issue25 November 2011

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Community Services Wandsworthintegration one year on

proudly supported by

Econtents

At the end of October I will standdown as chair after coming to theend of my second term in office. It iseight years since I was appointedchair of St George’s Healthcare NHSTrust and each year has been a greatprivilege as well as a challenging andlearning experience for me.

A lot of good progress has been madeduring this time and while significantchallenges remain I am confident thatthe future for the trust is a bright one.The trust has long been associated withdeveloping new and innovative ways ofworking to deliver improved care to all ofits patients. We have been associatedwith many clinical innovations, bothmedical and surgical and this pioneeringspirit can be seen today in many of ourclinical departments such as the majortrauma centre and hyper-acute strokeunit as well as in our responses toinfection control and patient safety.These innovations are possible becauseof our unique relationship with StGeorge’s, University of London, withwhom we share not only our campus buta relationship that goes back nearly 300years. I am confident that in workingtogether, the greater St George’s willbecome the even more successful inteaching, research and innovative clinicalcare. I am proud to have served as amember of Council of the University.

Integration with community servicesWandsworth (CSW) is also helping toshape new services and more appropriatecare pathways for children, adults andolder people.

I remain immensely proud of the factthat, in 2009, we were named Largetrust of the year by Dr Foster Intelligence.

As the NHS adapts to modern daychallenges, we must not lose sight ofpatient safety and quality of care whichmust be top of all of our agendas. Thelaunch of the trust values makes it clearto staff, patients and visitors alike whatkind of organisation we aspire to be andthese must be at the heart of everythingthe trust does.

Our financial performance continues topresent the biggest challenge. Whilst wehave managed our finances prudentlyover the last few years and paid off ourhistoric debt, colleagues should be in nodoubt that developing a robust financialposition is crucial to securing the trust’slong-term future. Our failure, so far, tobecome a Foundation Trust (FT) is a resultof our financial position and this remainsa major disappointment to me.

Becoming an FT will ensure increasedlocal involvement and provide the trustwith more control over its finances. It willalso provide a badge of quality care thatwill increase the confidence of all thosewho use our services.

I would like to acknowledge the supportof our volunteers and charities. A lot ofwhat we achieve would not be possiblewithout the support of our volunteersand the many charities that work onbehalf on the trust, in particular StGeorge’s Hospital Charity.

The Grosvenor Wing main entrance, newchest clinic and state-of the-artsimulation centre have all beensupported by generous charitabledonations. I am very proud of theGrosvenor Wing main entrance whichnow reflects our commitment toimproving the experience for all ourusers. The area was designed to providea designated patient transport loungeand a bigger and more comfortableseating area for visitors. It also houses aM&S Simply Food store and cafe, whichI’m sure everyone can agree is a big hitwith staff and patients alike! It is nowhard to remember the dark anddepressing entrance and reception areaof eight years ago which was not worthyof such a great institution.

Of course, our work would simply not bepossible if it were not for the dedicationand commitment of those staff who livethe trust values and ensure that patientsreceive the care they need. I would liketo take this opportunity to thank you allfor the support you have given meduring my time as chair.

Looking to the future I would like to wishthe new chair, Christopher Smallwoodevery success and I am sure that he willenjoy his time at St George’s Healthcareas much as I have. I will look back on mytime at the trust with happy memoriesand there will always be a part of methat remains in SW17.

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Naaz Coker, chair

the gazette is written and published by thecommunications unit. The opinions expresseddo not necessarily represent those of St George’s Healthcare NHS Trust. If you are a staff member with a story for thegazette, please email:communications@stgeorges.nhs.uk

Front page picture shows the Brysson WhyteRehabilitation Unit at Queen Mary's Hospital,Roehampton

3 Introduction from Peter Coles

3 New chair and chief executiveannounced

3 New lead for procurement team

4 Living our Values Awards -celebrating responsible

5 Community services - one year on

5 Marking history - 40 years of CTscanning

6 Spotlight on...Drew Fleming

6 Have your say on St Helier plans

7 View from the top Stuart Reeves

8 Annual Report summary

10 Patient feedback

10 Past and present – Queen Mary’sHospital, Roehampton

11 Pioneering stem cell treatmentfor sickle cell is a UK first

11 Play in hospital week

11 Clinical audit - ensuring bestpractice and driving change

12 AGM celebrates staff and trustachievements

12 Cardiac arrest survival rateamong the best in London

13 Macmillan information and supportcentre

13 New resuscitation unit opens

14 Enhanced service for womenhaving babies at home

14 Cancer team commended

14 Celebrating good practice

15 Saving carbon, saving lives

15 Palliative care team in thecommunity

16 Fundraising

Reflection from Naaz Coker,chair, 2003-2011

September saw theannouncement of a newchair and new chiefexecutive for the trust, bothof whom will take up theirroles in November.

Christopher Smallwood(pictured left) succeeds NaazCoker who has come to the endof her eight year term of office.

Christopher has extensive NHSexperience having previously been chairof Kingston Hospital NHS Trust and priorto that, chair of NHS Hounslow. He is apolicy adviser to The Prince’s Charitiesand until 2005, was economic adviser toBarclays plc, following several years as apartner at the City consultancy MakinsonCowell. He was also, until recently, amember of the CompetitionCommission.

Speaking about his appointment,Christopher said: “I am delighted to bejoining St George’s Healthcare at thiscrucial and exciting time and I lookforward to working with the board andstaff as the trust continues to develop itsservices to meet the needs of themodern NHS. I would like to pay tributeto Naaz Coker for her leadership overthe last eight years during which timethe trust has significantly improved itsquality and safety of care, successfullyintegrated with community servicesWandsworth and worked to improve itsfinancial position.”

Towards the end of September the board

appointed Miles Scott (pictured right) asthe trust’s new chief executive. Miles hasbeen chief executive of BradfordTeaching Hospitals NHS Foundation Trustsince August 2005.

Before joining Bradford TeachingHospitals Miles was chief executive ofHarrogate and District NHS FoundationTrust for four years. His career in the NHShas encompassed acute, community andmental health services, the King’s Fundand Trent Regional Office.

Miles said: “St George’s Healthcare is anorganisation with a proud history and astrong track record of leading-edgehealthcare delivery and development.

“In my new role I am determined tomaintain and enhance the trust’scommitment to providing quality care toits patients.

“The long-term future of St George’sHealthcare is dependent on it becominga Foundation Trust and I look forward toworking with the board and staff toachieve this. It is also important for thetrust to build strong alliances with localNHS organisations and to develop itspartnership with St George’s, Universityof London.”

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Chair and chief executiveannounced

New lead forprocurement teamA warm welcome to Vince Prosswho has joined the trust asassociate director of financeprocurement.

Vince, formerly director ofprocurement at Chelsea &Westminster Hospitals NHSFoundation Trust, has worked inthe NHS for 28 years. He aims tohelp improve the patient experienceand support the trust’s services byintroducing best practiceprocurement at the trust.. High onthe agenda is a restructuring of theprocurement department and theintroduction of divisionalprocurement managers.

Vince said: “I’m looking forward tointroducing some changes inprocurement that make a positiveimpact across the organisation. Thedivisional procurement managerswill be a major change, givingdedicated procurement supportand expertise to each of the trust’sdivisions.”

Over the last few months theprocurement team has beenhelping to create efficiencies inclinical products and services,including the outpatient antibioticservice, spinal surgery equipment,topical negative pressure woundtherapy and endo-mechanicalconsumables.

Vince explains: “There are othermajor projects going on, such asthe theatre materials managementproject. This is designed to improveefficiency and safety at the sametime as reducing the amount oftime clinicians spend ordering andretrieving medical products.Improvements to the agresso e-commerce system are givingcolleagues enhanced access toremote ordering of goods viaelectronic catalogues. An onlinecontract register is also beingdeveloped to ensure that the trusthas adequate legal protection andtimely renewal reminders whencontracts are expiring.”

If staff need any procurementadvice or assistance with costreduction programmes, pleasecontact the procurement team. The team is also asking for staff toemail electronic copies of anypricing agreements or contracts to Bridget Boyd atbridget.boyd@stgeorges.nhs.ukto maintain a central record.

It has been just over a year since we integratedwith community services Wandsworth (CSW) and

to celebrate this, November’s edition of the gazetteputs a particular focus on our community division.

This includes a report looking at the changes in care thathave been introduced since integration with CSW and aninterview with Stuart Reeves, associate chief operating officerfor adult specialist and diagnostic services. Queen Mary’sHospital is showcased in our ‘past and present’ feature providing a fascinatinginsight into its origins as a military hospital. Readers will also find the 2010/11summary annual report of interest and are encouraged to visit our website to readthe report in full. The report takes the trust values as its theme and these arereflected throughout the gazette. This is a time of change for St George’sHealthcare with a new chair and chief executive set to start in November. This willtherefore be my last ‘word’ in the gazette. I would like to take this opportunity tothank staff for their support during my time hereand to wish the trust the very best for the future.

Peter Coles, interimchief executive

A word with Peter

Responsible behaviours:

● Have patient safety as our primeconsideration

● Be responsible for ensuring goodpatient experience

● Use resources wisely ● Challenge poor behaviour in

others ● Learn from experience including

our mistakes ● Say sorry when things go wrong

Annett Blochberger, neuro pharmacist,won the individual award. Annett hasbeen at the trust for 2½ years and isthe ward pharmacist for Kent Ward andNeuro day unit. She also interacts withthe many specialist clinics which aresituated in Atkinson Morley Wing aswell as primary care. She manages ateam of pharmacists and a technicianwho look after neurology, neurosurgery,stroke and neurorehabilitation. Annettsaid: “This award has really taken meby surprise, but it’s very nice to receivethe recognition and being nominatedby one of the consultants is certainly avery humbling and new experience.

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livin

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our valuesLiving our Values Awards -

celebrating kindThe Living our Values Awards have been embraced by staff acrossthe trust and this month the gazette meets those who won theawards for personifying the trust value of

“I returned to hospital pharmacy aftermaternity leave and a stint in primarycare and felt very welcomed in my roleby nursing staff and doctors alike whomade it very easy for me to settle in.Suggestions to improve the service havealways been met with enthusiasm and Iam gaining more and more supportamong colleagues which is certainlyvery rewarding and motivating.

“I enjoy the variety of the differentaspects of my job, the interaction withall members of the multi-disciplinaryteam and the opportunities I have beengiven with this job to learn and to playa role within this fantastic team.”

Annett was nominated by JeremyIsaacs, consultant neurologist, fordemonstrating outstandingprofessionalism and commitment topatient care in her role as neuroscienceslead pharmacist. He said: “Annett’scommitment to the service isextraordinary. She is the lynchpin ofsafe prescribing on our busy neurologyward, displaying initiative andteamwork in developing complextreatment protocols and enthusiastically

RESPONSIBLE AWARD: Annett Blochberger (centre), receives her award from Ros Given-Wilson,medical director and Jeremy Isaacs, consultant neurologist

contributing to projects for vulnerablepatients. In the 20 months I’ve workedhere, she has consistently stood out asan unsung hero of our team.”

The team award went to Alexis Powelland Alex Stamp in Central BookingService, Outpatients. They werenominated by their manager, DougTreanor. Doug said: “They are anoutstanding example of a team fullycommitted, they never take a short-cutsor shy away from a challenge and theyare forever staying late or coming in atthe weekend, not because they arebeing paid but because they have aremarkable sense of responsibility.

“Their priorities are to get the job doneas quickly as possible, as efficiently aspossible, as accurately as possible andas thoroughly as possible while all thetime maintaining the highest level ofadministrative provision and, in turn,patient care.”

This month, the gazette is askingstaff to nominate a team orindividual who they think embodiesthe value of:

When making your decision, pleasetake into consideration thebehaviours which support this valueand how the person/teamincorporates these into theirworking lives. Download thenomination form from the ‘ourvalues’ page under the ‘about us’section of the intranet and emailthis to awards@stgeorges.nhs.uk

Winners will be announced in thenext edition of the gazette.

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It’s been a year since we integrated with communityservices Wandsworth (CSW) and patients from across theborough are seeing the benefits.

In older people’s services, streamlined care pathways andchanges such as the development of common processes for fallsprevention have had a significant impact.

New models of care have seen patients and staff benefit fromincreased access to consultant geriatrician expertise. Thecommunity ward has also improved long-term conditionmanagement and reduced admissions for high risk patients whonow receive treatment from a multi-disciplinary and agency teamin their own homes.

The ‘settling home’ and telehealth initiatives are also givingpatients access to primary care therapy equipment and urgentcare services at home, helping them to manage their conditionsbetter.

In respiratory services, patients are receiving earlier assessmentand follow-up on discharge, which has seen both length-of-stayand readmission rates for the services drop by 33 per cent. Theimproved discharge pathway from St George’s Hospital to QueenMary’s Hospital has also saved around 2,000 bed days betweenApril and September 2011.

Dr Andy Neil, consultant geriatrician and associate medicaldirector for CSW, said: “Integration has been a positiveexperience and change. CSW and St George's Healthcare staffnow have a much clearer understanding of each other'spriorities, which has helped us to start to clear what werepreviously some pretty big barriers and is helping us to worktogether better to improve patient care.

It was hailed as the biggest medical breakthrough sincethe stethoscope and the discovery of x-rays. Octobermarks 40 years since the very first clinical use ofcomputed tomography (CT) at the Atkinson MorleyHospital, Wimbledon.

CT scanning is a non-invasive medical imaging method, usedto create 3D images of human organs. A CT scanner sends x-rays from one side of an object to the other, allowing it tocalculate the density of the object it scans. The technologycreates an image ‘slice’ by measuring an object’s ability toblock the x-ray beam. These slices are assembled together andthe 3D image produced allows clinicians to identify differenttissues in the body, such as bone, muscle and tumours.

The world’s first CT scan on a patient was carried out on 1st

October 1971. It was a brain scan performed by Sir GodfreyHounsfield and Dr Jamie Ambrose, consultant radiologist. SirGodfrey was subsequently awarded the 1979 Nobel Prize inMedicine. CT scanning was a revolutionary technology thatdramatically improved patient safety by providing a non-invasive method to diagnose illness.

CT scanning remains a core service in the NHS today and StGeorge’s Hospital’s Atkinson Morley Wing, named after thehospital in Wimbledon which closed in 2003, is still home to

some of the most advanced scanning equipment in thecountry.

The earliest CT scanners took several minutes to create a stillimage slice of the body. The most modern machines take justseconds to scan the whole body. The technology today is sofast that it in many instances it can replace more invasive testssuch as angiography.

Jane Adam, consultant radiologist at St George’s Hospital,said: “It is hard to overestimate what an absolute revolutionCT was for medicine. Before CT, only really X-ray imaging wasavailable, which could show the bones and lungs, but littleelse in detail. When the first CT scan was used, the braintissue inside the skull could be visualised for the first time, andit was soon realised that CT could be used to see the rest ofthe organs of the body as well.

“Sir Godfrey Hounsfield was an interesting man and anamazing scientist, although personally unassuming andmodest. Whenever he travelled, he insisted on sticking withthe UK clock, so even in America he would hold meetings atUK times. He understood how important it would be tovisualise the internal organs to understand disease. He lived tosee his invention revolutionise medicine and contributeimmensely to patient care. We have much to thank him for.’’

Community services -one year on

Marking history - 40 years of CT scanning

“It has also been good for staff development. Community nursesare benefitting from increased acute consultant supervision, whileall staff have greater access to training and gaining experience inother areas.”

The work over the last 12 months has laid the foundations fornew models of care that will take shape during 2012 in sexualhealth, diabetes, neurorehabilitation, urgent care and sickle cell and thalassaemia services.

6 the gazette

about, he often calls up their GP. He said,“GPs are often surprised to have aconsultant call them, but we have aconversation and that helps me tounderstand my patient a bit better. Itdoesn’t take a lot of time or effort.”

Drew worked with Zoe Packman, formerdeputy director of nursing aroundimprovements following the Pickerinpatient surveys. He said: “We had quitea few ideas and did a few surveys in thesurgical admissions lounge to find outwhat people actually wanted there. And Ithink we’ve got things much better justby making a few simple changes, likegetting patient information out earlier sopatients know what to expect andmaking the lounge a more pleasantenvironment.

“I think our biggest problem is thatdoctors have become too remote fromtheir patients and staff. It’s about gettingback to doing what doctors were allabout – being people’s people.”

ones you need to spend the most timewith. If you listen to them, treat themwith good manners and respect you’lloften find that you reach a commonground and will be able to work throughtheir issues.”

He adopts the same style towards hisfellow colleagues and is a firm advocateof face-to-face communication. “If someone has a problem, they shouldeither pick up the phone or organise ameeting face to face. And clinical leadersneed to make themselves accessible,” hesays. “I try to encourage my care groupleads, consultants and nurses to comeand talk to me if they have problems as Iwould far rather deal with things face toface instead of hiding behind emails.”

As well as accessibility, Drew believes thatgood communication is also aboutaccountability. “Everyone needs to beaccountable for their own actions. All myconsultant colleagues are accountable atall levels to their colleagues, junior staffand nursing staff.” Drew feels thatnursing staff are a key part of improvingdoctor-patient communication. “It isimportant that we all engage with oneanother and talk through any problems orconcerns so we’re all moving in the samedirection. We are, after all, in the samebusiness together – looking afterpatients!”

This open communication extends to GPs.If Drew has a patient he is concerned

Drew Fleming has been working atthe trust for 11 years. He specialises inchildren and adults hand surgery anddoes general plastics on-call work aswell as some specialist plasticsreconstruction work.

Drew has been praised by colleagues asbeing an advocate for doctor-patientcommunication. Ros Given-Wilsonmedical director said: “Drew leads byexample through the compassionate andfriendly rapport he has with his patients.This translates through to his relationshipwith colleagues.”

Drew puts this recognition down to hisstyle of working, which he describes asapproachable. He says: “I like to discuss,instead of disperse, knowledge sopatients feel that they can talk to meabout any issues or concerns they mayhave.

“The more information people have andget, the less likely they are to bedissatisfied with the hospital process. Andthe process, as we all know, can and doesgo wrong at times. If people feel that theycan trust you they will open up to you. It’salso the most rewarding in the long run,because people will actually talk to youabout what their fears and concerns areand you can help them through it.

Drew often spends extra time in clinicstalking to patients about their concerns.He says: “I often find that the patientswho are giving you a hard time are the

kspotlight

Spotlight on... Drew Fleming,consultant plastic surgeon and clinicaldirector for surgery

Since being invited to tender forintegration, the trust has been busytalking to staff, patients and carers, GPs,local authorities and MPs about whattheir hopes and concerns are for anypotential merger to help us shape ourbid. These discussions have includedpublic and staff events at St George’sand St Helier Hospitals.

Mike Bailey, clinical lead for the potentialintegration, said: “Merging with St Helierwould allow us to build on the success ofexisting clinical and academic networks,and give us the opportunity to establishnew networks in areas where none exist.We believe that this would help us toimprove health outcomes for peoplefrom across southwest London.”

It is not too late for you to have your sayand let the project team know what youthink about a potential integration withSt Helier Hospital. Fill out the online form atwww.stgeorges.nhs.uk/aboutsthelier.asp or contact Suzanne Marsello, project director, atsuzanne.marsello@stgeorges.nhs.uk

Have your say on St Helier plansIn November the trust board will decide wither to submit a bid for integration with St Helier Hospital, includingSutton Hospital and Queen Mary’s Hospital for Children.

For any catering or cleaning (except Atkinson Morley Wing) enquiries, please contact MITIE helpdesk on 0208 725 4000

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become the man that people look to foranswers. Over the years I have developeda skill set that fits this job and have notbeen afraid to tackle the challenges headon.

I don’t get to treat patients any more, butmy job now means that I can influenceand improve services for more patientsthan I could have ever seen as a nurse.Last year the services I am responsible fortreated 175,000 patients, so I still get togo home and feel proud at the end of theday.

What are your biggestachievements? The opening of the new Queen Mary’s in2006 is right up there. The old hospitalwas a very different place, it was a hugesprawling site of ancient buildings

That’s a long job title – what doesit mean? Basically, it means I am responsible formost of the services based at QueenMary’s Hospital, Roehampton includingradiology, rehabilitation and urgent care,and for some specialist services providedin the community like dentistry. I am alsoresponsible for all the Queen Mary’sservice level agreements and businessmanagement.

How long have you worked atQueen Mary’s?I started working at Queen Mary’s as astudent nurse back in 1983 beforequalifying as a staff nurse in 1986 andworking on R Ward under Sister Sibthorp.I went on to work for Johnson andJohnson Orthopaedics and Kings CollegeHospital for a few years, but as soon asthe opportunity to come back in 1995arose, there was no stopping me.

I would never have thought on day onethat I would be back here nearly 30 yearslater managing the place!

How do you go from being astudent nurse to running thehospital?I have always been really keen to learnand develop so that I can do the best jobpossible for my patients. While I havealways been happy to take on extraresponsibility, I certainly never set out to

‘view from the top

Stuart Reeves, associate chief operatingofficer for adult specialistand diagnostic services

cobbled together by a very long corridor,nothing like the modern hospital we havenow. I was heavily involved in designingwhat services should go where and thedecant from the old site to the new. Itwas a great upheaval for staff, so perhapswhat I am most proud of is that thespecial atmosphere and great sense ofcamaraderie still exists five years after themove.

I am also particularly proud that QueenMary’s brings together community healthservices that do not traditionally sittogether, meaning that we can meet mostpatients’ physical, mental or sexual healthneeds locally.

What does the future hold forQueen Mary’s Hospital?The demand for services that havetraditionally been delivered in biggerhospitals like St George’s and Kingston tobe provided closer to patients’ homesmeans we will see more of these servicescome to Queen Mary’s to serve peoplefrom Roehampton, Putney and Richmond.

We already have a state-of-the-art daycase unit and rapid access diagnostic unit,and since integrating last year we havestarted to treat patients with morecomplex needs .

We are also working with local GPs toprovide primary care services from theMinor Injuries Unit and to look at otherareas we can develop further.

What do you do to relax?I’m a big football fan and get along towatch the real Dons (AFC Wimbledon ) asoften as I can.

I’m a keen motorcyclist and often ride mySuzuki 1250 Bandit to work. I also ride amuch less reliable Royal Enfield Bulletwhen I have the time.

7

Texas team A group of nursing students fromTarleton State University, inTexas visited the trust to learnabout the UK healthcare system. The visit is an annual tripundertaken by US nursing students to learn about thedifferences in the UK and US healthcare systems.

Time to get your flu jabThe flu vaccine protects staff and patients and isrecommended by the trust, professional bodies andthe Department of Health. Staff who had the `fluvaccination last year will still need to have thevaccination this year, as some of the flu strains thatwill be circulating this winter will be different fromlast year. Staff need the latest vaccine to protect youfrom these different strains.

Dates and times of flu vaccinationclinics are available on the intranet.

523,901 outpatient appointmentsat St George’s Hospital

7,862 members of staff

12,993 training courses funded

4,300 St George’s Healthcare NHS Trust members2hospitals –

St George’s Hospital in Tooting andQueen Mary’s Hospital in Roehampton

11health centres

1,400 prisoners atWandsworth Prison

315 majortraumacases

9MRSA infections – the second lowest inLondon teaching hospitals

117,577A&E patients

5,308 babies born at St George’s Hospital

6,421 people helped by PALS

250 volunteersworking acrossthe trust

9per cent reductionin carbon emissions

536,403 communityappointments

Our year in numbers

8 the gazette

Annual report summaryIntroduction from Peter Coles, interim chief executive

St George’s Healthcare is oneof the country’s largesthealthcare organisations,with nearly 8,000 staff caringfor patients across 17different sites in southwestLondon.

The past year has given us muchto be proud of, with many exciting developmentsthat have helped to strengthen the trust’s reputationas a leading provider of care.

Of course, we are not immune to the financialchallenges that all NHS organisations are facing, andwe will need to find new and more efficient ways ofworking while not losing sight of the importance ofpatient safety and excellent quality of care.

These are interesting times for the trust as we workto develop new services and forge partnerships andalliances with local organisations who share ourvalues.. Inspired by the opportunity to develop carepathways provided by our integration withCommunity Services Wandsworth, we are alsobuilding a key strategic alliance with KingstonHospital NHS Trust. Our partnership working with StGeorge’s, University of London will also ensure thatpatients benefit from our collaborative research anddevelopment teams.

None of this would be possible without thecontinued dedication and commitment of our staff,who I know will continue strive to maintain andimprove on the high standards we have set ourselves.

A full version of the annual report is available online:www.stgeorges.nhs.uk

Last year we treated 600 of themost vulnerable babies from

across south west London.

Last year St George’s Hospitalmanaged 315 major trauma cases, with a

further 85 trauma cases each month.

Our children’s speech andlanguage therapists helpchildren with theircommunication skills whilstsupporting their families,teachers and other healthprofessionals.

We are here to supportpatients with life-limiting conditions

and their families to make sure that allpatients are treated with dignity until

the end of their lives.

Living our valuesWe launched our staff values in April 2010

and have been working hard to establishthem throughout St George’s Healthcare.

These values set out the standards ofbehaviour we expect from all our staff.

Read the full St George’sHealthcare annual report atwww.stgeorges.nhs.uk

10 the gazette

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Every year St George’s Healthcarecares for more than 800,000 patientsacross its sites and many of thosepatients take the time to write andexpress their thanks. Each month inthe gazette we publish a selection ofthose letters.

● FAO the delivery suite I’d like to say a huge thank you to the seniorconsultant and delivery team who workedon the birth of our second son.

The delivery was nerve racking for us asexpecting parents, but team were great andthe senior consultant in particular wasabsolutely amazing.

Mum and baby are doing very well, baby isgrowing and developing every day – he’sbrilliant.

● FAO the hand unit I received excellent service from the StGeorge’s hand clinic. The staff were prompt,friendly and my doctor seems to have donean excellent job in mending the injury I hadto my hand.

● FAO endoscopyI wanted to say a big thank you to all thestaff in endoscopy who treated me, inparticular Dr Chakrabarty and nursesRosanne, David and Cynthia who were verysupportive, kind and reassuring.

● FAO the MITIE cateringteam

This is just a short note to say how much Iappreciated the food I had during my stay inKeate Ward. Good choice, tasty, adequateamounts, nicely presented – the standard,especially when compared with the days ofyore, was really impressive. Congratulationsto all concerned.

● FAO the breast unit I would like to convey mine and my wife’stremendous appreciation for the care,efficiency and consideration my wife hasrecently received from all at the breastscreening unit, staffed by breast care nursesEve, Sarah, Maria and Claire. Many thanksindeed.

● FAO the Walk-in Centre I wish to pass on my heartfelt thanks to thecentre and to the two nurses to dealt withmy wife, not only were they trulyprofessional but in my opinion they werefabulous to both my wife in her presentstate of health and myself.

Past and present – QueenMary’s Hospital, Roehampton Originally a 200 bed military hospital, Queen Mary’s opened itsdoors to its first 25 patients in 1915. It was founded by MaryEleanor Gwynne Halford whose vision was to provide a place forpeople who had lost a limb to come and be rehabilitated and befitted with the most scientifically advanced limbs possible.

Throughout the First World War (1914-1918) the reputation of thehospital grew and it quickly became known as one of the world’sleading limb fitting and amputee rehabilitation centres, providing notonly treatment but also training opportunities so that patients couldfind employment. This made the demand for Queen Mary’s services sohigh that by the end of the war in 1918 it had 900 beds and a waitinglist of over 4,000 people.

During the 1920s the type and age of patients being treated by thehospital was expanding rapidly and in response to the chaning needs ofpatients a fully equipped hospital was built on the current Roehamptonsite, with x-ray, electro-therapy services and a gymnasium.

Queen Mary’s continued to see developments right up to the openingof the new hospital in February 2006.

Today, Queen Mary’s sees over 130,000 patients a year and offers morethan 60 services. The hospital’s best known set of services are itsamputee rehabilitation ones which come together in the world famousDouglas Bader Unit. The unit is an established international centre ofexcellence and a national leader in the field of research anddevelopment of rehabilitation techniques.

As well as offering outpatients services, Queen Mary’s today has 20beds in the rehabilitation centre, 69 mental healthcare beds and 50elderly and intermediate care beds.

MILITARY HOSPITAL: A group of World War one amputees in the garden ofQueen Mary's Hospital in 1917

SPECIALIST CARE: the Douglas Bader Unit at Queen Mary’s Hospital providesspecialist care and rehabilitation for amputee patients

For any catering or cleaning (except Atkinson Morley Wing) enquiries, please contact MITIE helpdesk on 0208 725 4000

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Play in hospital weekPlay in hospital week took place from 12th – 16th September andprovided an opportunity for the play specialists at the trust tohighlight the importance of their role.

Rosie Littleboy, the trust’s lead hospital play specialist, said: “Play inhospital is very important to normalise and enhance the environment forchildren and young people.

“To do this we use play therapeutically, for example a child blowingbubbles may have difficulty in breathing; by blowing bubbles it is helpingthem strengthen their lungs. If a child is having a procedure of any sortdone we go into the treatment room, if requested by the family, and usea game or relaxation method to help them cope with theprocedure. This allows the child to have more control over the situationand allows the procedure to be done quicker and calmer than if thechild was anxious and upset about having it done.”

We all want to improve the care that patients receive and deliverservices in line with best practice. Clinical audit is an essential toolthat can help us to achieve this. 2011 has seen a number ofdevelopments designed to ensure staff make the most of auditand that projects lead to real change.

Kate Hutt, clinical effectiveness and audit manager, leads a team of sixclinical auditors who cover each division. She said: “There is a lot of auditgoing on, with some great projects demonstrating that we are makingour services better for patients. However, with increased pressure onpeople’s time we recognised that improvements to how we organise andcarry out audit needed to be made.”

In May the board approved a strategy designed to maximise the benefitof clinical audit and a key step is the development of a prioritised auditprogramme. The plan has projects identified nationally or by the trust asessential, alongside those seen as priorities for divisions. Kate explains:“Having a programme in place will help us to focus on the mostimportant projects and to make sure that they lead to improvements forpatients. The team still need to know about your audits so please registerthem using the form on our intranet pages.”

In addition to providing expert involvement in projects, the team offers atraining programme with two half-day sessions every 3 months and shortsessions delivered at a time and place to suit individual teams. The newclinical audit policy, essential for our NHS Litigation Authority assessment,is another resource in place to support colleagues.

The clinical audit intranet pages have everything you need to stay up-to-date. You can also find out more by going along to the clinical audit half-day on the morning of Friday 2nd December. Kate said: “This is youropportunity to show off the work that you have been doing and for us allto share best practice. There will be prizes on offer so it really will be acelebration of what we are all doing to improve the services we deliverfor patients.” To put your audit forward visit the clinical audit page on theintranet or contact the team via clinicalaudit@stgeorges.nhs.uk .

Clinical audit - ensuring bestpractice and driving change

MUSIC THERAPY: children enjoy a sing-along with a visit from Music in Hospitals

A pioneering stem cell transplant treatmentused for sickle cell patients has beensuccessful in curing 23-year-old Remmy Kamyaof this crippling disease. The treatment, which isa UK first, was led by Dr Mickey Koh, director ofstem cell transplants and consultant haematologistat St George’s Hospital in London.

Sickle cell anaemia is an inherited, lifelong diseaseand is the most common of the hereditary blooddisorders. Red blood cells are produced by stemcells within the marrow found inside the bones.Healthy red blood cells are biconcaved discs whichcan bend and flex easily. In those with sickle celldisease, faulty stem cells produce red blood cellsthat are crescent shaped. These are rigid, unable tosqueeze through smaller blood vessels, and proneto causing blockages that deprive parts of the bodyof oxygen, leading to periods of intense pain.

Management of sickle cell disease has alwaysfocused on treating symptoms with the only cureup until now being a stem cell transplant, wherethe abnormal red blood cells are replaced with newhealthy ones from a donor. To do this, high levels ofchemotherapy are given to the patient to kill offthe unhealthy blood cells and to ensure that thedonor’s tissue is not rejected. For this reason thesetransplants are often restricted to children as thelevels of chemotherapy may be too toxic for anadult, especially if their organs are already affectedfrom the disease.

The new procedure is novel because it does not useany chemotherapy in the transplant regimen.Instead, it relies on low dose radiotherapy andantibody which modulates the immune system.This makes the treatment tolerable to the patientwhile minimising graft rejection and other potentialserious complications from the transplant. Thistreatment was initially pioneered in America.

Mickey said: “This is an exciting development as itopens up the possibility for more patients affectedby this disease to be potentially cured by atransplant. This novel chemotherapy free regimenwas well tolerated and successful in terms of graftacceptance and the absence of serious posttransplant complications.”

After his referral, Remmy’s family was tested for asuitable donor and his brother came up as a match.He spent around a month in hospital for thetransplant as his immune system was quite low.Following the transplant, the new stem cells fromthe brother have grown well and tests haverevealed that his red cells are being replaced by hisbrother’s.

Six months on from his transplant, Remmy feels likehe leads a normal life now. He said: “I am less tiredand have not suffered a sickle cell crisis since!”

This story was featured in the Mail on Sunday on8th October.

Pioneering stem celltreatment for sickle cellis a UK first

The trust’s Annual General Meeting (AGM), held on 29th September,provided an opportunity to showcase the trust’s successes during the2010/11 financial year and also recognised staff for their hard workand commitment.

The event, held in the Monckton Lecture Theatre, was attended by nearly200 members of the public, patients and staff. As well as updates on trustperformance, the audience also heard presentations from staff about olderpeople’s services and paediatric intensive care.

The evening ended with the presentation of the Special Achievement Awardsto staff and volunteers by deputy chair, Emma Gilthorpe.

Individual award winnersSuzanne Davis, volunteer, haematology/oncology outpatients departmentHeather Dennis, stoma care nurseJenni Doman, general manager, facilitiesDiane Grennan, housekeeper, Keate WardPaula Lewis, induction support, education and developmentPat McCole, sister, neuro ITUVictoria Morrison, nurse, Benjamin Weir WardRachel Pearce, nurse practitioner, trauma and orthopaedicsAbbe Robertson, ward sister, Buckland WardNeil Robson, volunteer, haematology outpatient clinic 1Mary Smith, manager, Keate WardRuth Smith, coordinator, urology multi-disciplinary teamElisabeth Williams, consultant anaesthetist

Team award winnersCourtyard clinic patient steering groupImplementation of global trigger tool trust-wide teamMedical records volunteersMicrobiology biomedical scientistsMITIE catering and cleaning teamPharmacy patient experience task group: discharge medicinesStaff and specimen transport teamTraumatic brain injury teamVernon WardWilliam Drummond stroke serviceWolfson Aphasia Volunteers

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AGM celebrates staff andtrust achievements

Cardiac arrestsurvival rate amongthe best in LondonThe survival rate of patients broughtto St George’s Hospital havingsuffered a cardiac arrest is in the toptwo in London, according to a studypublished by London AmbulanceService.

The annual study examines survival ratesacross the capital and found that betweenAugust 2010 and July 2011 the survivalrate of patients brought to St George’sHospital was 15.4 per cent (16/104). Thisis the second year running that thehospital has been in the top two out ofmore than 30 hospitals included in thereport.

Paula McLean, resuscitation servicemanager, said: “These statistics areencouraging and demonstrate that theservice we provide is among the bestanywhere. The figures represent patientswho have suffered a cardiac arrest outsideof hospital – at home or at work – so theirhearts stopped beating prior to gettinginto hospital, which is very serious.

“The survival rate at St George’s is theresult of complex teamwork betweenseveral departments, including A&E,cardiology, resuscitation services andintensive care, combined with the latesttechnologies. This ensures that patientsreceive specialist attention as quickly aspossible, which ultimately saves lives.

“A specialist heart attack team was set upin July, which will help to coordinate thecare of patients suffering heart relatedillnesses even more efficiently. We areexpecting this to have a positive impacton patient survival rates for heart attacksand cardiac arrest in future.”

St George’s Hospital has one of thebiggest cardiology units in the country. Itprovides emergency care, diagnosis,medical treatment and outpatient servicesfor all heart disorders. This includes heartattacks, heart failure, heart valve disease,heart muscle disease, congenital heartdefects, high blood pressure andarrhythmia (irregular heart beat). Thehospital is the heart attack centre forsouthwest London, providing a 24-houremergency angioplasty service, enablinglife-saving treatment to be given to heartattack patients.

TEAM WINNERS: the MITIE team collect their award from Emma Gilthorpe, deputy chair (far right)

The centre provides free information and support for anyone affected by cancer and isstaffed by two specialist nurses; a Macmillan cancer information manager and aMacmillan cancer information officer, who are available to answer any questions.Patients or carers can drop in, without the need to make an appointment.

For any catering or cleaning (except Atkinson Morley Wing) enquiries, please contact MITIE helpdesk on 0208 725 4000

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The new Macmillan cancer information and support centre, based at St George’sHospital was officially opened in September by Cllr Mrs Jane Cooper, Mayor ofWandsworth and Chris Cotton, chief executive, Royal Albert Hall and a formerpatient of the hospital.

New resuscitation unit opensIn September the Mayor of Wandsworth, Cllr Mrs Jane Cooper, officially opened the new£1.4m resuscitation unit at St George’s Hospital.

The unit, the most modern in London,provides eight resuscitation bays eachwith a large bed space to allowemergency care staff to manage themost complex of cases. The unit alsohouses a dedicated overhead x-raysystem built into the ceiling of the

department. The Mayor toured thewhole of the accident and emergencydepartment at St George’s beforeofficially opening the new unit. Shesaid, “The people of Wandsworthshould be proud that this state-of-the-art facility is based at St George’s

Hospital. “As a major trauma unit thehospital cares for patients who are inneed of urgent and specialist care. Invisiting the A&E department, I wasstruck by the professionalism anddedication of all the staff that I met.”

GRAND OPENING: Left to right: Chris Lewis,member of Improving the Cancer Experience(ICE) group; Chris cotton, chief executive,Royal Albert Hall and former patient;Beverley van der Molen, information andsupport manager for the centre; Cllr Mrs JaneCooper, Mayor of Wandsworth and CarolFenton, Macmillan general manager forLondon, Anglia and the South East

Macmillan information and support centre opens

NEW TECHNOLOGY: Phil Moss, clinical director for A&E, and Heather Jarman, consultant nurse in emergency care, demonstrate to theMayor of Wandsworth how the new overhead x-ray system works

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In April 2011, the trust’s maternityservice launched the Rainbow teamfor women who choose to have theirbabies at home.

The team, based at Brocklebank HealthCentre on Garratt Lane, operates acrossWandsworth and Merton.

This enhanced service is open to allwomen who are expected to have a non-complex pregnancy, including first timemothers. Women can refer themselvesonline or direct to the midwives atBrocklebank Health Centre so don’t needa GP referral. Women who are on bookedto give birth at St George’s Hospital canchoose at any point in their pregnancy tohave a home birth.

All the care is offered by the midwives’ inpatients’ homes or at local clinics,

although the original booking is taken atthe Brocklebank Health Centre.

The team is lead by community midwifeDianna Fairman-Campbell under theguidance of Maria Brown, lead midwifecommunity and antenatal clinic. Othermembers are Jodette Holly, Diane Mack ,the team also has a link obstetricconsultant Polly Hughes.

Speeking about the service Dianna said: “Itis great to give women a choice as somewomen just hate the idea of hospitals.With our team, they receive all their care inthe comfort of their own home andchoose a variety of different ways to givebirth, such as water births or hypnobirths.”

For more information, call the RainbowTeam on 020 8812 5456.

Enhanced service for womenhaving babies at home

Celebrating good practiceSeptember’s patient safety week provided an opportunityto celebrate important safety initiatives that have been putin place by staff across the trust.

The highlight of the week was the patient safety conferencewhich featured national experts Dr Suzette Woodward, Directorof the National Patient Safety Agency and Jane Carthey, humanfactors expert. Staff also heard the harrowing story of ClareBowen who lost her daughter Beth in an untimely, tragic andavoidable error during an elective surgical operation to removeher spleen.

A number of safety initiatives were launched at the conferenceincluding, the pressure ulcer prevention pack, a new early warningobservation chart, and a protocol for variable rate insulin. A safetydashboard has also been launched on the intranet.

Yvonne Connolly, head of patient safety, said: “Patient safety isimportant every day of the year but patient safety week is a goodopportunity to highlight some of the important initiatives that canhelp to make our patients safer all the time. Thanks to manyenthusiastic staff the events were a great success and havepromoted safety messages across the organisation.”

MEDICINE MANAGEMENT: members of the pharmacy department wereon hand to answer questions

Cancer team commended Congratulations to our cancer services team, withparticular input from the Macmillan Clinical NurseSpecialists (CNS), who have been commended by theNHS National Cancer Action Team (NCAT) for theirparticipation as a beacon site in the cancerInformation Prescription Programme. The programmeoffers high quality information tailored to individualpatient’s needs in the form of an information prescription.

The team, based at St George’s Hospital, was commendedfor their level of engagement in the ‘train the trainerprogramme’. The majority of the trust’s Macmillan CNS’sand other members of staff who work with cancerpatients, have now been trained how to use the system.Their knowledge can also be passed on to other membersof the cancer team. NCAT also acknowledged thepartnership approach of learn and share events with TheRoyal Marsden and Croydon NHS Trust. These learningexercises have provided invaluable learning to the widernational programme.

Beverley van der Molen, Macmillan information andsupport manager, said “The Information PrescriptionsService (IPS) is a tool to support clinical teams offeringcondition and treatment specific related information totheir patients. It enables staff to tailor information to theneeds of patients and aims to improve the overallexperience at St George’s. The IPS is hosted by NHS Choicesand can also be accessed by patients and their families.”

Although cancer services is leading the way in theimplementation of this resource it is important to realisethat the IPS is available for other conditions such asdiabetes, dialysis, heart disease and sexual health to namebut a few.

The IPS is an online resource available for anyone atwww.nhs.uk/ipg

MORE CHOICE: Community midwife DiannaFairman-Campbell (back) with a family whoused the expertise of the rainbow team tohave their baby at home

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Saving carbon,saving livesHelping the trust drive energy efficiencies and meetgovernment statutory and legislative requirements isRathan Nagendra, energy and sustainability manager.

Rathan, who has a degree inmechanical engineering, hasworked in the NHS for nine yearsand said of the role: “I try to lookat the trust holistically and ensurethat energy efficiency is in thebasics of everything we do – fromprocurement to capital projects.These energy savings obviouslytranslate into efficiency savings.We have all the building blocks inplace, but the only way we canachieve carbon and cost saving isby working together.”

Some projects on the agenda for 2011/12 include:

● BMS building management system – thiscontrols heating, ventilation and air conditioning to thewhole site. Rathan is looking at way to minimise thehours it is used so we use less energy, and also reduceon maintenance costs.

● Combined heat and power plant (CHP) – this isan energy conversion process where heat and electricityare produced in a single process; this allows the trust toproduce its own electricity to feed the hospital instead ofimporting it. Rathan is looking at ways to increase theefficiency and availability of the plant, which has been onthe site since 1994, and exploring the potential for usingthe thermal energy of waste gases to heat the site.

● Smart metering – this is an electrical meter thatrecords consumption of electrical energy in intervals ofan hour or less and communicates the information backto a central point for monitoring and billing purposes.Over the next few months, Rathan will be looking atbuilding by building energy usage to see how much isbeing used, and how it can be reduced.

● Lighting projects – A new lighting system that useslight and movement sensors has been installed acrossseveral areas of the trust, so the lights automatically turnoff during the day and during unoccupied times, if therehas been no movement for 20 minutes, the lights switchoff. This project will be rolled out to other suitable areas.

● Energy patrols – Rathan and Jenni Doman, generalmanager for facilities, have been completing energypatrols, outside office hours to assess departmentalenergy behaviour patterns. Rathan is looking at ways toautomatically turn computers on and off duringunoccupied hours so that it does not disturb businesscontinuity.

ENERGY MANAGER:Rathan Nagendra

The community nursing teams (of which there are19 based in four community wards acrossWandsworth) deliver palliative care to patientsacross the borough.

Gillian Best, clinical team leader for community nursing,explains how the service operates: “End-of-life care is asignificant part of our work and involves the multi-disciplinary team (MDT). This usually includes the GP,community nursing team, night service communitynursing team, clinical nurse specialists from the acutesector and from the hospices, as well as therapists andsocial services.

“We provide all the hands-on care for patients, right upto and including their last day of life if they have chosento be cared for at home. We also receive specialist adviceand support from the clinical nurse specialists in thehospices who are part of the MDT, but are not activelyhands-on.

“We also play a vital role in helping to discharge patientsfrom hospital who would prefer to die at home. Sucharranegments need to be organised quickly and the teamwork hard to ensure that this happens.

“Good communication is crucial throughout the process.Once a palliative care patient is identified a nurse willdiscuss their ‘preferred place or priority for care’ and alsoasked for the patient’s decisions on whether they wish tobe resuscitated or to die naturally. These conversationsare quite complex and advanced training is offered to allnurses to support them. “The nursing teams will alsoaccess and co-ordinate any additional resources, such asMarie Curie nurses and the ‘Trinity at Home’ service,which is currently being piloted in Wandsworth. Trinity atHome is for patients who may need additional supportfor more complex physical and emotional needs, orwhere the family and carers need the additional support.

“The teams have also worked with commissioners todevelop a ‘Yellow Communication Book’; which hascreated an accessible and easy way to gather and storeall the documents and information. This folder is uniqueto the teams’ patients and is being used increasingly inthe community. It contains personal information,including all contact names and details of the MDT anddetails of hospitals, appointments and specialist nurses.Important information such as the Preferred Priority forCare, the do not attempt resuscitation agreement and,for the last days of life, the Community Care Pathway arealso all kept in the yellow book. In addition informationsheets for patients are also included.

“As the folder belongs to the patient, they are also ableto keep other bits and pieces such as a will or a ‘letter ofwishes’. After a patient has passed away, we keep theCare Pathway information for our nursing records, butthe folder and other contents are left with the patient’sfamily.”

“The care we provide for this group of patients isprobably the most privileged and rewarding aspect ofbeing a community nurse.”

Palliative care teamin the community

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Tour de St George’sA local school rivalry was re-ignighted bystaff members Colin Davis and AlanThorne, who completed a marathoncycling challenge around the perimeterroad at St George’s Hospital duringAugust.

Their 26.3 mile cycling race raised funds for StGeorge’s Hospital Charity and Help for Heroes.

Throughout their preparation for the challengethe two swapped banter about their oldschools and the intention was to race to thefinish to settle the dispute, but on the dayColin, who was representing Elliott School andAlan, sporting the colours of WandsworthComprehensive, came over the finish linetogether!

Go girls!There was a terrific atmosphere in Hyde Park at thebeginning of September when a team of womenran, jogged or walked the annual Ladies 5k.

There were some 16,000 runners in all, including a teamof enthusiasts from across St George’s, (pictured) includingestates and facilities, accommodation services, fundraising,the University, and further afield.

Liz Woods, head of fundraising, explains the team’scollective motivation: “Given that this is a ladies event, wewanted to support something that will be of benefit to women in particular(but not exclusively). So, the money we raise will go towards a piece of artworkfor one of the counselling rooms in the new state-of-the-art breast diagnosticunit, due to open at St George’s Hoapital this autumn. It’s here that patientslearn about their diagnosis, so the environment needs to be conducive.”

You can still show your support by making a donation at the team’s Justgivingpage: www.justgiving.com/stgeorges5kteam

At the same time as the 5k, Lisa Lewington (pictured) from the playroom wastaking part in the London to Brighton bike ride. Lisa completed the 54 milechallenge, raising money for St George’s Hospital Charity respiratoryequipment and education fund. “It was amazing!” says Lisa.

Rfundraising

Cheesy choonsJuly saw the culmination of several months’ work by a group offriends and mothers at a local primary school at Wimbledon Chase,when they held a fundraising event at the David Lloyd centre inRaynes Park.

Louise Bellamy, Mandy Bynon, Helen Somerville and Denise Yamaguchipresented ‘The Vinyl Countdown’ to their friends and family, an evening of‘cheesy choons’ from the past few decades, which packed the dancefloor allnight. However they still found time to host a raffle, a silent auction, anexcellent buffet and of course the wine flowed ….

Inspired by the fantastic care that one of their children received when he spenttime on Nicholls Paediatric ward, they have managed to raise over £4500 plusdonations of equipment making the value of their gift to Nicholls Wardaround £9000!

In September the team returned to St George’s with their children for a thankyou event. This gave sister Julia Sexton and her team from Nicholls ward andRosie Littleboy and her colleague from play therapy the opportunity to showtheir appreciation for the benefits that this fundraising will bring to thechildren they will care for in the future.