September/October 2017

In this edition: Improving care through simulation p12

Learn while you earn p14

A holistic approach to dentistry p18

University Hospitals NHS Foundation Trust @UHBristolNHS IN THIS ISSUE CONTENTS NEWS

ello and welcome to the News 3-4 HSeptember/October edition of Voices. Launch of new Unity Recognising success 5 This edition is packed with National recognition for checklist that improves Sexual Health service inspiring information about the patient safety In brief work we are doing to ensure Members 6 our patients get the best care. On page 5 you can read about Getting to know your new governors the safety checklist that was Free dental From the chair 7 developed and piloted in our adults’ emergency department treatment at Delivering best care 8 that has been nationally Bristol Dental recognised for its significant contribution to patient safety. 100th patient treated with unique treatment for prostate cancer Hospital We are also offering innovative treatments such as Transforming care 9-11 brachytherapy high-dose-rate (HDR) monotherapy, a Our mission as a Global Digital Exemplar 9 one-off treatment for prostate cancer (page 8), while Seizing control 10-11 our ketogenic dieticians are helping children with epileptic seizures and infantile spasms (page 10). The Unity team celebrated the Research and innovation 12 service launch at Bristol Pride and Weston-super-Mare Pride in July Improving patient care with simulation training While patient services are what unites us, in this edition you can also find out about how you can earn while you new sexual health service led UH Bristol is working in partnership with learn by starting an apprenticeship at UH Bristol (page 14). Aby UH Bristol, for people living seven organisations – British Pregnancy in Bristol, North and South Advisory Service, Brook, Marie Stopes UK, Gloucestershire launched in June. Terrence Higgins Trust, The Eddystone I hope you enjoy this edition. Trust, North Bristol NHS Trust and Weston Unity Sexual Health offers new initiatives Area Health NHS Trust – to deliver the including more evening and Saturday Unity service. clinic appointment slots, a new sexual health service at Concord Medical Dr Helen Wheeler, clinical lead and sexual Fiona Reid Centre in South Gloucestershire and health consultant at Unity Sexual Health, Head of communications Making an IMPACT with bone 13 self-testing kits for sexually transmitted UH Bristol said: “We are thrilled to be f your teeth need some routine marrow transplants infections (STIs), which can be ordered able to offer a range of new sexual Idental treatment and you’re online through the Unity website: health initiatives through Unity such as flexible with your time on Chat to us: unitysexualhealth.co.uk. self-testing kits available online.” weekdays, you could be eligible for Building capability 14 free dental treatment at the Bristol @UHBristolNHS using our hashtag #ProudToCare Learn while you earn Dental Hospital. University Hospitals Bristol NHS Foundation Trust Student dentists, therapists and hygienists from the University of 100,000 genomes Bristol Dental School are offering Lizzie Beale @LizzieBeale1025 free treatment, which includes I can’t thank the staff at Bristol Eye Hospital and 1,000 patients fillings, oral hygiene advice, scale and enough for looking after me so well over the last 6 weeks. They are all stars @UHBristolNHS polish, crowns, bridges or dentures, he West of England NHS Genomic to people who currently don’t TMedicine Centre (WEGMC), led by have a dentist. All treatments are UH Bristol, has enrolled 1,000 patients supervised by qualified clinical staff. Nicola Folker @FolkerNicola and family members to take part in the Embracing change 15 Thank you to all the staff @UHBristolNHS C602 100,000 Genomes Project. Interested? Download a especially Tim for the brilliant care yesterday at Empowering staff to deliver safe and quality Bristol Heart Institute #brilliantnhs self-referral form at uhbristol.nhs. patient care Nicola Windless, from Midsomer uk/media/2812524/bdh_generic_ Norton, and her family have joined this referral_letter_2010v2.doc or pick Above & Beyond 16-17 ground-breaking initiative, which aims one up from the Bristol Dental Julie Alderson @smilealdie to sequence 100,000 genomes from Hospital main reception. Respecting everyone I am proud to work @UHBristolNHS in a team that 18 patients with rare inherited diseases or strives to offer the very best support and care A holistic approach to dentistry with cancer. help provide some answers. Professor Completed forms can be handed to Andrew Mumford, clinical director of the hospital’s reception or posted Meet the manager 19 Nicola’s twin daughters, Kayleigh the WEGMC, said: “The enthusiasm to: Student co-ordinator, Bristol Mark Goninon, head of nursing and Michelle, have an undiagnosed around the project from patients, their Dental Hospital, Lower Maudlin Charlotte Hitchcock @gremlin2c condition and Nicola hopes that families, and the healthcare community Street, Bristol BS1 2LY or emailed to Working together 20 Thank you to staff @UHBristolNHS cardiac research like 100,000 Genomes can has been incredible.” [email protected]. surgical team & the wonderful Charlotte on A607 Celebrating our green impact for care you are giving my brother.

2 3 NEWS RECOGNISING SUCCESS

Innovating care for teenage and National young adult cancer patients recognition

he Teenage and Young Adult portal (tyaiam.co.uk) in which patients T(TYA) Cancer South West team can self-assess their needs at any point for checklist have been shortlisted for a Macmillan during their treatment, including how The team posing with the IAM portal Professionals Excellence Award in the their cancer is affecting their emotional that improves Innovation Excellence category for and psychological wellbeing. This means access to the IAM database for reporting their IAM Portal project. that TYA professionals can access and and assessing overall service demands. review what having this cancer and its patient safety The team has worked with teenage treatment mean for this young person Winners will be announced at the and young adult patients to develop and their support network at that given Excellence Awards ceremony on and design the online mobile-friendly time. Multi-disciplinary teams also have Thursday 16 November 2017. At UH Bristol delivering best care to our patients is our top priority and we do all we can to improve Reduced repeat Reduced Increased interventions the safety of the care we provide. A patient safety Working together attendance with self-discharge such as psychosocial self harm by rates assessment by checklist developed and piloted in our adult emergency to improve care in department has been nationally recognised for its From self-harm significant improvements to patient safety. Hannah 27 20 To % % Allen investigates. recent evaluation of a partnership 13 11 % % Abetween the liaison psychiatry team and Health Integration Team (HIT) STITCH The partnership looks to reduce self-harm Positive results were shown in a report by has revealed the real positive impact they by implementing specialist mental the National Institute for Health Research are having on patient experience. The HIT health services in the adult emergency Collaboration for Leadership in Applied he adult emergency medicine team at “Our standard of care has dramatically that kept patients safe during periods is made up of a multidisciplinary steering department (ED), such as supporting Health Research and Care West (NIHR Tthe Bristol Royal Infirmary (BRI) has improved with statistical significance. of overcrowding in the department.” group who are leading experts in suicide patients presenting with self-harm/suicide CLAHRC West), some of which you can been recognised for its innovative work Since the safety checklist was introduced and self-harm. attempts in adult ED seven days a week. find in the graphic above. to address patient safety and care in the there have been no clinical incidents Since its launch the checklist has been department with a safety checklist tool. where failure to recognise a patient’s continually recognised for its success The checklist, developed by the team, aims deterioration was a contributing factor,” in improving patient safety, and in July to provide a safe, standardised approach says Emma. “As a result of our success here 2017 it scooped a national award at to basic care which is both resilient to at the BRI, the safety checklist has been the HSJ Patient Safety Awards for ‘best Grand Appeal funds jam-packed periods of overcrowding and a variable rolled out to emergency departments in patient safety initiative in A&E’. Jason Arts Week at Bristol Royal nursing skill mix. the region, providing safer care to patients Lugg, matron, previously lead nurse for using these departments, with support the safety checklist project, says: “This Hospital for Children Emma Redfern, consultant in emergency from the West of England Academic national recognition proves that a simple, medicine, explains: “The checklist is an A4 Health Science Network and South West well-designed checklist such as this can ristol Royal Hospital for Children said: “The tree is a really nice way to document used by emergency department Ambulance Service NHS Foundation greatly improve the delivery of safe care.” Bplayed host to an amazing array spread positivity to everyone and lets staff to standardise the basic care. It Trust. It was also noted in the Trust’s of activities in August as part of Arts us know that there are other people ensures hourly observations and National most recent Care Quality Commission A paediatric safety checklist has also been Week, which was funded by its charity, thinking of us! It was lovely to read Early Warning scores (NEWS), pain scores, (CQC) report that the safety checklist developed and is currently being piloted Wallace & Gromit’s Grand Appeal. the messages and it gave us hope.” analgesia and medication administration was being actively managed in a way in the children’s emergency department. are constantly maintained even during Patients, families and staff at the As well as the workshops, The Grand periods when we are extremely busy. hospital were treated to workshops Appeal funded activities around the The aim is to stop us missing early in the play centre, including graffiti, wards for children unable to make signs that a patient is deteriorating. drumming, balloon modelling and it to the play centre. printing, while the play staff were “It also provides a template for busy hanging 1,000 origami paper One activity saw Paula Bowles, ambulance staff to work to, helping to cranes – a symbol of hope and healing illustrator and Gromit Unleashed improve the transition of care between – which were made by wards and artist, join storyteller Wilf Merttens as the ambulance service and clinicians departments across the hospital. they visited patients, working together in the emergency department.” to create wonderful stories which Greeting families as they came into they illustrated simultaneously. To find out how you can help A pilot study of the safety checklist the hospital’s reception during the A huge #TeamGrandAppeal thanks to The Grand Appeal continue its took place at the adult emergency week were two ‘Thought Trees’ which everyone who made Arts Week 2017 vital work to support sick department of the BRI and was supported were soon filled up with messages, such a brilliant experience for the young children and their families, visit by the Health Foundation in winter thoughts and doodles. One parent patients treated at the children’s hospital. grandappeal.org.uk. 2014/15. The Trust then successfully implemented it in winter 2015/16. Some of the ED team standing proud with the checklist

4 ®The Grand Appeal. Registered charity 1043603. ©&™ Wallace & Gromit’s Children’s Foundation/ Ltd 2017. All rights reserved. 5 MEMBERS Getting to know From the chair your new governors Present tense –

UH Bristol continues to keep in touch with our Trust members via Voices, our Health Matters Events and importantly, through our future perfect? recently elected Council of Governors.

n June this year 18 new governors Mary Whittington, a patient, and as the carer of patients, his is my last piece for “Voices” before lack of homes continues and there is still Ijoined the council here at the Trust, public governor – the benefits of having the NHS. As a Tretiring after 13 years with the best an almost wanton disregard by some of including four members of Trust staff, “Before retiring I governor I hope to help ensure quality public service establishment in our the true scale of this basic need. People with a responsibility to represent was an architect and care continues to be available to us all.” region. It has been the greatest privilege are sleeping in the streets again. This members’ views and feed back to worked a lot with to be the chairman. cannot be right in a civilised society in the members whenever possible. Some of NHS trusts to help John Chablo, patient 21st century. These issues have a distorting our governors have shared their reasons them improve the governor – “My Before this I was invited in 1988 to lead a effect on the work of those involved in This is my last piece for for wanting to get more involved in the experience of their patients from the son was treated for small group of people wanting to bring healthcare and particularly the problems “Voices” before retiring Trust and what they hope to achieve in best use of their buildings. I hope to leukaemia at the new answers to the urgent problems faced by the chronically ill and an after 13 years with the best their role. share my experiences with the other Bristol Royal Hospital of the time. The aim was to inspire an increasing elderly population and those public service establishment governors and in doing so support for Children, and ambitious vision for Bristol and to work with special needs. The delivery structures in our region. Jenny James, public my local trust with this agenda.” continues to have to ensure its successful future for the sake that we employ routinely are fragmented governor – “I trained regular follow up appointments there. of its citizens. The largest commercial and are just not adequate for this as a nurse at the BRI Derek Wholey, Following our experience I wanted to enterprises, the universities, the church, challenge and, increasingly, a burgeoning and then spent most patient governor – “I get involved and give something back police service and the local authorities shortage of people with the necessary of my working life at am old enough to after all the support we received.” came together in the Bristol Initiative to skills is insufficiently addressed. the Trust. Following remember life before pledge delivery of creative and positive and sensible constraint, the point of life retirement I wanted the NHS! It was often action. Much was achieved and the group Of course, the nation as a whole needs to is to have the enjoyment of it; to have a to stay involved, and in addition to a struggle for poor survives today in increased numbers. be more imaginative about its approach good life. In thinking about it I recalled becoming a governor I also volunteer at working-class families For a full list of the Council of The members continue to commit to the to these vital matters and more honest. some words of the Roman philosopher the Bristol Haematology and Oncology to pay for healthcare, so often they Governors, please go to the Trust long-term improvement of the place in Our local strategic partnership, in which and politician Cicero from the last century Centre. I really feel it’s important to did not seek treatment until it was too website: uhbristol.nhs.uk/about-us/ which they choose to operate, believing the Trust plays a major part, begins to before Christ. He argued that the basis support the NHS, and hope that in my late for a satisfactory outcome. I’m how-we-are-managed/governors that their own organisations will naturally take effect in seeking radical change of moral goodness and the ability to live role as a governor I’ll be doing this.” getting involved as I know first-hand as benefit from enlightened self-interest in but it deserves more resource if it is to a good life depended on, amongst other the condition of others. ensure the successful long-term plan that things, the need to behave considerately is an imperative if standards are to be and understandingly in our associations The Initiative led partnerships to bring maintained and improved. with other people. Another leader, 80 positive activity through flagship odd years later, exhorted us above all projects like renewal and the The world around us grows more ugly and else to love one another, which I have regeneration of the Harbourside amongst infinitely less civilised in spite of the great interpreted as to take care of each other. I many others. It provided resource, triumph over evil accomplished 70 years see the efforts of our staff applying these expertise and immense commitment from ago with the ending of the Second World maxims as a routine of their daily lives, leading players. War. We cannot boast our position as one often against great odds, and I have been of the most civilised societies ever seen on enormously inspired by it over my time Looking back I believe we failed to earth until we do properly consider our with the Trust. adequately understand the long-term obligations to each other and as part of problems that would be posed for this achieve the level of care promised by I wish all the fortitude to continue and health and welfare services. The starkest the creation of the welfare state and the good fortune in your own lives. challenges then were homelessness, the National Health Service. We have a vast poor performance of state education and debt to those who fought for our free threats to the economy. existence but could not go on to enjoy it themselves; we are obliged to complete Look out for details of our next Health Matters event, to be held in November, on our website at Sadly the fundamental ills have not the job. Health uhbristol.nhs.uk/about-us/how-we-are-managed/membership/. changed greatly; Bristol is not as threatened as it was 30 years ago, My general belief has been that, within Matters Our governors are always keen to hear from you; you can get in touch with them by emailing investment has occurred, but a chronic the bounds of considerate behaviour Canon Doctor John Savage CBE, chairman events [email protected]. You can contact them with your queries and suggestions for future events.

6 7 DELIVERING BEST CARE TRANSFORMING CARE

Our mission as a Global Digital 100th patient Exemplar treated with A digital revolution is happening in our nurses to record patient observations, hospitals. John Kirk discovers how the Trust’s such as heart rate and blood pressure, unique treatment in real-time on a portable device. This role as a ‘Global Digital Exemplar’ will lead will keep track of a patient’s vital signs, to improvements in quality of care, safety and reducing the risk of errors, giving for prostate cancer access to information for our patients. early warning if a patient’s condition deteriorates, and prompting where more frequent observations are needed. The brachytherapy team at the Bristol Haematology “There are many advantages to brachytherapy HDR monotherapy, but t UH Bristol, we’re on a mission to A secure messaging system, similar to and Oncology Centre has recently treated its 100th it appears few men who are diagnosed Atrial pioneering digital technology to smartphone messaging apps, will allow patient with brachytherapy high-dose-rate (HDR) are aware. Following treatment there drive radical transformation in the care of clinicians to have conversations about a monotherapy; a one-off treatment for prostate are no immediate restrictions, including our patients. patient’s care remotely. They will be able interruptions to the patient’s diet or ability to securely access patient information and cancer. The unique treatment offers a less invasive to drive. Interactions with family and Last September, we were named by health connect to other systems, revolutionising alternative to surgery, and normally requires just friends will not be affected as a result of secretary Jeremy Hunt as one of 16 acute the way they work. radiation and the outcomes are the same trusts in the UK to become a ‘Global Digital one overnight stay in hospital before the patient can as for those patients who have surgery.” Exemplar’ to lead the way in using the Ensuring systems work together is key and return home. latest technologies to benefit our patients the projects being developed will allow Alan added: “Following the treatment I and improve our working practices. data to be shared electronically, reducing he 100th patient to be treated “For years my tests were clear but last year, feel fine, and I have no regrets. I will be duplication and ensuring staff have the Twith the therapy, Alan Windslow, after a biopsy, it was confirmed that I did followed up with a call and will return The three-and-a-half year programme latest information available about a was informed in December 2016 that have prostate cancer.” Alan discussed his to the hospital for future check-ups with features 20 major projects and many smaller patient’s condition and treatment. he had prostate cancer following an treatment options with clinicians closer to the team. My tests have always been ones all designed to bring improvements annual check-up with his GP. “After home, and was introduced to Amit Bahl, straight-forward and the only discomfort for our patients and staff. Dr Dangoor says the future looks exciting my brother had surgery for prostate oncology consultant in Bristol, who could I’ve experienced to date is the biopsy and with systems due to be trialled early next cancer in the United States 14 years perform brachytherapy HDR monotherapy. immediate swelling following treatment. Dr Adam Dangoor, consultant in medical year that will bring further benefits to ago, I was advised to regularly visit No comparison to what could have been.” oncology, said: “This is a really exciting patients. “This programme will mean my GP for check-ups in case I was at Amit said: “We are very fortunate opportunity to provide new technology to doctors and other healthcare staff will risk of prostate cancer,” said Alan. to be one of a handful of hospitals support patient care faster than would have find it easier to share data faster, reducing in the UK to offer this treatment been possible outside of this programme. delays in treatment and improving “I was aware the prostate enlarges as to prostate cancer patients. The advantages for patients will be both in safety,” he added. you get older, and have always been the quality of care they receive, and easier proactive about checking if there are any “Often we see patients local to the access to services and information.” “In addition, patients will have more noticeable changes. When my brother hospital, but because there are few convenient access to their own information was diagnosed, he didn’t know where hospitals that can offer this service we can Over the coming months some of the online. They will be able to check their the prostate was and had no noticeable see patients from as far as Cornwall to the systems we have been developing own health records or perhaps have symptoms, so I knew it was important to Midlands and have even treated a patient will begin to be rolled out across our consultations via mobile phone to reduce remain vigilant and check. from the Isle of Wight. Amit Bahl, oncology consultant hospitals, including one which will allow hospital attendances.”

8 9 TRANSFORMING CARE TRANSFORMING CARE Seizing

controlhe ketogenic diet is high in fat, Victoria adds: “We have found Mandy Savin’s son, Jack (pictured), Twith low amounts of carbohydrate the diet to be effective in lots of experienced a seizure at 18-months-old, and sufficient protein for growth. The different types of seizure disorders which led to him being taken to the Royal exact mechanism of how the diet works and infantile spasms. Fasting has been United Hospital in Bath. It was discovered he isn’t yet known, however it appears to used as a treatment for seizures for had a rare genetic disorder known as SCN2A. reduce the abnormal electrical activity many years and was first used in the in the brain which can cause seizures. 1920s as a treatment for epilepsy. After trying different medications, consultants suggested that they “This may be due to the direct action of “Generally, a third of patients respond begin a ketogenic diet to help the ketones produced, or the metabolic very well, 10-20% becoming seizure-free. reduce Jack’s seizures. changes associated with ketosis,” A third have a 50% improvement and a explains Victoria Bittle, specialist third unfortunately don’t respond at all. “I had done some reading about it and paediatric ketogenic dietitian. In some cases, it may be possible to reduce thought it sounded great, but didn’t or even stop anti-epileptic medications, realise they offered it in the UK, so I “When eating a normal diet our brain a decision made by the neurologist. was thrilled when we got referred over uses glucose as its main source of to the team in Bristol,” said Mandy. fuel, which comes from carbohydrate “A three-month trial is offered to all foods. When these foods are removed patients to assess the effectiveness of “They were fantastic. They ran some tests from the diet and replaced with a diet the diet and we only continue with it if on him to make sure he was going to very high in fat, the body responds by there has been a marked improvement be okay on the diet and we started it in producing ketones, which the brain in the child’s quality of life. February 2016. A few weeks later he picked starts to use as its new fuel source.” up a bug and we got sent back to hospital “Children should be considered for the with terrible seizures, but we weren’t Since it was set up in 2010, the service diet if they have failed to respond to deterred and continued with the diet. has seen more than 90 patients from two or more anti-epileptic medications. birth to 18 years of age, with more A paediatric neurologist or consultant “We started noticing some real neurologists considering a ketogenic paediatrician can then refer them to us. cognitive changes in him – a few smiles diet as a robust treatment option for started shining through, something the management of epilepsy. The team “It’s so rewarding to be able to help we hadn’t seen in nearly six months. of dietitians will tailor a food plan to children through the diet and see We were so excited and the seizures an individual’s needs, with the food the incredible life-changing effects it were becoming less and less.” given orally or through a feeding tube. can have.” Jack, now three-and-a-half years old, has been going from strength-to- strength. Before starting the diet he was having up to 50 seizures a day, now he gets one or two a week.

Epileptic seizures and infantile spasms can be disruptive and distressing. In “It’s amazing how well he is doing, he’s gone from being tube-fed to feeding instances where several different anti-epileptic medications fail to make an himself with a bottle. He is crawling impact, neurologists from across the country are frequently referring young around the room and even looking to patients to the ketogenic dietitians at Bristol Royal Hospital for Children. Now play with his toys again, and best of all, he’s laughing with his little sister. that the team has begun receiving referrals from South Wales, Abigail Evans met them to find out more about the difference they’re making to children’s lives. “We are so grateful to the staff in Bath and Bristol for never giving up on our Paediatric dietitians Chloe Elliot, Victoria Bittle and Phillipa Thomas little boy and always fighting for him.”

10 11 RESEARCH AND INNOVATION RESEARCH AND INNOVATION Improving patient care Making an IMPACT with with simulation training bone marrow transplants

At UH Bristol, developing where they are cared for in our newly our staff and enhancing their built specialised ward. skills is really important as The specialist BHOC Clinical Trials part of our mission to improve Unit (CTU) is already experienced in the health of the people we recruiting patients into clinical trials, serve. The Bristol Medical allowing many patients to access new and pioneering treatments. Simulation Centre (BMSC) provides simulation training Last year, over 500 patients were to our staff as well as other recruited into BHOC clinical trials, healthcare teams from across including 22 into adult BMT trials. The BMT unit recruits twice as many the country. Hayley Billington patients into transplant trials than the investigates. national average.

he BMSC’s unique simulation More recently, UH Bristol was the first Tprogramme helps to improve training, centre in the world to recruit and treat patient safety and quality of care across a patient into a global trial exploring the Trust. Provided to around a quarter treatments for possible complications of of our staff, the training is used at UH a bone marrow or stem cell transplant Bristol as an effective way for staff to from another person. practice their skills in treating and caring UH Bristol’s IMPACT centre team for patients. H Bristol strives to be a world-class who need a bone marrow transplant. It The leading centre trained more than Uleader in healthcare research will mean our patients, where eligible, 2,100 UH Bristol staff between April 2016 to explore ways to improve patient can experience pioneering techniques, and March 2017, providing over 400 care. Our efforts received a boost in therapies or treatments, improving their innovative training sessions in the wards May, when we were named as one care, outcomes and quality of life. and departments where they work. of ten new funded IMPACT centres in the UK to lead the way in Bone “To play a part in such a ground-breaking Made to mimic a human patient, Marrow Transplant (BMT) research. development is an exciting prospect. the lifelike simulators can physically Each trial brings new challenges open eyes, breathe and even make The funding pays for a research nurse for and we look forward to continuing sounds. They can be used to simulate four years who will lead clinical trials to to develop our specialised skills a variety of situations including asthma explore ways to improve outcomes for within the Trust to improve patient and burn wounds. patients who receive transplants to treat care and overall outcomes.” conditions affecting the blood cells, such as The simulators are transported to various leukaemia and lymphoma. The focus of the IMPACT programme is clinical workspaces across the Trust, stem cell transplantation. A stem cell or with sessions being delivered in a wide The funding will allow us to build on the bone marrow transplant replaces damaged range of areas including emergency their skills in a familiar environment with The BMSC was the first simulation centre great work already under way on our adult blood cells with healthy ones. departments, medical and surgical wards, their own equipment and teams. It also to open in the UK and the adult and BMT unit at the Bristol Haematology and high dependency areas, intensive care, serves as an effective way to test processes paediatric simulation programmes here Oncology Centre (BHOC), as well as the Stem cells are special cells produced by theatres and recovery units. This method within wards and clinical areas, and make in Bristol support some of the most efforts of the centre’s clinical trials team to bone marrow (a spongy tissue found in of training also allows multidisciplinary any necessary adjustments.” diverse and well established simulation research new techniques and treatments. the centre of some bones) that can turn teams to exercise working together, activity in the UK. into different types of blood cells. A stem making use of the variety of expertise, At UH Bristol, nursing staff often take Newly appointed IMPACT clinical trials cell transplant involves destroying any skills and knowledge within the teams. part in simulation training as part of their “This type of simulation training helps nurse Peter Robertson said: “The IMPACT unhealthy blood cells and replacing them induction before they begin work on our us guide teams towards improved award is fantastic news for UH Bristol and with healthy stem cells removed from the Dr Dan Magnus, paediatric simulation wards. Tailored training is also provided performance and patient safety,“ says Dan. in particular for our BMT patients. blood or bone marrow. programme director, explains: “The BMSC’s to staff when necessary so they can gain unique simulation programme gives experience and practice management of “The ultimate aim is simple: to improve the “It will allow us to access more studies Each year around 200 patients are referred Peter Robertson, IMPACT UH Bristol staff a chance to consolidate specific clinical problems. care we provide for patients and families.” than ever before to benefit patients to the Bristol Adult BMT unit at BHOC, clinical trials nurse

12 13 BUILDING CAPABILITY EMBRACING CHANGE Learn while Empowering staff you earn to deliver quality Apprenticeships are a great way to learn and earn patient care on the job. UH Bristol is now an official provider of apprenticeships and offers a huge range of career opportunities in clinical and support services.

ith rising tuition fees and increased competition for jobs, apprenticeships Ware becoming more of an attractive option for career development.

As one of the largest acute trusts in England and one of only seven NHS trusts with main apprenticeship provider status which is recognised by the Government, the opportunities available to learn transferable skills at UH Bristol are widespread.

“Our Trust is one of Bristol’s largest employers and an apprenticeship with us is an opportunity to gain professional skills, knowledge and UK-recognised accreditations while you are in a paid job,” said Julian Newberry, deputy head of education at UH Bristol.

“People think because we are a healthcare organisation the only career opportunities we can offer are clinical but we have a vast range of job opportunities in support services such as finance, administration, team leadership and management, engineering, Empowering our staff to deliver high-quality patient library services, maintenance and information technology.” care is vital. We want to encourage and give staff the Winner Naomi Hryb Ian White is a senior electrical engineer “I’m in my third year of my four-year tools to continually improve what they do. at UH Bristol and currently hosts six apprenticeship at the Trust. It’s been apprentices on his team. He said: “There great having the opportunity to gain the arlier this year we launched our Congratulations to those winners; are many great benefits to employing qualifications that I want whilst getting EQuality Improvement Academy Naomi Hryb and Caroline Horrobin, apprentices such as more flexibility within paid and experience all at the same time. which aims to encourage and support patient safety nurses, for their poster the workforce, the chance to pass on Once I’m a qualified mechanical engineer, staff to get their innovative ideas off titled “Improving the identification and knowledge and experience of the unique I’d like to continue to work at UH Bristol the ground. Since April, over 50 staff treatment of sepsis in the adult inpatient engineering requirements of the Trust as it’s a good team and the work is really have attended a “bronze” entry level population”; to Lucinda Armstrong, and the enthusiasm and drive to learn interesting and varied.” programme to expand their knowledge senior staff nurse, and Mark Lyttle, from our apprentices is really inspiring for and practical skills about quality emergency department consultant, for Stephen Brown, improvement manager, Anne Reader, head of quality, Anne Frampton, the entire team.” Charlie Pugsley, mechanical engineering improvement. their poster “Criteria Led Discharge is apprentice, UH Bristol estates department clinical lead for transformation and Simon safe and effective for wheezy children” Chamberlain, director of transformation This was followed in July by a quality and to Nathaniel Ahearn, orthopaedic Did you know? improvement forum which showcased registrar, Paul Gravestock, F2 trauma & Anne Reader, head of quality (patient An apprenticeship is not just for “I originally joined the Trust from a retail staff members’ quality improvement orthopaedics and colleagues for their safety), who presented the prizes, said: school leavers. They are available background as an assistant technical officer work, brought colleagues together and poster titled “Optimisation of BRI acute “I knew our staff were doing some great to anyone who is aged 16 years or in the pharmacy department. Working gave them the opportunity to interact fracture clinic”. quality improvement projects within the over and looking for an exciting new alongside pharmacy apprentices, I saw and discuss their work with peers. In Trust, but I was amazed at the number opportunity to develop or further a progression route for myself. I didn’t total staff created and submitted over Naomi said: “I entered the forum to and variety of fantastic projects from their career. want to leave the Trust to gain training, so 70 posters into a competition and 66 showcase the good work and outcomes different teams. enrolling as an apprentice meant I could of those were displayed at the event in that we have achieved in the care of train and work here at the same time. I aim the atrium of the Bristol Heart Institute. patients with sepsis.” “If evidence of our commitment to quality For more information on to get more experience at the Trust and to The audience, full of entrants and and safety improvement was needed, the apprenticeships at UH Bristol, further my qualifications.” staff members from across the Trust, “We recognise that healthcare is quality improvement forum provides a please email apprenticeships@ quietened to hear Anne Frampton, always evolving and therefore quality focus to recognise and share some of this Hayley McSweeney, pharmacy technician clinical lead for transformation, improvement is vital to keep pace and great work to help us deliver the best care uhbristol.nhs.uk apprentice, UH Bristol pharmacy department announce the three winning posters. improve patient care”, added Caroline. we can for our patients and their families.”

14 15 ABOVE & BEYOND Above & Beyond is the local charity raising funds for patients, families and staff in hospitals 0117 927 7120 aboveandbeyond.org.uk

Fundraising for Bristol city centre hospitals Providing comfort The Bristol Heart in times of need our support has helped give Y£5,000 to the hospitals’ palliative Institute Appeal care team to create ‘Comfort Boxes’ for relatives or carers staying in hospital Help raise £830,000 with patients at the end of their lives. and together we can The new boxes contain little things continue to provide the that make a big difference when you don’t want to leave a loved one’s side very best care to those including toiletries, tea, coffee and even who need it most. a small thermos flask.

Sue Coghlan, Sister on Ward 78 at n Friday 29 September, we launched St Michael’s Hospital, said: “During Oour new Bristol Heart Institute difficult times, it really is the little things Appeal to celebrate World Heart Day. that can make all the difference to a relative’s or carer’s stay on the ward. Christmas Star The Appeal will raise funds to ensure the Having simple amenities such as the Bristol Heart Institute (BHI) continues to ability to make yourself a cup of tea in the patient and their family, friend or Concert stay at the forefront of treatment for the early hours without having to leave carer, when they need it most.” Thursday 14 December patients with serious heart conditions. your loved one is so important. 7.30pm – 9pm The funds have also purchased special Bristol Cathedral We need to ensure hospital staff have the “These comfort boxes will allow us to chairs which convert into a bed for latest hi-tech heart scanning equipment provide the best possible care for both relatives or carers who stay overnight. oin us for a magical evening and facilities to perform complex keyhole Jof musical performances and surgeries. Minimally invasive keyhole traditional carols in the magnificent surgery is particularly important for Bristol Cathedral. Featuring The patients considered too high risk for open Queen Elizabeth’s Hospital School heart surgery and results in faster recovery, The whole team wants to make a Choir, The Above & Beyond Singers fewer post-surgery complications and less New partnership and many more! difference and enhance patient time away from home. experience even further, and your support through Above & supports Bristol Royal Now in its fifth year, this enchanting We’re fundraising for… Beyond means the world to us. event is a must on the city’s calendar. People from across the South £30,000 West directly benefit from having CorKnot devices Hospital for Children specialist cardiac services on To assist surgeons carrying out their doorstep. Your help with the intricate keyhole procedures such as Bristol Heart Institute Appeal will he UK’s original balance bike heart valve surgery. The device rapidly enable us to push the boundaries company, Kiddimoto, has teamed up ties surgical knots in extremely small T of innovation even further for with Above & Beyond to support Bristol and difficult to reach spaces, giving Royal Hospital for Children. surgeons greater control, accuracy future provision of care. Jenny Anstey, matron and speed to aid a faster recovery. £1 from every helmet sold on their official website (kiddimoto.co.uk) will be donated to projects that make a real difference to Echocardiography £378,000 children being treated in the South West. facility To relocate all heart scanning services £106,800 Throughout August, Kiddimoto also Tickets: £12 adult, £5 child, £25 A new echo machine under one roof. Currently these launched a special Above & Beyond family (2 adults, 2 children). To provide the Cardiac Intensive are split between the Bristol Royal To donate, or for information ‘Design-a-Helmet’ competition for will be donated to help children and To book, call Above & Beyond on 0117 Care Unit with its own ultrasound Infirmary (BRI) and the BHI, so this about fundraising events, visit children to design their very own helmet. families being treated in our hospital. 927 7120, visit aboveandbeyond.org.uk equipment. This will enable urgent would mean that cardiac patients aboveandbeyond.org.uk or call The winner will spend the day with or pop into our Fundraising Hub in bedside diagnosis and prevent would no longer have to be moved 0117 927 7120. Thank you. Kiddimoto’s design team and see their Thank you to everyone who has entered the BRI Welcome Centre, delays in diagnosing life-threatening around the hospitals for a scan. creation come to life ready for Christmas. and to the wonderful Kiddimoto team Mon–Fri, 10am–5pm. conditions. £5 from every ‘Above & Beyond’ helmet based in Cheddar.

16 17 RESPECTING EVERYONE MEET THE MANAGER

We’re sitting in a spacious, private room which has equipment you wouldn’t expect A holistic approach to see, such as walking aids, a wheelchair tipper and a hoist. There is another room nearby that has a specially-adapted to dentistry bariatric dental chair for patients who can’t be treated in a standard chair.

Patient-centred care is something all our clinical teams Shabnum says: “We aim to provide holistic care and make all the reasonable strive to achieve, but there’s a small and busy team in adjustments we can to ensure patient Mark Goninon Bristol Dental Hospital who have set the gold standard experience is the best it can be, as the with their holistic approach to caring for vulnerable standard care pathway isn’t always suitable. Primarily our focus is patient- Head of nursing patients. Steph Feldwicke finds out about the work of centred, in support of their families the special care dentistry team. and carers and we do our best to provide care that’s tailored for them.”

As some patients do not have the capacity to give consent, their carers, relatives, social workers, and other medical teams are fully involved in their treatment. Shabnum says: “Working out the best plan can be very complex, we have to juggle the best clinical outcome with what is holistically in the patient’s best interests. If a patient doesn’t have family or friends, an independent mental capacity advocate (IMCA) will be involved.”

The special care dentists provide all of the outpatient treatments at Bristol Dental Hospital, and provide dental treatment under general anaesthetic once a week at the day case unit at St Michael’s Hospital for patients who can’t be treated while they are awake. Other medical How long have you been in within our services against the more innovation, and I think the hospital has procedures or tests are often carried out your current post and what long-term goals of the hospital. To boil an enormous amount of potential to at the same time, so the patient does is your background? it down, I have oversight of all aspects of deliver even more pioneering patient not need another general anaesthetic. I’ve been at the Trust since September nursing within the children’s hospital. care. What I want to do is to raise the 2016, so, 12 months now. I’m Australian; profile of the hospital on a national Lorna Hayles, learning disability liaison I trained in Australia and came to the What are some of your level and I think that’s a really exciting nurse (LDSN), works closely with the UK in 1990. I’m hospital trained and focuses right now? opportunity, to get all of the staff Heather McKenny, nursing assistant who specialises in caring for patients with special needs team to ensure that adjustments in care went straight into paediatrics after We’re about to take the initial steps here the recognition they deserve. and Shabnum Ali, senior specialty registrar are made to support equal access for training. I worked for five years in general towards setting up a South West those living with learning difficulties, paediatrics before working in paediatric Hospital network. This means that all What’s your management style? meet Shabnum Ali in a large, specially Dental Council in 2008, and the specialist their families and carers. She says: “It’s intensive care. I’ve worked at Guy’s and the children’s wards across the South My ethos around leadership is Iequipped treatment room. She is a training pathway started in the Bristol rewarding to champion and advocate the St. Thomas’, Harefield Hospital and West will support each other with clinical collaborative, I believe in doing things specialist in special care dentistry and Dental Hospital in 2010; it has since needs of people with learning difficulties. Birmingham Children’s Hospital. I then advice, strategic planning and innovation. together. There are times when I need to one of eight members of a team led by become a regional training centre. Recent feedback has highlighted that worked as a clinical site practitioner for Working together with other hospitals make decisions, but, as much as possible, consultant Tony Brooke, which includes having the support of the LDLN makes eight years and as head of nursing for will encourage children’s healthcare to I like to get feedback from the teams to specialty registrars, a specialty dentist, Shabnum explains: “We see adults with such a difference to patient experience.” four years at Great Ormond Street. Most be more streamlined in the region, and understand what their views are. I’ve never dental core trainees (DCTs) and nurses. many different types of physical or recently I was head of children’s nursing ultimately help us to deliver high-quality professed to know it all and I never will. learning disabilities, medical problems, Shabnum adds: “It is a challenging but for the Royal Free Trust. patient care. We also have a lot of new I’m always learning, the same as everyone They receive referrals from GPs, mental health conditions, patients who rewarding specialty which requires a wide nurses joining us in September and else, therefore we should be making a lot NHS and private dentists and other have cancer, those who are elderly range of skills and medical knowledge, What does your job involve October so I’m focusing on what we can do of decisions together. parts of the Trust and treat a diverse or end-of-life patients, patients who as well as proficiency in all aspects on a daily basis? to ensure they are settled and supported. group of patients who are not able have social barriers to care such as of dentistry. But the most important Along with the operational lead, I’m If you could have dinner to access conventional dental care. homelessness or drug abuse, or anyone qualities are empathy and compassion for responsible for coordinating and delivering What do you enjoy most with somebody famous, who who is not able to access dental care patients. I get a huge sense of satisfaction everyday activities and processes for our about your job? would it be and why? Special care dentistry is a specialty that on the high street. We reach out to from knowing I’ve done everything I nursing workforce. This involves balancing I enjoy the challenge. The staff at the Bill Nighy. He just strikes me as a very became recognised by the General some of the most vulnerable people.” can to help a vulnerable patient.” the management of day-to-day pressures children’s hospital are beaming with interesting person.

18 19 WORKING TOGETHER Celebrating our green impact

The Green Impact Awards have been running at UH Bristol since 2008, supporting staff to make small changes that make a big difference to the environment. The 2016/17 ceremony was held at the ’s Wills Memorial Building. Abigail Evans attended the event to find out more.

he Green Impact Awards celebrate along with six teams and individuals who “I also nominated the Early Supported Tand recognise the efforts of teams received Special awards. Each winning Discharge team for a Special award who perform activities in their workspace team received a recycled slate plaque due to their use of electric bikes. that have a positive environmental to display in their department and a We’re now able to offer more impact. Activities range from making sure Fairtrade hamper. patient home visits by e-bike.” all lights are switched off at the end of the day, to taking the stairs instead of Caroline Bannister, deputy general Sam Willitts, sustainability manager for the the lift, to calculating the team’s carbon manager at South Bristol Community Trust, said, “The Green Impact Awards are footprint for business mileage. Hospital, took part in the Green Impact part of a wider sustainability agenda at awards this year for this first time. the Trust, known as the Big Green Scheme. The 2016/17 Awards were launched in October 2016 as part of Bristol Healthy “I set about gaining the Bronze award by “We recognise that one of the biggest City week; teams had from then until ensuring rooms had the correct recycling effects of climate change will be April to complete their green activities. bins, and adding posters and stickers to on the health of people. Therefore, During this time a nominated team remind people to think green and recycle as a Trust, we have committed to member logs the team’s actions in an where possible,” said Caroline. improving efficiency, promoting healthy, online workbook which monitors their low-carbon lifestyles and creating a progress towards a Green Impact award. “We followed the online workbook and shared vision where NHS trusts are part activity list, whilst communicating to of the solution to climate change.” The ceremony was a joint event with relevant colleagues exactly what we were North Bristol NHS Trust and the University aiming to achieve. In doing so we’ve For further information and of Bristol. UH Bristol chief executive, raised staff awareness and encouraged to get involved please email Robert Woolley, presented 21 teams from them to take responsibility for recycling [email protected]. the Trust with a Green Impact award, and turning lights off.

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