6 September 2019 Dear Colleague, As the Schools Go Back And

6 September 2019 Dear Colleague,

As the schools go back and students are gearing up for university life the UHB has been as busy as ever. To those of you who have enjoyed a summer break - welcome back.

The summer period did not result in the usual dip in numbers with as many patients presenting at EU remaining as during some of our busiest winter months and this has in some areas placed some pressures on us, which is a picture replicated across the whole of Wales.

Politically the activity on the run-up to Brexit has increased including a lot more interest in the health service and how we would cope with a shortage of medicines, reduced access to medical equipment and, vitally important, our staffing levels.

I’m pleased to say that all of the indications for us are that there is no exodus of EU staff as a result of Brexit and the surveys completed by workforce colleagues are demonstrating that people are providing us with their nationality details so that we can engage with them on obtaining Settled Status in the UK post-Brexit. We have continued the forward planning and contingency work to ensure that we are as prepared as we possibly can be to mitigate any kind of shortages. So, while we are not complacent - none of us can be specific on what a no deal Brexit will mean for health care or health services we provide for our patients - our priority is that staff nor patients are affected adversely by any of the scenarios deal or no deal and that we will remain an open and inclusive NHS service and employer to all.

Due to the increase in activity and the concerns raised, we have placed the Brexit details at the front and centre of our website and we will endeavour to keep you as informed and updated as possible.

Over the past 12 months there have been a number of workshops outlining processes for our Clinical Boards, Estates and Facilities and it’s important that as many staff as possible familiarise themselves with these processes to ensure they know what to do. We will be reissuing some of the operational processes through our internal routes so please look out for these and ensure you know what to do in areas that affect you.

I recognise that this is an unsettling period for some and it’s important that during uncertain times we stick to what we know and continue to operate in the same way that we always do unless required to do something different.

Please keep up the great work that you do every day across Cardiff and Vale and lets look towards the start of the new “school term” optimistically.

As this is my first CEO Connects for almost a month, I would like to take the opportunity to reflect on a summer of success for teams and individuals throughout the health board. I have enjoyed reading about a number of award wins and letters of praise about the fantastic work that is taking place here.

One group of staff that this certainly applies to is our Public Health team, who run ‘Food and Fun’ – the School Holiday Enrichment Programme - together with WLGA, Cardiff council catering services Food Cardiff and Sports Cardiff. I was delighted to read a letter that Vaughan Gething AM sent to our Dietetic Lead Emma Holmes to praise the scheme.

The award winning programme provides good quality meals, nutrition skills, sports education and enrichment activities to children living in areas of need in Wales. It was devised and piloted here in Cardiff in 2015 before being rolled out nationally. It was quickly recognised as a success, winning an NHS Wales Award in 2016.

Vaughan's letter highlighted the fantastic feedback that he received from parents about the schemes when he visited them during the summer, the outstanding effort that he could see being put in by the team to make the schemes a success, and the benefits that had been achieved for some of the most vulnerable local children and families through good partnership working, which are all sentiments that I would certainly echo.

I'd like to thank Emma and the Public Health team for their fantastic efforts on this year's School Holiday Enrichment Programme, which makes such a difference to the health and wellbeing of local families, and highlight their success as a shining example of how working effectively with our partners can have significant benefits on those in our care and the wider community.

Improving care for frail older people in the Vale

This week, we have opened our engagement process for our proposals to improve care for frail older people in the Vale of Glamorgan. With an ageing population that is expected to continue growing in the coming years, we need to adapt the way that our services are delivered to ensure that they are fit for their needs.

In line with the plans set out in our Shaping Our Future Wellbeing Strategy, we have invested significantly in primary and community services to increase the support available to keep people living well at home. At the heart of our proposals are the principles of quicker assessment, quicker discharge and supporting ongoing care needs in the community, which will reduce the need for hospital stays.

Patients tell us that they want to return home quickly to recover after a hospital admission, or avoid being admitted to hospital at all. We know that long stays in hospital can reduce an individual’s independence and confidence as they lose mobility, which we routinely see contributing to clinical deconditioning. Ten days in a hospital bed can equal 10 years of muscle wastage in the elderly, which is what our proposals seek to avoid.

When patients no longer need to be in hospital they should be able to leave with appropriate support in place more quickly, in order to give them the best chance of continued independence and dignity in their own home or a community setting.

The Engagement Document, Frequently Asked Questions and Equality and Health Impact Assessment can be viewed on our website, and we will also be holding a public workshop on Monday 23 September between 1pm and 3.30pm at the Barry Memo Arts Centre, before the engagement process ends on Friday 1 November.

For the latest news about Barry Hospital, read the September edition of the hospital’s newsletter.

Pioneering transplants introduced at UHW

This week is also Organ Donation Week, which is a great opportunity to celebrate the pioneering transplants that have recently been achieved by the transplant team at UHW. The team have successfully transplanted kidneys from donors infected with Hepatitis C, which was a UK first.

Hepatitis C is treated using direct acting antiviral (DAA) tablets, which are the safest and most effective medicines for treating the virus. Since DAA tablets were made available on the NHS in Wales in 2014 those with the virus are able to be cured entirely of the virus over the course of just 12 weeks, with a less than a 1-in-2500 chance that the disease would not be cured.

With an estimated 12,000 people affected by Hepatitis C in Wales, this breakthrough is a great outcome for patients in need of a kidney. Some patients’ health will deteriorate before a suitable organ is identified, and on average three die every day in the UK because of the shortage of organs, despite innovations such as the Welsh opt out system. Any new treatment that increases the number of available organs is therefore of great importance, and demonstrating that organs can be safely transplanted from donors with Hepatitis C is important not just for our patients, but also for those across the whole United Kingdom.

Single cancer pathway introduced

Last month, a new single pathway was introduced for cancer patients across Wales, with waiting times now being measured from when cancer is first suspected rather than from when the referral is first received in hospital.

This is great news for patients, whose waiting times will all be measured in one consistent way, regardless of how their cancer is identified. As well as being diagnosed and treated more quickly, it means that patients will now also be treated more equitably.

Cancer is the single biggest cause of premature death in Wales and the UK, and will touch all of our lives in some way, so I’m pleased that this new single pathway is set to improve treatment for patients both locally and throughout Wales.

Partnership working played a key role in our Stop A Stroke project team being recognised with a national team excellence award at the Welsh Stroke Conference in July. The team has worked very closely with colleagues in primary care to optimise anticoagulation for atrial fibrillation (AF) patients who are at risk of stroke.

AF related strokes are the most debilitating type of stroke, with the greatest mortality risk. Through their work the team has seen an increase in anticoagulation to over 80% in this patient group, and a significant reduction in AF patients being admitted to hospital suffering a stroke.

The team has also processed more than 150 e-advice referrals in the last year, caring for people closer to their homes through avoiding the need for outpatient clinic appointments.

In addition to improving outcomes for patients, the value to us as a health board of reducing the number of patients that need to be admitted to hospital and visiting our sites for outpatient care is clear, which is something that we are increasingly considering. Thanks and congratulations to the team for their fantastic work, which is now being used as an exemplar framework for other health boards in Wales.

Charlotte Church

Readers of the Guardian may have seen a recent article by Charlotte Church about palliative care for her grandmother, who spent her final days with us at UHL. In her article, Charlotte discusses the role that our palliative care specialists played in making sure that her grandmother's time at UHL was as comfortable and dignified as possible, as well as giving the family the opportunity to say goodbye.

For me, the article really brought into focus the special role that the palliative care team plays at what is an upsetting and difficult time for the patient and their loved ones. Their care and compassion for patients and their families makes a huge difference, as Charlotte and her family found when sharing those difficult final moments with her grandmother. You can read Charlotte’s article on the Guardian website.

Lace up for Steptember

For many of us, the summer period can be a time when healthy habits lapse, but the return of the school year and cooler weather is often a good prompt to get back on track. We’ve launched Steptember - a month-long challenge to track as many footsteps as possible throughout September and enjoy the health and wellbeing benefits of being more active.

There has been plenty of activity on social media during the past couple of days and it’s shaping up to be a fun and hotly contested challenge. Some members of staff have already tracked impressive numbers of steps, but we’re only a few days into the challenge and there is still plenty of time to get involved. There are no rules or set activities for participants to follow - simply track as many footsteps as possible before the end of the month.

We have formed a team of Execs and Independent Board members and would like to challenge teams across the organisation to see if they can ‘Beat the Board’ with the number of steps they are able to track throughout the month. Team up with colleagues in your ward, department or service and send your weekly combined total of steps to [email protected] every Monday during the challenge so your team can be added to the leader board.

Please also share your progress, support colleagues and stoke up the competition by joining the conversation on Twitter, using the hashtag #cavsteptember. Good luck, and put your best foot forward!

Marching with Pride

Last month, I thoroughly enjoyed taking part in this year’s Pride Cymru Parade in Cardiff, which was once again a brilliant celebration of the local LGBT+ community. It was fantastic to march alongside so many colleagues from across the NHS Wales family, and to soak up

5 the atmosphere of acceptance and inclusivity, which are attitudes that I am committed to embedding within our culture here in the Health Board.

As an organisation we want to challenge the impact of homophobia, biphobia and transphobia, and work to help reduce significant health inequalities faced by LGBT+ people. We recognise and value the contribution of all CAV staff regardless of their gender identity or sexual orientation, and want to create an environment where everybody can feel comfortable being their true selves.

If you are part of the LGBT+ community or would like to support colleagues within it, I would draw your attention to our Rainbow LGBT+ FFlag Network, which is a support system for all LGBT+ staff across the UHB. As well as having the opportunity to engage with like-minded people, members of the network are consulted on improving and ensuring that all internal policies, practices, and organisational development and priorities remain LGBT+ inclusive.

Sustainable travel

During the past few weeks we have taken some significant strides forward in encouraging sustainable travel at our sites. It’s really important that we do all we can to reduce the number of vehicles at our sites to not only ease some of the challenges that we have with parking, but also to minimise the effects of pollution on both the environment and our patients.

The new Park and Ride Service for UHL has been exceptionally popular since its introduction a few weeks ago, and was especially busy during the temporary closure of the hospital’s multi-storey car park for repairs.

Like the recently extended service at UHW, The UHL Park and Ride offers a great stress-free alternative to parking on site for visitors and staff. If you haven’t yet tried the service, which is being funded by our own Health Charity, I would certainly recommend giving it a go - there is ample free parking, buses leave every 20 minutes and take just a few moments to reach the hospital’s Plaza.

In addition to our Park and Ride Services we have also recently launched a new free staff shuttle bus service between UHW and UHL. The service runs every hour and a half from 7am every weekday, and takes approximately 45 minutes to travel between sites with the last bus departing UHL Plaza at 6.15pm.

Like our Park and Ride services, not only does the new shuttle bus remove the hassle of having to find a car parking space when travelling between sites, but reducing the number of vehicles travelling between our sites is better for the environment, better for our hospitals and better for our patients.

Display Boards

If you have visited UHW or UHL recently, you may have seen new displays that we have installed to celebrate the achievements of our staff. The displays are designed to represent a spread of newspapers and magazines, which share the stories of our staff who were celebrated at this year’s Staff Recognition Awards.

This year’s award ceremony was the first that I had the privilege to attend, and really shone a light on the staff and teams that we are lucky to have here at Cardiff and Vale. When patients come into hospital, we want them to be reassured that those who provide their care are world leaders and award winners in their fields, which is exactly what these installations will achieve.

Some of the things for which our staff win Staff Recognition Awards are not only awe- inspiring but very humbling, so it’s great that we can draw further attention and celebration

7 to them through these new displays. If you have the opportunity, I’d encourage you to drop by and take a look through some of the inspirational stories that are on display.

And Finally…

I would like to share my Congratulations with Sarah Davies, who is our Macmillan Information and Support Facilitator. Sarah has become the very first Macmillan professional in Wales to be presented with the Macmillan Volunteering Quality Standard (MVQS), which recognises the development and improvement that she has made to the volunteer experience at our three information centres at UHW, UHL and Barry Hospital.

This achievement highlights the fantastic effort that Sarah puts into ensuring our volunteers have the support they need to be able to provide their invaluable service to our patients.

I would also like to give my best wishes to Mel Lewis, who has recently retired after an impressive 37 years working here at Cardiff and Vale UHB. Mel joined the health board in June 1982, and has worked in a variety of clinical areas in both UHL and UHW, most notably in palliative care in which she has specialised for 25 years.

In that time Mel has worked to establish and develop a service that delivers well-respected, high quality palliative and end of life care. She has also contributed on a strategic national level, and more recently led the All Wales Palliative Nurses Forum.

Mel's contribution to the service and indeed the UHB can't be overstated. She will certainly be missed but I know that her colleagues will join me in thanking her for her years of service and congratulating her in her retirement. Thank you and congratulations, Mel.

Len Richards Chief Executive