer, diagnosing cancer early and raising the public awareness necessary around this. There is also a greater focus given to living with cancer as a chronic condition rather than something very acute with a poor outcome – more people are living longer, and living after their period of cancer treatment. As a nation we are getting more used to living with cancer – like other chronic conditions such as diabetes, you may need to adapt your lifestyle but it’s not necessarily life limiting.”

Why is the Cancer Strategy important for the people of Norfolk?

The second reason was in response to feedback provided by NNUH multidisciplinary teams about cancer care at the trust. Earlier in the year, the Cancer Strategy team asked the clinical leads from every cancer multidisciplinary team, as well as Oncology and Diagnostics and Clinical Support Service what they feel NNUH needs to do to be a centre of excellence for cancer care. These views were taken into account when establishing the strategy. The final reason for the Cancer Strategy is due to an increase in demand. With data taken from Public Health Norfolk, we can see that they predict a significant increase in the amount of suspected cancer referrals being made over the next five years, and shows we will need to increase our capacity by an additional 50,000 appointments by 2025. Mr Kumar said: “Research from Cancer Research UK says that now one in two of us, at some point in our lives, will be affected by a cancer diagnosis. This therefore means that we need to

Matt Keeling, Cancer Manager at NNUH said: “The public should take reassurance around the fact that we are responding to the dual challenge of increase in demand for our services, and of us playing a greater role in the events either side of cancer diagnosis and treatment. Fundamental to our strategy is the capacity to see more patients more quickly to enable them to have cancer ruled out or get their diagnosis and treatment faster.” “By 2025 we expect, considering the increase in referrals, that it will be less than three per cent of patients referred in who will have a diagnosis of cancer. Of those three per cent who get diagnosed, we want their diagnoses as early as possible so that their outcome is better. The Cancer Strategy is about how we are going to meet that challenge.” The Cancer Strategy allows for the people of Norfolk to see how the hospital is going to meet the challenge of delivering cancer services over the next five years. The strategy will show people that the trust is involved in prevention, as well as ‘living beyond’ cancer and also in the context that as many of us live longer, we are likely to be affected by a cancer diagnosis. Mark Davies, NNUH Chief Executive said: “We’re extremely proud of the range of services we offer cancer patients within our hospital. Our Cancer Strategy shows how our services are going to develop over the next coming years and assures the people of Norfolk how we are going to respond to the rise in demand of referrals.”

CANCER STRATEGY

STRATEGY OBJECTIVES

Challenge The 2015 National Strategy

To transform our approach to support people living with and beyond cancer

To radically upgrade prevention and public health

1 2 3 4 To lead the organisation of integrated cancer services in Norfolk and Waveney

To make necessary investments to deliver a modern high-quality service

To establish patient experience as being on a par with clinical effectiveness and safety

To achieve earlier diagnosis and treatment within NHS Constitution targets

5 6

2017/18

Challenge The increase in cancer referrals

2018/19

2019/20

With our Partners Actively promote healthy living to our population Secure alternative funding sources / arrangements

Challenge Input from MDT’s to become a ‘Centre of Excellence’

2020/21 to 21/22

Place in top 20% in the National Cancer Patient Experience Survey (NCPES)

Increase the proportion of cancers diagnosed at stage 1 and 2

Seek employer accreditation for health and wellbeing

Increase diagnostic capacity Integrated regional cancer pathway(s)

Increase treatment capacity Designated Cancer Nurse Specialist or key worker for all patients Expand Cancer Nurse Specialist Workforce

Enhanced relationship with key Third Sector partners

Roll out the Macmillan recovery package

Collaborative approach to palliative care pathway Roll-out stratified follow-up pathways of care Increase the proportion of patients entering clinical research trials

Develop our clinical and non-clinical workforce Improve our clinical outcomes Develop a capital replacement programme for cancer facilities

Lead collaborative working across Norfolk and Waveney STP Champion innovation and transformation linked to national vanguard

Drive shared systems and common processes to improve outcomes

NNUH AGM 2017

CROMER & DISTRICT HOSPITAL

An update from Cromer & District Hospital This year, Cromer & District Hospital marks its 150th anniversary so it is only natural for part of this year’s AGM to feature an update from the Cromer team. Cromer Hospital currently treats over 139,000 patients each year, up from 126,000 in 2014, and since 2012, activity on the site has increased by 10% with lots of new services being introduced to enhance the delivery of care to the people of north Norfolk. These services include a new andrology service, portable chemotherapy packs for cancer patients and a One Stop Urology service to name but a few. There is also a Minor Injuries Unit which operates from 8am to 8pm, 7 days a week. Plans are currently being drawn up to show how the hospital is going to expand its services, which you will hear more about at this year’s AGM with a talk led by Iain Young, Operational Manager at Cromer Hospital.

provide care closer to home, which has been reflected in how much we have expanded over the last five years.” James Hernon, NNUH Consultant Surgeon and Service Director at Cromer Hospital said: “For patients living in north Norfolk, Cromer Hospital is a fantastic facility which ensures people are able to receive care a lot closer to their doorstep. The work carried out at Cromer Hospital really emphasises how patient care is at the forefront of everything we do and we are very excited to be sharing an update on the future of Cromer Hospital at this year’s AGM.”

Sally Sellex and Scott Curson, Registered Nurses on the Muriel Thoms Procedure Unit

Iain Young, Operational Manager at Cromer Hospital said: “With the increase in population and property development in the local area, we recognise that there is a need to develop more services in the coming years. We are always looking at innovative and different ways to

The Cromer Hospital team earlier this year

The Cromer Hospital site. Photo credit: www.mike-page.co.uk 6

NNUH AGM 2017

REVIEW OF THE YEAR

April 2016

May 2016

With information received from the new system the consultants can prescribe medication within two days, preventing further strokes. Previously this process could take several weeks. NNUH Stroke Consultant Dr Kneale Metcalf said: “This is an exciting new use of technology to benefit patient care.”

Research has shown that a finger food menu for patients with dementia could help with enjoyment of food and drink, improve nutritional intake, help maintain independence and avoid co-ordination problems with cutlery.

In April, stroke patients at NNUH were the first in the country to benefit from a new monitoring system which will help prevent a second stroke occurring.

The month of May saw the launch of our improved ‘finger food menu’ during Dementia Awareness Week to aid patients including those with dementia.

July 2016 June 2016

In June, neonatologists at NNUH were the first in the world to publish research showing the thermal safety of scanning newborn babies with high powered 3T magnetic resonance imaging (MRI) scanners. This research was done when NNUH took part in the national MARBLE study which investigated the benefits of using the more detailed 3T MRI scans for babies.

In July, NNUH gained international recognition from Unicef (United Nation’s Children’s Fund) and was fully accredited with its prestigious Baby Friendly Initiative (BFI) Award. The Award was presented by TV and radio broadcaster Jake Humphrey, his wife Harriet and their 11 month old son Sebastian who was born at NNUH. The rigorous Unicef assessment involved interviews with 55 new mothers about all aspects of their care relating to feeding and caring for their babies. The report noted: “It was clear to the assessment team that pregnant women and new mothers receive a very high standard of care. This is a busy unit providing care for mothers living across a wide geographical area, however in spite of this many mothers commented on the personal service received, complementing individual staff by name”.

Also in June, we were delighted to celebrate the valuable contribution of our 675 volunteers as part of Volunteer’s Week.

NNUH AGM 2017

REVIEW OF THE YEAR

August 2016

In August, we launched our monthly PRIDE awards, which celebrate the work of staff who make a difference to the lives of patients and colleagues through their kindness, dedication and expertise. The Awards are based on the Trust’s values Peoplefocused, Respect, Integrity, Dedication and Excellence (PRIDE), and each month two members of staff receive recognition and one team winner every quarter. Our first two winners were Sarah Harper, Asthma Nurse Specialist (pictured below) and Katie Symonds, Matron for Respiratory Medicine (previously Cringleford Ward Sister).

September 2016

In September, thanks to kind donations, a group of dialysis patients were given the chance to enjoy a holiday to Bournemouth with no interruption to their treatment. Staff and volunteers at Cromer Hospital’s dialysis unit organised the five-day trip for patients who attend sessions at their unit. During the break, it was arranged that there was a dialysis session at the privately run KC Dialysis Centre which specifically provides facilities for patients who wish to visit the seaside town of Bournemouth and the surrounding area for a holiday. A great time was had by all!

October 2016

A large-scale research trial got underway at NNUH in October which is part of a nationwide study to revolutionise cancer treatments, leading the way to personalised medicine and more effective treatments, based on a genetic diagnosis. NNUH is one of the hospitals in the UK which is taking part in the 100,000 Genomes Project, a world-leading DNA project which aims to sequence 100,000 complete sets of DNA from around 70,000 NHS patients.

NNUH AGM 2017

November 2016

In November it was annouced that we achieved our best best ever result in getting our staff vaccinated against flu. More than 70% of staff opted in to the “Proud to be an NNUH flu fighter!” campaign and received their flu jab. A fantastic result!

REVIEW OF THE YEAR December 2016

NNUH celebrated the festive season by giving all inpatients a present to open on Christmas Day as part of the ‘Send a Smile with Santa’ campaign. Gifts flooded in after we set a target of securing donations of 1000 presents as part of their appeal and also sought to ensure that a suitable gift was provided to patients of all ages, male and female. A massive thank you to all those who donated lovely gifts!

January 2017

In January, our Cellular Pathology department celebrated receiving their accreditation from the United Kingdom Accreditation Service (UKAS) against the International Standards Institute under their certification for Medical Laboratories. Patients who have Cellular Pathology tests such as biopsies and cervical cytology samples can be assured that our laboratory operates to the highest quality standards and that the tests and staff have been assessed to operate within a system that delivers a safe and effective service.

February 2017

March 2017

The Norfolk Care Awards aim to showcase excellence in care and support services across the county.

The team, which is made up of four assistant practitioners and a project manager, contact patients shortly after their diagnosis and carry out an Holistic Needs Assessment. This involves looking at all aspects of the patient’s life and working with them to ensure their physical, emotional and social needs are met.

In February, the Trust’s ‘Integrated Apprenticeship’ programme was nominated in the Norfolk Care Awards Most Supportive Employer (Student Placement) category.

A new Survivorship Team, funded by Macmillan Cancer Support, was established at NNUH to assess cancer patient’s individual needs and signpost them to support at key points in their cancer journey.

NNUH AGM 2017

QUALITY REPORT

Every year as part of our annual report, we produce a detailed Quality Report which focuses on the quality of care we provide. The report shows how we are performing on patient safety, our patients’ experience and the clinical effectiveness of services. We have summarised the key elements of our quality report below and would like to take this opportunity to thank our dedicated staff and volunteers who work tirelessly to deliver a high standard of patient care.

Our Quality Priorities PATIENT SAFETY Reduction in Medication Errors Goal: To have zero insulin errors causing National Patient Safety Agency category ‘moderate harm’ or above. At the end of February 2016/17 there had been one insulin error in this NSPA category (3 in 2015/16). The learning from the case review is the need to identify those patients at risk with diabetes which we will now be able to do more effectively through our electronic prescribing system and to focus the resource of the diabetic team on supporting that group. Prompt recognition and treatment of sepsis Goal: To improve screening and compliance with the ‘Sepsis 6’ Care bundle, of which the single most important aspect is the administration of antibiotics within an hour of diagnosis. We launched a new and innovative ‘Sepsis Screening and Emergency Treatment Pathway’ for inpatients. This treats sepsis with the same level of priority as a cardiac arrest. This new pathway has enabled us to have a consistent method for the timely recognition and treatment of sepsis across all inpatient areas; a key improvement on previous years. Keeping patients safe from hospital acquired thrombosis (blood clot) Goal: To achieve 95% compliance with thromboprophylaxis risk assessment (TRA), as evidenced on the Electronic Prescribing and Medicines Administration system (EPMA). Compliance is now nearing 100%. Incident reporting and management Goal: To remain within the top 25% of acute trusts for incident reporting on The National Reporting and Learning System (NRLS) with 100% compliance with Duty of Candour. When comparing NNUH against 136 other Acute (non- specialist) organisations we are ranked at 61st out of 136 so that we are outside the top 25% on the last return but within the top 50%.

PATIENT EXPERIENCE Treat patients with privacy and dignity Goal: For 100% of patients in all areas to report through FFT that they are ‘satisfied’ or ‘very satisfied’ with the standard of care that they receive. We score highly for patient satisfaction with scores consistently over 90 per cent for inpatient and outpatient care. Improved continuity of care and experience Goal: To reduce ward moves and reduce numbers of patient boaders, so that no more than 20 patients at any one time are recorded as boarders, as measured by a monthly average report. The term ‘boarder’ is a patient who is not cared for on the speciality ward which would be most appropriate for their condition.

NNUH AGM 2017

QUALITY REPORT

During February 2017 a sample review of notes was carried out of patients who were recorded as having had multiple transfers during their stay. No significant concerns were identified in relation to inappropriate multiple transfers. We have also reduced the length of stay for ‘stranded’ patients – those with a hospital stay of over 14 days – from over 300 patients to just over 140 patients. Improved discharge processes Goal: Electronic discharge letter (eDL) to be completed within 24 hours in 95% of discharges. Our performance has improved marginally over the course of the year though has not reached the 95% requirement. We have plans for improvement with regular monitoring in the coming year. Dementia screening & assessment Goal: For new admissions, patients aged over 75 to be appropriately screened and assessed for dementia, in accordance with national reporting requirements Since launching dementia screening and assessment in November 2012, we have been achieved 90%+ compliance for each separate element of the pathway (screening, assessment and referral).

CLINICAL EFFECTIVENESS Acute Kidney Injury Goal: To improve communication with GPs for patients who have experienced an episode of acute kidney injury (AKI) during the course of their admission. In the ten month period 1st April 2016 – 31st January 2017, the inclusion of appropriate information to GPs on patient discharge improved by 83% when compared against the baseline period. Keeping patients safe from infection Goal: C. Diff within trajectory target, 0 cases of Hospital Acquired MRSA bacteraemia. Our 2016-17 Clostridium difficile objective was to stay below 49 hospital acquired cases. The objective was achieved and there was an improvement on the 2015-16 figures with a total of 42 C. diff cases deemed to be hospital acquired. Improve quality of care through research Goal: Year on year increase in patients recruited into research studies. Aim to achieve 5000 recruitment into NIHR studies in 2016-17. During 2016/17, our total recruitment was 5,438 for 2016/17, compared against 2015/16 recruitment of 5,008. Fifteen new studies were approved in February, of which fourteen were portfolio studies and six were commercially sponsored. Timely medical review of all patients Goal: All new and unstable patients and all patients potentially ready for discharge to be reviewed daily by an ST3 or above. The audit evidenced that the percentage of patients that had a documented Senior Review increased from 33% in June 2016 to 53% in January 2017.

NNUH AGM 2017

AGM 2017