Thursday, 12 January 2017

New year, new opportunities

We’ve welcomed in the new year with interviews for an exciting new role for our aspiring nurses. NUH is one of 11 test sites in England to be piloting the Trainee Nursing Associate role, which will complement the care provided by our fully-qualified registered nurses and care support workers. These new recruits will deliver hands-on care for patients whilst undergoing a two year programme of study.

This a fantastic opportunity for our healthcare assistants to progress into a new nursing role, allowing us to retain their knowledge but develop them further within the Trust. The trainees will attend the University of Derby one day a week undertaking a foundation degree as part of their course. They will spend the remainder of their time working in clinical practice as a member of the nursing team. At the end of their training they will qualify as a Nursing Associate and will increase from a Band 3 to a Band 4 (subject to the national job description going through job matching).

The Band 4 Nursing Associate role will help to plan, coordinate and deliver care in different settings. It is not a substitute for a registered nurse, but will support the existing teams in primary, secondary and community care.

There are 62 places available across Nottinghamshire and 230 in the East Midlands. Other providers in Nottinghamshire include Sherwood Forest Hospitals NHS Foundation Trust, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham CityCare, Social Care and Primary Care.

I’m proud that our nursing colleagues are taking the lead on the pilot for the East Midlands. Mandie Sunderland, our Chief Nurse, is the regional lead, Sue Haines, Assistant Director of Nursing and Rachel Tennyson, Nurse Lead for Healthcare Assistants and Wider Workforce careers, are co-ordinating the implementation and evaluation of the role for NUH. As part of this we will work closely and collaboratively with colleagues across Nottinghamshire and the East Midlands to ensure consistency in how the role is delivered and developed.

Interviews took place last week and the candidates were all of an exceptional standard. For all those who applied and weren’t successful, thank you for putting yourself forwards and there will be more opportunities in the future, I am sure.  To the 20 new trainees who will start their exciting journey at the end of January, I would like to extend my warmest congratulations, and wish you every success in the development of your future career.  I look forward to hearing all about your experiences over the next two years.

Tuesday, 10 January 2017

Preventing Flu starts with you

You might think getting the flu jab in January is too late to help fight the virus. However, each year the flu season starts in October and finishes around April, and in 2016, the peak of the flu season hit us at the beginning of March. There are signs last week and this that the 2017 flu season is now starting to bite at NUH.

Did you also know that, as a healthy, symptom-free individual you can pass on the flu virus to critically ill patients? Flu is a devastating illness that can lead to death in what may have been a healthy individual, and as healthcare professionals it is our duty to make sure we take the appropriate steps to protect our patients.

Just 57.4% of NUH staff have had their jab (versus our 75% target). Our peer trusts are doing better. And while it’s by no means the most important issue, it’s worth noting that NUH will lose significant income (over £1million) if we do not achieve the 75% target.

It’s now our last chance to try to keep everyone safe from contracting the virus and adding to our present pressures. I am encouraging those who haven’t yet had their jab to do so. I’ve had mine. It was quick, easy and painless!

Over the next three weeks roaming clinics are being offered by Occupational Health. Workplace vaccinators will come to your ward if you and your team would prefer. You can call them on x55957 to arrange a group session for your ward (consider inviting multi-disciplinary colleagues to join you). Names and numbers of your local vaccinator are available on the intranet. There is no shortage of options. If you’ve already have had your jab at your GP or pharmacy, please let your manager know so that this can be recorded and accounted for.

My final plea: There is still time to be vaccinated. This is about keeping your patients, your family, your colleagues and yourself safe. Please be vaccinated, and remind your teams.

Monday, 9 January 2017

Thank you…. After a record week

In my first blog of 2017, I write to say ‘thank you’ to colleagues across NUH for your hard work during what has been an incredibly tough holiday period and start to the new year. After a difficult start to the year, we continue to have limited flow and capacity within NUH and significant pressures remain.

The pressure on our services (and on those of other emergency services, including East Midlands Ambulance Service) has been unrelenting. There are some striking figures if we look at the last few weeks which put into context the pressure the whole system has been under. In the 9 day period between Christmas Day and 2 January, we admitted a patient every 7 minutes (215 every 24 hours; in contrast to  a “normal” average of about 120 each day). We admitted 395 more patients than we discharged over that same 9 day period.

And last Monday (2 Jan), we had the highest ever number of patients in our ED at one time – 180 patients. Our services have been pushed to the limit, and we are acutely aware that overcrowding in our ED has understandably caused concerns for patients, staff and the public more widely about safety, privacy and dignity and the quality of care.

Changing the subject a little, some other figures caught my eye this week that help provide even more context. This year we celebrate 40 years of QMC. Paul Swift, NUH’s Archivist, is kindly writing a book to mark the occasion, in which he includes some figures showing how busy ED was when it first opened in the late 1970’s compared to the current day ED pressures. QMC’s original ED was designed to treat 65,000 patients a year. In 1979, 100,000 patients passed through the doors of ED, compared to the 70,000 patients that passed through the doors of ED at the former Nottingham General Hospital-based ED. Some 45 years later, in 2015, 207,000 patients are using our ED, an increase of more then 100%!

Thank you again to all colleagues working in ED, colleagues working across NUH to support the emergency pathway, and colleagues in the wider health and social care system for everything you do to mitigate concerns, and provide the best possible care to our vulnerable patients in such challenging circumstances.

Thursday, 29 December 2016

A review of 2016

What a year. In the year we mark 10 years of NUH, so much has happened. Some we could have predicted, some not.

As I look back at the last 12 months, I am so proud of what we have achieved.

In no particular order……

In the last two years we have reduced avoidable stage 3 pressure ulcers by 70%. In the last five years, we have halved the rate of patients falling while in our care.

Members of the Trust Board have taken part in 34 patient safety conversations with teams and colleagues across NUH over the last year. As a result of these conversations, the Board keeps firmly in touch with what matters most to staff. It is through these conversations that we learned the strength of feeling from our staff about Carillion; feedback we have listened to and acted on.

Earlier this year we appointed our first ever Freedom to Speak Up Guardian – Kirstie Macdonald. Kirstie is providing independent advice and support to staff who wish to raise safety-related concerns.

The Trust was rated ‘Good’ overall by the Care Quality Commission, instilling confidence among our patients, their relatives and carers in the quality of our care and services.

We have consistently been the strongest performer in our peer group for 18 week waits (planned operations).

Through quarterly recruitment events and international recruitment, 355 UK nurses, 130 overseas nurses and 602 HCAs have joined TeamNUH over the last 12 months. We have the best retention rate in the country for international nurses. And to top it off, NUH was recently named as 1 of just 11 Trusts who will be piloting the new trainee Nursing Associate role, with our first associates due to join us in January ’17.

Earlier this year, the National Institute for Health Research (NIHR) announced the award of £23.6m over 5 years from April 2017 to establish a Biomedical Research Centre for Nottingham. Just a few weeks ago, we learned that NUH was to be designated an NIHR Clinical Research Facility, with an award £2.4m of funding to develop and deliver our research infrastructure over the next five years, helping to speed up the translation of scientific advances for the benefit of our patients.

Over 40 NUH staff have won national awards in 2016. Many more have been nominated, shortlisted and won at regional level – as well of course as our 14 individual and team winners at last week’s NUHonours Awards. Congratulations and thanks to you all for everything you do.

In August, we celebrated one year of the tram. Over 2,200 passengers are now using QMC’s tram stop daily; some 700 more patients, visitors and staff than was predicted back in 2015. In 2017, we can look forward to the opening of a dedicated tram entrance which will further improve access to QMC for all tram passengers. I was delighted to see the tram volunteers pick up this year’s Volunteer of the Year Award at our NUHonours Awards last week in recognition of their hard work and dedication over the last 16 months.

Over 6,000 mobile devices are now in use across NUH, giving clinical teams access to real-time information. Nervecentre is revolutionising the way in which clinicians are accessing information, in turn further improving patient safety and experience.

We opened a new, purpose-built bereavement suite at QMC for patients and their families who have been affected by stillbirth, thanks to the impressive fundraising efforts of Richard and Michelle Daniels, the founders of the Forever Stars Charity. I had the privilege of meeting Richard and Michelle earlier this month and visiting the Serenity Suite at QMC for the first time. This amazing couple have now helped to raise over £200,000 in less than 2 years to improve bereavement facilities at our hospitals, with all eyes now on the fundraising efforts to open a City facility in 2017.

Thanks to sponsorship from the QMC and City League of Friends, we held our first formal dinner to celebrate our longest serving colleagues to show how much we appreciate their hard work and dedication. And of course last week we marked 10 years of NUHonours Awards. Thank you to Nottingham Hospitals Charity for making this event possible and for all your support over the last decade.

Over the last year, Nottingham Hospitals Charity received £4m from donors and granted £3.5m to NUH to further improve the experience of patients and staff. Examples of the charity’s vital contribution includes £100,000 for nursing and midwifery development, £50,000 to support the implementation of ‘Just Do It’ ideas from staff and 76,000 towards research posts to help improve the diagnosis and treatment of breast cancer. And in December we received the welcome news that the Charity was successful in its bid for £1.3m of LIBOR funding as part of the Chancellor’s Autumn Statement towards its Appeal for a helipad at QMC to support our Major Trauma Centre. My mention of the charity wouldn’t be complete without praising our Chief Executive and Executive colleagues for the abseil and sky-dives they have done to show their personal support for our Charity. Thank you, on behalf of the NUH Board, to our Charity for everything they do.

The doctor in training strikes caused much disruption to patient appointments and operations during 2016. One of the few positives to come out of the contract dispute is the work we have done to listen to and act on trainees’ concerns to improve their overall experience of working at NUH. There is ongoing work to address trainees’ concerns and improve communication with our doctors of the future.

This review of the year would not be complete if I didn’t mention our work with Sherwood Forest Hospitals. We started the year being named as the preferred long-term partner for SFH after a competitive exercise. Thank you to the many clinical colleagues who have supported important quality and safety improvements at SFH. While the merger is no longer proceeding, there are many positives to come out of the closer working relationships we have developed with our friends at SFH during 2016 – which we should not lose sight of.

For now, we are focussed on addressing our own challenges, which remain building on our recently improved four hour performance and delivering the financial plan we have agreed with our regulator. Early 2017, we will be clearer on next steps for the future of our Estates and Facilities services as we conclude our discussions with Carillion. Thank you to staff for their patience as the Board has deliberated on this important issue, which we know has troubled you all.

As I sign off for 2016, all that leaves is for me to say thank you to our staff and volunteers who make up ‘team NUH’ for all you have done in 2016 to further improve the experience of our patients, their loved ones and carers.

Friday, 2 December 2016

Putting the priority on safety

This week I was delighted to be invited to the Trent Simulation and Clinical Skills Centre at NUH. The team at the Centre do fantastic work developing safety skills and behaviours in individuals and teams taking their mannequins, simulated patients and human factors knowledge around the Trust to make NUH even safer for our patients. This time,  I was invited to the centre to meet the Healthcare Safety Investigation Branch (HSIB) who were visiting NUH. Patient safety is and must always be the priority for NUH, so the opportunity to discuss how we can improve learning when unintended events occur in healthcare, particularly with the soon to be functional HSIB, was very welcome.

HSIB will be operational from April 2017 and while their scope is yet to be confirmed, it was positive to learn how they will undertake certain investigations, but also provide an exemplar approach to investigation of incidents, with support and guidance to NHS organisations. The discussions orientated around how we can improve our learning processes; we owe a debt to patients who have been harmed while in our care and must do everything we can to prevent future occurrence. While it may be impossible to completely remove errors in healthcare, we can certainly do our  best to minimise them as far as humanly possible.

Talking about incidents can often be seen as negative, but the conversations were very positive and provided an opportunity to explore NUH’s new approaches to improving patient safety. Much research now considers how we can also learn from excellence and successful outcomes despite staff facing complex and difficult situations. This focus on celebration and resilience has been embraced with a new pilot of a “Learning from Excellence” reporting system across certain areas at NUH, including in the Nottingham Children’s Hospital. The anticipation is that this will provide vast learning to help minimise incidents by learning from “where things go well,” as well as celebrating staff success. We hope to roll out “Learning from Excellence” to wider areas across NUH from 2017.

“Learning from Excellence” is just one new safety initiative at NUH, with others including enhancing learning from our electronic observation systems, electronic handover, sepsis screening, medications safety, patient involvement in safety, developing high-performing teams through the NUHTEAMS programme and integrating more processes into incident analysis that help truly explore influences on performance.

The enthusiasm of the improvement teams is evident. They are passionate and committed to improving care and experience for both patients and staff. Often this work is done as an extra to their day jobs and recognition is well deserved. They are honest with the challenges that they face, but also willing to share to help others overcome similar problems.

We end the year at NUH with an ever-growing mountain of innovative programmes aimed at improving patient safety and the quality of care that patients receive. There is no doubt that these programmes make patients safer and NUH a better place to work for staff.

This week we started our ‘Advent Actions and Festive Facts for Safety’ messages to celebrate, each day during December, our 2016 safety success stories and areas we need to give greater focus as part of our continuous improvement. You can find these daily messages via @nuhstaff and on the intranet.

And of course, don’t forget, the deadline is approaching for this year’s Patient Safety Awards (13 Jan) – find out more here. Let’s celebrate our safety achievements. Our Communications Team can help with nominations x65063/

Roll on 2017!

Friday, 25 November 2016

‘Oh what a night’!

Celebrating outstanding achievements and contributions with 400 plus members of ‘teamNUH’ at the NUHonours Awards tonight was undoubtedly one of the highlights of 2016.

Over 650 individuals and teams were nominated for NUHonours, in the year we celebrate 10 years of NUH, 10 years of the Nottingham Hospitals Charity and 10 years of NUHonours.

And what a night it has been. To see how much receiving this well-deserved recognition means to our staff was worth its weight in gold.

We don’t often get to ‘let our hair down’, given the nature of the busy jobs we each do, where every minute counts. It’s been a tough year for staff working at NUH, and the wider NHS. And for this reason, never has recognising and celebrating our staff been so important. And Friday night was another reminder to me of the truly talented and committed people we are lucky to have the pleasure of working with at our hospitals. Listening to the success stories and achievements on Friday and saying ‘thank you’ to our teams who could not work harder for our patients, was just incredible.

Thank you to Mike Sassi, Editor from The Nottingham Post for being such a brilliant host and demonstrating the strength of NUH’s relationship with our local media. There were a few sentences in Mike’s column that will feature in next Wednesday’s special NUHonours supplement in the Post that stand to me and which I would like all NUH staff to hear. He wrote: “The staff at NUH keep our hospitals running 24 hours a day, 365 days a year and have always performed brilliantly. And they continue to perform brilliantly. They skill and hard work is worthy of the highest praise. We are indeed lucky to have such a dedicated band of healthcare professionals always on-call to look after us……Their desire to make a difference is unrelenting. Patients and families are hugely grateful…….. Thank you for your care. Thank you for your professionalism. Thank you for being there when we need you.”

A very well-deserved pat on the back from our local newspaper, giving credit where credit’s due.

Thank you also to other ‘known’ Nottingham faces and our partners who supported NUHonours this year – whether attending in person or via the medium of video to express their appreciation to our staff.

I look forward to reading more about our 2016 winners in the special supplement that will feature in The Post and be available (free) at the entrances at QMC, City Hospital and Ropewalk House on Wednesday 30 November.

For now though, what a way to see out the year. Let’s celebrate members of ‘team NUH’ who were this year’s nominees and shortlist, and of course our class of 2016 winners.

Carers’ Rights Day: supporting and involving carers

I’ve been taking a closer look at the amazing role carers play in our society,  as often unsung heroes, supporting the people they care for.

Some of the facts I read were quite startling. Did you know that there are over 7 million carers in the UK? That’s 1 in 10 people.

Here are a few more statistics;
  • At least 3 out of 5 people will become a carer at some point in their lives
  • 65% are older carers (60-94yrs)
  • There are 700,000 young carers. That’s about 1 in 12 secondary aged pupils, with the average age being 12
  • By 2030, only 14 years away, the total  number of carers in the UK will increase by 60%
  • The economic contribution made by our carers is estimated at £132 billion per year

Today marks Carers’ Rights Day today, and the campaign this year is focusing on ‘Missing out? Know your rights.’  So what can NUH do to make sure our carers are not missing out during the time they are with us?

First and foremost, we have our Carers Policy. This sets out how we should work in partnership with patients and carers to make sure that carers feel safe, confident and included in the care of patients and decision-making during their hospital stay.

There are some simple steps we can take to better help and support our carers and their friends/families, including:

  • Asking friends and family of patients if they are the primary carer
  • Give Carers and ask them to carry our Carers Passport
  • Ensuring that the ‘About Me’ form is completed
  • Highlighting the information about carers in the bedside folders
  • Involving carers in key decisions
  • Supporting carers by signposting where they can find support,  in the community or from  

There is always more we can do to maximise the support we provide carers right across our hospitals, not just in our healthcare of the elderly wards. It is so important that we involve carers in discussions with patients, including where patients may have capacity to make decisions yet are confused. In this scenario, carers can play a vital role in ensuring that patients really understand what is happening next in their treatment and are able to talk through the decisions that are being made about their care.

And finally, I mentioned our Carers Passport, and I was so pleased when this was shortlisted recently for a national award by the Academy of Fabulous Stuff. The awards event was held yesterday at the O2 and although the Carers Passport didn’t go on to win in its category, being shortlisted just goes to show what a great idea it is.  The Carers Passport is now being rolled-out and used in other hospitals across the UK, and I’d like congratulate everyone involved in putting the passport together for their hard work and innovation – such a simple idea that can make such a real difference to the experience of patients and their carers.