October 2014 by Sally M

The staff magazine of Great Ormond Street Hospital for Children

Working out Helping children with cystic ﬁbrosis improve their quality of life, page 14

October 2014

Be a flu fighter with this year’s annu al flu vaccina tion programm e, page 5

Flu s l l i k I know that influenza is dangerous, highly contagious and largely preventable. I could carry and pass on the virus to others without having any symptoms myself, so even though I consider myself healthy, I might be risking the lives of others. Protect yourself, your family, colleagues and patients – be a flu fighter, get your flu jab.

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Welcome

Contents

from the Interim

Regulars

Chief Executive

In the news

Word on the tweet

Julian Nettel Our new vision is that we become the leading children’s hospital in the world over the next decade. Getting there will mean we must deliver the best patient experience and clinical outcomes right across the Trust, and the way we all listen and respond to the feedback we get from both patients and staff is vital to making sure we are successful. So, it’s encouraging to see some of the good work already underway featured in this edition. In particular, as part of our response to the inpatient survey results last year, we’ve appointed our first nurse consultant for children with learning difficulties. Jim Blair is helping to train teams so that they are better informed and about caring for our patients with learning difficulties. Listening to each other is also vital to our success, and this was strongly reinforced in our values development survey earlier this year. So it’s good to read more about the Critical Care Future Search day, where colleagues from all parts of this patient pathway came together to share experiences and then mapped what a successful, more integrated approach to providing intensive care might look like, and how to get there. It is vital that we encourage this kind of closer working, bringing together people from across the Trust and beyond to ensure we are approaching things from the patient perspective too.

GO Create!

Noticeboard

Last word

Features 6 Members Council elections 2014/15 Have you got what it takes to help drive Great Ormond Street Hospital’s (GOSH) strategy? Find out about becoming a Foundation Trust Staff Councillor A better experience for patients with learning disabilities 8 How GOSH is improving the patient experience for children and young people with learning disabilities A day in the life Paediatric Physiotherapist Faye Mason tells us about a typical day on the job

Working out 14 How GOSH is working with private gyms for the beneﬁt of children with cystic ﬁbrosis Taking the pressure off Find out how GOSH is achieving Zero Harm by dramatically reducing the number of pressure ulcers

Finally, making sure everyone who works here feels involved with the work of the Trust is key too. So I hope you’ll read and think about the forthcoming election to our Members’ Council and really help inﬂuence the way we work in future. The copy deadline for the November edition is Wednesday 8 October. Please note that submitting articles does not guarantee a place in the next issue. Submissions should be sent to publications@gosh.org Editor Sally Mavin, ext *643042 Email: sally.mavin@gosh.org Designer Allira Tee, ext *643100 Contributors Mark McKenzie-Ray, Corinne Clark and Alice Woodward

Printer Jigsaw Colour, www.jigsawcolour.co.uk Charity logo Great Ormond Street Hospital Children’s Charity. Registered charity no. 235825.

In the news Consultant Paediatric Surgeon Paolo De Coppi

This month’s social media highlights from Great Ormond Street Hospital’s (GOSH) Facebook and Twitter accounts.

@GreatOrmondSt Thank you to all the staff on Walrus Ward, ICU and Bear Ward for looking after my little girl. Can’t praise you all enough! A big thank you to Ms Smith and Ms Dubert from Plastic Surgery and also OT Nicky Jessop and staff on Puffin and Peter Pan Wards for their amazing care of my son Kelley. You do a fantastic job! x Great Ormond Street Hospital (GOSH) Consultant Paediatric Surgeon Paolo De Coppi appeared in a number of national media stories, commenting on the announcement that scientists have, for the first time, grown a fully functional organ from scratch in a living animal. A team from the University of Edinburgh successfully grew the working thymus within the bodies of mice, an advance that could revolutionise the treatment of transplant patients. Dr De Coppi’s quote was included in The Times, The Daily Telegraph, The Guardian, The Independent, Daily Mirror and BBC Online. A team of GOSH patients represented the hospital at the 2014 British Transplant Games in Bolton. The patients, who have all had heart, lung or kidney transplants, competed against athletes from other UK hospitals in sports including track and field, tennis, football, swimming, table tennis, badminton and even team tug-of-war. The team brought home lots of medals and were featured across their regional papers, including Kent Messenger, Southend Echo, Bedford Times & Citizen, Northampton Chronicle & Echo and Herts Advertiser. Dr Neil Shah, Paediatric Gastroenterologist at GOSH, contributed to an article in The Mail on Sunday that highlights that many doctors are failing to recognise when children are allergic to cow’s milk. Dr Shah explains that: “there is an awareness issue with GPs and all doctors about cow’s milk allergy (CMA) and, in fact, there is still some disbelief that it exists at all”. The comments are made to coincide with a campaign launched by the charity Allergy UK that aims to raise awareness of CMA. Like many other children, five-year-old Harrison Grahame started school last month. But his first day at school is something that Harrison’s parents didn’t think they’d see after Harrison developed group B streptococcus and meningitis at four weeks old. He was admitted to the intensive care unit at GOSH and his future looked uncertain, but Harrison defied the odds and after several weeks started breathing on his own. The family’s story was featured on ITV Granada News, as well as in the Metro, Daily Mirror and Daily Star.

Parrot Ward saved my son’s life x We were on Peter Pan Ward after theatre. All the nurses and medical staff were lovely. Even the cleaners – they know how to treat the parents so well too. You are all amazing! xxx Can’t praise or thank the staff on Pufﬁn and Woodpecker Wards enough. I spent 16 yrs under GOSH. Brilliant hospital. I’m now 61. Amazing team at Safari Ward. Really friendly, welcoming and helpful staff there including Mina, always with a smile! Thank you for all your help/ support when Harvir was having his treatment x

Join the conversation Facebook: facebook.com/ GreatOrmondSt Twitter: @GreatOrmondSt

Be a flu fighter This year’s flu vaccination programme starts on Monday 6 October. For the majority of people who catch it, flu is unpleasant, but for some it can lead to chest infections, severe complications and even death. Globally, seasonal flu accounts for about three to five million causes of severe illness annually and between 250,000 and 500,000 deaths. Protect our patients At Great Ormond Street Hospital (GOSH), we strongly promote the free flu vaccination for all employees, especially those in contact with patients and families. Vaccination isn’t just about keeping you safe, it’s about protecting your colleagues, your family and your patients. You can carry and pass the virus on to others without having any symptoms yourself, so even if you consider yourself healthy, you might be risking the lives of others.

Flu vaccine facts The flu vaccine is one of the safest in the world, given to millions in the UK each year. The vaccines are thoroughly tested, and the risk of having a serious reaction is less than one in a million: much lower than the risk of getting seriously ill from having the flu. It is impossible to get flu from having the flu jab because the vaccine doesn’t contain live viruses. A small number of people experience flu-like side effects such as aching muscles, but this is simply the immune system responding to the vaccine. For the most part, the side effects are mild or often non-existent. The most common side effect is soreness around the site of the injection and occasionally aching muscles. Pregnant women can have the flu vaccination at any stage of their pregnancy. It also helps protect the baby from flu over the first few months of life. Hand-washing is very important, but it won’t stop flu. One of the most common reasons for not getting vaccinated is “I’ve never had flu before”. There’s no such thing as natural immunity to influenza as there are new strains circulating every year. If you were vaccinated last year, you helped to fight the flu and took an extra step towards excellent patient care. Please do the same again this year. You won’t be protected against the new strains of flu circulating. Watch out for more information on your payslips, the GOSH email newsletter and GOSH Web for details of campaign times and sites.

Members’ Council election 2014/15

Play a more active role in Great Ormond Street Hospital (GOSH) with the upcoming Members’ Council election. Whether you vote for your staff councillor or stand for election yourself, make sure your voice is heard.

On 19 November, the Trust will issue its Notice of Election for the upcoming election to the Members’ Council, and we want you to get involved. What does the Members’ Council do? The Members’ Council is a group of 27 elected and appointed councillors who represent the interests and views of patients, their families and carers, staff and stakeholders. Our councillors bring valuable perspectives and contributions to the Trust. Importantly, they hold the Non-Executive Directors to account for the performance of the Board and represent the interests and views of Foundation Trust members. They provide a steer on how the Trust will make a difference to the future health and wellbeing of its patients.

“I am passionate about providing high-quality care for our children and am a strong advocate for the Trust’s motto ‘the child first and always’. I am delighted to be able to work with colleagues on the Members’ Council as it gives me the exciting opportunity to really make a difference.” – Current staff councillor Where do GOSH staff fit in? In this year’s election there are five seats available for staff councillors on the Members’ Council. Becoming a staff councillor gives you a greater say in the running of our Trust and allows you to represent the views of patients, their families and carers to shape the future of GOSH’s services.

As a GOSH staff member, you can nominate yourself for election. If you do not choose to run for election, please use your vote for the staff councillor you feel best represents you. What does the role entail? As a staff councillor you will work closely with a wide range of people at the hospital to consider and propose new or different approaches that could help improve the experience of GOSH for everyone. The role includes: • Supporting the Board of Directors in setting the long-term strategic direction for the Trust. • Taking a full role in Members’ Council meetings and other Trust groups and committees. • Making the membership voice heard at Members’ Council meetings by posing questions or bringing ideas on behalf of staff, patients, their families and carers on the key issues affecting them. • Meeting with staff to share information about the Trust, its direction and vision, how it is performing and to hear back from staff about their experiences. Being a councillor involves significant time, commitment and responsibility. There are five official Members’ Council meetings every year, plus a number of Trust groups and committees you can join.

Election timetable 19 NOVEMBER 2014 Notice of Election – once you have received the letter announcing the election, please follow the instructions to request a nomination form. 17 DECEMBER 2014 Prospective councillors – please return your nomination form with a photo and statement by this date. 20–27 JANUARY 2015 Members – voting packs are dispatched. Look out for yours and use your vote! 20 FEBRUARY 2015 Announcement of results – councillors serve for a three-year term (but can stand for re-election for a further three years).

More information Members’ Council information sessions We are holding two election information sessions. Anyone interested in nominating themselves as a councillor can attend and learn more about the role and the election process. Saturday 6 December 2014 10am–12pm, Weston House Lecture Theatre Thursday 11 December 2014 5–6.30pm, Conference Room, Level 2, York House Staff surgeries Staff councillors now hold staff surgeries in the staff side of The Lagoon restaurant. At these, you can meet your staff councillors, ﬁnd out more about what they do and also talk through any issues or queries with them. Wednesday 15 October, 1–2pm Wednesday 19 November, 1–2pm Wednesday 17 December, 1–2pm For more information on the role of a staff councillor please visit the Chief Executive’s section of GOSH Web, under the Corporate tab. Alternatively, contact Deirdre Leyden, Membership and Governance Manager, on ext 5668 or deirdre.leyden@gosh.nhs.uk

A better experience for patients with learning disabilities Great Ormond Street Hospital’s (GOSH) highest priority is ensuring world-class care for patients and their families. However, in the 2013/14 Inpatient Experience Survey, we discovered that patients with learning disabilities were less satisﬁed with their experience of GOSH than those without. In response to this, GOSH has been busy making improvements.

Jim Blair

In September 2013, Jim Blair joined GOSH as the hospital’s ﬁrst Consultant Nurse for children with learning disabilities, and is also Health Advisor at the British Institute of Learning Disabilities. This specialist role is intended to ensure that children, young people and their families are involved in the decision-making process around the care and treatment that they receive at GOSH. This involves providing specialist advice, assisting in complex decisions, assessing capacity, advising on reasonable adjustments and helping manage difﬁcult situations. Excellent work has been done across the hospital both now and before Jim started. Working together with all staff in all areas, GOSH is committed to getting it right for children and young people with learning disabilities and their families.

New ways of working “I’ve started introducing a range of new initiatives to improve our care,” says Jim. “We’ve had some quick wins that have still made a real difference. For example, all children identified as having a learning disability now have a purple sticker put on the front of their notes. It’s a simple thing but it helps with identification and means we can make reasonable adjustments.” These adjustments may be small, but can make all the difference to children and young people with learning disabilities. They include allocating double appointments, or the first or last appointment of the day to children with learning disabilities, giving families more time so everything is less rushed.

Jim continues: “We also carried out an audit of our patient population so we know, for instance, that we have 1,579 children on our books who have Down’s syndrome. Identifying this group allows us to communicate with the parents in a more co-ordinated manner and to keep them updated.” Training staff “Similarly, we’ve used a survey to do an audit of how well staff understand learning disability issues. From the survey we’ve been able to gauge where staff have a good level of understanding regarding learning disabilities and where they could do with more education and training.” The survey results have played a key role in identifying staff training needs. “We’ve embarked on a training programme around the complexities

of caring for children with learning difﬁculties. For example, some children can express pain through laughing, so it’s important that our nursing staff are aware that a laugh isn’t necessarily a positive reaction. By teaching staff about the different forms of communication available, including pictures, symbols and music, we’re making sure staff are receiving the correct message from their patients.” The hospital now has over 20 link leads in learning disability across the hospital, including consultant doctors, clinical nurse specialists, healthcare assistants, sisters, speech therapists and occupational therapists, to help drive forward the learning disability initiatives. Jim Blair’s post is funded by Great Ormond Street Hospital Children’s Charity.

Patient-led initiatives The hospital is also rolling out a ‘hospital passport’ for patients with learning disabilities. The passport is a simple document filled in by the child’s family. In it, they write down important information about the child’s physical and emotional needs. This includes information about what they like and don’t like, how they express pain, how they communicate, and what to do if they get anxious. The passport helps doctors to treat each child sympathetically, and understand quickly which symptoms are part of their disability, and which are symptoms of a specific medical problem. “As it’s patient led, it means they have real ownership of it and can express their wishes,” says Jim. “It’s already making a real difference. Recently a patient mentioned that they found the lighting in their room too strong so we were able to amend it with lamps and the mum was so grateful as the patient was in less discomfort.” Using technology Jim is also looking at ways to use technology to support children with learning disabilities. “It can be very stressful for patients to undergo an MRI scan for example. Words describing the procedure can fail to alleviate the anxiety, so we’re looking at working with partners to create a video of someone having a scan so the children will know exactly what it entails.” A wider impact GOSH has partnered with a variety of institutions to produce resources suitable for children and young people with learning disabilities and their families. These include: • Trialling a communications toolkit to aid those communicating with children and young people with learning disabilities, designed by Keele University and Asist Advocacy Services. • A partnership with Books Beyond Words, which helps people with communication and/or learning disabilities to make sense of what is happening to, for and with them in an easy, accessible manner. Jim’s goal is for this work to impact children not only at GOSH, but further afield. “We’re starting to attract attention both nationally and overseas. A number of other European countries are keen to translate the hospital passport and other materials for their patients with learning disabilities. I also recently visited the Norwegian embassy at the request of the Norwegian Health Commissioner as they want to learn more about the work we’re doing.”

In September, Jim attended the Special Olympics European Summer Games for people with learning disabilities to undertake health screening for athletes. During the games, Jim forged links with clinicians from all over Europe who are interested in transferring and translating a number of initiatives and materials from GOSH. Jim concludes: “It’d be great if the beneﬁts of the work we’re doing at GOSH stretch even further so we can help more children, whatever country they live in.” For more information, please contact Jim Blair, Consultant Nurse for Intellectual (Learning) Disabilities, at jim.blair@gosh.nhs.uk or ext 8465, or visit gosh.nhs.uk/intellectual-learning-disability

A grateful mum’s story “Our son is a great boy with a wicked sense of humour. He also has learning disabilities. Last January we were told that he would need major surgery in 2014. The news was daunting as he already finds hospitals challenging. How was he going to cope? We knew we needed to step outside the mainstream and access additional support. That was when we asked for a referral to GOSH and first made contact with Jim Blair. “From the start, Jim has listened to our son’s needs and worked with others to make flexible adjustments to treatment. For instance, Jim helped us access a first appointment slot for an MRI. We were able to stay in the Paul O’Gorman Patient Hotel opposite the hospital in Weston House the night before and then, in the morning, we simply walked across the road and straight in for the scan, minimising our son’s anxieties. Jim has helped us access other resources too. The hospital passport is a great idea. We have used it to flag up his allergies and to share that laughter often gets the best results! “This is a stressful time for our whole family. However, we know Jim is there to support us and that he takes our son’s needs seriously. That makes a difference.”

Intensively improving care

Staff taking part in the Critical Care Future Search event

More than 70 members of staff involved in looking after patients needing intensive care have come together to create a roadmap for the future. The Critical Care Future Search event brought colleagues from every part of this patient pathway together, including referrers and allied health professionals. They reﬂected on current pressures, recent successes and areas for improvement, with the ultimate goal of identifying how they could all work better together to put the child ﬁrst and always. The session included groups of staff being given free rein to come up with creative ways of sharing a vision for the future with the rest of the group. The outputs were as diverse as they were impressive and included a song, dramatic sketches, a TV news report and a newspaper (pictured right). Divisional Director for Critical Care Services, Allan Goldman, said: “This was a great opportunity for colleagues from across the Trust to come together and have a frank and open discussion about what was working really well and some of the issues that need addressing. I was taken aback by the energy, honesty and creativity of my colleagues and I am excited about the next steps.”

Trust Chairman Baroness Blackstone attended the event for part of the day to help provide context and support. Some of the issues that came to light on the day included inconsistent experiences of referral teams, the challenges of managing the tension between elective and emergency cases, and thinking laterally about how to improve skills and knowledge despite resource constraints. At the end of the session, four key issues were identiﬁed to take forward through action teams. These were: • • • •

leadership ﬂow values and behaviours learning and education

A follow-up session will take place on 17 October 2014 to review progress on all of the working groups and agree next steps.

A day in the life of a Paediatric Physiotherapist

Faye Mason is a Paediatric Physiotherapist at Great Ormond Street Hospital (GOSH). She has been working at the hospital for 18 months in a rotational post, which means she moves to a different specialist area every eight months. So far, Faye has worked within rheumatology, the Cardiac Intensive Care Unit and orthopaedics.

Getting started “I usually get up around 6am. If I have time, I’ll have some porridge for breakfast, otherwise it’s Nutella on toast on the train! I commute from Woking, so I’m on the train by 7.30am, and I’ll either catch up with friends and family on the phone or read a book or magazine. After I’ve arrived at Waterloo I walk to work.” Choosing a specialty “I have always wanted to be a physiotherapist. When I was doing my A levels, I took part in a volunteer programme and worked in a special needs school. Initially, I was really scared of doing it, but now, even 10 years on, I will try and pop back to visit! During my time at the school, I began working for a charity providing respite care for children with disabilities and their siblings.

orthopaedic and spinal surgery are cared for. I saw children who came in for interventions such as spinal surgery, limb lengthening procedures and soft tissue procedures. Now I’m just settling into my new role in haematology and oncology. “Being a physiotherapist at GOSH is a very diverse role. Often we’re involved in the patient’s journey from beginning to end and we’re part of the multidisciplinary team that assesses a patient when they come in for a pre-operative clinic. During rehab sessions, we bring children to the gym or work with them on the ward, and if necessary we’ll use the hydrotherapy pool.

“I also worked for Social Services and the Independent Living Association as a sessional worker for children with disabilities. I loved this work and it fed my ambition to work with children more and more. When I went to university and studied for my physiotherapy degree I tried to gear all of the work I did towards getting into a career in paediatrics. “As a newly qualiﬁed physiotherapist, I worked in Hull for two years before pursuing my career in paediatrics at hospitals in Sidcup and Tooting: I was then lucky enough to get a job at GOSH!” An ever-changing role “My job is currently a rotational post, and I’ve just ﬁnished working in orthopaedics. I worked on Sky Ward, which is where children who are having

Faye gets patient Ruby up and about with her mum

“When a patient is set to be discharged, I liaise and speak with their local physiotherapists to make sure their rehab is set up, and I sometimes attend the follow-up clinic with the consultants and registrars to see how they’re getting on.

“In addition, I work on a rota to cover the on-call respiratory service in the evenings once or twice a month. I also cover a respiratory weekend once a month, working within the intensive care units as well.” Being adaptable “I have to work quite ﬂexibly to meet the needs of the families and the children, and to ensure that I’m getting through my workload, so my day may not be as structured as with other roles. The variety of clinics and rehab sessions changes day to day, so we work very much as a team, whatever the specialty, to ensure that we’re doing the best we can for each child. “I love the diversity of my job. The variety keeps it so interesting, and the role that physiotherapists have as part of the child’s journey in hospital is great – I just love working with the families and supporting them.

“My favourite part is changing the patients’ and families’ perceptions of physiotherapy. A child might come in who is really scared and not very compliant with physiotherapy – they may not want to do it and view it as a really negative experience. I really like working with them to achieve a little bit more each day. Seeing those smiles before they go home when they realise how much they’ve accomplished is great. “Some people don’t expect physiotherapy to play the role that it does during their time in hospital.” The end of the day “I generally ﬁnish at 5pm. I try and get going quickly after work because I have a fairly long journey and I like to have as much of the evening as I can at home. I’m a little bit of a gym addict, so I will be at the gym almost every day! I’m training for a half marathon. I also spend lots of time travelling around and seeing friends, and I’m currently planning my wedding!”

Faye listens to patient Alﬁe’s heart

Working out

Dion and Sean working out

Roundabout sees how a successful collaboration between the Cystic Fibrosis Unit at Great Ormond Street Hospital (GOSH) and private sector gyms is benefitting patients. “If you don’t ask, then you don’t get,” says Sean Ledger, Lead Paediatric Respiratory Research Physiotherapist of INSPIRE-CF, a research programme investigating the potential benefits of exercise in children with cystic fibrosis (CF). He is referring to the 45 requests he’s made of private sector gyms in London and surrounding counties to provide free gym access for children with CF. “We’ve had a 98 per cent success rate from our requests. Generally, centre managers have only said no if they have very stringent corporate rules about under 16s exercising in their gyms.”

CF is an autosomal recessive inherited disease – if each parent has one copy of the recessive gene, then the child has a one in four chance of having CF. The disease affects multiple organs, especially the lungs and digestive system, and is characterised by chronic lung infection and inﬂammation and digestive problems. Physiotherapy treatment of children with CF typically consists of a combination of regular airway clearance and inhalation therapies, and exercise. Occasionally, when required, children may be admitted to hospital for intensive intravenous antibiotic treatment.

Sean and Dr Eleanor Main, Senior Lecturer in Physiotherapy at the UCL Institute of Child Health, are leading research into an alternative model of physiotherapy care based on a previous successful pilot study, the Frequent Flyer Programme (FFP), which involved encouraging children with CF to regularly engage in high-intensity exercise, and more regular monitoring of their nutritional intake. The results were impressive. “With the pilot we purposefully chose the sickest group of children as they were spending considerable periods of time in hospital. These children were spending many days off school and away from their homes. We were looking for a way to reduce the amount of inpatient care they required.” “In the FFP I personally trained the 16 children on a weekly basis. By using the gyms I’d arranged to support the venture, we were able to build up the children’s overall fitness. The results of gold standard exercise testing showed that we’d significantly improved global fitness by more than 50 per cent in some patients. The subsequent improvement in the children’s health was fantastic, with children telling us they were able to exercise at the same level or higher than their peers. They also spent less time in hospital, which is so important for helping them maintain a normal lifestyle.” With the success of the FFP assured and having been published in the Journal of Cystic Fibrosis, Sean launched INSPIRE-CF, funded by Great Ormond Street Hospital Children’s Charity. “This study involves 70 children and we’ve now got four specialist trainers working with the children. We started the project in May 2012 and it’ll run for three years in total. It’s slightly different from the pilot in that we’ve opened the programme up to children with a wider range of disease severity. While the FFP successfully showed

Good for children, good for the NHS As the health of children involved in the first pilot improved, it reduced the amount of time they spent in hospital, with financial benefits for the NHS. The smaller pilot alone saved the NHS over £220,000 (without start-up costs). Hopes are high that the current project INSPIRE-CF, may show similar savings:

INSPIRE-CF has led to CF patients spending less time in hospital

the difference we can make to the most ill children, if we’re to roll this out on a much larger scale we need to prove it can work for most children with CF. GOSH’s CF Unit is currently the only Unit that offers this innovative programme, but if INSPIRE-CF can be proven to make a difference to these children, then we’d hope that this model be adopted as standard clinical practice.”

Pre

Post

£963,904

£743,566

Cost saving £220,338 15

Taking the pressure off As part of the Transformation programmeâ&#x20AC;&#x2122;s goals to achieve zero harm, no waits and no waste at Great Ormond Street Hospital (GOSH), the Trust has seen a dramatic reduction in the number of pressure ulcers. We found out more.

Miffy Ward Sister Kate Harkus with Kamil

What is a pressure ulcer? A pressure ulcer is a sore that develops from sustained pressure on a particular part of the body. They can also form when there is friction against the skin, such as rubbing on a bed sheet or medical device. Critically ill children are more at risk of getting pressure ulcers because their condition can make it difﬁcult to reposition them. Pressure ulcers are graded from one to four depending on the degree of injury to the skin, with higher grades being more severe.

Our skin is the most important barrier against infection, so we need to look after it carefully. Sometimes, for a variety of reasons, infants, children and young people who are unwell develop pressure ulcers, which can be very painful. Over the past two-and-a-half years, clinical teams across the Trust have worked alongside the Tissue Viability team to eliminate all avoidable pressure ulcers while children are in hospital. What have we done? Teams have implemented a variety of ways of working to reduce the incidence and severity of pressure ulcers. These include: • Rolling out a specialist pressure ulcer training programme to nursing staff. • Embedding the Glamorgan paediatric risk assessment tool into daily clinical practice and integrating it into our intensive care IT systems, which helps us identify children at risk of pressure ulcers. • Ensuring that every patient admitted to GOSH receives a pressure ulcer risk assessment score and that appropriate action is taken to manage pressure ulcers developed prior to arrival at GOSH. • Introducing the paediatric SSKIN Care Bundle – a series of actions nurses must take when a risk is identiﬁed. • Investing in new prevention technologies, such as new dermal pads and specialist beds. How are we doing? • In August 2014, 97 per cent of children had a pressure ulcer risk assessment every day of their admission. • We reduced the number of hospital-acquired grade three pressure ulcers from seven in 2012/13 to three in 2013/14, with one of these classiﬁed as unavoidable because the child was so sick that

the comprehensive range of pressure prevention measures were not enough to prevent the breakdown of their skin.

• The total number of grade two and over hospitalacquired pressure ulcers in the Trust reduced by 26 per cent in 2013/14, which is a significant reduction in harm to our patients. A focus on medical devices While we are encouraged by these results, there’s still more we can do. In particular, our aim is to reduce the number of avoidable pressure ulcers and skin injuries further by raising awareness of one specific cause of pressure ulcers – medical devices. Medical devices play a crucial role in the diagnosis, care and treatment of patients, and the number and variety of medical devices is huge. Healthcare professionals handle a wide range of devices every day. However, it is important to remain vigilant, as some medical devices can also cause skin irritation and potentially pressure ulcers due to friction and pressure. The Tissue Viability team have created a new acronym to help raise awareness of medical device related pressure ulcers. If you notice a child’s skin becoming red under a medical device, please alert a member of staff as soon as possible so they can check your child’s skin condition and make the necessary interventions. DEVICE – preventing medical device-related pressure ulcers • D: Document skin integrity on and throughout admission. • E: Ensure equipment is the correct size and fits the child to avoid excessive pressure. • V: regularly Visualise skin under the device, if possible. • I: Inspect skin/device interface and use protective dressings. • C: Correct the tension and positioning, and follow manufacturer’s specifications. • E: rEposition device regularly, if it is clinically safe to do so. For more information contact Sarah Kipps, Nursing Quality Practice Educator (Pressure Ulcer Prevention and Management team), at sarah.kipps@gosh.nhs.uk The Transformation team is funded by Great Ormond Street Hospital Children’s Charity.

Family Arts Week 27–31 October

ARTS AWARD What: GO Create! and the Activity Centre present the ﬁrst ever Family Arts Week! When: 27–31 October Where: Activity Centre and The Children’s Hospital School This October half term, Great Ormond Street Hospital (GOSH) families will have the opportunity to take part in some fantastic arts activities led by a team of experienced artists, musicians and performers. From hat making and print making to contemporary dance and Indonesian drumming, this jam-packed week of workshops and events will be sure to inspire creativity across the Trust. GO Create! is thrilled to be joining forces with the Activity Centre, who share in our commitment to increasing wellbeing by providing participatory arts.

Family Arts Week is a chance for GO Create! to kickstart Arts Award, a scheme established by Trinity College London that helps children and young people grow their creative talents. Arts Award has five accredited qualifications, with the highest level of the award equivalent to 35 UCAS points. The beauty of Arts Award is that it recognises creativity across a wide range of activities, from popular culture to traditional crafts. The Arts Award approach to learning will be of great benefit to patients because it can be tailored to suit the needs and interests of individuals, allowing young people to work entirely at their own pace. During the Family Arts Week, participants will have the opportunity to complete a Discover or Explore Arts Award with the support of 12 trained GOSH Arts Award advisors.

The Big Draw Family Arts Week will form part of the Family Arts Festival, a national event that brings the arts alive for families all over the country. We will also be running a Big Draw event from Tuesday to Thursday, which will be led by artist Tanya Kaprielian. The Big Draw is part of the international campaign for drawing, which inspires people of all ages to use drawing to understand the world around them and to communicate ideas. During Family Arts Week, all activities will be inspired by the Big Draw theme: ‘It’s Our World’, a celebration of our environment – urban, rural and coastal.

Find out more We want to make sure that all of our families know about Family Arts Week, so please help us to spread the word. We wouldn’t want any families missing out on learning new skills, meeting other families, making their mark and having fun! Look out for the Family Arts Week posters and ﬂyers being distributed across the Trust to ﬁnd out what will be happening when. For more information about Family Arts Week, follow us on Twitter at @gocreateGOSH For more information about the Family Arts Festival, the Big Draw and Arts Award, please have a look at: thebigdraw.org familyartsfestival.com artsaward.org.uk

GO Create! is funded by Great Ormond Street Hospital Children’s Charity.

GOSH noticeboard

GEMS awards winners: August

Individual award: Andrew Dinsdale, Data Manager, Palliative Care team

Nominate someone for a GEMS award!

Team award: Blood Transfusion Laboratory team

If you think an individual or team should get wider recognition then just drop an email to staffrecognition@gosh.nhs.uk providing as much information as you can about why theyâ&#x20AC;&#x2122;re a Great Ormond Street Hospital GEM.

Free ﬁlm show 13 OCTOBER

Postman Pat (U) 6.15pm

Edge of Tomorrow (12) 8pm

t u o b a d n a Out Listen

12 OCTOBER

Diwali, the Festival of Lights

Free

Trafalgar Square

See

UNTIL 2 NOVEMBER

Quentin Blake – Inside Stories

Ground Floor Lecture Theatre, Weston House

Multi-faith festivals

House of Illustration

Eat and drink

£7.70

8 –27 OCTOBER

London Restaurant Festival

3–4 OCTOBER Yom Kippur Jewish

Various venues

4 OCTOBER Eid-Ul-Adha Muslim

Prices

vary

1 OCTOBER TO 2 NOVEMBER

The Big Draw 8–15 OCTOBER

Various venues

Sukkot Jewish 15 OCTOBER Al-Hijira Muslim

Watch

8 –19 OCTOBER

BFI London Film Festival

20 OCTOBER Birth of the Bab Bahá’í

Free

TBC

Various venues

Read 23 OCTOBER Diwali Hindu

23 OCTOBER Diwali/Bandi Chhor Diwas Sikh

Dragons at Crumbling Castle and Other Stories by Terry Pratchett “Warm, silly, compulsively readable, fantastically inventive.” Evening Standard

Second to the right, and straight on till morning!

Thanks to JM Barrie’s amazing gift to Great Ormond Street Hospital in 1929, every performance of Peter Pan benefits the hospital, so enjoy a great family night out and support us when you go and see one of the shows opening for Christmas, whether pantomime or musical! 20 November – 4 January

27 November – 3 January

11–14 December

Peter Pan, Watermill Theatre, Newbury watermill.org.uk 01635 46044

Peter Pan panto, Polka Dot Pantomimes, Broadway Theatre, Barking thebroadwaybarking.com 020 8507 5607

Peter Pan, A Musical Adventure, Mayhem Musical Theatre Co, Bloomsbury Theatre, London thebloomsbury.com 020 3108 1000

3 December – 4 January

12 December – 4 January

Peter Pan panto, Chelmsford City Council, The Civic Theatre, Chelmsford chelmsford.gov.uk/theatres 01245 606505

Peter Pan panto, UK Productions, Assembly Hall, Tunbridge Wells assemblyhalltheatre.co.uk 01892 530613

21 November – 14 February Peter Pan, Polka Theatre, Wimbledon polkatheatre.com 020 8543 4888

There may be many more not listed above, including local amateur productions, so keep an eye out for Peter Pan shows near you and don’t miss out!

In brief

Learnabout

New web pages for TeenGOSH patients

Clinical leadership in action

New web pages for teenagers visiting Great Ormond Street Hospital (GOSH) are now live on the hospital website. The pages were developed by the Digital and Design teams at Great Ormond Street Hospital Children’s Charity, who are responsible for the charity and hospital websites. Current and former teenage GOSH patients advised on the content and design of the new pages, which you can see at gosh.nhs.uk/teenagers. The teens web pages redesign project began in Autumn 2013 following audience research into how well the old pages were meeting the information and support needs of young people at the hospital. The new ‘TeenGOSH’ web pages will continue to develop over the coming months to ensure that they meet the needs of our teenage GOSH patients. If you have any comments or questions, please email web.content@gosh.org

Senior staff at Great Ormond Street Hospital (GOSH) are being encouraged to learn by ‘doing’ in a new threeday leadership programme from the Postgraduate Medical Education (PGME) team. ‘Clinical leadership in action’ takes learning outside the lecture theatre by providing a more interactive approach to developing the core knowledge, behaviours, attitudes and skills that are important for a senior role. The aim of the programme is to give staff a more in-depth understanding of the role of a leader in the NHS, by learning about themselves, others, teams and leadership in a fully immersive scenario-based simulation. During the programme, participants work together as a team to resolve a ‘real’ set of issues based around scenarios that commonly arise in hospital care. The idea is that, with an increased understanding of how to approach these challenges, participants will have the potential to become more effective leaders earlier on in their careers. Good leadership is vital to the smooth and efﬁcient running of any organisation. This is just as true in the NHS as it is in government and business. Within the hospital the role of the leader is to set its overarching goals, to create the trust culture and spread its values. That is why we have created this interactive course to prepare senior medical trainees, nurses and those newly appointed to a senior role to take on the real challenges that they will face in the job. The clinical leadership in action programme also gives doctors in training the opportunity to attend leadership training, as required by their curriculum, and better prepares them for their assessments before they take on a consultant role. Additional programme dates have been added to meet demand following feedback from participants saying how valuable they have found it. Applications for the next course (Wednesday 28 to Friday 30 January 2015) open on Wednesday 8 October and close on Wednesday 19 November 2014. For more information about the clinical leadership in action training, please visit gosweb/pgme

For all patients and their families Join the fun in The Lagoon restaurant, Morgan Stanley Clinical Building, for the

Thursday 30 October 2014 2.30â&#x20AC;&#x201C;4.30pm For further details, please contact: Patti Hogan, Volunteer Co-ordinator T 020 7829 8861 E patti.hogan@gosh.nhs.uk

Great Ormond Street Hospital Childrenâ&#x20AC;&#x2122;s Charity. Registered charity no. 235825.