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February 2010 issue 16 In the spotlight: community nursing  ODUJHWUXVWRIWKH\HDU contents

2 Dialysis unit brings care closer to home 3 A word from David 3 South London HIEC bid successful 4 Hole-hearted 4 Welcome Sanjay Sharma 4 Joined-up thinking will benefit Wandsworth patients 5 New clinical director for A&E 5 New technology delivers clearer scans in seconds 6 New Trust website 6 March deployment date for iCLIP 7 Vaccination heroes

8 In the spotlight Amor Marasigan (left), Clinical Manager for the north Wandsworth satellite dialysis unit, with Karen Jones, dialysis nurse 9 View from the top 10 Foundation Trust: Q&A 11 10:10 Dialysis treatment is 12 PM visits St George’s 12 A&E nurse visits No 10 moved closer to home 12 Stop smoking drop-in clinics A new satellite dialysis unit has opened in Battersea for St George’s renal 13 Clean sweep (kidney) patients so they can get treatment closer to home. 13 Welcome news The centre, run by Fresenius Medical Care Renal Services, operates in addition to the 13 V&A delivers new collection renal department at St George’s and serves patients from north Wandsworth and surrounding areas. St George’s renal consultants, specialist nurses and dieticians visit 14 Appraisal: Have you had yours? their patients at the unit on a regular basis. 14 Training leaders The unit has 18 individual dialysis stations which come with adjustable electronic 14 Chief Executive congratulates chairs and their own flat screen TV. A wireless network is also available which One Team Service Partners patients can access for their own computers. Consulting rooms are available for 15 Health and safety outpatients and other individual patient consultations. 16 Fundraising news Mattias Persson, Lead Nurse for Haemodialysis Unit, said, “Quality of life is of prime importance when treating patients with long term conditions. This new centre brings With thanks to Mark Evenden, Media huge benefits to patients who not only enjoy a shorter journey to receive their dialysis Services, St George’s University of London, treatment away from the hustle and bustle of the main hospital, but also the state of for photographic services. the art facilities.”

Front page picture shows Sam Prigmore, The unit will be officially Respiratory Nurse Consultant, with patient opened on February Pat Osmond. 16th by Naaz Coker, Chair of St George's and Patron of the gazette is written and published by St George's Kidney the Communications Unit. The opinions Patients' Association. It expressed do not necessarily represent is one of a handful of those of St George’s Healthcare NHS Trust. units set to open to The next edition will be published April 2010. If you are a staff member with a increase the choice story for the gazette, please email: available to people who [email protected] need dialysis in south- west London and Surrey.

2 the gazette #stop press A word from David

South London HIEC Welcome to the first bid successful gazette of 2010. This edition highlights several exciting South West London developments which Academic Health and Social Care will happen during Network this year. There is news of our planned integration with NHS, education and social care organisations in Community Services south London have become one of only 17 Wandsworth, which networks across England to receive government will increase our range of experience and expertise funding to improve healthcare delivery and and enable us to improve patient pathways. Our education in the region. major IT upgrade, iCLIP, will go live from the end The Department of Health announced successful HIEC of March and I know many of you will have applications in January following a rigorous selection process, received training for this. 2010 is, of course, a including a formal interview by the National Award Panel critical year for our journey towards Foundation chaired by Sir Alan Langlands. Trust (FT) status and in this issue of the gazette our Chair, Naaz Coker, answers questions from The collaboration, made up of around 30 organisations, forms Staff Side about FT and what it will mean for staff the South London Health Innovation Education Cluster (HIEC) and patients. - one of the new government funded networks aimed at delivering high quality patient care through better trained 2010 is also a year when we have pledged to clinicians and faster translation and adoption of research and reduce our carbon footprint by 10 per cent. St innovation. George’s has been committed to carbon reduction South London HIEC brings together members of south for a number of years. In joining with the national London’s two major healthcare networks – the South West 10:10 campaign, we are supporting the idea of London Academic Health and Social Care Network and King’s taking positive action against the climate change Health Partners Academic Health Sciences Centre. This and encouraging others to do the same. includes all south London’s primary care and mental health Colleagues will not have failed to notice that this trusts, 17 NHS hospitals including St George’s, the London Ambulance Service and the local Health Protection Unit, as is an election year. Whatever the outcome, there well as six universities, further education providers and social will inevitably still be pressure on public sector care teams. finances. The NHS will be challenged with delivering high quality services for less money. I Members of the HIEC will work together to improve patient am confident that St George’s is well placed to care and local health services by more rapidly delivering the meet this tough challenge but it certainly won’t be benefits of research and innovation directly to patients. Early easy. Whatever the future may hold, we will work will include a review of current education and training continue to develop improved services for our aimed at health professionals across south London. This is patients. The new dialysis unit in north expected to lead to the introduction of new programmes, as Wandsworth is an example of the changes that well as enhancements to existing training courses. are being made. The South London HIEC has identified four areas to focus on initially: mental health; infection prevention and control; Finally, I would like to thank those who made diabetes, and stroke. outstanding efforts to get to work despite January’s snow and ice. While Tooting only saw a The new HIEC will be jointly led by the South West London few inches of snow, heavier falls occurred outside Academic Health and Social Care Network and King’s Health London and affected the travel of many staff and Partners Academic Health Sciences Centre. patients. The winter overall has been extremely Commenting on the successful bid, St George’s Chief challenging with high numbers of emergency Executive, David Astley, said: “This is an exciting development admissions. I am grateful for the support of for South London, as the diversity of this region brings unique colleagues across the Trust in helping to ensure challenges to local services. The collaborative solutions of our patients still continue to receive researchers, doctors and nurses will be put into practice by the high standards of care. HIEC to deliver real benefits to local people.”

the gazette 3 Hole-hearted Welcome to Sanjay Sharma

Professor Sanjay Sharma has been appointed Academic Consultant Cardiologist for St George’s. Previously consultant cardiologist for the charity CRY (Cardiac Risk in the Young), Sanjay has an international reputation for A live procedure to close holes in a patient’s teaching and tutoring junior staff heart was the highlight of a December to enable them to pass their MRCP conference hosted by St George’s. (Membership of the Royal College of Physicians) UK examination. Atrial Septal Defect (ASD) is a heart defect, evaluate the effectiveness of which is present at birth, where the wall that Sanjay is no stranger to St George’s; screening young people for separates the upper heart chambers (atria) does he studied at St George’s, conditions which make them not close completely. University of London and also vulnerable to sudden cardiac The aim of the live demonstration was to teach established initial links with CRY at death. He will continue his cardiologists about advanced techniques to close the Trust. St George’s was the first teaching role and will support these holes in the heart using catheters and hospital in the UK to develop a student and post graduate closure devices. Doctors from Europe, the Middle family screening clinic which teaching, with particular emphasis East and Asia attended the conference, including screens whole families after a on the MRCP examination. two world-renowned cardiology experts. St tragic young sudden cardiac death. George’s was selected as the host site due to its Sanjay says: “St George’s is Sanjay will build on this service and reputation of clinical excellence in this field and historically recognised as a major is keen to establish St George’s as a superb catheter laboratory facilities provided in force in inherited nationally recognised the Atkinson Morley Wing. cardiomyopathies. I am hopeful cardiomyopathy service. Dr Stephen Brecker, Consultant Cardiologist and that my appointment will be Cardiomyopathy is a serious Clinical Lead for the catheter labs, said: “We pivotal in establishing St George’s condition in which the heart were delighted to have been selected to host this as a nationally recognised centre in muscle becomes enlarged and course. Our reputation and facilities are second inherited cardiac diseases. This will inflamed. to none, but what makes this type of live include the assessment of demonstration course possible are the people Sanjay also hopes to develop the individuals with cardiomyopathies, who work with us in the catheter labs. They are first sports cardiology unit in the ion channel diseases and a dedicated group of professionals who have the UK. In addition he would like to evaluation of families of victims of highest clinical standards.” establish a research programme to sudden cardiac death syndrome.”

Joined-up thinking will benefit Wandsworth patients Plans to integrate St George’s with Integrated clinical teams could provide an exciting opportunity to improve patient Community Services Wandsworth are complete patients pathways spanning care. Staff from across the Trust will be being developed with the aim of community and acute care. This should involved in preparing for the safe bringing improved services to local help reduce avoidable admissions into integration of hospital and community patients. hospital, and reduce the time inpatients services. St George’s has been chosen by NHS have to spend in hospital. It should also Di Caulfeild-Stoker, Chief Operating Wandsworth as the preferred organisation help to improve local access to outpatient Officer of Community Services to integrate with their community services. and diagnostic services by moving more Wandsworth, said “By joining our two This is likely to include district nursing, services off the acute hospital site and into organisations together we can make real community specialist nursing, school the community. differences to patient pathways and nursing and many of the services provided Any change is subject to a formal experiences and we will be able to share at Queen Mary’s Hospital, Roehampton. ’transaction’ process being completed with our knowledge and skills between our The aim is to improve patient experience final approval from the boards of St staff. When acute and community and outcomes by linking community care George’s, NHS Wandworth and NHS services work hand in hand there are some and hospital care even more closely. This London. At the point of integration, St real benefits for patients and the would mean building on existing George’s would welcome around 1,000 partnership will give us the opportunity to partnerships and strengths, and re- new staff. look at how we change and improve designing services around the patient. David Astley, Chief Executive, said: “This is services in the future.”

4 the gazette New technology delivers clearer scans in seconds

St George’s is preparing for the human patient CT scan was launch of its major trauma centre undertaken on 1 October 1971, by and hyper-acute stroke unit by Dr James Ambrose, a consultant becoming one of only a handful radiologist. Some staff members who of Trust’s in the UK to install an worked on the first commercial version of the scanner are still employed in the advanced CT scanner. Trust’s neuro-radiology department. he SOMATOM® Definition Flash CT Dr Johnny Vlahos, Radiology scanner carries out the fastest T Consultant, said “We hope that the available scanning in CT, and can provision of extremely fast state-of- image a person as tall as six feet six the-art imaging for our sickest patients inches in less than five seconds. will further improve the clinical Two x-ray tubes simultaneously revolve outcome of these patients. Reducing around the patient’s body while the the length of stay and unnecessary patient lies on a couch inside the hospital admissions will also have scanner. This technology allows a scan beneficial effects for the availability of New clinical to be performed much faster and to a imaging services for all other patients higher quality than using traditional CT attending St George’s.” director for A&E scanners. The technology also benefits patients who may be concerned about The scanner will be located in Phil Moss, the new Clinical Director undergoing a scan, such as children, St James’ Wing, adjacent to A&E, for the Emergency Department, intensive care patients and those who which means that emergency patients joined St George’s in November have suffered a major trauma. can be transferred quickly and easily at the start of A&E’s busiest time when need be. of year. A complete scan of the whole chest takes just one second. This means that “At St George’s we are proud of our history and our contribution to the Phil has extensive experience in patients admitted to hospital with development of CT scanning emergency medicine having previously chest pains can undergo an early CT technology. The combination of new worked for Newham University Hospital scan to identify potential heart disease hardware technology and our expert and the Royal London Hospital as a and reduce the need for overnight staff ensures that St George’s remains consultant in emergency medicine. Phil stays or invasive tests. at the forefront of imaging technology has also worked for the Helicopter St George’s has a long standing and innovations that benefit the Emergency Medical Service (HEMS) as a affiliation with the CT scanner; the people of south-west London and flight registrar. world’s first prototype was installed in beyond,” said Chief Executive, Speaking about his appointment, Phil Atkinson Morley Hospital. The first David Astley. said: “This is an exciting time to be A CT scanner of the type which is now operational in St James’ Wing joining St George’s with the development of the major trauma centre as well as the hyper-acute stroke unit at the hospital’s main site in Tooting. I look forward to working with colleagues to develop these services in order to ensure the best possible care for patients. I will also be working to strengthen St George’s role as a major player in the emergency and urgent care landscape of southwest London” Welcoming Phil on board, Mike Bailey, Deputy Chief Executive and Medical Director, said: “As Clinical Director for the Emergency Department, Phil is involved in the clinical, operational and strategic decisions that take place around A&E. He is an accomplished professional who brings a wealth of emergency medicine knowledge and experience to this role.”

the gazette 5 Fnew look website

Pages from the re-vamped website

New Year brings in March deployment date for new Trust website

January saw the launch of “The new website is a major St George’s new website development and represents www.stgeorges.nhs.uk which has St George’s as a modern, leading-edge been completely overhauled by healthcare provider,” says Director of At its December meeting, the staff in the communications team. Communications, Jean-Pierre Moser. Board endorsed a new deployment date for the iCLIP programme, of Several new features have been “Having conducted a survey of 29th March. The iCLIP project team introduced to provide patients consultants, patients groups and GPs is working hard to complete all and the public with better access in 2009, we knew that changing the essential project activities so that to information about St George’s. look and feel of the website would the deployment of the new have a positive impact. This was a The site benefits from a new electronic records system runs as navigation, which is easier for users, major project delivered using the skills smoothly and efficiently as possible. providing improved accessibility to and knowledge of our in-house The new March date has allowed information and clearer presentation. It team.” the iCLIP team to run more also allows greater flexibility, meaning “The Healthcare professionals area can training, demonstrations and dress that content for each department can host microsites to cater for niche rehearsals, to ensure that all staff be developed beyond the basics that audiences, such as consultants, nurses, are confident with the new systems were hosted on the old site. GPs and medical students,” says and feel fully prepared for deployment. Fresh photography has been included Jean-Pierre. “This is an important and a new area has been developed to development for the website and will “It is vitally important for the host more sophisticated information, offer services the opportunity to present success of the programme that we which will allow the Trust to cater for information to their peers in a maintain the momentum generated over the last five or six specialist audiences. The Healthcare professional online environment under months, so staff should continue to Professionals pages, designed to provide the St George’s banner.” prepare,”said Patrick Mitchell, information to GPs and other healthcare Chief Operating Officer. professionals are work in progress. This For more information about section currently hosts information about  Details of iCLIP training schedules www.stgeorges.nhs.uk, its courses and day seminars for GPs, as well have published on the iCLIP training new feature areas, or to contribute pages of the intranet and staff as referral guides and GP News The area content, contact the communications should continue to book their places also includes St George’s tracheostomy team on ext 5151, or email if they haven’t already done so. guidance and a full contact list of [email protected] appointed consultants. 6 the gazette Vaccination heroes

Latest figures show that more than 2,400 frontline staff at St George’s have taken up the opportunity to be vaccinated against swine flu. The programme of vaccination began with those working with the most vulnerable patients but, thanks to good supplies of swine flu vaccine, it was extended to all clinical staff working with patients. Seasonal flu vaccinations were offered at the same time and St George’s has so far been able to double the numbers of staff receiving this compared to previous years. A team of 14 vaccinators (specially trained nurses) were released from their The Pre-pack team: Helen Arnold, Mavis Hewlett, Magdalena Bauyon, Sharon Canhye, Imran Latif, Alma Monk with Vinodh Kumar. Absent is Sandra Browne normal duties. This team vaccinated as vaccinating 500 patients – much more than one GP practice can use or store. Therefore, we have been packing them down into packs of one, three or five vials along with the relevant leaflets and information for GP surgeries.” “Staff have worked evenings and weekends to get the first batches of vaccines out and we continue packing down vaccines as GPs are now vaccinating children under five. At the beginning of the swine flu pandemic last year, we were also involved in packing down Tamiflu, the anti-viral pills, and labelling products with instructions for use,” he added. As a Medicines and Healthcare products David Astley with vaccinators Jamillah Mwariko, Akua Kyei, and Cesar Lacuna Regulatory Agency (MHRA) licensed facility, St George’s Pharmacy re-packs many as 100 staff a day during the first Pharmacy staff at St George’s played a medicines for healthcare providers seven weeks of the programme before key part in the vaccination programme. across the UK. Within the Trust, the Occupational Health took over the Staff members were on the Vaccination same team also ensure individual running of the clinics in mid-December. Steering Group, which led the patient packs of labelled medicines are David Astley, Chief Executive, offered a implementation of the Trust’s available at the point of need, for personal thank you to vaccinators when programme. The Pharmacy also had an example, in A&E. he visited the clinic in early December. important role in distributing the vaccine to healthcare providers across Occupational Health, located on the He said: “The vaccination programme is southwest London. Perimeter Road, is offering a daily crucial in protecting our patients and drop-in clinic for staff swine flu staff from swine flu. I’m grateful that so Vinodh Kumar, Assistant Chief vaccination: Monday to many colleagues recognised the Pharmacist (Technical Services), said: Wednesday, between 8.30am and importance of vaccination as one way “The swine flu vaccine comes as a 1pm, and Thursday and Friday, between 10am and 4pm. to avoid spreading this infection.” multi-dose vial with each box of 50 vials the gazette 7 Fspotlight Meet Sam Prigmore, providing expert care in the heart of the community

“In my role as Respiratory Nurse Consultant I care for a range of patients from teenage asthmatics to elderly people with respiratory problems. Around 60 per cent of my clinical work is seeing patients at the Chest Clinic but around 40 per cent of patients I see in their own homes. “The Respiratory Nurse post was established in 1992 and has grown considerably. It was set up to provide care at home to people who were frequently Sam visits patient Pat Osmond coming in and out of hospital, in order to avoid hospital admissions. The original advice about using their inhalers or young people from paediatric to adult funding came from a healthcare bid to ventilator, or giving up smoking. It may care, as the change can be daunting “add years to life and life to years”, in also include discussing how to make for them. other words to prolong life and improve difficult decisions about care at the end “I qualified in 1987 and specialised in quality of life for these patients. of life. This group is usually happy to cardiothoracics, working at the Royal “There is now a team of community-based follow treatment and advice from a health Brompton Hospital. I came to St George’s British Lung Foundation respiratory nurses professional but they can be forgetful, in 1989 and worked on a respiratory for NHS Wandsworth and Community especially about remembering to take ward, and in 1992 I joined the Chest Respiratory Nurses for Merton and Sutton their medication. Their families and carers Clinic as a respiratory nurse specialist. My Primary Care Trust, who visit and monitor often need a lot of support too. academic study includes post-basic these patients at home. I jointly manage courses in cardiothoracics, asthma and “The role also involves liaising with other and supervise the Wandsworth respiratory allergy, and I have a BSc in Primary Care allied health professionals - nursing team with Jo Jackson, Head of Nursing and an MSc in Cardio-respiratory physiotherapists, social workers and Intermediate Care at NHS Wandsworth. Nursing. I become a Nurse Consultant in occupational therapists - and with 2004. This was an ideal and natural step “My role now involves seeing patients palliative care services at Trinity Hospice for me as I wanted to stay in clinical with the most complex problems, often and St Raphael’s, to ensure the patients practice and not go into a management receive the most appropriate those requiring ventilation at home or role. This role combines clinical expertise, interventions and support.” those with other health problems which leadership and also education; I lecture complicate their condition. The majority of “One area of my work at the Chest at Imperial College once a fortnight. these patients are over 60 because this is Clinic is providing care for asthmatic “I am also working with the Department the age when problems become serious. adolescents. I also see asthmatic patients of Health in developing a clinical strategy This group would include anyone whom as Outpatients, following attacks which for patients with Chronic Obstructive the community team is concerned about have resulted in an admission to hospital. Pulmonary Disease (COPD), a smoking- and after any patient’s admission into Usually this is in the clinic but I have related disease which is underdiagnosed. hospital following their discharge home. I been known to track people down at It cannot be cured but early monitor them, for example by checking home if they do not attend, especially if management can help. I chair the for signs of infection or deterioration in they are at risk of being re-admitted with Respiratory Working Group with NHS their oxygen levels which may result in an a life-threatening asthma attack. I also Wandsworth looking at patient pathways admission to hospital, if not acted on provide a service for asthmatic for patients with asthmas and COPD, promptly. I also teach people how to care adolescents. I see them initially in a joint and I’m a Trustee of the British Lung for themselves and discuss the treatment clinic run with Ann Christopher in Foundation. I really enjoy my job but they are receiving. This might include Paediatrics. This provides a bridge for there are a lot of aspects of it to juggle!” 8 the gazette view from the top

In April 2009, clinicians Eric Chemla, Val Thomas and Ken Anson were appointed as Divisional Chairs, a new role for the Trust. This month Eric Chemla talks to the gazette about his role as Divisional Chair for the Medicine and Cardiovascular Division and Consultant Transplant Surgeon.

What is the role of a Divisional Chair? It is taking on a role which was previously part of the Medical Director’s remit. The Medical Director’s role had previously included clinical governance and medical management. However, St George’s is a big organisation; and the role of overseeing clinical governance is enough of a job in its own right. Divisional Chairs now undertake the managerial role and oversee issues like business planning, consultant’s job planning, watching financial spend, bed planning, or disciplinary issues. It is quite that clinicians have a role in When I came to see the unit before my hands-on in terms of running the management. It helps stop that ‘them’ job interview, I was asked what I would Division. Issues recently have often been and ‘us’ thinking: managers and doctors do to improve it. I said there needed to related to winter pressures, for example, at opposite ends. I can talk to consultant be more work on vascular access looking at ways to organise ward rounds colleagues because I understand their (creating access points in a dialysis to ensure that patients who are ready perspective – they are concerned about patient’s blood vessels for blood to for discharge can go early in the day or their patients. For example, they have to leave and return to their body). I have looking at areas where there could be consider whether to see the sickest been allowed to develop that work nurse-led discharge. patient first, or the patient who can be here and St George’s is now a tertiary discharged so then there is a bed for referral centre for vascular access and is I work with five Clinical Directors who another patient. I can hopefully engage recognised internationally. I have also lead A&E, Acute Medicine, Specialist with people and have an informed been encouraged to develop better Medicine, Renal and Haemo-oncology discussion. I find most of my consultant leadership and management skills such and Cardiovascular care groups. I meet colleagues are very reasonable; they are as managing conflict better. I have with them regularly and also with the clever people and understand that there been offered this opportunity to be other Divisional Chairs, Val and Ken. is a wider perspective; not just their Divisional Chair and have been patient’s interests, but what is in all encouraged to go further. How do you balance this patient’s best interests. role with your role as a What do you do to relax? Consultant Transplant Tell us about your I have a cross-training machine and Surgeon? experience of St George’s? I do around 10 miles on that a day. I I am busy but it is very interesting so I I came here from France in 2002 and find it good for getting rid of stress can’t complain. I still have four this was my first job in the UK. I would and I have also lost weight. I saw a operating lists a week and two clinics. It not go back now. I have been offered picture of myself in the gazette has meant developing new ways of opportunities here to develop which I do some time ago and, well, I have lost working. However, I think it is important not think I would have had in France. four stone since then. the gazette 9 Fyour questions

In terms of Governors there is a potential liability however in general, so long as Foundation Trust: they behave responsibly, there should be no problems.

How would FT status affect the terms and conditions for staff? Becoming a FT does not affect the Q&A continuity of service of staff. Staff will This is an important year for have full access to the NHS pension scheme and other NHS benefits. To date, St George’s as the organisation only one out of 125 FTs (Southend moves forward with its University Hospital) has made changes to application to become a its terms and conditions. We have no Foundation Trust (FT). As part plans to change the terms and conditions of the work to help inform of our staff under Agenda for Change. colleagues about what providers and the pursuit of profits? Are there any costs involved in becoming an FT really means, For example, FTs are meant to becoming a FT? cooperate with other NHS Clearly there are costs involved in Stafff Side was invited to put a organisations, but there is no number of questions to Naaz becoming a FT, but these are covered by obligation to share examples of the overall corporate budget. We are Coker, the Trust Chair. good practice to improve patient acutely aware of the current financial care throughout the NHS. climate and are therefore committed to Why do we have to become a FT The NHS has gone through many changes doing most of the FT work using existing and what would happen if we fail since it was founded in 1948 with FT in-house resources. to get approval? status being the latest of these. FTs are The government is committed to creating under a legal duty to co-operate and to What is the role of the Council of a patient-led NHS. FT status will mean implement national NHS standards. St Governors? having more freedom to manage our George’s already has strong partnerships The Council of Governors’ is elected by services for the benefit of our patients with local NHS organisations, with shared the members of the FT. The Council of and to re-invest our surpluses in clinical work at local acute hospitals in the Governors’ has some statutory duties developing and improving those services. sector such as Epsom and St Helier, such as the appointment of the Chair and If we don’t become a FT then St George’s Kingston, Mayday and Queen Mary’s, non-executive directors, but most position as a major teaching hospital will Roehampton. importantly they provide the stakeholder, be weakened and our future will be out The work we are leading on behalf of the public and staff representation in matters concerning the strategic direction of the of our control. We will run the real risk of sector in stroke, trauma, cancer services FT. being merged with an existing FT. and paediatric services are all clear It is important to note that the day-to-day Does the recent media exposure of examples of partnership working. These are all in the interests of improved clinical operational management of the FT sits failing FTs prove that they are not outcomes and patient care and this with the Board of Directors, as does the better than a non-FT? approach will not change with FT status. liability of the organisation. Whether a hospital has FT status or not, The Council of Governors have a number patient care must always be the priority. What are the tangible benefits of FT of defined responsibilities such as: While there have been some high profile status for staff? G Contributing to the vision and strategic media reports of failing Trusts, on Staff membership of the FT will be direction of the Trust balance, research shows that FTs perform automatic with the option to opt-out and better than non-FTs and tend to come out G Appointing or removing the Trust’s it is for individual members to decide how on top of the quality rating lists. Chairman and non-executive directors actively they want to be involved. By According to Monitor, the independent G Approving the appointment of any becoming an FT member, staff will have regulator, in 2009 out of the 125 existing new Chief Executive an increased say in how services at St FTs, no more than a handful were being George’s are developed. They will be able G Approving the remuneration and closely scrutinised for possible poor to stand for election to the Board of allowances of non-executive directors performance. Governors and also vote in these G Appointing or removing the Trust’s Don’t FTs undermine the principles elections. financial auditor of the NHS, by encouraging There is no liability for debts or legal G Communicating the views of the competition with other local damages for staff who are FT members. membership to the Trust Board 10 the gazette a hospital

G Evaluating the success of the membership recruitment campaign April launch for 10:10 G Overseeing the development of the policy for ongoing membership Plans to fulfil St George’s commitment to reduce its carbon emissions recruitment and ensuring the by 10 per cent during 2010/11 are being developed and will be membership is representative of its launched in April. communities The Trust signed up to 10:10, a positive impact on both our carbon G Representing the FT and acting as national campaign to tackle climate footprint and our fuel bills. On capital an ambassador for the organisation change, last autumn and will be projects, building design now and its members encouraging all staff to get involved includes things like motion-sensor G Ensuring accountability of the FT to this year. lighting, which automatically local people. “Reducing carbon emissions is not a switches off when no one is around, in order to save electricity. However, Will you offer the local unions new thing for St George’s,” explains on such a large estate all staff can (staff side) a reserved Governor Director of Estates and Facilities, Neal play a big part in reducing electricity post, as is the case at King’s Deans. “This is something we have consumption by simply switching off College Hospital FT? been doing for many years and we will be building on the success of our lights and equipment when they are There will be five posts available for existing carbon reduction programme not needed.“ staff Governors and it has yet to be and the work previously done under decided if any of these will be reserved. During 2010/11, the gazette will the ‘Think Green’ banner. However all members of staff have the update staff about 10:10 and give an right to stand for election as Governor. The 10:10 challenge is to reduce insight into how the Trust is cutting carbon emission by 10 per cent in consumption and waste. How much do you intend to four areas: Neal said: “People may not be aware borrow and won’t this make our ● Electricity sourced from the of how ‘green’ St George’s already is. financial problems even worse? national grid For example, our catering contract St George’s made great strides in ● with MITIE has sustainability written recent years to improve its finances and On-site fossil fuel use, eg gas, coal or heating oil into it in terms of reducing this work must continue. In order to packaging, plastics, the number achieve FT status we will need to ● Vehicle fuel use deliveries we receive and food ensure we have a secure financial ● Air travel wastage. I hope people see that position and our business plans are MITIE outlets encourage use of based on achieving this. There are no Neal said: “Reducing carbon involves recyclable products and work with plans to borrow additional funds. all areas of Trust activity. For example, suppliers that share a ‘green’ reducing vehicle fuel use means culture.” The application process includes a considering all the different vehicles 12 week public consultation. that come and go from our sites each “The launch of the campaign will be When will this begin? day. That not only includes patient on the 1st April. We want people to The public consultation is due to start transport, but staff travel – getting to understand how what the Trust in early summer 2010. work and travel during working hours already does will help us meet our 10 to other sites. In addition, it includes per cent target, and we want to Will there be open forums to the many suppliers who deliver to the develop new and exciting ways to discuss the various issues? Trust. All this equates to a significant help staff, patients and visitors Yes. We want to ensure that all our number of patient journeys.“ support that goal. We want to invite staff are fully engaged in the FT The Trust’s annual expenditure on staff across the Trust to become process. In order to build utilities is £6million and meeting the involved in carbon reduction and to understanding and support we will be climate change agenda of reducing take ideas home and put them into communicating in a number of ways carbon emissions by 10 per cent practice there as well.” with open staff and public forums would equate to £600,000. The campaign will be in partnership being among the methods we will use Neal explains that the campaign will with St George’s, University of to reach our audience. need everyone’s support. “This is not London, and all the other partners that are based at St George’s, Is there a mandatory requirement just about what the Trust as a whole St John’s Therapy Centre and the for FTs to hold annual general does, but also about the actions of individuals. For example, the Trust Wolfson Centre. The Estates and meetings? has just reviewed its combined heat Facilities team will be appointing an Yes and the Trust will continue to hold and power plant and invested in it to Energy Manager to champion the them. improve its efficiency. This will have a works. the gazette 11 Stop smoking drop-in clinics

NHS Wandsworth has opened two new drop-in clinics at St George’s for smokers who want help quitting. These clinics will run every week, between 10am and 2pm. The clinics will be located near M&S in the Grosvenor Wing entrance entrance and in the Atkinson Prime Minister Gordon Brown and Alan Milburn MP chat to students at St George’s University of London Morley Wing foyer. Stop Smoking Advisors will: PM visits St George’s G Provide free and confidential advice Prime Minister Gordon Brown was among a group of ministers visiting G Tailor a programme around your St George’s, University of London, in January. individual needs and s the government launched a drive to widen access to university, the prime circumstances Aminister chatted to medical students about their education and aspirations. G Help you plan a quit date and Also visiting were Alan Milburn MP, Pat McFadden MP and local Tooting MP Sadiq cope with stressful situations Khan. G Introduce you to others in the The University has a widening participation team which works with pupils from the same boat age of nine years old upwards to raise aspirations and encourage student to think G Understand that you need to about careers in healthcare. Access schemes and initiatives such as summer schools take it one day at a time support this work and as a result, the proportion of students joining from state For further information, contact the school has increased from 53 per cent nine years ago to 80 per cent today. Stop Smoking Service on A video of the Prime Minister’s visit can be found on the Number 10 website 020 8812 7794 or www.number10.gov.uk [email protected] or visit A&E nurse visits No 10 www.smokefreewandsworth.nhs.uk Stella Davey, Senior Emergency Department Nurse, joined Tooting MP Sadiq Khan at a reception at Downing street in December. The event, entitled Christmas Community Heroes, was aimed at celebrating the hard work of those in the community who work on Christmas day and around the Christmas period. Stella was selected for her dedication to patient care and for demonstrating sound knowledge and leadership within the emergency department. She has also worked numerous Christmases to ensure patients are provided with a high level of quality care when they come into the emergency department. “I thoroughly enjoyed the evening, and it was a real privilege to be able to go and represent St George’s,” says Stella. Stella Davey with Gordon Brown and Sadiq Khan 12 the gazette Fspot check V&A delivers Clean sweep new collection An unannounced inspection of St George’s by the Delivery Suite staff, mothers-to-be and their visitors Quality Care Commission (CQC) in November has can enjoy a collection of 12 prints from the V&A confirmed the hospital is meeting its duty to protect museum currently on display in the Delivery Suite. patients and staff from infections. The display is made up of work from several The CQC spot check focused on four areas of the hospital, two contemporary women printmakers and covers a wards and two units where patients are treated. The CQC variety of subjects, from the female body to examined against 16 hygiene measures including ward questions of identity. It includes a limited edition cleanliness, hand-washing facilities and availability of print by the supermodel Kate Moss entitled Lipstick antibacterial hand gel. Inspectors questioned staff across the Kiss. Trust including doctors, nurses, cleaners, and management, in The display of prints from the V&A has been order to test their knowledge of hygiene standards. The organised in association with Paintings in Hospitals, watchdog also reviewed the Trust’s processes for staff infection a charity dedicated to improving health, well-being control training and providing information for the public and the Board. and the patient experience, through the display of art, in healthcare facilities across the UK. The CQC reported no concerns on 15 of its 16 measures. On one measure concerned with maintaining healthcare The prints will be on display until 30th May. environments, it made a recommendation to improve cleaning as it found dust in extraction vents. This was a problem that Trust staff had already identified and were seeking to rectify. The recommendation did not mean the standard was breached. The inspection report also noted that the Trust’s rates of Clostridium difficile were lower than the rates for the majority of similar trusts between July 2008 and June 2009. In the same period, the Trust’s rates for MRSA were between average for similar trusts and well below this range. Zoe Packman, Interim Director of Nursing, said: “We are pleased with the CQC’s report as it confirms our ongoing work to improve standards of hygiene within the Trust is protecting our patients, visitors and staff.” Welcome news A new Welcome to St George’s leaflet is to be published next month to provide essential up-to-date information Giulia Zaniol’s My Grandma’s Kitchen to patients about the hospital and make a positive first impression. The new A5 leaflet will combine the previously published Welcome to Inpatients and Welcome to Outpatients leaflets. Designed to answer many of the questions that first time visitors to the hospital may have, the leaflet should be sent out with appointment letters but also will be available to download from the website. Illustrated with full-colour photographs, it will include advice about travel and parking, suggestions of how to prepare and what to bring, and details of facilities and services on site for patients. Sponsorship support for the leaflet’s print costs has been generously provided by SSP which runs M&S and Whistlestop at St George’s. For further information, please contact Abigail Changer, Interim Patient Information Manager, by emailing Marlene MacCallum’s Strange Chambers [email protected]

the gazette 13 Fstaff news

Appraisal: Have you had yours?

Appraisals are essential for the effective management and evaluation of staff at St George’s – they help develop individuals, improve organisational performance, and feed into June Allen, Bridget Kalber, Mike Shaw, and Loke Ramnarine on the Senior Staff business planning. Induction and Leadership Programme “An appraisal is an opportunity for an open two-way discussion, usually between an individual and their line Training leaders manager,” explains Louise Holmes, There is a range of programmes The overall aim is to give Appraisal Project Manager. “The and masterclasses for leaders participants practical information meeting focuses on the individual’s available from the Trust’s and skills to support their leadership performance during the previous year. Training and Development team. role and includes a session A structured appraisal system helps These help senior leaders to build understanding their own personality staff feel that their good work is the skills, knowledge and networks June Allen, Lead Cancer Nurse, said: recognised and that they are valued. and so achieve the transformation “Having recently attended the It also provides the opportunity to goals of the Trust. Leadership training course, I now feel discuss any weaknesses or problems One example is the Senior Staff even more equipped with confidence they may have and come up with Induction and Leadership and the practical skills to meet the solutions“. Programme which is for consultants, ever increasing challenges both within There is a joint responsibility between general managers, matrons, heads this Trust and the wider NHS. I individual staff and managers to of nursing, senior therapists, particularly enjoyed and found useful organise a formal appraisal date and pharmacists and others. the sessions on Effective Influencing.” time. Either your line manager or you The six-day course takes place over Information on leadership can start the process – so if you are an three months and is facilitated by courses can be found via a employee with a shy boss then take Trust staff and externals specialists. link on the Education and the lead and ask for one. Development homepage. Louise added: “Anyone who hasn’t had an appraisal in the last 12 months, or perhaps at all, should speak to their line manager and arrange one. We Chief Executive congratulates want to see 100 per cent of staff at St George’s receive an appraisal, as One Team Service Partners they not only benefit the individual, th but also benefit our patients by On Friday 11 December around 40 of the Trust’s new One Team Service helping us to improve the service we Partners were presented their certificates in a ceremony hosted by provide.” Chief Executive, David Astley, in the Philip Constable Board Room, Grosvenor Wing. A podcast of the event is now available on the  For further information, One Team intranet pages. The podcast also please visit the includes interviews with some of the new Service Partners, who explain how the One appraisal pages on the Team initiative is changing how they view their intranet or get in touch roles at St George’s. with Louise on ext 0837. To watch the podcast, visit the One Team intranet pages.

14 the gazette Fnew posters

HEALTH AND Health and Safety SAFETY LAW Your health, safety and welfare are protected by law. Your employer has a duty to protect and keep What you you informed about health and safety. You have a responsibility to look after others. If there is a New posters outlining health and safety law will soon be problem, discuss it with your employer or safety representative, if there is one. Below is a brief should know guide to health and safety law. It does not describe the law in detail, but it does list the key points. on view around the Trust so all staff can be clear on their Your employer has a duty under the law to In particular, your employer must: As an employee you have legal duties too. ensure, so far as is reasonably practicable, They include: rights and responsibilities. - assess the risks to your health and safety; your health, safety and welfare at work. - taking reasonable care for your own health - make arrangements for implementing the Your employer must consult you or your and safety and that of others who may be health and safety measures identified as safety representative on matters relating to affected by what you do or do not do; being necessary by the assessment; your health and safety at work (see box - co-operating with your employer on ach poster outlines the legal responsibilities an employer - if there are five or more employees, record below). health and safety; the significant findings of the risk In general, your employer's duties include: assessment and the arrangements for health - correctly using work items provided by has for its staff to provide a safe environment for work, and - making your workplace safe and without and safety measures; your employer, including personal risks to health; protective equipment, in accordance with - if there are five or more employees, draw training or instructions; and - ensuring plant and machinery are safe up a health and safety policy statement, the legal responsibility of staff in maintaining health and and that safe systems of work are set and including the health and safety organisation - not interfering with or misusing anything followed; and arrangements in force, and bring it to provided for your health, safety or E your attention; welfare. - ensuring articles and substances are safety. It also has details of who to contact if there is a problem. moved, stored and used safely; - appoint someone competent to assist with If you think there is a health and safety problem in your - providing adequate welfare facilities; health and safety responsibilities, and workplace you should first discuss it with your employer, consult you or your safety representative supervisor or manager. You may also wish to discuss it with - giving you the information, instruction, about this appointment; your safety representative, if there is one. You, your employer training and supervision necessary for or your safety representative can get information on health The Health and Safety Executive (HSE), the government your health and safety. Management of health and safety and safety in confidence by calling HSEʼs Infoline telephone service on 0845 345 0055. Appointed person(s): Health and safety If you think your employer is exposing you to risks or is not Health and safety consultation and responsibilities: representation arrangements at this workplace carrying out legal duties, and you have pointed this out without department responsible for preventing work-related illness and getting a satisfactory answer, you can contact the enforcing Your employer must consult you or your representative on authority for health and safety in your workplace (see below). matters to do with your health and safety, including: Health and safety inspectors can give advice on how to comply with the law. They also have powers to enforce it. injury, gave employers until 2014 to change old-style posters for - any change which may substantially affect your health and HSEʼs Employment Medical Advisory Service can give advice safety at work, eg in procedures, equipment or ways of on health at work. You can contact them at the addresses working; below. - the employerʼs arrangements for getting competent people - co-operate on health and safety with other Name and address of enforcing authority whose health and new. St George’s will receive its posters shortly and more than to help him/her satisfy health and safety laws; employers sharing the same workplace; safety inspectors cover this workplace (eg HSE or your local authority’s Environmental Health Department): - the information you have to be given on the likely risks and - set up emergency procedures; dangers arising from your work, measures to reduce or get 100 will be displayed in its buildings located in key points such rid of these risks and what you should do if you have to deal - provide adequate first-aid facilities; Name: with a risk or danger; - make sure that the workplace satisfies Address: - the planning of health and safety; and health, safety and welfare requirements, as reception areas where most people are likely to see them. - the health and safety consequences of introducing new eg for ventilation, temperature, lighting, technology. and sanitary, washing and rest facilities; Names and locations of trade union or other safety Employment Medical Advisory Service representatives, and the groups they represent: - make sure that work equipment is suitable Research by HSE showed that the old text-heavy poster from for its intended use, so far as health and Address: Name: safety is concerned, and that it is properly maintained and used; Location: - prevent or adequately control exposure to You can get advice on general fire precautions etc from the 1999 was visually unappealing and rarely read. Peter substances which may damage your health; Fire Brigade or your fire officer. Group: - take precautions against danger from flammable or explosive hazards, electrical More information about health and safety law McDermott, Health and Safety Manager, said: “It is important equipment, noise and radiation; is set out in HSE publications, such as: Name: - avoid hazardous manual handling Essentials of health and safety at work that St George’s staff understand what the law says about Location: operations, and where they cannot be HSE Books 1994 ISBN 0 7176 0716 X avoided, reduce the risk of injury; An introduction to health and safety: Health and Group: - provide health surveillance as appropriate; safety in small businesses Leaflet INDG259(rev1) HSE Books 2003 (single copy free) health and safety at work. This new brighter version with bullet - provide free any protective clothing or equipment, where risks are not adequately HSE priced and free publications are available Name: controlled by other means; by mail order from HSE Books, points will hopefully get read and understood by more people PO Box 1999, Sudbury, Suffolk CO10 2WA Location: - ensure that appropriate safety signs are Tel: 01787 881165 Fax: 01787 313995 provided and maintained; Website: www.hsebooks.co.uk than the very long, rather grey, old-style poster.” Group: - report certain injuries, diseases and (HSE priced publications are also available dangerous occurrences to the appropriate from bookshops and free leaflets can be health and safety enforcing authority (see downloaded from HSE’s website: box in column 3 for who this is). Another way in which the Trust’s Health and Safety team keep www.hse.gov.uk)

© Crown copyright 1999 First published 1999 Approved by the Health and Safety Executive 1 October 1999 ISBN 0 7176 1779 3 Reprinted 12/06 Price £12.00 (including VAT) workplace risk management front of mind is through the Risk 9 780717617791 Management Calendar. These run April to March and each The old and new health and safety law posters month focuses on a different topic of risk management. About 1,000 are published and distributed to wards and departments and the calendar is also available to download from the intranet. Checklists are available on the intranet for each Health and Safety Law month’s theme and managers are encouraged to use them What you need to know identify unmanaged areas of risk. Allworkershavearighttoworkinplaceswhereriskstotheirhealthandsafetyareproperly February’s theme is violence and aggression. The checklist will controlled. Health and safety is about stopping you getting hurt at work or ill through work. encourage managers to consider issues such as physical security, Your employer is responsible for health and safety, but you must help. eg door locks, whether staff been trained in dealing with conflict and difficult people, and ensuring staff know how to report incidents. Peter explains: “Risk cannot always be eliminated but there are What employers What you If there’s a usually straight forward measures to reduce risk and it is must do for you must do problem

everyone’s responsibility to take action. Local managers can use Decidewhatcouldharmyou Provide toilets, washing facilities Follow the training you have Ifyouareworriedabouthealth 1 in your job and the precautions 6 and drinking water. 1 received when using any 1 andsafetyinyourworkplace, tostopit.Thisispartofrisk workitemsyouremployer talk to your employer, assessment. Provideadequatefirst-aid has given you. supervisor,orhealthandsafety the checklists to identify and manage risk in their area and seek 7 facilities. representative. In a way you can understand, Take reasonable care of your 2 explainhowriskswillbe Report injuries, diseases and 2 own and other people’s health You can also look at our website advice from the Health and Safety team when necessary. controlledandtellyouwho 8 dangerous incidents at work to and safety. 2 for general information about is responsible for this. our Incident Contact Centre: health and safety at work. Co-operate with your employer Problems may need to be escalated to a Divisional Health and Consult and work with you 0845 300 9923 3 on health and safety. If,aftertalkingwithyour 3 andyourhealthandsafety 3 employer, you are still worried, representatives in protecting Haveinsurancethatcoversyou Tell someone (your employer, phoneourInfoline.Wecan everyone from harm in 9 in case you get hurt at work 4 supervisor,orhealthandsafety putyouintouchwiththelocal Safety team to get resolved or the Trust’s overall Health and the workplace. or ill through work. Display a representative)ifyouthinkthe enforcing authority for health hard copy or electronic copy of work or inadequate precautions and safety and the Employment Freeofcharge,giveyouthe the current insurance certificate are putting anyone’s health and Medical Advisory Service. You Safety Committee.” 4 health and safety training you where you can easily read it. safety at serious risk. don’t have to give your name. need to do your job. Work with any other employers HSE Infoline: Free of charge, provide you with 10 or contractors sharing the 0845 345 0055 Peter added: “By highlighting areas of risk, managers can 5 any equipment and protective workplaceorproviding clothingyouneed,andensure employees (such as agency HSE website: it is properly looked after. workers),sothateveryone’s ensure that we are aware of any trends across the Trust which health and safety is protected. www.hse.gov.uk

Your health and safety representatives: Fire safety may need a Trust-wide solution.” Youcangetadviceonfiresafety from the Fire and Rescue Services or your workplace fire officer.

Other health and safety contacts: Employment rights Findoutmoreaboutyour employment rights at: To contact the Health and Safety team, call ext 2487 or www.direct.gov.uk email [email protected] To find the checklists and information about health and safety

workshops and the IOSH Managing Safely course, visit Health and Safety Executive HOLO GRAM © Crown copyright 2009 Published by the Health and Safety Executive (HSE). delete box This product is biodegradable. The hologram shows this is a genuine HSE product. when sending The information in this poster is available in a number of formats. to print the Risk Management homepage on the intranet. ISBN 978 0 7176 6314 9 04/09 Price £6.38 + VAT   

the gazette 15 -fundraising

Life-saving simulation Charity spinathon training for NNU Staff are invited to take part in a charity spinathon at St George’s on St George’s Neonatal Unit (NNU) March 2nd in aid of Action Medical has received more than £60,000 -Research. to set up simulation equipment and training for its staff. The charity funds five research projects based either at the hospital or at St The donation will fund a live George’s, University of London. simulation set up with ‘dummy’ NNU equipment and patient. It will The event has jointly organised by Jon also pay for a specialist nurse to Porter, Transformation Workstream train doctors, nurses and other staff Lead, and Mike Boland, Manager of the in caring for premature and sick Robert Lowe Sport Centre. The six hour babies, and managing life- event will run from 12pm in the bar of threatening situations. the university. The grant has come from a Jon explains: “Fit individuals could charitable trust based in America, take on the challenge of spinning the RBaby Foundation, given to the for all six 50-minute sessions but NNU via its charity, First Touch teams are also invited to cover (formerly the Friends of St George’s the sessions. We will have at least NNU). 13 bikes but are organising for more so that more people can Dr Justin Richards, the Neonatal Justin Richards with baby Mia Richard-Londt take part and raise some cash.” Consultant and project lead, explains that the equipment will year and half. However, this is just enable staff to learn routine tasks the start. safely, but also to practice “Once the simulation training is up Magnificent identifying and responding to and running then we can extend it emergencies. “Simulation- allows us to any teams in the hospital who to train staff safely on situations might deal with newborns babies seven which may not happen often in requiring emergency care, for St George’s Hospital Charity will be clinical practice. We will use the example, A&E staff,” explains Justin. well represented at this year’s equipment for one-to-one training “We also hope to collaborate with Virgin London Marathon with but also for training teams, as in other local hospitals and partner seven runners doing their bit to emergencies it is not just the organisations in south-west London raise money. individuals’ skills which count, but to provide simulation training”. - St George’s staff members Alex Garner, also the teamwork.” “As there is a lot of interest in Marie Synnott-Wells and Jason Bernard He added: “We can also practice for simulation, we will also be hoping to are all running on 25th April, raising rare cases which we know will look at how effective it is as a money for general funds or a for a actually be coming to NNU. For means of delivering training and specific service. Four members of the example, conditions that can be helping staff gain the skills they public are also taking on the 26-mile identified through antenatal need.” challenge for St George’s each hoping scanning but which some staff may to raise around £2,000. Justin will be liaising with St not have encountered before.” George’s Clinical Simulation and The equipment will be based on the Skills team, part of Training and If you would like to Neonatal Unit so it is to hand for Development, in order to set up the sponsor the runners, short training sessions. Current Neonatal Unit’s simulation training. donations can be made via -funding will allow a senior nurse will It is hoped training will be underway the charity office in the work part-time on the project for a by early summer 2010. Grosvenor Wing entrance.

16 the gazette