Issue 102 • April 2012

Pennine NewsT O P R O V I D E T H E V E RY B E S T C A R E F O R E A C H PAT I E N T O N E V E R Y O C C A S I O N

VoluNteeRspRoVIde ACtIVIty theRApy

• Emergency surgery in cutting edge operation

• Birth of a new era as services transfer

• Celebrating one year of UCC

• Get your nominations for staff awards 2012 in now!

In the news2 April 2012

ContentsBirth of a new era as services transfer . . . . . . . . . . Pg 4

Footballer praises Oldham . . . Pg 4

Food for thought . . . . . . . . . Pg 5

New head of nutrition and dietetics . . . . . . . . . . . . . Pg 5

Endoscopic ultrasounds new service offered . . . . . . . Pg 6

Volunteers provide activity therapy . . . . . . . . . . . . . . . . . Pg 6

Warding off criminals at TROH Pg 7

UCC and CAU celebrate first birthday . . . . . . . . . . . . . . . . Pg 7

Professor leads simulation . . Pg 7

Warding off criminals at The Royal Oldham . . . . . . Pg 7

One year of Rochdale’s UCC Pg 7

Diary dates . . . . . . . . . . . . . . Pg 7

Core brief . . . . . . . . . . . . . . . Pg 8

Team focus on end of life care team . . . . . . . . . . . . . . . Pg 9

National year of pathology . Pg 10

New TAU at NMGH . . . . . . . Pg 11

Thought for the month . . . . Pg 11

Staff noticeboard . . . . . . . . . Pg 12/3

National heart failure audit Pg 14

Infectious diseases unit bumper cake sale . . . . . . . . . Pg 14

Staff awards 2012 . . . . . . . . Pg 15/6

AN international conference saw many countries looking to adopt systems which have worked at Pennine Acute .

Allan Cordwell, the Trust’s emergency planning manager, attended the five day Healthcare System Preparedness and Response to Emergencies and Disaster conference in Tel Aviv, Israel and was invited to speak on methods which had been successfully implemented at the Trust .

He said: “A representative from the Laniado Hospital in Israel initially approached me about the CBRNE (chemical, biological, radiological, nuclear and explosives) and Hazmat (hazardous materials) models of management that I had designed and employed at Pennine . She believed that there would be world wide interest in the application of our response to threat processes and the maintenance of service continuity whilst responding to an incident .”

Speaking to around 300 delegates, Allan described how he had instigated the procedure around the management of contaminated patients and the processes that have been put in place to support them . This includes the specialist operational training of all staff within A&E departments in how to deal with CBRNE and Hazmat incidents . As well as ‘live’ exercises and an exam at the end of the training, staff have also had to deal with four separate incidents at three Pennine Acute hospital sites where ‘white powder’/toxic industrial contaminations occurred .

Gaining positive feedback from the lecture, Allan has now been invited to speak at the National Conference on Medicine Informatics at the All India

Institute of Medical Sciences in New Delhi, plus the Dutch Government will be sending representatives to attend Pennine’s two day CBRNE / Hazmat Course . The Centre for Disease Control in Atlanta, USA have also expressed an interest in adopting some of Allan’s work into their guidance for US hospitals and web site pages .

Allan said: “The conference as a whole illustrated to me that unresolved issues which PAT, other acute trusts and the UK experience, are not unique . By forging international links there are potential resolutions that can be sourced and applied to the UK models of emergency management and service continuity and vice versa .

“The whole Tel Aviv experience was interesting to say the least! It rained for the first time in six months as I arrived and there are around 10,000 feral cats loose around the city!”

Inside NewsTHE Trust has several communication tools to help keep staff up to date:

Core brief is sent round monthly, for use in all team briefings .

Weekly bulletins are emailed on Mondays and contain a range of operational and site information .

A medical director/nursing director bulletin is circulated monthly .

Online copies of all the bulletins and core brief, plus more, can be found on the Trust intranet at nww .pat .nhs .uk/communications

You can send your stories for either Pennine News or for local media to Trust communications at trust .communications @pat .nhs .uk, or call Nicola Berry on 44284 .

If you have any ideas, views or suggestions regarding communications across the Trust, please email staff .views@pat .nhs .uk

Revised retirement policyTHE Trust has agreed a revised retirement policy which sets out the Trust’s procedures in relation to retirement and flexible retirement .

From 6 April 2011, the Trust will no longer issue notifications of compulsory retirement and will no longer compulsorily retire staff . Employees will be able to make the decision about when they wish to retire, subject to the rules of the NHS Pension Scheme .

For flexible retirement, staff will be able to reduce their hours in advance of retirement, undertake a less demanding role or retire and start to receive an NHS pension, but return to work following a break in service of seven calendar days .

The policy can be viewed on the Trust intranet under documents . Line managers should ensure that staff who do not have direct access to the intranet can see a hard copy of the policy . Any questions should be directed to your divisional HR team .

No pANIC As peNNINe ACute leAds the wAy

emergency surgery performed under local anaesthetic in cutting edge opA Middleton man has praised the trust for saving his life in an emergency keyhole surgery operation.

John Farrell was rushed into North Manchester General Hospital in January after falling ill at home . Semi conscious with pain and discomfort, Mr Farrell was diagnosed with a leaking aneurysm which needed immediate treatment .

A surgical team, headed by consultant vascular surgeon, Mr Riza Ibrahim was scrambled at The Royal Oldham Hospital, and Mr Farrell was transferred there where he underwent surgery .

With a 25% chance of survival, the team which comprised Mr Ibrahim; vascular specialist registrar Natasha Charlwood; consultant anaesthetist Dr Gareth Vickers; consultant radiologist Dr Abysinia Sibanda; specialist radiographer Steve Trimble and scrub nurse Sarah Marshall, knew that they were up against it, both in terms of time and in the technique used to repair the rupture .

Mr Ibrahim said: “An aneurysm is a dilatation of a blood vessel . The aorta is the main blood vessel in the body and is connected to the heart . It is normally the size of a garden hose, but in some people it can blow up like a balloon and when it does so, it is called an aneurysm .

“As with blowing up a balloon, if the pressure continues to increase it can burst . An aneurysm which ruptures is usually fatal with 50% of ruptured aneurysm patients dying at home, and 50% of those who make it to hospital can also die . Only 25% of ruptured aneurysms actually make it to emergency surgery and survive .”

Ruptured aneurysms have traditionally been treated with an emergency operation which involves a general anaesthetic and a large incision in the abdomen and replacement of the ruptured aorta with an artificial graft . The patients usually have a long stay in intensive care and the mortality rate is very high .

Aneurysms are therefore usually treated electively before they rupture, and with the introduction of the national aneurysm screening programme, all men on their 65th birthday are invited for an ultrasound scan and if an aneurysm is picked up they are referred for treatment . In spite of this however, most aneurysms are still picked up as incidental findings when a scan has been done for another reason or when patients present as an emergency at hospital with a rupture .

Mr Ibrahim continued: “Traditionally aneurysm repair has been done by an open operation, where the diseased

aorta is replaced by an artificial tube . This is a major undertaking even in an elective setting and the traditional method has now largely been replaced by a key hole technique where a graft is placed inside the aorta through small incisions in the groin .

“This has reduced the morbidity and mortality of the procedure, but unfortunately it requires careful planning so that a stent that fits the patient's aneurysm can be ordered . Given this, when a ruptured aneurysm presents, the logistics of getting this done in an emergency setting is significant .”

There is increasing evidence that repairing a ruptured aneurysm by the key hole method reduces mortality and this procedure is now being performed by a few units across the world . Pennine Acute does carry out a large volume of

3In the news

Northern Air shortlistedNORTH Manchester’s hospital radio ‘Northern Air’ could hopefully soon be playing Cliff Richard’s track ‘Congratulations’ to itself!

The station which broadcasts 24 hours a day to both North Manchester and Salford Royal Hospitals, has been shortlisted for two categories in the National Hospital Broadcasting Awards .

Over 200 stations throughout the UK entered the awards, and these have now been whittled down to the final ten for the grand awards event at the end of March .

Station manager/programme controller Dave Bee has been shortlisted as the male presenter of the year and Hilary Bowick has been shortlisted in the specialist music programme for her Disney special .

The National Hospital Radio Awards is an annual celebration of the excellent standards found in hospital radio stations across the country . They are open to any HBA member station and are divided into different categories, each one recognising a specific area of excellence . Most of the categories recognise gold, silver, and bronze winners .

Dave said: “I have been lucky enough to have been nominated nine times in the last 10 years . I have already won a bronze and silver award, and so hopefully this year, I can add a gold one to my collection! The station has also won dozens of top ten certificates in several categories over the years .”

key hole elective aneurysm repairs, but until Mr Farrell became ill, the vascular team had not performed the procedure as an emergency repair .

Undergoing an hour long operation which involved a key hole repair under local anaesthetic, Mr Farrell was soon back on the high dependency unit, where he stayed for two weeks, before being discharged home . Now recovering well, he said: “I can’t thank Mr Ibrahim and his team enough for saving my life . I was told when I was rushed into hospital that I was very lucky as 80% of people die immediately . I didn’t worry too much about the operation as I knew that I was in safe hands .”

Birth of a new era as services transfer

lABouR ward co-ordinator Rose-Marie Newport is just one of forty members of staff who have been welcomed by colleagues at North Manchester General hospital maternity team following the transfer of inpatient maternity services from Fairfield General hospital.

Inpatient maternity, paediatric and neonatal services relocated to the new £35m purpose built women and children’s development at North Manchester General at the end of February .

Women in Bury will now choose to have their baby at either the new maternity unit at NMGH or The Royal Bolton Hospital .

Other maternity services, including routine outpatient antenatal care and scans, will remain at Fairfield General Hospital . This includes the hospital’s new Antenatal Day Unit which will play a vital role in limiting the need for most women to travel to hospitals outside the area for treatment .

Midwives, healthcare assistants and ward clerks have also transferred over to the maternity assessment unit, ante natal clinic, antenatal and

postnatal wards, labour ward, community and the birth centre at North Manchester .

Rose-Marie said: “We had a close knit group of midwives at Fairfield who had worked together for numerous years, with many of us having our own babies on the maternity unit at the hospital and

looking after each other . We have cared for around 2,500 mothers, babies and their families over the years and we were very proud of the service we provided .

“Our colleagues at North Manchester have been really helpful in getting us settled in and they arranged shadowing visits before we moved so that we could see the areas which we would be working in . It really feels like the end of an era for us, but although the new maternity unit at North Manchester is a lot bigger than what we have been used to, we know that we will continue to offer the same high quality of care to women and families in our new jobs .”

The changes to maternity and children’s services at Fairfield General Hospital are part of the Making it Better (MiB) programme – the reorganisation of children’s and maternity services across Greater Manchester to provide improved healthcare in the community and concentrate hospital services in fewer, larger units .

Pictured: Midwife Regina Sammut in the birthing pool at North Manchester General Hospital with labour ward co-ordinator Rose-Marie Newport.

In the news4 April 2012

Sister Susan Briscall, ward manager, said: “Stephen was admitted to the A&E department at 4 .37pm on Saturday and after having an x-ray which confirmed his fractures, he was admitted to the TASU at 6 .50pm . Just over 15 hours later, he was operated on at 10 .30am and had a metal plate inserted in his leg which is fixed with screws . A protective cast in the red and black colours of his football team was applied and he was then discharged home on Tuesday .

“The ward team were really pleased to treat him and it shows that changes made recently in the

emergency trauma and orthopaedic service have benefited patients like Stephen as he was able to be

seen and treated much quicker by a specialist team .”

Stephen said: “I was very impressed with the care, treatment and service I received at The Royal Oldham

Hospital . The new TASU is wonderful . My side room was a good size and the staff couldn’t have cared for and looked

after me better . I have been in many hospitals and private clinics during my footballing career and I have to say that The Royal

Oldham Hospital is one of, if not the best!

“Once again, my sincere thanks and gratitude go to all the staff at The Royal Oldham, who looked after me so well .”

A PROFESSIONAL footballer from Bournemouth Athletic Football Club has praised the staff and services at the Trust following a successful operation at The Royal Oldham Hospital .

League One defender Stephen Purches, 32, suffered a double leg fracture on Saturday 18 February whilst playing for his team away at Rochdale against Rochdale Town FC . During the opening moments of the match, Stephen broke his tibia and fibula in a challenge with Rochdale’s Gary Jones .

Taken straight to The Royal Oldham Hospital by ambulance, Stephen was treated on the hospital’s new Trauma Assessment and Stabilisation Unit (TASU) which opened in December 2011 and which was featured in last month’s Pennine News .

praise for the Royal oldham from football star

Zoe joins as new manager for the teamTHE opportunity to make a real difference to nutritional care and the way it is delivered has brought Zoe Cook over the Pennines from Leeds to become the new professional head of nutrition and dietetics at the Trust .

With 20 years experience advising on clinical nutrition in hospital, community and mental health settings, Zoe has also had articles published in the Yorkshire Evening Post, nutrition magazines and appeared in the Yorkshire Television documentary series ‘Jimmies’!

Based at The Royal Oldham Hospital, Zoe (pictured below left) is looking forward to working with the two teams that are dietetics and clinical professions . She said: “There is a wealth of local and professional knowledge within the services and I am keen to harness this to inform my role .

“In the short space of time I have been at Pennine Acute, I have seen some excellent examples of good practice within nutrition and dietetics from some very committed and compassionate dietitians and assistants . The hard work was positively reflected in the CQC report on Nutrition and Dignity in July last year and I am keen to keep this momentum going and continue to raise the profile of nutrition, ensuring we are a visible, responsive service .

“In addition, I do think we still have a long way to go in ensuring patients receive adequate food and drink in hospital and receive the appropriate support to consume what is provided . There is no doubt we have some very useful documentation around food, mealtimes and nutrition, which is supported by robust guidelines . It is essential we have this to underpin nutritional care, but sometimes the practicalities can be lost in academia . I definitely think there is mileage in going back to basics and really looking carefully at what patients need and want to eat and drink, what we are providing and how much is consumed .”

As the professional lead for nutrition and dietetics, Zoe will be strategically leading the team, ensuring the service is cost effective, delivers measurable outcomes and meets the needs of the local population . “We have real opportunities to improve the nutrition of the local people, some of whom suffer

the worst health in the country .”

A mother of five, who enjoys reading, theatre and singing, Zoe describes herself as a passionate ‘foodie’ . She said: “I love to eat! However, I am mindful that people’s relationships with food can be complicated, but I feel strongly that everyone should be able to get enjoyment, as well as health benefits from their food .”

▼

5Feature

Food for thought in nutrition

and hydration week

the importance of good nutrition and hydration for patients in recovering from illness and in the prevention of complications was highlighted during national Nutrition and hydration week.

Held during January, the Trust got behind the National Patient Safety initiative which was led by the National Patient Safety Agency (NPSA) and Patient Safety First .

A Trust screensaver was developed to publicise the week which included a number of interactive Web Ex sessions and activities to encourage people to become involved . A leadership walk where members of the catering department, nursing teams and members of the nutrition and department also took place . They visited wards at The Royal Oldham and North Manchester General Hospital to observe meal times and speak to patients and ward staff about their experiences and issues .

The walk round included looking if patients had access to fresh drinking water, had assistance with feeding when required, that there was evidence of protected mealtimes and that patients and their environments were prepared for mealtimes, as well as assessing the quality of the food provided to patients .

The observations made were fed back to the Trust’s nutritional steering group

which is chaired by director of nursing, Marian Carroll . Suzy Hilton, dietitian section manager, acute, at The Royal Oldham Hospital said: “It was agreed that this activity had been very useful and that future walk rounds should be planned to encourage existing good practice to continue, and to monitor improvements that were identified in other areas .

“These improvements which included re-launching protected mealtimes, ensuring water jugs are changed regularly and encouraging hand hygiene of patients before mealtimes will be added to the action plan of the Food and Nutrition Group, a sub group of the Nutritional Steering Group, which has representation from nursing, catering and nutrition and dietetics teams .”

Helen Smith, healthcare assistant; Julie Mills, clinical matron surgery; Zoe Cook, professional head nutrition and dietetics; Steven Lowe, catering services manager; Kath Mills, food operations co- ordinator and Jean Taylor, housekeeper.

Volunteers provide activity therapyVOLUNTEERS have been helping staff at the Trust in providing stimulation for patients on medical and stroke rehabilitation wards . Part of the ‘Impres Project’, introduced in 2011 by the Greater Manchester and Cheshire Cardiac and Stroke Network - the aim is to improve rehab services by increasing the amount of meaningful activity for patients .

The activities volunteers work on ward E1 at North Manchester General Hospital, G1 at The Royal Oldham Hospital and ward 19 at Fairfield General Hospital .

Supporting staff on the wards, the volunteers carry out a variety of one to one activities with patients, which include playing Connect 4, completing jigsaws and crosswords, supporting patients in going through reminiscence newspapers and carrying out various arts and crafts activities . They also support therapists in running groups such as lunch clubs and bingo sessions .

Abby Fisher, occupational therapist, who supervises the volunteers on ward E1, said: “It has been shown that increasing the amount of

meaningful activity complements patients’ therapy sessions by improving their mood and helping them to achieve their rehabilitation goals . Patients return home sooner and more able .

“We run a group work programme, which the volunteers help out with . They also undertake one to one ‘prescribed activities’ with the patients –

these are basic activities which most people would find easy to manage . For some patients, however, these can be difficult tasks because they may have limited use of one of their hands, struggle to see items on one side of their environment or have problems with concentration . These activities can help them to re-learn some of the skills which they may have lost as a result of a stroke .

“It is fantastic having the support of the volunteers . The patients really enjoy the social interaction as it breaks their routine . I would like to thank all of the volunteers for their enthusiasm and time .”

Marion Buckley, a patient on E1 ward at North Manchester General Hospital, said: "I enjoy the activities the volunteers run . It's more interesting doing groups or seeing the volunteers than reading alone . It's kind of them to spare the time ."

If anyone is interested in supporting this scheme and helping out on the wards, please contact Voluntary Services on 0161 604 5892 .

Patients Marion Buckley, Sheila Borkin and Colin Hoskinson get active with the Trust team on ward E1.

News - trust stories6 April 2012

The procedure which combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs is a relatively new diagnostic tool, but it is already proving to be invaluable in providing information on the prognosis of a cancer patient in relation to the stage at which their cancer is at .

Dr Atta Abbasi, consultant gastro enterologist has undertaken specialist training at The Royal Blackburn Hospital and University Hospital Aintree, and along with clinical nurse lead Elaine Graham and the staff within the endoscopy unit, they now perform around 12 EUS per month .

Investing £200,000 into the service, the Trust has purchased one ultrasound machine and two scopes for the procedure .

Dr Abbasi said: “The new service allows us to get a much more accurate picture in diagnosing what is wrong with a patient . The endoscopy refers to the procedure of inserting a long flexible tube via the month to look at the digestive tract, whereas the ultrasound uses high frequency sound waves to produce images of the organs and structures inside the body such as the gallbladder and pancreas .

“Traditional ultrasound sends sound waves to the organs and back with a transducer placed on the skin over the organ which you want to look at .

Images obtained in this way are not always of a high quality, but in EUS, a small ultrasound transducer is installed on the tip of the endoscope . By inserting the endoscope into the upper or lower digestive tract, you can obtain high quality ultrasound images of the organs inside the body .

“We can also obtain tissue samples by passing a special needle, under ultrasound guidance, into suspicious tumours . The tissues and cells can then be examined by a pathologist under a microscope .”

Clinical nurse lead Elaine Graham, has relished the training and the chance to undertake the new practice . She said: “The whole procedure takes around 30 to 45 minutes to complete . Patients are sedated and so only feel minimal discomfort . It’s fantastic that we can now see the inside of the intestinal tract on a TV monitor, plus at the same time, the ultrasound image on another monitor .

“As the facility is now available within The Pennine Acute Hospitals NHS Trust, this makes it so much simpler for patients as they no longer have to travel to other hospitals to be diagnosed . The surgical team can therefore in effect close the gap for the patient and ensure that they are treated completely within Pennine hospitals .”

Due to the demand for the service, there are plans to set up a second EUS list at NMGH with Dr Hammonds, consultant gastroenterologist .

endoscopic ultrasoundsA new service offered at pennine Acute is set to improve the patient pathway and experience by providing a specialist diagnostic procedure at North Manchester General hospital.

Previously patients had to travel to hospitals throughout the north west region for an endoscopic ultrasound (EUS), but this is now available within the endoscopy unit at North Manchester for patients undergoing tests for gallstones, pancreatic tumours, cysts and strictures (narrowing) of the bile duct .

7In the news

Celebrating first birthday of Rochdale’s UCC and CAU

Professor leads the way in simulationPROFESSOR Pramod Luthra, consultant had and plastic surgeon at The Royal Oldham Hospital and associate postgraduate dean at the North Western Deanery has been appointed as the visiting professor to the department of health care, psychology and social care at Manchester Metropolitan University . He is also visiting professor to the faculty of education at Edge Hill University .

As visiting professor, he has jointly led a team that has developed a programme leading to a postgraduate certificate in simulation and clinical learning at Edge Hill University and a module on simulation based learning in a Masters programme at Manchester Metropolitan University .

He said: “The use of simulation allows us to learn and practice in a safe environment, allowing the skills learnt to be transferred to safe patient care .”

He leads simulation based learning for the North Western Deanery and is also a member of the simulation working group for the Joint Committee of Surgical Training (JCST) UK .

diary dates

2 April - New rheumatology unit opens at Rochdale

6 April - Good Friday

30 April - deadline for staff awards nomination forms

warding off criminals at hospitalSECURITY has been stepped up at The Royal Oldham Hospital in a zero tolerance approach following a spate of thefts .

A dedicated police officer, PC Rosie Richardson has been assigned to the hospital to protect and educate staff, patients and visitors .

The new post is in addition to the local neighbourhood policing team already based at the hospital and a much needed boost for hospital security staff . PC Richardson’s role will not include dealing with troublemakers in the A&E department on busy Friday and Saturday evenings, as this is already patrolled by officers .

She said: “A lot of people think because it’s a hospital they can leave their belongings around - but unfortunately you can’t do this .

“There has been a few theft problems, for example, a member of staff had her car keys stolen and her vehicle was taken - plus outside workers, constructing the

new maternity unit have had items stolen .

“So many people come into the hospital and my job is to educate people about the risk of crime at the hospital and make people more safe in a comfortable environment .”

She warns those who step out of line face being slapped with anti-social behaviour orders for the hospital .

Pam Miller, associate director of facilities at PAT, said: “The safety and security of our patients and staff is extremely important to us . We work closely with Greater Manchester police and constantly look at ways in which we can work together to support and improve the Trust’s security arrangements wherever possible .

“PC Richardson will work closely with our staff across the hospital and members of the public when necessary .”

Photo courtesy of Oldham Evening Chronicle.

STAFF at Rochdale Infirmary’s Urgent Care Centre (UCC) and Clinical Assessment Unit (CAU) are set to celebrate their first full year in operation since opening on 4 April last year .

Replacing the former A&E department and Walk-in centre at the Infirmary, the UCC is open 24/7, 365 days a week . It consists of a team of GPs and nurses who have the skills to treat approximately 85% of patients who would have previously been treated at the A&E department . To date, over 45,000 patients have been treated at the UCC .

Patients with very serious injury or illness (999 calls) are taken, usually by ambulance, to neighbouring A&E departments or a specialist hospital, where appropriate .

The largest proportion of attendances to the UCC since opening has been residents from Heywood, Middleton and Rochdale areas . Figures show that the majority of patients attend the UCC between the hours of 8am and 10pm . Almost 70% of all UCC attendances live within 3Km of the UCC and only 5 .6% live more than 5Km away .

Nicola Rigby, UCC nurse manager, said: “It was important to ensure that the service was quickly established and accepted by our local community . This was soon evident from the number of patients coming through the doors and from the excellent feedback we continue to receive from our patients .”

The Clinical Assessment Unit (CAU) for adults opened at the same time as the

UCC . The 12-bed unit provides rapid patient assessment and treats patients who are referred directly from their local GP, from the community, or come via the UCC . Patients are assessed, observed and treated on the CAU usually up to a maximum of 48 hours . Over 5,000 patients have been treated there since April 2011 .

Sister Lou Harkness-Hudson, nurse manager, said:

“The CAU is the only one of its kind and it has proved very successful because everyone in the team has had a hand in making it so . We are very proud of what we have achieved in our first year and are constantly thinking of ways to improve the service .“

Core brief - team talk8 April 2012

have you been briefed?Core brief takes place once a month and is a way of updating you about the latest news from the trust.

Mixed sex accommodation - declaration of compliance

EVERY patient has the right to receive high quality care that is safe, effective and respects their privacy and dignity . All NHS Trusts and providers of NHS funded care are required to confirm they are compliant ‘to eliminate mixed sex accommodation except where it is in the overall best interests of the patient, or reflects their patient choice’ . The Trust was able to confirm that we are compliant with the Government requirement .

4 hour emergency access standard THE Trust continues to perform well against the 4 hour emergency access standard across all sites . The Board would like to thank staff, not only in emergency departments but across all services, for the hard work and commitment to ensure patients are treated, transferred and discharged promptly and appropriately . This is an important national target which prevents patients having lengthy delays in A&E .

New calculators for Nhs pension scheme proposals

UPDATED NHS Pension Scheme calculators are now available on the Department of Health website . The calculators allow members of the scheme to a) estimate their future benefits and b) see any changes to their current scheme under the Government’s new proposals . They have been developed by an independent pension specialist, working with NHS trades unions, the Department of Health and NHS employers . www .dh .gov .uk/health/2012/02/ pension-calculators

Changes to radiology on-call services

FROM 5 March 2012 the out of hours radiology service changed Trust wide to support the introduction of a formal interventional radiology on call rota which will provide improved support for vascular, urology and surgical services out of hours . The new radiology on-call service Trust wide will be provided by a single radiologist from 5pm each weeknight until 9am the following day and from 9pm Saturday and Sunday evening to 9am the following day . Weekend daytime cover between 9am – 9pm is provided locally at NMGH as it is currently and at Oldham and Fairfield by a merged rota to provide a dual site service .

ALL referrals MUST first be discussed with the consultant clinician on call before calling the radiologist . Consultant radiologists will no longer accept calls from any junior doctors . Calls will only be accepted from consultants, on-call registrars and named middle grades in A&E .

When calling the on call radiologist, it is essential that you inform switchboard whether you require the general or interventional radiologist . During weekend days you should stipulate the site of origin so that the Switchboard team can direct your call accordingly . At NMGH between 9am and 9pm calls should be directed to the radiology registrar first on call .

Ultrasound will NO LONGER be available out of hours apart from during 9am – 9pm Saturday and Sunday .

decommissioning - consultations into proposed job lossesAS reported in last month’s Core Brief, the Trust has made it clear to staff and externally that since April 2011, the number of patients being sent to hospital for certain outpatient appointments and minor surgical procedures has fallen significantly over the last twelve months .

The reduction in referrals is linked to the use of explicit evidence based clinical referral criteria which has reduced the number of patients being sent to us . Operations for conditions that have limited health benefits are only being carried out when GPs and hospital consultants consider there is exceptional clinical need . In addition, many conditions are being treated closer to people’s homes in primary and community healthcare premises .

This reduction in the number of patients we are treating (i .e . activity) has a direct impact on the income we receive . This reduces our income by a further £21m . With less income, we have less money to spend on our services . This may result in up to 160 job losses across the Trust .

The Trust is starting a 90 day period of consultation with Trades Unions to explain the full impact of this significant reduction in income, the effect on services and the measures the Trust is taking to avoid job losses . Every effort will be made to ensure that the necessary reductions in staffing, where possible, will be achieved through voluntary means but compulsory redundancies cannot be ruled out .

The overwhelming majority of hospital services and essential services, including cancer services, A&E and all emergency services, maternity and children’s services, as well as acute medical and major surgical services will not be affected . These changes will not result in any rise in waiting list numbers or waiting times for patients and the national standards set by the Government will be met in 2012/13 .

Core Brief

A typical dayI can honestly say that no two days are the same . The variety in the job is very exciting and a great motivator working with different people to bring about a change process . Meetings are a key element, such as attending the Organ and Tissue Committee that are supporting the future implementation of offering bereaved relatives the choice of fulfiling loved ones wishes to donate tissue . A draft policy is work in progress and policy writing, reviewing and ratifying documents can dominate certain days . Teaching is a key part of the role and this can vary from ward based teaching to the classroom setting . I can be project managing in the morning to meeting colleagues in the afternoon planning for the third Pennine palliative care conference, in partnership with NHS Manchester .

The 60 econd interview

what are the highlights of your job/service?

what don’t you like about your job/service?

what would make your job/service better?

what word best describes your job/service?

what is the current biggest challenge in your

job/to your team?

what is the one thing you would change about your

job/service?

how do you see your role developing?

what aspect of your job/service is the most

rewarding?

how has your job/service changed?

team focus - a day in the life of

It has changed beyond recognition . The team did not exist within the Trust 18 months ago and now the amount of work being undertaken for patient and carer benefit is tremendous .

Knowing that all the work the team engage in is for the improvement of the end of life care journey, and into bereavement, for patients in Pennine Acute . Dame Cicely Saunders, who was a prominent Anglican, nurse, physician and writer, who helped the dying and terminally ill end their lives in the most comfortable ways possible said: “You matter because you are you, and you matter to the end of your life . We will do all we can, not only to help you die peacefully, but also to live until you die ." We aim to do the same .

There is a fantastic task and finish group in the Trust, chaired by Dr Iain Lawrie, and knowing that all services are working together to make improvements is very heart warming . All the team’s input is greatly appreciated .

I see my role developing alongside new and exciting national initiatives, such as the piloting of the Routes to Success in acute hospitals . I am looking forward to the results from pilot areas so that a forward plan on new areas can be developed for Pennine, such as introducing an infrastructure to offer patients the choice to complete an advance care plan .

If resources allowed, extending the team so that ward based presence could be increased to support the excellent work that ward staff undertake, such as using the Liverpool Care Pathway for the Dying Patient, version 12 .

The size of the end of life care strategy agenda and having enough time to fully implement streams of work that come from the North West End of Life Care model . Standardising best practice on all sites when there are only two permanent team members can be a challenge .

In a word-essential

An increase in team members . It would be fabulous to be able to have an end of life care facilitator based on each site . I realise that this is a new service and the team has only been in existence since 2010, so the positive is that Pennine have an end of life care team that hopefully can be built upon in the future . Trudy Taylor, administrative support, joined the team in March and is a very welcome, and much needed, addition to the service .

The thing I dislike most about the job is time pressures . I sometimes get frustrated not being able to spend as much quality time as I would like with colleagues .

Working alongside very caring dedicated professionals . I have recently been joined by Gaynor Barlow who is on a 12 month secondment into the team and Jane Ashworth who is also on a secondment as end of life care and palliative care educator for Oldham, hospital, community and hospice . The team works very closely with the specialist palliative care teams across all sites and it’s a real pleasure to work with people with the same aim, to help give people the best quality of life possible whilst having a life threatening illness .

Christine taylor is the Macmillan end of life care facilitator working in the end of life care team.

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team focus on end of life care team

“Excellent tour, exceeded my expectations . Please thank the staff for their time and patience and for their hospitality in inviting the public into a busy working environment .”

“Very informative and well presented .”

“Excellent tour – learned much more than I thought I would – increased confidence and reassurance in path lab services .”

“Beyond my expectations it was fascinating – the demonstrations done were excellent .”

pAt joins celebrations for national year of pathology

facility . The key driver for us is that patients get accurate results quickly, secure in the knowledge that the individuals screening their specimens are experts .

“This year is ‘National Pathology Year’ and marks the 50th anniversary of The Royal College of Pathology and 100 years of Biomedical Sciences . This event offered a great opportunity for the public to see how our pathology laboratory functions and what we do here .”

Photos courtesy of Oldham Evening Chronicle.

THE pathology laboratory at The Royal Oldham Hospital opened its doors and invited the public to an exclusive, ‘behind the scene’ tour of the high-tech facilities in February .

The tour marked ‘National Pathology Year 2012’ and gave visitors an overview of pathology – the branch of medicine concerned with the cause, origin and nature of disease, including the changes occurring as a result of disease .

Hailed a resounding success by the 61 people who took part in the tour, all thought that it was fascinating and interesting .

Opened in 2008, the £17 .5m central pathology laboratory at The Royal Oldham is a state of the art three-storey facility and is one of the largest laboratories of its kind in the UK .

The Trust’s laboratories perform some 20 million tests for the Greater Manchester population, with over 80% of medical diagnoses being based on a pathology testing .

The members of the public on the tour, who ranged from 13 to 70 years of age, were given an overview of the impact of the laboratories’ role in all aspects of healthcare pathways within the Trust and service users in the community . They were treated to tours around all the labs including microbiology, histopathology, biochemistry and haematology .

Len Fielding, pathology directorate manager at the Trust, said: "The central pathology laboratory at The Royal Oldham Hospital is a state-of-the-art

what did they see?In haematology a number of anonymised results were shown highlighting a variety of conditions including anaemia, leukaemia and malaria . A slide show was set up to illustrate the morphological abnormalities which the laboratory had detected and how this fitted into initial abnormal result presentation, laboratory diagnosis and referral to a consultant haematologist .

In cellular pathology there was a presentation showing the dissection room and the type of specimens cellular pathology receives . A microtomy was performed, where a piece of tissue was embedded into a wax block and a section of the tissue cut away and placed on a slide .

Microbiology saw the interested members of the public being shown some of the department’s bigger analysers and the containment level 3 area where ‘high risk’ work is processed . Agar plates containing bacteria such as MRSA and salmonella were also displayed and the staff demonstrated how they perform antibiotic susceptibility testing .

Feature10 April 2012

11News - trust stories

thought for the month by chaplaincy co-ordinator Rev John Hall

CURRENTLY we are in the season of Lent . Now, to many people that may not mean a great deal, but for those of the Christian faith this is a significant time leading up to Easter .

Many people do understand the challenge to give something up during Lent and this will be a challenge to many who try and give up the treats in life that often help us through the struggles we all face .

Once Easter has been reached there is the anticipation of having whatever it is we have denied ourselves during the Lent period . Some people treat it a bit like having a MOT, a time to pause, to renew, replace those broken parts and to anticipate the feeling of refreshment and renewal .

Many patients in hospital feel that MOT effect all too readily as they deal with their physical, emotional and psychological aliments .

Connected to all of these is the spiritual, whether that is faith connected or not . That sense of inner well being, of value and compassion that is so important to good healthcare that is one of our main commitments as a spiritual care multi-faith chaplaincy team .

We all may be feeling in need of a MOT with all the difficult news that we face locally as a Trust, nationally as part of the NHS .

Life is particularly hard for everyone currently . And as we struggle, we mustn’t forget all the examples of excellence that we see and hear about in the health service .

As we find time for our own MOT we need to nurture our own spirituality as we respect others’ spirituality .

Easter is about new beginnings, new hope, and a different way; let us always hope for better as we work alongside one another during these challenging times .

ChANGes to the way in which specialist trauma and orthopaedic services are delivered for patients in Bury and North Manchester have been set in place after months of careful planning.

The Trust has invested £400,000 in the service and established a specialist centre for emergency trauma and orthopaedic services at North Manchester .

From 17 March 2012, orthopaedic trauma patients needing urgent surgery will be taken, usually by ambulance to the specialist orthopaedic team at NMGH . People who attend Fairfield General Hospital with broken bones will continue to be seen and treated at Fairfield’s accident and emergency department, but if they need an urgent operation to repair their injury, they will be transferred to the specialist orthopaedic trauma team based at North Manchester .

The TAU provides a dedicated trauma assessment unit for patients who have been admitted to hospital with a proven fracture of the neck of femur, tibia, fibula, wrist injury or complex ankle injury .

Patients who have undergone an x-ray in the A&E department and who need an operation, will now be fast tracked up to the unit within one hour so that they can be operated on within 24 to 36 hours, as they will be optimised for surgery by the dedicated team consisting of trauma co-ordinators, anaesthetists and an ortho geriatrician .

Nurse manager Alison Jones said: “The ethos of the unit is to provide high quality care to patients . We want to optimise and stabilise them to promote timely surgery . National evidence has shown

that patients who have a delay in getting to theatre for their operation have a higher post operative mortality .”

The trauma co-ordinators focus on managing the patient pathway by keeping the smooth flow of trauma patients being treated within the unit . Their job is about achieving a better pathway for patients and decreasing their length of stay . It involves working with consultants, junior doctors and ward staff to help organise patients coming in, getting them to theatre and discharged . They all optimise patients for theatre by organising tests, chasing results and preparing the patient so that they are ready for their operation .

The unit has 38 beds which are split into seven beds on the trauma assessment unit (TAU), 21 beds in the post operative section and 10 beds in the rehabilitation section . Each section has both bed bays and single side rooms .

Physiotherapists and occupational therapists are on the ward and are able to assess and mobilise patients without them having to leave the ward .

Mr . Ronan McGivney, clinical director for trauma orthopaedic services said: “We believe this is the most efficient and effective way to use staff skills, expertise and resources to provide improved and safer services for patients . By concentrating our expertise and resources we are able to create first class specialist fracture surgery and inpatient orthopaedic surgery services for the people of Bury, North Manchester and surrounding areas .”

Fairfield General Hospital will continue to provide planned (elective) orthopaedic surgery, day case and outpatient services .

specialist trauma centre opens at NMGh

Jess Comer, trauma coordinator; Professor David Sochart, consultant orthopaedic surgeon and site orthopaedic lead at North Manchester General Hospital, Alison Clarke, trauma coordinator and Laura Spaven, support worker . Patient Cameron Lowe, 22, from Failsworth was admitted on 4 March and operated on 5 March .

Welcome to Natalie and PamelaTHE tissue viability service is pleased to announced the arrival of two new members of staff .

Natalie Cavanagh is the equipment co-ordinator to cover the days left vacant, following the reduction in hours of Ann Vickers . She will be available Wednesday, Thursdays and Fridays at the North Manchester and Fairfield sites . Natalie can be contacted on 07659 119 316 .

pamela williams-westwood has joined the team as a tissue viability nurse following the department of Angela Davies to pastures new . She will be based mainly on the North Manchester and Fairfield sites, but will also be offering support to Oldham as required . She can be contacted on pager 07659 108679 .

The team would like to welcome Natalie and Pamela and wish them every success in their roles .

Wedding wishes for a perfect day for Lauren and DavidALL the staff on wards J3 and J4 at North Manchester would like to wish lauren humphreys lots of love and luck on her wedding day in Ayrshire on Friday 6 April . Lauren will be marrying David Rainey .

staff room - noticeboard12 April 2012

Staff noticeboard Let it snow, let it show!A frosty friend made an appearance at Fairfield earlier in the year .

Staff from North ward made the snowman along with patients Damo, Jamie, Lisa and Steve .

Well doneCONGRATULATIONS to Angela Newton and Colin simmonds on successfully completing their NVQ level two in health and social care . From Nicola, Debbie and all the staff on ward G2 at Oldham .

Look who’s 40!HAPPY 40th birthday to staff nurse Joanne denby from ward F6 at North Manchester .

All her friends and colleagues wish her all the very best .

Good health and happiness always Joanne . They say 40 is the new 20 now!!

In memoryJANet Robinson, workforce planning and information manager, passed away on 5 March 2012 following a short illness .

Janet had worked in the NHS for a long time, having started her career in the former Rochdale Healthcare NHS Trust and had, prior to that, worked in the NHS in Yorkshire . She was based at Birch Hill Hospital in Rochdale before moving to Oldham and was

a well respected member of the HR team . More recently she moved to the North Manchester site and oversaw the implementation of ESR for the Trust .

She was a dear friend and colleague and well known for being a kind, thoughtful, caring and helpful person and will be greatly missed by everyone . All our thoughts and prayers are with her family .

RetirementsFond farewells to our colleagues

In memoryANNe Marie Medford (AnnieMed to those who knew her) lost her long battle for life on Tuesday, 21 February 2012 .

She had trained and worked in Oldham from 1979 to 1986, when she then joined the department of

infectious diseases and tropical medicine at Monsall Hospital – working first as a staff nurse, and then as an infectious diseases based specialist liaison nurse for HIV, until she retired on health grounds in 2008 .

Throughout her nursing career with PAT, Anne brought a sense of fun, loyalty, compassion and care to anyone that knew her – patients, friends or colleagues, and continued to support patients through her charitable work with her Church for as long as she was able .

Memories of Anne will be treasured and she will be sorely missed . Heartfelt condolences go out to her family and friends .

Farewell to consultant anaesthetistsWORKING as a consultant anaesthetist at NMGH since 1985, dr Victoria petts graduated from St Mary’s Medical School in 1975 and completed her senior registrar training in Manchester . Dr Petts has been a valuable member of the department, undertaking important roles such as, chair of the department and Royal College Tutor . One of her legacies is the reputation the department has for the ‘Airway Skills course’, attended by all registrars in anaesthesia on the North West Deanery rotation . During her retirement she intends to pursue various interests .

dr Ruth Mayall has worked as a consultant at NMGH since 1993 . Prior to this she worked in Australia and Liverpool . Dr Mayall graduated in 1978 from Manchester Medical School and completed her training in Manchester .

Ruth contributed widely to the teaching of nurses and doctors during her career including introducing simulation training . She also has a strong interest in alcohol addiction and works closely with the Medical Council on Alcohol . She hopes to continue with this area of interest following her retirement from clinical practice .

The department wishes them both an enjoyable retirement .

13staff room - noticeboard

FRIENDS and colleagues would like to wish elsie Mellor all the best on her retirement . She has worked for the Trust at Fairfield in various guises for over 20 years . We wish you well Elsie .

elvet smith, consultant rheumatologist for Fairfield and Rochdale retired at the end of February, after over 30 years service .

Thanks to all who kindly contributed to his retirement gifts and those who attended his modest retirement gathering . Good luck and best wishes from all your colleagues at Pennine . He was a much respected colleague who will be a hard act to follow .

GARy Boothby, head of finance for the division of diagnostics and clinical support, left the Trust on 15 February . Friends and colleagues gathered in the Boardroom at Fairfield House to say farewell to him . Gary had worked for the division since it was formed nine years ago and was presented with gifts and cards by Chris Sleight, divisional director . Gary will be starting his new post at Wakefield Hospital and is wished every success in his new position .

A century of dedication

THESE three happy ladies have plenty to smile about - between them they have clocked up almost 100 years of loyal and dedicated service to North Manchester General Hospital .

Support worker teresa preston, staff nurse Jeanette ellis and support worker Bernice Morrison will finally get to hang up their aprons for a well earned rest .

Teresa came to North Manchester when Monsall Hospital closed and after over 30 years service deserves a break!

Jeanette started as a cadet at North Manchester in 1972 and has remained here since, working in neurology, surgery and outpatients .

Bernice has completed 25 years at North Manchester General Hospital .

Everyone wishes them all a healthy and happy retirement, you will certainly be missed . “As you slide down the bannister of life, may the splinters never point in the wrong direction!”

A hug in a blanket from pamelaBABIES at The Royal Oldham Hospital are being kept nice and snug, thanks to the generosity of a 74-year-old patient .

Pamela Hixon from Shaw was undergoing treatment at the hospital for oesophageal cancer when the staff on ward G2 spotted a beautiful baby blanket which Pamela was knitting .

Impressed by her handiwork, they asked to take the blanket to show to another ward . This then started Pamela knitting 20 blankets to date and donating them to the maternity unit for new born babies .

She said: “There is nothing better than

babies in my view and putting a blanket around them, gives them comfort . I love the idea that a baby can be wrapped in one of my homemade blankets and then take it home with them to cherish .”

Taking around three days to make, each blanket is different and brightly coloured . Her neighbour Jean Metcalfe supplies Pamela with a fresh batch of wool every week and inspires her to get her knitting needles clicking!

Viv Twomey, maternity inpatient matron, said: “We very much appreciate Mrs Hixon’s efforts within the maternity unit and the blankets are well received by the staff, mothers and babies .”

trust responds to national heart failure audit

News - trust stories14 April 2012

THE National Heart Failure Audit for April 2011 – March 2012 has been published .

Commissioned by the Healthcare Commission and managed by the National Institute for Cardiovascular Outcomes Research (NICOR), the audit aims to provide national comparative data to help clinicians and managers improve the quality and outcomes of their services .

The Trust participates in these audits and this year has achieved 100% data submission rate relating to patients discharged with a primary diagnosis of heart failure, an improvement from 49% for the previous year . The figures show that the Trust is also submitting more data than other participating Trusts .

The audit report has been presented to PAT’s consultant cardiologists and other clinicians at a recent cardiology education meeting . The key recommendations from the report include the following:

The use of beta blockers in patients with left ventricular systolic dysfunction (LVSD) still appears sub-optimal . We need to renew efforts to educate clinicians about their safety and

efficacy . In line with NICE guidance, beta blockers should be used in all patients with heart failure due to LVSD, including patients with Chronic Obstructive Pulmonary Disease (COPD) without reversibility .

Where possible, patients admitted to heart failure should be cared for in a cardiology ward, and should have input from a consultant cardiologist and heart failure specialist nurse .

In accordance with NICE quality standards for chronic heart failure, a personalised management plan should be developed for all patients admitted to hospital with heart failure . The plan should be developed with input from a multi-disciplinary heart failure team .

A referral form is available on the Trust’s intranet to refer heart failure patients to the cardiologist and heart failure specialist nurse teams .

Providing services to patients with heart failure costs the NHS an estimated £625 million per year . Heart failure is in the top ten diagnoses for use of hospital bed days and places a significant demand on hospital facilities and resources through emergency admissions and readmissions .

tasty treats fund hIV treatmentSTAFF from the infectious diseases unit at North Manchester, incorporating wards J3 and J4 have been thanked by the National Aids Trust (NAT), for their bumper fundraising effort .

Selling home baked goods including cookies, cupcakes and gingerbread, staff on the unit managed to raise a fantastic £300 .

They have now been thanked by the NAT and have received a thank you letter and certificate .

Staff nurse Helen Conroy, who organised the event with the help of J block nurses and doctors, said: “As the regional infectious diseases unit, we are heavily involved in the acute care of patients with HIV . We have always been keen to to be involved with fundraising for HIV and AIDS charities .

“The bake stall went really well . We decorated J4’s patient sitting room and quickly sold out of the delicious treats, plus the red ribbons which denoted world aids day . The ID research department also provided us with leaflets and posters to promote awareness and education surrounding current issues in HIV .

“We were pleased to raise so much money for the NAT as we are passionate about HIV and reducing the stigma around the condition for our patients .”

The National Aids Trust works towards preventing the spread of HIV and protects the rights of people with HIV by ensuring they have access to the correct treatment and care .”

staff awards event

Award Categories Support function team of the year

Front line team of the year

Skills award

Manager of the Year

Award for Innovation

Rising star award

Nurse or midwife of the year

Hospital doctor of the year

Professional or technical worker of the year

Support worker of the year

Administrative or secretarial worker of the year

Outstanding contribution to patient care/safety

Additional prizes Patients’ choice award

Medical educator of the year

Outstanding achievement in medical education 2012

the trust is launching its third pennine staff events award.

Due to be held on 20 June, everyone will have the opportunity to nominate their colleagues from each division for a total of 12 award categories .

Recognising the very best of Pennine, there will be winners within each division who will be invited to a special celebration dinner event .

The awards are a key part of the Trust celebrating success across all sites, bands and job roles, so please consider all your colleagues for an award .

You can nominate an individual who excels in their role or goes the extra mile, or a team who have recently developed a new process or implemented a new project that benefits our patients .

How can you nominate colleagues for an award?

You can fill in the nomination form printed overleaf, complete a form online following the link on the homepage of the intranet or printed copies of the nomination forms will be available across the Trust .

All nominations MUST be submitted by 30 April .

Winners will be notified during May and invited to divisional events and also to the Trust main event which will be held at Manchester City Stadium and hosted by a celebrity guest .

There will be a prize of a holiday for one winner this year, courtesy of NHS Discounts and cottages4u .

The event is fully sponsored by companies who work in partnership with the Trust .

15people

staff Awards 2012 who will you nominate?

people16 April 2012

Nomination form

About your nominationCategory (see overleaf for details of categories): ..................................................................................................................................

Name of individual or team nominated: .................................................................................................................................................

division of individual or team nominated: ............................................................................................................................................

Nominees’ contact details: ......................................................................................................................................................................

title of entry: ............................................................................................................................................................................................

what was the achievement or contribution? (max. 150 words - please complete on separate sheet and attach to nomination form)

how has it benefited the organisation? (max 100 words - please complete on separate sheet and attach to nomination form)

how has it benefited patients? (max 150 words - please complete on separate sheet and attach to nomination form)

how did the nominee demonstrate the trust values? (max 100 words please complete on separate sheet and attach to nomination form)

Please submit your form by email to maxine.monksfield@pat.nhs.uk or by post to Maxine Monksfield at Trust Headquarters, North Manchester General. Forms to be submitted by email or internal post to arrive as early as possible and no later than 30th April 2012. staff awards event

About youyour name: .................................................................................................................................................................................................

email address: ............................................................................................................................................................................................

telephone: ..................................................................................................................................................................................................

division: ....................................................................................................................................................................................................

staff awards 2012 who will you nominate?