In This Edition

Home , Russell Howard

Jan/Feb 2019 The magazine for the UH Bristol community PAGE

In this edition:

Helping our patients live well with and beyond cancer p7

UH Bristol fights flu! p10

Let's talk about alcohol and tobacco p11

Promoting equality and diversity in the NHS p19

Get involved:

IN THIS ISSUE CONTENTS NEWS

News 3-4 Welcome to the Promoting rest and January/February From your chair 5 edition of Voices - the first edition of 2019. Members 6 sleep in our hospitals Building capability 7 In brief I am excited to be taking on the editorial role for Voices Helping our patients live well with and beyond cancer magazine, especially as there is Recognising success 8-9 UH Bristol consistently so much fantastic Sharing best practice with future generations work to showcase from across is now our hospitals. In 2019 it’s Nationally recognised for making a difference important we continue to Working together 10 completely recognise the successes of our staff and the hard work UH Bristol fights flu! that goes into improving the health of the people we serve. smoke free Embracing change 11 In this edition you can find out about the great work Let's talk about alcohol and tobacco of our Bristol Haematology and Oncology Centre staff which is improving the experience of our patients; how staff across our hospitals have been working together to promote the flu vaccine; and how a team of elderly care registrars have developed a ten-minute delirium training session.

I hope you enjoy this edition. taff across the Trust have joined initiative, said: “We wanted to Stogether to help reduce noise re-establish the importance of rest at night time for our patients. and sleep on patient recovery and ensure this is provided in all ward areas The Noise@Night initiative raises within the Trust as much as possible.” awareness of the importance of Tasmeen Warr being quiet around our hospitals at To mark the launch of the initiative, Internal communications manager Delivering best care 12-13 night, which can help our patients an art installation was displayed in the Service development proves life-changing for patients to get a restful night’s sleep. Bristol Heart Institute, a local choir visited wards to sing lullabies, and Delerium training on wheels Chat to us: Julie Crawford, cardiac intensive care new posters and banners are being Research and innovation 14-15 and surgery matron and lead for the displayed across our hospital sites. niversity Hospitals Bristol NHS Foundation Trust is @UHBristolNHS using our hashtag #ProudToCare Pain relief – how research could help to treat pain U now completely smoke free. University Hospitals Bristol NHS Foundation Trust following surgery For the greater good Patients, visitors and staff are not Justin Ridge @jpridge Children receive permitted to smoke anywhere on Heading home to #brisvegas after having to Above & Beyond 16-17 race to the UK when Dad had a heart attack. toy models our hospital sites. This includes 11 days on he’s doing better than expected Renewing our hospitals 18 inside the buildings and outside - poss home next week. Thx to the staff Improving wellbeing through arts and culture of treatment the buildings within the boundaries in #ITU and #Bristol_Heart_Institute at of our grounds (signified by a @UHBristolNHS (BRI) for working miracles. Respecting everyone 19 machine white painted line on the ground). Marvin Rees @MarvinJRees Promoting equality and diversity in the NHS E-cigarettes are also not permitted It was great to visit anywhere on the hospital sites. @UHBristolNHS hildren and young people undergoing a wonderful addition to our specialist today, where I had the cancer therapy at UH Bristol are being resources that we use to prepare children Matthew Joint, director of people opportunity to talk with C patients & staff. Thanks given toy models of the machine used in and young people for radiotherapy, which at UH Bristol, said: “As a healthcare to all #Bristol #NHS staff their treatment to help them better prepare can be very frightening and cause a great provider we have a role to play for your hard work & for radiotherapy and ease their anxiety. deal of apprehension to the child and their in promoting healthy living and important contribution to the health of our city, family. Having a model of the machines can offering support to staff and patients especially at this time of The Institute of Physics and Engineering help the child to understand what they who want to give up smoking.” the year #WhyILoveTheNHS in Medicine (IPEM) initiated the ‘Little are going to see and experience.” #NHS70 @NHSEngland Linac’ project to give every child in the UK undergoing radiotherapy treatment for The ‘Little Linac’ project is being rolled Kathryn Tully @KathrynTully Find out more at cancer a free kit of play bricks to make a out to every children’s radiotherapy Thank you to all the amazing staff at www.uhbristol.nhs.uk, call the Bristol Heart Institute @UHBristolNHS model linear accelerator machine (Linac centre across the country thanks to a Smokefree national helpline on for the outstanding care you gave my for short), which is used in their treatment. York-based charity. Steve Blake, head Meet the Manager 20 0300 123 1044, or drop into your dad for the last 7 days. A special thank of radiotherapy physics, is working with you to the nursing team, and in particular Sheena Vernon, lead nurse for the congenital heart local pharmacy for advice. Matt, Michelle and Debbie, on ward C705. Joanna Casely, oncology play specialist IPEM to share the model linacs with We’re so very grateful to you all! disease network for the South West and South Wales at the children’s hospital, said: “This is the children’s hospital here in Bristol.

2 3 NEWS FROM YOUR CHAIRMAN

20 teams from We’re here UH Bristol to help awarded for In December, we launched a new patient green impact experience programme called ‘Here to help’.

t UH Bristol, we take pride in delivering an outstanding service. This makes Aa difference to our patients, 98% of whom rate the care they receive here From as excellent, very good or good. The ‘Here to help’ programme will support our continued development as a listening and responsive organisation.

Part of the programme is seeing the roll-out of new touchscreen feedback points across our hospital sites, which will enable patients and visitors to provide feedback to the the On Thursday 6 December 2018, Trust in real-time. Paul Lewis, patient experience manager, said: “UH Bristol already 20 teams from the UH Bristol has a 'here to help' culture - we want to celebrate this and ensure that this is always received a Green Impact award the experience that our colleagues, patients and visitors have at the Trust. We will be in recognition of their efforts keeping staff informed of new developments as the programme is rolled out over the to implement sustainability next few months.” chair solutions in the workplace.

Colleagues from UH Bristol, North Bristol NHS Trust and would like to start by thanking our would anyone fill it in if they didn’t University of Bristol attended the Gromit Unleashed 2 Istaff that worked over the Christmas think it would make any difference? ceremony, which took place in period; it’s hard to leave our loved As chair of the Board I will continue to the Wills Memorial Building. raises £2million ones at times of festivities, but the encourage a significant focus on how we I’m looking forward to being out feedback we receive from patients review the responses and act to change and about in the coming months For seven years UH Bristol has been uring the summer of 2018, Bristol long-time patron of The Grand and their families shows how grateful things where we can. Where we can’t so please don’t let me pass you taking part in the National Union of Dwelcomed back its beloved pooch Appeal and Aardman co-founder they are. I completed my first year as change things you should have a clear without saying hello. Students (NUS) led initiative, which Gromit in The Grand Appeal’s third Peter Lord - were all in attendance chairman of the Trust and am grateful explanation why it is not possible. has driven a reduction of over one arts trail, Gromit Unleashed 2. Joined for the spectacular evening as well to so many people for the help, support million kilogrammes of greenhouse this time by his best pal Wallace and as around 600 guests bidding in- and guidance they have given me in I was pleased to be asked to open the emissions in Bristol alone. arch nemesis Feathers McGraw, the person, while online bidders across settling into a new role. I’d particularly positive culture day in the dental school sculptures were visited over 2.5 million the country upped the ante. like to thank our governors and other in December. I thought this was a really CQC inspection this year that we will Paula Clarke, director of strategy times by trail fans across the globe. volunteers who give up their time to optimistic move by the management again receive positive feedback based and transformation at UH Bristol, Coupled with fundraising efforts tirelessly help us improve everything team to discuss the values and behaviour on everything I am seeing in the Trust. presented the awards. She said: In a first for arts trails across the during the trail, including contactless we do. There will be governor elections we expect in the Trust. It gave me an However, I think we are reaching a “The Green Impact awards are world, Gromit Unleashed 2 brought donations, proceeds from a sculpture in Spring of this year and this will opportunity to reinforce that nobody is crossroads in healthcare. Working in a wonderful celebration of together arts and science, with raffle, exhibition tickets, app provide an opportunity for both new more important than anyone else in the the way we have has served us well individuals and teams right across interactive sculptures, the use of downloads and private donations, and returning governors to join a great Trust and that we just do different jobs, up until now, but both from national UH Bristol who are taking personal contactless donation technology Gromit Unleashed 2 has raised team in the Trust. I feel immensely something I strongly believe. I also had requirements, gaps in funding and the responsibility to make positive and augmented and virtual reality. a phenomenal £2million for the privileged to be representing the Trust the chance to reinforce how if we stop opportunity to reduce duplication across changes for the environment Bristol Royal Hospital for Children as your Chairman and I proudly tell listening to what our staff are telling us, the system, we are going to be required they work and deliver care in, as After an epic summer of sculpture and the neonatal intensive care people this at every opportunity. however hard that can be at times, then to work differently and together in a well as finding more efficient and hunting, eager bidders and guests unit at St Michael’s Hospital! These we stop leading. That is why at the Board more effective way. I believe we have a sustainable ways of doing this. were welcomed to an electrifying proceeds are directly supporting We are gaining a growing reputation I have introduced sessions at the start huge leadership role to play in this and auction as each sculpture went the young patients and families as one of the best trusts in the country in which a member of staff is invited to whilst that may mean some changes "We have made significant under the hammer beneath the cared for by the hospital and The in the services we provide and the way talk about their experiences of working to the way we work, if that benefits progress in the last four years, wings of Concorde at Aerospace Grand Appeal, providing life-saving we manage in a challenging financial in the Trust, from a variety of different patients and the wider public it’s the with a 26% reduction in our Bristol. Extra special guests - medical equipment and facilities, environment, but I firmly believe that backgrounds. This has been extremely right thing to do. carbon footprint, over £1.8million comedian Dawn French, renowned pioneering research, patient this success will be short lived if we useful in exploring different experiences savings in energy costs and 21% auctioneer Richard Madley and and family support and more. don’t listen to our staff and understand and perspectives and has been enhanced of staff engaged by our green what works well and what doesn’t. I am by a process of reverse mentoring for champions in sustainable activities delighted that we have seen a significant Board members from some of our black but we must keep improving so I rise in the completion of the staff survey and minority ethnic staff. urge our colleagues to play their this year. For me the staff survey is part and get involved in 2019.” the first document I turn to in any Finally I just want to focus on the year organisation in trying to understand the ahead. Things are unlikely to get easier, For further information and to challenges people face. However, why but I am optimistic that in our expected Jeff Farrar, Trust chair get involved in the Green Impact awards at UH Bristol please contact: [email protected]

4 ®The Grand Appeal. Registered charity 1043603. ©&™ Wallace & Gromit’s Children’s Foundation/Aardman Animations Ltd 2017. All rights reserved. 5 MEMBERS BUILDING CAPABILITY Your Health Matters – Helping our join us to find out more patients live We want to hear what you think about the services we provide. In 2019 we will be hosting ‘Health Matters’ events on a variety of health topics – well with and and we hope you will join us to hear what we have to say, share your views and meet your governors and members of staff from across our hospitals. beyond cancer Living with arthritis 5.00-6.30pm Results from the latest National Cancer 5 Patient Experience Survey has shown that our MAR This talk will look at the causes, symptoms and treatments for arthritis Trust is now better than the national average in eight areas which are scored by patients. 11 Living with dementia 5.00-6.30pm Abigail Evans met with interim lead cancer APR Hear about improvements in care for patients with dementia nurse, Lisa Castellaro, to find out more.

very year, people receiving “We’ve increased access to clinical nurse Managing pain 6.00-7.30pm Etreatment for cancer are asked specialists by investing in new posts 22 for their feedback as part of a national and different ways of working. As MAY Are you living with pain or interested in hearing more about managing pain? survey, so trusts across the country part of this we’ve further developed Come along to hear from our expert pain management team can assess how the care they provide is the cancer support worker role so impacting on their patients’ experience. that all new patients have access to The children’s hospital as a major trauma centre 6.00-7.30pm ensure non-clinical needs are met. 20 Over the past four years, UH Bristol JUN This talk will look at the role of the children's hospital as a major trauma centre has undertaken a range of work to “There are now more volunteers in enhance this experience, including the chemotherapy and radiotherapy an extensive feedback project in departments, and we’ve reviewed Stroke services 6.00-7.30pm 2016 which has helped to create an and developed the psychology 16 improvement plan for the service. services available in the BHOC. JUL Find out about how to be aware of the symptoms of a stroke and how to reduce the chances of having a stroke As a result, the Trust has seen its “When you come through the Bristol scores from patients steadily increase, Royal Infirmary (BRI) Welcome Centre Members’ Meeting 5.00-7.00pm with this year’s being some of the you’ll now see a Macmillan cancer 19 best our hospitals have received. information hub, and we’ve also SEP A chance to hear from our Board and Governors about extended our Macmillan therapies the highlights of the past year and plans for the next Lisa Castellaro, the interim lead support service which provides access to cancer nurse for the Trust, explains therapy and fatigue management courses what has been done so far to benefit for all those going through treatment. ealth Matters events are free talks hosted by consultants or senior managers Could you be a governor? cancer patients receiving treatment Hon specialist areas of health, or on issues affecting the Trust. They are at the Bristol Haematology and “We’re also about to start the an opportunity for our Foundation Trust members to meet Trust staff, ask If you are interested in getting more Oncology Centre (BHOC). refurbishment and reconfiguration work questions and give feedback. These events are also open to the public. involved in the work of our Trust, then in the BHOC. Ward D603 is going to be do consider becoming a governor. You Lisa said: “The Recovery Package is an refurbished, and we’re increasing the All events take place in Lecture Theatre 1, Education & Research Centre, Upper can find out more information about integral part of the work we are doing amount of space in both our outpatient Maudlin Street, Bristol BS2 8AE. Doors will open 30 minutes before each talk. To book the Spring elections on our website or to help our patients live better with and areas by expanding to level 4 as well your place and for any updates or changes to the programme, please visit our website: you can contact the membership team beyond cancer. It includes holistic as additional chairs in our oncology www.uhbristol.nhs.uk/healthmatters or contact the membership team. for more details. needs assessments, health and chemotherapy day unit on level 5. wellbeing events and treatment summaries all of which help patients “In the future, we’re also looking If you are not already a member of our Trust, and would like to keep updated access the help they need. We have towards building a cancer Wellbeing on what’s happening around our hospitals, you can fill out a simple form on the allocated two years of funding from Centre at the Trust. This is one of the website: www.uhbristol.nhs.uk/membership or call the membership team on NHS England to enable us to deliver most exciting changes that will happen 0117 342 3764. It is free to join. You can also come along to any of the talks and this work with the hope that the for our patients and will provide a haven sign up on the day. service will be taken on by the Trust away from the hospital environment at the end. for support and information.”

6 7 RECOGNISING SUCCESS RECOGNISING SUCCESS Sharing best practice Nationally recognised with future generations for making a difference

Patients born with a rare genetic bone condition, osteogenesis imperfecta, can expect Excerpts from to receive exceptional treatment delivered by Bristol’s multidisciplinary team; just one student nominators: of four highly specialised paediatric services in England. Hannah Allen met the team “My mentor supported and challenged to hear of their success and cohesive approach to providing an outstanding service. me and we really connected on our enthusiasm for the job. I gained so much steogenesis imperfecta (OI), more knowledge from her and I can only hope Ocommonly known as brittle bone to become half the nurse she is.” disease, affects around 5,000 individuals living in the UK. Characterised by fragile “It was an absolute privilege to be bones that break easily, presenting in part of such a fantastic team , even many different ways and a range of if only for a short while. As a result severity, the condition requires medical Since 2011 we have had 75 nominations for UWE’s Best Practice Awards of the support I received during this intervention and patient support from placement my knowledge base, decision newborn babies through to adulthood. UH Bristol is one of the UK’s leading teaching making skills, clinical reasoning and hospitals and providing exceptional training to future my confidence have been enhanced Dr Christine Burren (pictured, second beyond measure. I’m extremely from left with the OI team), consultant generations of healthcare professionals is a key part of grateful to everyone for the support paediatric endocrinologist and service The OI team are based in the Bristol Royal Hospital for Children our Trust mission. Sabrina Lee finds out more about and encouragement they’ve given lead, said: “Bristol has been delivering how our staff are being recognised for the outstanding in facilitating my transition from treatment and surgery to affected Last summer, colleagues from OI Society Excellence Awards, including student to newly qualified nurse.” patients since the 1980s. In 2012, NHS services across the country, and affected Bristol Royal Hospital for Children. mentorship and support they provide to students. (The neonatal intensive care unit England selected our services as one of individuals and their families, were team won the UWE Best Practice four highly specialised childhood services welcomed to a Parliamentary Reception “I am extremely proud of the service n 2017, we hosted 193 students “Since 2011, we’ve had 75 nominations Child Nursing Category in 2014) in the country to provide more intensive at Westminster. In celebration of the we are able to deliver to our patients across adult/paediatric nursing and for UWE’s Best Practice Awards and 12 support to patients; including occupational Brittle Bone Society’s 50th anniversary, and their families, which wouldn’t be I Ema Swingwood is a physiotherapist midwifery specialities who can spend category winners. This is an amazing therapy, psychologists, social workers, the event continued to raise awareness possible without the whole team who and the 2018 winner of the up to 24 weeks per year completing achievement and testament to the physiotherapy and specialised nurse input. of the condition and the requirement input their expertise”, says Dr Burren. their placements in our hospitals. exceptional work and effort our physiotherapy category. She said: for improved multidisciplinary “In addition to the recognition we staff put in to nurture and support “It was a massive surprise and I feel “The team consists of 14 healthcare for adult services that meet received last summer, we are also an We are one of the largest placement high quality nursing, midwifery and very lucky to receive the award but colleagues who deliver a the same standard of treatment and accredited member of the European providers for University of West of allied health professionals of the it really is a team effort. The team multidisciplinary approach care available to paediatric patients. Reference Network for Rare Bone England (UWE) students and we can have future,” said Tricia Hewitt, academic and I recognise that we were all once to patient care, so that all Disease, and often collaborate with over a hundred students on placement dean pre-registration nursing and students and it’s important that we aspects of the condition, its In a letter from Prime Minister international colleagues. at the Trust at any one time. During midwifery and LEF team leader. physical and psychological Theresa May, clinicians delivering OI give back and help them develop their their time at UH Bristol, our staff act effects, are managed. As a services were thanked for their tireless “We strive to make improvements skills and provide them with a as mentors and practice educators to “We have a significant number of result, almost 100 patients from contributions tackling the condition to ensure patients receive the best positive experience.” support them through their placement. mentors, practice educators and across the South West region, in order to make a real difference and possible care, and continue to work supervisors who go beyond the essential and a small cohort from Wales, heartfelt congratulations to those on a number of initiatives to ensure The annual UWE Best Practice requirements to support students whilst are under our care.” recognised through the Brittle Bone patient needs are catered for.” Awards were created in 2010 to on placement with us. The awards enable recognise individuals and teams us to formally recognise and celebrate who have been identified as providing the mentorship achievements of our excellent support for students on busy frontline clinicians.” placement. Nominations can be made Service improvements for 2019 will include more by students or Trust staff including the Hannah Smith, LEF, said: “Our staff education sessions for professionals working Learning Education Facilitator team promote positive learing environments; with children with OI, a range of therapy-led (LEF). The awards cover physiotherapy, create learning opportunities, not just groups to aid motor and social skills, research radiography, radiotherapy, occupational in their teams but across wider services. projects and strengthening links to adult services, therapy, paramedic science, sports They also assist and support students, therapy and rehabilitation, nursing, some of whom may be struggling building on our established transition pathway. mental health and learning disability, due to an array of factors, as well as midwifery, specialist community public continually wanting to improve the Dr Christine Burren health nursing, health care science and experience of students who have Hannah (right) pictured with consultant paediatric endocrinologist physician’s associates. their placements with them.” Caroline (left), one of the winners

8 9 WORKING TOGETHER EMBRACING CHANGE Let's talk about alcohol and tobacco With the Department of Health and Social Care putting prevention as a priority, the tobacco and alcohol screening team are looking out for our patients’ long-term health by asking important questions and UH Bristol providing interventions. The team is in place until March 2019, so Abigail Evans went to find out what they’ve done so far and what they hope to achieve. fights flu! t’s all about having the “Iconversation,” says Kate Turkentine, his season’s staff flu programme has a senior staff nurse and member of the Tso far seen over 5,850 UH Bristol staff tobacco and alcohol screening team. come together to fight flu in our hospitals. “Not just with patients, but with staff Each year UH Bristol offers all of its staff as well. We need to make asking about a free flu jab, but this year’s programme smoking and alcohol an everyday thing, has seen record-breaking engagement, and make sure we’re offering people the with over 78% of frontline staff getting right advice and support.” vaccinated within the first 12 weeks of the 22-week long programme. Working across the acute medical unit (AMU), the older persons assessment The comprehensive planning of the flu Thank you to our staff unit (OPAU), surgical trauma assessment vaccination programme has been down who help to protect unit (STAU) and hoping to branch out to the efforts of a multidisciplinary our patients, relatives to A602, A604 and the Bristol Heart team led by the Trust’s deputy director and friends by getting Institute (BHI), the screening team is of people, Lynn Lane. She said: “It was their flu vaccination made up of three specialist nurses: fantastic to see over 100 clinical staff Kate, Laura Cossar and Rosa Carter. from our hospitals volunteering to be a vaccinator this year and hosting regular vaccine. The programme also has mobile The team is dedicated to preventing staff flu clinics across our hospitals. vaccinators who take vaccines round to the long-term health effects of alcohol clinical staff that might find it difficult and smoking, with the aim of reducing “From communications colleagues and to come away from the ward. Jeanette further patient admissions down the line. our wellbeing team, to occupational Jones, peer-vaccinator and Royal College of health, our divisional matrons and Nursing representative, said: “We need to Rosa explains: “When it comes to alcohol the pharmacy team, everyone has gone offer the vaccine to all staff. For some staff, use, we ask patients how often they above and beyond to ensure the success it can be difficult to get time to attend a drink alcohol, how many units they drink drink, so providing accurate information "We have developed the of this year’s programme.” set clinic so the clinic comes to them.” on a day where they’re drinking, and in can really make a difference.” smoking cessation page on the the last year how often they drank over Trust’s intranet which is full of This year staff were able to access the Joanna Coles, director of infection a certain amount of units in one session With patients who currently smoke, the resources to help staff provide clinic calendar on a mobile device as well control, said: “The flu vaccine offers the – six units for women, eight for men. team realise that it can be difficult for stop smoking advice, nicotine as a desktop PC, enabling colleagues best protection against flu particularly to nursing staff on the wards to know what replacement therapy and support. who don’t have regular contact with a those at risk, including over 65s, young “This allows us to develop a score, and if to do for the best, particularly with the computer to be able to easily view the school children and pregnant women. they score above five we start looking at Trust going completely smoke-free. It’s hoped that by embedding the clinic times. The vaccine is offered free of charge to ways to reduce their alcohol intake. routine of having these conversations health and social care staff." “Our aim is to give staff the confidence with patients, it will also prompt Some vaccinators have hosted clinics “This can be as simple as making them to talk to patients about the harms staff to look at their own relationships during the early hours of the morning and aware of what harm alcohol can do to associated with smoking and to help with tobacco and alcohol use, over the weekend to ensure colleagues their body. We often find that people them to make a quit attempt whilst in and put this public health advice working different shifts had access to the don’t realise how many units are in a hospital,” adds Laura. into practice."

10 11 DELIVERING BEST CARE DELIVERING BEST CARE Service development proves Delirium training life-changing for patients on wheels

sually developing over one to two Udays, delirium is characterised by disturbed consciousness and cognitive function. It can lead to further complications such as risk of falls, pressure sores, poor nutrition and subsequent issues with wound healing. This then often results in a prolonged stay in hospital and Delirium – a state of sudden leaves the patient with greater care confusion – is thought to affect: needs than before being admitted. Up to 30% of older hospital patients

Up to 50% of As well as being able to Older people and those with dementia, They also include a pre and post patients severe illness or a hip fracture are learning questionnaire to gauge provide emotional support, post-surgery* more at risk of delirium. Research also understanding, along with posters and *NICE Guidance The trio recently received a ‘Highly Commended Clinical Team of we can signpost to a variety shows that there is an increased risk handouts with additional information the Year’ award at UH Bristol’s Recognising Success staff awards of other services that may of death within the first year after on the ‘Dos and Don’ts of Delirium’. for their work to transform care for their patients be helpful to the patient. diagnosis. However, it can be prevented really pleased with the impact of this and treated if dealt with promptly. Signs of delirium can include project. The initial results are great and Three UH Bristol nurses are helping patients to improve Ruth Harding, hallucinations, an inability to speak we have been very encouraged by the their fitness so they can undergo life-saving surgery. Upper GI clinical nurse specialist In a bid to increase awareness of the clearly and disorientation. The training engagement and interest that staff across symptoms, a team of elderly care encourages staff to look out for all levels have displayed. registrars have developed a short the symptoms and to think about urgery is often the only route of Patients on the programme will work “Although the programme is training session which can be taken common reversible causes including “It can be difficult to find the time Streatment for patients with upper with a multi-disciplinary team to plan a predominantly about getting directly to staff. Armed with a tea trolley pain, infection or dehydration. to have off work to go to formal gastrointestinal (GI) cancers and can fitness regime tailored to their abilities. patients fit for surgery, part of and plenty of biscuits, they drop in teaching sessions. By squeezing these bring life-saving benefits. However, the service is providing emotional to different wards across the Trust to The response to the sessions has been very sessions into the normal working day many of these patients suffer with “The aim is to plan exercises which support. Often the side effects of provide 10 minutes of teaching designed positive explains Anna: “We have been it enables more learning to happen." symptoms that damage their overall work around the patients’ fitness these cancers can be a strain on for all disciplines and staff levels. fitness such as jaundice and malnutrition, capabilities and lifestyle. It might a patient’s mental wellbeing. which means that they might be be that the patient can take their “The benefit of increasing awareness is too high risk to undergo surgery. neighbour’s dog for a walk once a day, “As well as being able to provide that it becomes everybody’s business,” go to a Pilates class or simply walk to the emotional support, we can signpost said junior doctor Anna O’Brien. But in 2017, upper GI clinical nurse shop. It’s about increasing their heart rate to a variety of other services that specialists Ruth Harding, Cathy and exercising to the point where they may be helpful to the patient.” “We wanted to encourage engagement Pillinger and Karen Clemett, set up a are hot and perspiring - this will ensure across all levels so that staff feel prehabilitation programme that helps they are benefiting from the exercise. 43 patients have been on the empowered to diagnose delirium and patients improve their overall fitness programme so far, 73% of those have therefore help to start the treatment early so they are able to have this vital “We also have a dietitian who works improved their overall fitness to be which can help prevent its progression. surgery. Ruth said: “Due to the nature with the team and helps patients with able to be considered for surgery. The staff who spend the longest time of these cancers, patients are often their diet, which can contribute to an with patients are the ones who can spot diagnosed when their cancer is at an overall improvement in fitness.” “Those patients who are still unable to the start of confusion early e.g. health advanced stage, which means that undergo surgery after the programme care assistants and therapy staff.” surgery would be the only option. During the programme, which usually lasts have fed back that they feel much around six weeks, patients will receive a better in themselves overall. Just the The sessions are designed to be “About a third of this patient group weekly phone call from one of the nurses act of regularly exercising and having short and succinct focusing on the would only be suitable to have who will discuss the progress of their fitness frequent contact with one of us helps key learning points of recognising, surgery if they were fit enough.” plan and also how they feel in themselves. to improve their overall wellbeing.” diagnosing and managing delirium.

12 13 RESEARCH AND INNOVATION RESEARCH AND INNOVATION For the greater good

Extra follow-up appointments and close monitoring are two of the well-known Pain relief – how research benefits to patients who take part in clinical trials. However, one of the nurses who cares for patients on the cancer treatment trial called PALLAS says the overarching could help to treat pain reason people give her for taking part is to help improve treatment for future patients.

number of patients participate in Cancer patients, who have had surgery As with other clinical trials, data following surgery “A clinical trials in order to advance at Southmead Hospital, are referred to collected from the study will influence treatments and so their participation BHOC for subsequent treatment (adjuvant the development of drug therapies might be purely for altruistic reasons”, chemotherapy and/or radiotherapy). and other treatment pathways. A trial is looking at the benefits of trying a different medication to treat says Carlota Clemente, who works Potentially eligible patients were offered pain for patients following an operation. John Kirk found out more. in the six-strong nursing team based at the study and given the option to Heather Carroll, clinical trials manager the Bristol Haematology and Oncology participate in the trial and have further at the Clinical Trials Unit in the BHOC, he GAP study, which is being Centre (BHOC), looking after patients follow up at the hospital after completing explains: “Patients’ participation in Tsponsored by UH Bristol and on the PALLAS trial. standard curative treatment; those found clinical studies contributes to data which involves the University of Bristol, not to be eligible who have completed can support the licensing of new drugs, University Hospitals Southampton NHS This selfless attitude is illustrative of their adjuvant treatment are discharged change clinical practice or help develop Foundation Trust and the University the positive response patients have to from BHOC care, and go on to receive whole new treatment pathways. of Oxford, is focusing on gabapentin, clinical trials, says Carlota. It also goes follow-up care at either Southmead a medicine used to treat epilepsy and some way to understanding why the Hospital or at their GP surgery. “Although participant numbers in trials pain caused by dysfunctional nerves. Trust has become the top recruiter of appear to be low, this is because the participants in this international study Those who continue on the PALLAS number of eligible patients is relatively Recently, doctors have begun which aims to reduce the recurrence trial will be monitored at follow- small. The uptake here at the BHOC is using gabapentin to treat pain of cancer in breast cancer patients. up appointments in the BHOC. The very good as our clinical teams are good after an operation, with the aim of trial group is split into two sets of at identifying eligible patients and at reducing the amount of other drugs The team leading the study The PALLAS, or PALbociclib CoLlaborative patients – ones who receive the outlining the treatment options to them.” needed to help with pain relief. Adjuvant Study, explores whether a targeted medication (in tablet form) use of gabapentin to help with pain relief “We will give patients gabapentin targeted medication called palbociclib with endocrine therapy and the others The research nurses’ priority is to Opioid drugs such as morphine and following an operation will reduce the or placebo one hour before surgery taken alongside endocrine therapy can who receive endocrine therapy only. ensure the patient receives the highest fentanyl are the most commonly used need for opioid drugs, lead to fewer side and for two days after surgery. Every decrease the chance of a patient’s cancer quality care and comprehensive drugs to control pain after surgery, but effects and, as a result, help patients other aspect of care will stay the coming back, compared to receiving “This medication and therapy information to enable patients doctors want to try to reduce the use of to recover more quickly from surgery. same. We will then compare patients endocrine therapy on its own. Palbociclib combination is generally well tolerated,” to make informed decisions. opioid drugs because they can cause side who received gabapentin with was found to stop cancer growing in a explains Carlota. “Unlike chemotherapy, effects, delaying discharge from hospital “The trial is recruiting patients having those who received the placebo to different clinical trial called PALOMA-2. there are very few side effects. The main and leading to slower recovery. cardiac, thoracic or abdominal surgery determine the impact on recovery.” one is a drop in the patient’s white blood in Bristol or Southampton, and so Recruitment to the PALLAS trial, which cells, but adjusting levels of medication Staff and patients can find out more information about research Professor Chris Rogers, non-clinical lead far 205 patients have agreed to Trial recruitment began in April has been running internationally for and therapy can correct this.” and how to take part in the Trust’s for the trial and based in the Clinical take part. Patients are randomised 2018 and the findings are expected the past 10 years but only started in this Research & Innovation pages at Trials and Evaluation Unit, Bristol Trials to either receive gabapentin or an in May 2021. This study is funded Trust 18 months ago, closed in November. It must be noted that long-term side- www.uhbristol.nhs.uk/research- Centre at Bristol Medical School at the identical looking dummy pill, known by the National Institute for Health But with 22 patients taking part at the effects of the therapy are still unknown. innovation/information-for-patients- University of Bristol, said: “The trial is as a placebo, in addition to the usual Research - Health Technology BHOC, the Trust has attracted more PALLAS trial participants will be followed and-the-public/ focusing on the question of whether the painkillers for each type of surgery. Assessment Programme. participants than any other organisation. up for 10 years post-trial treatment.

14 15 Above & Beyond is the local charity raising funds for patients, families and staff in Bristol city centre hospitals 0117 927 7120 aboveandbeyond.org.uk @aboveandbeyond1

Fundraising for Bristol city centre hospitals BHI Appeal complete! We’re pleased to announce that we’ve hit the target in our £830,000 Bristol Heart Institute Thanks for your support in 2018! (BHI) Appeal! Generous donors, determined fundraisers and encouraging hospital staff have From the Above & Beyond trustees, staff and volunteers, we’d like to say all helped to provide the latest treatments, surgery techniques and facilities at the BHI. a huge thank you to everyone who supported Bristol’s hospitals in 2018. veryone has really rallied behind the Ecause. From Pete Lamb doing eight ast year was another incredible year marathons in eight countries to John Lfor the charity – from our first comedy Griffin, who raised over £11,000 with night to celebrating 70 years of the NHS. his 12 hour spinning challenge. Not to Our dedicated supporters made a real mention BHI physiotherapist Caroline difference to the 989,000 patients who who got a team together to take part visited Bristol’s hospitals in 2018. in the Cotswolds 24-hour Challenge.

We had some brand new charity Of the money raised, £378,000 will go to events in 2018, including Write your the relocation of the echocardiography Will Fortnight and Funny Bones: facility from the BRI to right next to the Russell Howard and Guests. coronary care unit in the BHI. This will make a huge difference to patient care, with During Write your Will Fortnight in poorly patients no longer having to make September, local solicitors donated the long, public journey for their scan. their time for free to make or update Wills in exchange for a donation to Above The end of the appeal does not & Beyond. More than 70 appointments mean our work with the BHI stops. were booked across the two weeks. On 15 September, five brave daredevils in the Bristol to Paris Cycle Challenge for Any potential fundraisers or donors took part in our skydive day. Raising almost the last three years, and Nisbets who can get in touch with us at Above & Funny Bones: Russell Howard and Guests £5,000. This year’s participants included Rod have raised more than £20,000 through Beyond either by phone or email. saw comedians come together for some Lawless, a BRI carpenter, and Pat Lockett, running the Bristol 10k. huge laughs at Bristol Hippodrome – raising who did the 10,000ft jump aged 90! £100,000. Russell Howard was joined by We announced new partnerships with Joel Dommett, Laura Lexx, Jon Richardson If you’re inspired by Michelle, Rod, Pat, Bristol Twenty Coffee and Carbase and and many others – all hosted by Mark Olver. or any of our fundraisers and want to raised £12,000 for our BHI Appeal with Sunflower challenge yourself in 2019 get in touch the help of football head coaches Gary Following the event Michelle, who on [email protected] and Lee Johnson. Ward gets a has worked at UH Bristol for almost 20 years, was so inspired she raised In 2018 we also celebrated with DAC If you're interested in fundraising refurbishment funds for Above & Beyond by taking Beachcroft, who hit the £100,000 with your colleagues, email part in the Cardiff Half Marathon. fundraising milestone after taking part [email protected] t the end of 2018, Sunflower AWard, the neuro-rehabilitation unit at Bristol Royal Hospital for Children, reopened after a refurbishment to Here’s just some of the For more details on supporting improve the environment and space things we’ve funded thanks Above & Beyond in 2019, visit for both families and staff. to your support… our website.Things you could do:

The work was funded thanks to Craft materials for the children’s the participants in the 2017 Bristol to Take part in an event hospital Play Team Paris Cycle Challenge, who together raised £119,000, and a donation from Westerleigh Parish Council. A meeting venue for Breast Fundraise at work Cancer Care Sally and George, who share the sister role on the ward, said: “The improvement for Ocean-themed wall vinyls in Set up a direct debit or make everyone is just fantastic. With limited the children’s department of To sign up for next year’s challenge go to a one-off donation space we had to be creative and the the eye hospital estates team and architect did a great job. www.aboveadnbeyond.org.uk/event/bristol2paris

Cleft palate diagnostic models “In particular the nurse’s station is much This year’s Bristol to Paris Cycle choice. The ride takes place from Volunteer for the charity for the dental hospital more effective work space that still allows Challenge participants will be able 11-15 September 2019 and registration general oversight of the whole ward.” to fundraise for the hospital of their is open now.

16 Registered Charity No. 1170973. Company Number 10394287 17 RENEWING OUR HOSPITALS RESPECTING EVERYONE Improving Promoting wellbeing through equality and arts and culture diversity in Thanks to funding from Above & Beyond, UH Bristol has appointed its first arts programme the NHS director. Dr Anna Farthing’s brief is to create an arts and culture strategy and programme that supports patients, staff, students, volunteers and visitors across all of our nine sites.

nna said: “The arts programme at “Artist Luke Jerram’s ‘The Impossible AUH Bristol responds to increasing Garden’ shown at University of Bristol's A learning disability nurse from UH Bristol has been helping NHS England evidence that shows a link between Botanic Garden over the summer, was better understand the experiences of black and minority ethnic (BME) healthy lifestyles and creative or the product of his artist’s residency frontline NHS staff within the workplace. cultural activities.” within our Bristol Eye Hospital. round one in five colleagues in the The Trust has recently started a reverse As a WRES frontline staff representative, The programme is organised around “‘Gutted’, a touching comedy about ANHS are from a BME background, mentoring scheme - an initiative Lorna recently took part in an NHS England- monthly themes. As well as signposting living with Crohn’s disease was but data suggests that the general recommended by the WRES forum led video project and attended a storytelling opportunities both within the Trust and performed at the invitation of our treatment and experiences of those whereby a BME staff member shares workshop where she made a short film in in nearby venues, each month includes stoma nurses, and more recently we staff in the workplace falls short of their experiences with an executive regards to her experiences as a BME staff a ‘Second Wednesday’ evening of exhibited the award-winning work of the values and principles of our NHS. director during one-to-one sessions. member. The emotional and engaging discussion supported by the University our own medical photography team.” This relationship will help to improve storytelling video aims to highlight the of Bristol. These informal events bring To gain further insight, NHS England the Trust’s understanding of issues issues still met by BME staff today. people together from across the Trust This programme is reliant on people set up a discussion forum in which faced by BME staff and stimulates and from the wider public, to share getting involved, but the Trust also around 25 BME frontline staff from creative thinking about how it can ideas and experiences. benefits from links with experienced across the NHS meet to share their increase diversity within its workforce. practitioners and researchers through experiences as BME staff and support Anna said: “Audiences seem to really networks such as Arts and Health each other to implement positive Lorna, who is one of the scheme’s enjoy talking to people they would South West, the national Culture, changes in their own organisations. mentors, said: “Reverse mentoring not normally encounter. In December, Health and Wellbeing Alliance and the has been fantastic experience so far the evening with the ‘Sound’ theme network of hospital arts programmers, Lorna Hayles, whose parents arrived while giving me the opportunity to included a neurosurgeon discussing sound as well as civic partnerships. in the UK from the Caribbean, has share my knowledge and learning. perception, nurses on tackling noise at been attending the group on behalf As a nurse within the organisation In October 2018, we hosted a Black night, a patient who is making a VR opera Anna said: “The film ‘NHS70: A Picture of UH Bristol. I would encourage more senior History Month celebration at the about her experiences, and our music of Health’ was created with support leaders to take up this fruitful Trust in collaboration with the Royal therapists, who demonstrated the effect from Bristol Archives, Watershed and The forum was set up in 2017 following opportunity, as it is such a positive College of Nursing. Special guest of music on the body by getting everyone Empica Medica and the new ‘Civic the launch of the Workforce Race experience for all to get involved.” May Tanner, who was the first ever singing. People were having such a good Welcome Pack’ was supported by Equality and Standard (WRES) initiative black ward sister at the Bristol Royal time, they were reluctant to leave.” the Lord Mayor’s office, Destination in 2015, which is a set of nine measures Matthew Joint, director of people, said: Infirmary in 1966, attended the Bristol and Bristol Arts Marketing. that NHS providers use to help identify “WRES has demonstrated that when event with her husband Michael. Highlighting the creativity and the issues and challenges for BME organisations ensure that individuals Speakers included Councillor Asher ingenuity of staff through forming “Bristol Culture will be providing our What’s Next? staff within their organisations. from BME backgrounds have equal Craig, deputy mayor of Bristol, and new partnerships both in the dementia team with reminiscence access to career opportunities and Neomi Bennett, a nurse inventor. THEMES for 2019 city and further afield is a major resources and a new Memorandum of The first five WRES forum meetings receive fair treatment in the workplace, objective of the programme. Understanding with University of West helped NHS England build a picture those organisations are better places Amongst the attendees were February NOURISH – exploring the of England (UWE) enables us to welcome of the challenges still faced by BME to work and provide a better service. members of the BME workers forum, Anna added: “The ‘Heart of the Matter’ art and design students as interns.” food of diverse cultures staff in today’s NHS. The initial including forum chair Everton Barclay, exhibition came about through a for health and care feedback sessions have completed “The reverse mentoring scheme is just who regularly meet to share their partnership between Giovanni Biglino, More information about the UH but the group will continue to one of many initiatives but it enables experiences, discuss BME related bioengineer at the Bristol Heart Insititute, Bristol Arts and Culture Programme March MOVING – to move and be meet in 2019 to share best practice staff from BME backgrounds to expose issues and provide each other with and the arts teams at Great Ormond can be found here: moved for emotional and and support each other - the first their challenges and frustrations to the support. The group can raise any Street and Newcastle hospitals. www.uhbristol.nhs.uk/artsandculture physical wellbeing session of its kind will be hosted most senior leaders of the Trust, which issues and feedback to the Trust. by UH Bristol in January. is already resulting in positive action.”

18 19 MEET THE MANAGER

Sheena Vernon Lead nurse for the Congenital Heart Disease Network for the South West and South Wales and adult congenital heart disease clinical nurse specialist

What is your background and how clinic, need congenital cardiac surgery appointed lead nurse two years ago. long have you been with the Trust? and cardiology procedures. A number Our recently launched website provides I moved to UH Bristol in 1984 and began of patients may have additional special information and resources for patients, working on the cardiac intensive care needs and require extra support. There families and health care professionals unit; I became a sister in 1986 and worked are around 200 teenagers moving from and can be found at www.swswchd.co.uk on the unit for 18 years. During that time the children’s service to the adult service I got married, completed a three year every year and we work as a team to The NHS marked its 70th birthday diploma in nursing and had three children. transfer them to the adult service. in 2018 – what makes you proud to work in the NHS? In 2002 the role of clinical nurse specialist Women born with heart conditions who I feel really proud to work in the NHS. in adult congenital heart disease was are pregnant also need varying degrees I enjoy making a difference to patients advertised. I was keen to look after a of support. with long-term conditions and getting smaller group of patients and get to know to know them and their family well. them better. However, this was not the What is the Congenital case as one in every 100 babies is born Heart Disease Network? I have worked with some fantastic with a heart condition and there were In 2016 NHS England published the people - people who want to give around 6,500 adult congenital patients in national ‘Congenital Heart Disease their best clinically, work hard the South West at that time! My medical Standards and Specifications’, in which under difficult circumstances, often colleague Dr Graham Stuart had begun was a requirement for formal regional with a great sense of humour. to set the service up and there was no hub and spoke networks. The South clinical nurse specialist at the time. Wales and South West Congenital Heart What do you enjoy doing Disease Network was set up two years in your spare time? What was it like starting such ago and covers a huge geographical Walking and taking my binoculars a new role at the Trust? area. We have a number of children’s with me in case there are any interesting Developing the service was very and adult outreach clinics across the birds. I swim regularly, enjoy reading, exciting. Patients would be seen in South Wales and the South West. I was films and cooking for family and friends.