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Staff Focus


22nd August 2013

“Welcome to GP News. This is the first edition of a new newsletter designed to keep clinical colleagues across Essex up to date on news from Mid Essex Hospital Trust. We aim to ensure we share with you important information about our services, facilities and teams to enable you to support your patients in making the best choice for their care".

Ronan Fenton
Ronan Fenton, Medical Director
New ambulatory care service

“We are pleased to update you on a new ambulatory care service, developed with the support of GPs and primary care, targeted to reduce hospital admissions. The new ambulatory care service at MEHT is looking to replicate and build on the success of other hospital Trusts with this service. The service is working in collaboration with GPs with patients who they refer to us to be reviewed by a consultant or senior nurse. We are targeting to review over 5% of medical referrals with a zero length of hospital stay. The process works by GPs calling the service directly and, as appropriate after conversation with a consultant, senior nurse or middle-grade ambulatory care doctor – the patient is asked to attend the ambulatory care unit (situated between A&E and EAU). If the patient is able to walk in the report is to EAU reception. If the patient requires an ambulance transfer, this is booked with a planned appointment allocated. Should a GP wish to speak directly with a Consultant, the first available from patient care will call back to discuss a patient as required. The service is running from 10 am to 6 pm, and after 6 pm via junior doctors with a hospital bleep. We currently support all ambulatory care tariff conditions with this service but not children under sixteen years of age. Kevin Kiff, Clinical Director stated, “We are very excited about this service and it’s a true attempt to put the patient first with regard to emergency care. We can measure the performance and continue to develop the service in collaboration with our colleagues in primary care and we welcome feedback to enable us to do this”. If you would like to provide feedback or service development suggestions regarding the ambulatory care model please email Kevin on: kevin.kiff@meht.nhs.uk

Wendy Bartram (far left) - Senior Sister, Caroline Sinclair (left) - Band 4, Harry Bartram (right) - Admin Support, Jilly Parker (far right) - Health Care Support Worker.
Also in the team is Carole Oughton - Junior Sister.

We have spoken about integrated care for many years and there have been many excellent initiatives at generating true integrated care in the past. At present we have some good examples of primary care and secondary care working together to develop this concept. We have recently had GP input into our A&E department, assistance with setting up an admission-avoidance process in A&E and last year we began looking together at how we could improve the end-of-life pathway for patients. I hope through this communication we can provide further focus on this area and provide updates on the reality, or otherwise, of the integrated care agenda.

I firmly believe that if we wish to serve our population well we need to act together rather than in silos. I know that this is an aspiration shared by many primary and secondary care colleagues. Making it a reality is the hard bit – that’s the challenge we face.

I hope you find this edition of GP News informative and enjoyable and I welcome your feedback as to what you would like to see featured or discussed in future editions.

Ronan Fenton, Medical Director

StaffFocus 23rd Nov 2012
First in the country for national accreditation in theatres
Staff in the Mid Essex Hospitals theatres and anaesthetics have set a new precedent by being the first NHS Trust theatre department in the country to be awarded accreditation to ISO 9001.
The certification means that every element and process of the patient pathway in theatres is measurable against a quality standard that is nationally recognised. Keith Clark, Co-ordinator of Quality & Education, explained: “The ISO system enables us to control all the documentation being used in theatres and ensure it is of a high standard. Using this, we can provide evidence of the quality of care being provided from the time the patient arrives in theatre to the time they leave recovery.”

This new system is in place to provide the patients we care for with the highest-quality service from their theatre experience. Staff will also directly benefit from the new system, as they will each have a training pack providing a portfolio of evidence that they are qualified to work in their area.

Receiving the ISO 9001 certification has taken two and a half years of work, led by Keith Clark and Julie Slater, which included updating all the documentation and embedding the new process across theatres. A huge congratulations to all staff involved in setting a new standard for patient care in theatres.

For further details contact keith.clark@meht.nhs.uk
Latest News
Nurse and Patient
Pictured: Quentin Frew, Clinical Fellow, and Brenda Smith, a patient being treated for a hot-water-bottle scald.

St Andrew’s partnership
with Anglia Ruskin University (StARRS)

An international Breast Reconstruction Conference was hosted by St Andrew's Regional Burns and Plastics Centre at Broomfield Hospital in partnership with Anglia Ruskin University in November 2012, where speakers from around the world met in Essex to debate the very best practices in the field to enhance patient care.

This conference also hosted the launch of a new partnership between the two organisations (StAAR).

The aims of the co-operation are to focus on regional research activity to provide an infrastructure to maximise funding, and to create opportunities for training and partnerships with industry.

The clinical aims are to increase the evidence base for current practice and to provide a multidisciplinary platform for regional, national and international co-operation and to provide an educational framework for clinical activity.

The first major new research – the first of its kind in Europe – revealed the dangers associated with the spontaneous rupture of hot water bottles.

‘Burn injuries resulting from hot water bottle use’ is authored by Dr Shehab Jabir, Quentin Frew and Professor Peter Dziewulski of the StAAR Research Unit.

This story made international headlines on its release, being picked up as far away as Russia.

For further details please contact
Quentin Frew: quentin.frew@meht.nhs.uk

Meredith Deane (on the far left), Head of Midwifery at Mid Essex Hospitals with some of the members of the team responsible for the successful CNST Level 2 accreditation
The Maternity Unit at Mid Essex Hospitals has maintained its level 2 CNST status
Congratulations to Meredith Deane, Head of Midwifery, and all her team who have worked so hard to deliver a high-quality service deserving of CNST Level 2 accreditation following a successful assessment by the NHSLA team.

The NHS Litigation Authority (NHSLA) provides an 'insurance scheme' to NHS Trusts through the Clinical Negligence Scheme for Trusts (CNST), and Trusts have to meet certain standards of care that show they are providing safe and high-quality care to women and their families. This is promoted by the effective use of risk management strategies to minimise the risk of harm to patients.

Because of the different nature of claims in NHS maternity services a separate set of CNST standards are in place. Each standard covers an area of risk and has ten specific underpinning criteria, against which all maternity services are assessed.

The five standards, applying to antenatal, intrapartum and postnatal services, including care of the newborn, are:

• Organisation

• Clinical care

• High-risk conditions

• Communication

• Postnatal and newborn care

The NHSLA assessors visited our Maternity Unit on the 19th and 20th February and reviewed Maternity Records, Guidelines and Policies, and talked to staff, reassuring themselves that our reviewed Maternity Records, Guidelines, Policies, talking to staff and assuring themselves that our Governance processes were fit for purpose. This means that mothers coming to Mid Essex Hospitals can be assured that their care is of a very high standard. The maternity service is based in a state-of-the-art unit at Broomfield Hospital and delivers over 4,900 babies a year across three sites.

For more details please contact meredith.deane@meht.nhs.uk

Nurse and Patient
Members of Friends at Broomfield provide a donation of adapted cutlery and dinner bells to ward staff and Angela Wade (far left), Professional Development Nurse and lead for the Mealtime Mission.
Mid Essex Mealtime Mission
At Mid Essex Hospitals, ensuring that our patients have the right nutrition and hydration is a fundamental part of care, not only to provide an excellent patient experience, but to promote healing, recovery and reduce the risk of complications whilst in hospital.

To ensure our patients receive the best care possible, we have recently launched the Mealtime Mission. The aim of the Mealtime Mission is to ensure that all in-patients have their nutritional and hydration needs met whilst they are in the care of Mid Essex Hospitals. Part of the Mealtime Mission is to recruit volunteers to become Mealtime Companions. Mealtime Companion volunteers assist the nursing staff and healthcare assistants at mealtimes on wards by offering extra support to those patients that require it.

For more details please contact:
Jonathan Wright
Tel: 01245 514577
Email: jonathan.wright@meht.nhs.uk

New Chief Exec at the Trust

Mid Essex Hospital Services NHS Trust is pleased to announce the appointment of Paul Forden as the new substantive Chief Executive Officer for the Trust. Paul brings a wealth of experience with eighteen years in the NHS, ten of those in CEO roles in major acute hospital Trusts across the country. Most recently, for the last two and a half years Paul has been working as Managing Director for Clinical Services for Serco, with responsibilities for acute and community services. Paul has also been involved in developing Serco's health business in Australia, based there for the last six months.

Nurse and Patient

Paul Forden states, "I have an absolute passion for delivering safe, patient-centred care and I am looking forward to returning to the NHS, for which I have a true commitment and experience over many years. I welcome the opportunity at MEHT to build on the strong vision the Trust has to Care, Excel and Innovate. I see my role as leading the organisation on their path to this vision. During my career in the NHS I have had the opportunity to work with MEHT, to develop certain services, including those for cancer patients, and I have seen the Trust grow as a tertiary centre. The redevelopment of the site, including the new wing, is a key building block to creating an exceptional hospital that will deliver the care that one would desire in a modern twenty-first-century hospital and I look forward to building on the quality of services delivered by MEHT
in the future."

Professor Sheila Salmon, Chair at MEHT welcomed the appointment of Paul Forden, noting: "He will provide inspirational leadership and bring his depth and breadth of top-level management experience and creativity into our organisation. It is excellent to have Paul back serving the NHS. That is where his passion lies and I am confident that he will make a positive impact in Essex."

Paul will be taking up post from September 2013 and in the interim Nick Gerrard, Chief Finance Officer at MEHT, will be acting Chief Executive Officer.

Care, Excel, Innovate

Apply to be a member of our Foundation Trust. See the web site at www.meht.nhs.uk for further details.


Enhanced specialist stroke services at Essex Hospitals under consideration

Clinical Commissioning Groups (CCGs), set to lead the NHS from 1 April 2013, are considering their outline recommendations for moving to the next phase of enhancing stroke services in Essex. The CCGs are examining the case for change in stroke services, subject to affordability and a due diligence process.

Subject to a full assessment of the impact on patients, healthcare providers and ambulance services, the CCGs will consolidate their recommendations around the business case for enhancing stroke services at five main hospitals in Essex.

This would involve creating “hyper-acute stroke units” at three of the main stroke units.

The recommendation is at an early stage and subject to further work and public consultation later in the year.

Hyper-acute stroke units in three hospitals would give all patients in Essex immediate access to top stroke specialists 24 hours a day, 7 days a week. This is not currently available for all patients in Essex.

The hyper-acute stroke units would provide critical care for patients in the first three crucial days of having a stroke. After that, patients would return to their nearest stroke unit, if they needed further specialist care, or they would return home with a full rehabilitation programme.

Dr Tony Rudd, Professor of Stroke Medicine at Guy's and St Thomas' NHS Foundation Trust, led a detailed review of the potential options for Essex, including an options appraisal by a panel of health experts and a patient representative. After a thorough analysis of all the options, the panel came to the view that three hyper-acute stroke units was the right balance for Essex between accessibility for patients and the available specialist clinical expertise.

The CCGs are considering the case for hospitals with enhanced services in Southend, Colchester and Chelmsford to provide “hyperacute stroke units”. All five hospitals in Essex would continue to have an acute stroke unit.

The enhancements are just recommendations at this stage. There is still some way to go before reaching any firm decisions. Further work includes an analysis of the financial implications and how the proposed configuration would work across the county and in conjunction with other hyper-acute stroke units in neighbouring counties and London. An important part of reaching a final decision would be a public consultation process, expected to start in the autumn.

For more details please contact
George Zachariah: george.zachariah@meht.nhs.uk

Nurse and Patient Nurse and Patient

Providing high-quality care for young patients at the Paediatric Ophthalmology clinic

The Paediatric Ophthalmology clinic at Broomfield Hospital treats patients in the mid-Essex area from birth to 16 years.

The team consists of a Paediatric Ophthalmologist, Mr Hamid Porooshani, alongside a number of middle-grade and junior doctors, six Orthoptists, a Prescribing Optometrist and a Dispensing Optician. This team is also supported by secretaries, nursing staff and theatre staff.

Eye problems can start at the time of birth, and can include congenital cataracts, congenital glaucoma and retinopathy of prematurity. As they get older, babies can have problems with watery eyes, strabismus or having abnormal visual behaviour such as seen with a baby with nystagmus. Once they reach childhood, some will develop refractive error, which can either be picked up by community optometrists or caught through the school screening programme

School nurses screen children between the age of 4 and 5 and will refer any child with suspected reduced vision to our secondary screening clinic. These are held in Braintree, Witham, Maldon, Burnham on Crouch, South Woodham Ferrers and Chelmsford. The aim of this secondary clinic is to avoid negative referrals to hospital. Referrals can be made via the Orthoptic Secretary.

If patients need to be referred to the paediatric ophthalmology clinic at Broomfield, they will usually be assessed by three different professionals. Orthoptists assess their vision, eye movement and measure strabismus. The Optometrist checks if they need glasses, which can be dispensed on site if necessary, and the doctor examines the child to ensure they have healthy eyes.

The paediatric ophthalmology clinic is held on Friday afternoons at Broomfield Hospital.

Referrals can be made via the Choose and Book system but referrals by mail or fax are also welcome. The referrals can be sent to Mr Porooshani’s secretary, angela.sclater@meht.nhs.uk

Tel: 01245 514855 Fax: 01245 516110.

If you have any questions about our screening service or any other paediatric eye concerns, please contact our Head Orthoptist, Mrs Linda Melvin, via the Orthoptic Secretary Yvonne Bright

Tel: 01245 514500 Fax: 01245 516330.

Pictured (right):
Mr Hamid Porooshani – Paediatric Ophthalmologist
Chris Day – Dispensing Optician
Linda Melvin – Head Orthoptist
Yvonne Bright – Orthoptic Secretary
Brian Driffill – Optomotrist
Emily Murdock – Senior Orthoptist
Miss Arun Borman – ST

Also in the team:
Sharon McCabe – Senior Orthoptist
Linda Kelly – Senior Orthoptist
Sian Handley – Senior Orthoptist
Victoria Wilson – Senior Orthoptist
Carole Oughton - Junior Sister

We innovate
StaffFocus 23rd Nov 2012
Nurse and Patient
Cutting-edge surgery taking place at Broomfield
Consultants at Broomfield Hospital are now working together to provide faster and more effective treatment for patients requiring pelvic floor surgery.
The new pelvic floor unit brings together urology, gynaecology, colorectal, radiology and physiotherapy staff to ensure seamless care of patients from diagnosis to treatment.

Mr Shahab Siddiqi, Colorectal Surgeon, explained: “Pelvic floor surgery is a relatively new field, and as our understanding in the area has developed, we have been able to establish new and efficient ways of treating patients. Many pelvic floor repair cases require more than one procedure, and previously, patients would have been referred to more than one consultant for treatment. By working together in theatre, the patient will only require one surgery and as a result will spend less time in hospital.”

Surgeons use the da Vinci robot to perform many of the procedures, making Broomfield Hospital one of the few centres in the country to combine robotic surgery with existing surgical techniques to carry out pelvic floor repair surgery.

Mr Siddiqi continued: “Using the robot brings a number of advantages to both the consultant and the patient. I find it faster and more accurate to perform surgery with, and, since it is a less invasive procedure, it means fewer complications and a shorter recovery time for the patient. Having the robot allows us the flexibility to use whichever method of surgery we feel is best for the patient.”

For patients with conditions such as pelvic organ prolapse, faecal and urinary incontinence, and constipation, surgery may be the best option. However, many can be treated through a combination of diet, exercise and medications. Consultants work with the community continence team to decide on the best course of treatment for patients.

The core unit consists of:

Shahab Siddiqi – Consultant Colorectal Surgeon
Paul Fiadjoe – Consultant Urogynaecologist
Bill McAllister – Consultant Urological Surgeon
Nigel Richardson – Consultant Colorectal Surgeon
Louise Shea Simmons – Pelvic Floor Physiotherapist
Dr Peng Lee – Consultant Radiologist

For further details please contact Mr Shahab Siddiqi: shahab.siddiqi@meht.nhs.uk
Latest News
Nurse and Patient
The Trust website
The Trust website is currently undergoing a major redesign of look and content to give patients and visitors as much useful information as possible before they visit the hospital.

Site maps, parking details, travel information and service details will all be updated

An important part of this redesign has been the updating of the consultant pages. These pages give visitors to the website information on the consultant’s specialist areas, their areas of interest, where they studied, their GMC number and previous experience. Contact details for the consultant are also included on each page.

To ensure emails sent to the consultants get responded to quickly, department email accounts have been set up for specific which have groups of secretaries within that department overseeing e-mails sent in, rather than relying on a single secretary who might be on leave.

These pages are still being updated, but a majority of the information has already been processed and the remaining information is being updated regularly.

We are keen to hear your views on what you would like to see on the website, both professionally and for your patients.

Please feedback any thoughts and ideas to communications@meht.nhs.uk

MEHT Commissioning Team

Helen Hughes, Director of Performance & Business Planning, is the lead director for the MEHT Commissioning Team.

The team comprises the following people:

Elizabeth Podd Deputy Director of Commissioning elizabeth.podd@meht.nhs.uk 01245 514346
Kelly Pinder Contracting kelly.pinder@meht.nhs.uk 01245 516640
Caroline Holmes Head of Data Quality & Coding c.holmes@meht.nhs.uk 01245 515239
Ian Harrison Head of Information ian.harrison@meht.nhs.uk 01245 515008
Liz Stewart Information Governance Manager liz.stewart@meht.nhs.uk 01245 514536

The commissioning team launched a central secure email address in order to receive direct feedback, suggestions and queries with regard to any element of service or care MEHT offers or provides to local people. After Helen recently attended the CCGs primary care forum meeting we are aware that not all practices were aware of this facility so we are taking the opportunity again to remind you it’s there and assure you that the email address is looked at daily. We then forward your questions and queries the most appropriate MEHT Team or employee to answer and ensure this is done in a through and timely manner. For all specific consultant patient enquiries, please continue to use the Choose and Book Advice & Guidance service.

Please note, where appropriate some queries and issues will be escalated and managed through the formal process.

This year's priority areas

MEHT have agreed with the CCG to specifically focus on improving the quality and timeliness of discharge letters from all areas of the hospital. The Trust have signed up to a range of performance improvement targets. Our achievement will be audited by the CCG in the near future. We look forward to receiving the results, which will inform us where to concentrate our focus.

We care. We excel. We innovate. Always
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Apply to be a member of our Foundation Trust. See the web site at www.meht.nhs.uk for further details.