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issue 20 October 2010

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Stroke service ratedbest in the country

!contents

2 the gazette

the gazette is written and published by thecommunications unit, with contributions fromCharles Whitney. The opinions expressed donot necessarily represent those of St George’sHealthcare NHS Trust. The next edition will bepublished in December 2010. If you are a staffmember with a story for the gazette, pleaseemail: communications@stgeorges.nhs.uk

Front page picture shows stroke consultant Barry Moynihan with patient John Davies

A new system is increasing patientsafety by ensuring the right staff withthe right skill mix are in the right placeat the right time. eRP, an electronicrostering staff bank and paymentsystem, is expected to generatesavings of £5m over the next twoyears. It was rolled out to nursing staffat the end of August, after a pilotintroduction on the general intensivecare ward proved to be a greatsuccess.

The system will reduce time spent onadministration and payroll errors, providinggreater transparency of staffing andreduce spend on bank and agency staff. Itwill also allow for greater flexibility, as anonline self-service function allows nursingstaff to plan their working lives, for example,requesting shifts and annual leave.

The eRP project team will train staff on thesystems and provide support as theybecome familiar with the system. This willbe followed, at a later stage, with theimplementation of time and attendancewhich will ensure payroll errors areminimised.

The initial rollout is across eight wards –Amyand, Richmond, A&E, Nicholls,Vernon, McKissock, delivery suite, cardiacintensive care unit as well as communitymidwives.

A system for junior doctors will beintroduced by the eRP team towards theend of the year.

Steve Loveridge, eRP project manager,said, “This is an exciting project which willmake a real difference to staff andmanagement.”

Electronic rostering programme (eRP): a safer staffing programme The trust’s 2009/10 annual

report and summaryaccounts is out now. Itcontains a review of some ofthe key areas of work fromthe last financial year.

The report also includes anawards section, whichcelebrates the success that St George’s staff have hadduring 2009/10.

Please contact thecommunications unit onext 2717 or via email if

you would like a hard copy. Anelectronic copy is available onthe websitewww.stgeorges.nhs.uk

National award for rare cancer care

GOLDEN AWARD: (l-r) Mr Derek Fawcett, president of BAUS; Mr Nick Watkin and Mr Richard Greenhalgh, Urology Business Manager of Karl Storz

Nick Watkin, consultant urologicalsurgeon at St George’s, was awardedthe coveted Karl-Storz-Harold HopkinsGolden Telescope at the 2010 BritishAssociation of Urological SurgeonsAnnual General Meeting held in June.The award is in recognition of Nick’swork in male genital reconstructionand penile cancer.St George’s is a specialist centre forpenile cancer, a rare condition affectingaround 400 men in Britain every year.The trust takes referrals from across theSouth of England, and is working toimprove the treatments available forthis distressing condition. Speaking about the care provided atthe trust Nick Watkin said: “In themajority of cases, surgery can beoffered which preserves the penis. Thisobviously has a huge impact on the

quality of life for patients.”Anne Bishop, chief executive of theBritish Association of UrologicalSurgeons, said: “The award is given tourologists who have made a significantand lasting contribution to urology.”Rebecca Porta, chief executive of themale cancer charity Orchid, said: “It isencouraging to see the important workat St George’s being recognised and wecongratulate the team on their success.Penile cancer is a rare illness, and oneof the most emotionally difficult formen to deal with. “The research carried out by Mr Watkinand his team will undoubtedly help theoverall wellbeing of patients who arediagnosed with this disease and givethem the encouragement and supportthey need during their treatment.”

2 National award for rare cancer care2 Electronic rostering programme (eRP)3 A word from David3 End unnecessary pathology tests3 Cancer teams lead peer review4 Foundation trust update4 Acute Pain Management Service 5 Nurse honoured for Afghan rotation6 Spotlight on Dr Andy Rhodes7 View from the top8 The patient experience9 AAA screening programme 9 Clinic celebrates five successful years10 Stroke service rated best in the country10 State-of-the-art scanner goes live11 Informing patients 11 Choose and book improvements12 Wheels in motion 12 Integration stakeholder event12 Procument update13 Greener healthcare is no waste of space13 Health and safety hazards14 Lunchtime snack turns into attack14 Benjamin Weir past and present 15 Art – the heart of a healing environment15 State-of-the-art breast diagnostic unit 16 Charity news

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Plea to end unnecessarypathology testsUnnecessary tests are delaying patient care and wasting money. That’s themessage from the pathology service as it calls on clinicians to thinkcarefully about whether tests are really required before requesting them.

Paul Collinson consultant, chemical pathology, from clinical blood sciences, said:“There are three types of inappropriate testing that we need to reduce.

“The first is when tests are re-ordered despite already having been carried out thatday. For example you might have a patientadmitted to A&E who has a series of tests,then exactly the same tests are ordered atthe medical assessment unit and again whenthe patient is on a ward, all within 24 hours.

“The second is when tests are repeated tooclosely together and there is no way ofdetermining meaning from the results.Sometimes thyroid function tests are carriedout within a few days of each other but theinternational guidance is clear, there shouldbe a six week interval between tests.“The third is tests that are clearlyinappropriate for the patient. I’ve seen A&Epatients being screened for cancer by bloodtesting and even male patients being testedfor breast cancer, all at St George’s.”

Success issomething I

am pleased tosay we aregetting veryfamiliar with hereat St George’s.However I amacutely awarethat it does notcome without alot of hard workand dedication from our staff.

In August the trust came out top in anational stroke audit, which assessedmore than 200 trusts in England, Walesand Northern Ireland. The audit assessedquality of care by looking at the processof care in place for patients and how theservice is organised. St George’s achievedthe highest overall score and mycongratulations go to the stroke team onthis outstanding achievement.

October’s edition of the gazette is filledwith other examples of the great workthat goes on around the trust in clinicaland non-clinical settings.

As the gazette goes to print, our plans forintegration with Community ServicesWandsworth are being finalisied. OurFoundation Trust plans also continue togather pace; the consultation came to anend in August and I’d like to thank thosewho took the time to respond.

This month the gazette focuses on theimportance of clinical leadership at StGeorge’s. In view from the top we speakto Val Thomas, one of our divisionalchairs, while the spotlight falls on AndyRhodes, consultant in general intensivecare unit.

In the last issue of the gazette welaunched the trust’s new values which are aimed at improving the trust’s culturefor staff and patients. Look out for thevalues special logos introduced inthis edition.

the gazette 3

A word from David

David Astley, chief executive

"technology

Cancer teams at St George’sdemonstrated excellence in thelatest round of assessmentsconducted under the NationalCancer Peer Review Programme.

Out of 30 teams from the SouthWest London Cancer Network, sixwere awarded Earned Autonomy thismeans they have improved on ormaintained excellent performance fortwo consecutive years and will notneed to be internally verified duringnext year’s review.

Three of those six were teams fromSt George’s. The breast, lung andupper gastro-intestinal teams allgained Earned Autonomy.

Macmillan lead cancer nurse June

Allen, who leads on peer review at St George’s, said: “This shows thefantastic work which is going onwithin these teams. The other cancerteams scored extremely well and weare looking forward to more teamsachieving Earned Autonomy next year.

“Everyone within cancer has workedextremely hard to achieve andmaintain such high complianceagainst the peer review measures.”

June Allen and Steve Powell, cancerand neuro auditor, would like tothank the teams involved for all theirhard work and commitment topatient care, making St George’s aleader in cancer treatment.

Cancer teams lead peer review

Congratulations to Helen Jarvis, practice educator,who is the lucky winner of our July competition. Theanswer to the question Arthur Smith is a regular guest onwhat BBC2 programme was Grumpy Old Men.

Helen wins a signed copy of Arthur Smith’s book My Name is Daphne Fairfax.

kind

responsible

respectful

excellent

#FT status

The health white paper Equity and excellence: liberatingthe NHS, published in July, made it clear that thegovernment expects all NHS trusts to become FoundationTrusts (FTs) by 2013. FT status is therefore vital if StGeorge’s is to stay in control of its future.

St George’s 12-week public consultation on its plans to becomea FT ended in August – a big thank you goes to those whoresponded.

Overall there was strong support for our plans and, from a staffperspective, we have learned more about how we need toincrease engagement to ensure staff can contribute fully to ourfuture plans.

We held two staff FT open forums during the summer, led by thetrust chair, Naaz Coker and chief executive, David Astley, andthere was good attendance at both meetings.

The FT team is now established in its new office on the groundfloor of Grosvenor Wing, giving more prominence to thisimportant stream of work. If you would like someone to attendyour staff meeting to talk about our FT application, pleasecontact the team. The next staff open forum will be on Thursday11th November at 3pm in the Hyde Park room and we lookforward to seeing you then.

The FT membership office launched a major membershiprecruitment drive at the beginning of September to recruitseveral thousand members. It is hoped that staff will help withmembership recruitment by encouraging family members andfriends to sign up. For more details contact the FT membershipofficer on 020 8266 6132 or emailadrienne.long@stgeorges.nhs.uk

4 the gazette

FT TEAM: (l-r) Adrienne Long, Esther Corcoran and Wilfred Carneiro

Patient Sophie Mayo knows St George’s Hospital betterthan most of its staff, having had 20 abdominal operationsfor Crohn’s Disease since 1999, and spent around sixmonths on the wards during a recent stay.

She is one of the 3,000 patients treated by the acute painmanagement service last year, and is full of praise for the team.Sophie said: “They’re really helpful, they give you advice aboutthe best use of drugs, like morphine, at hospital and how toswitch to less powerful drugs when you go home.”

Expanding role for acute pain management service

Foundation trust update

After her operation Sophie uses patient controlled analgesia, amachine that contains a syringe of morphine connected to a lineand button, which she can press when she feels she needs it, toreceive a controlled dose of painkiller.

Jeremy Cashman, consultant anaethetist, who leads the team,said he is seeing more patients than ever since St George’s wasdesignated one of four major trauma centres for London.

He said: “The team is made up of anaesthetists, nurses and otherhealth professionals, and 94 per cent of patients said they had apositive experience of the service during 2009.

“We are developing ways of delivering the safest, most effectivepain management possible, while reducing the risk of patientsbecoming tolerant of medicines.”

The service also evaluates and refines practice for specificconditions, to ensure pain management is taken into accountthroughout the patient pathway. For example, procedures inplace for patients being treated for a fractured pelvis haveimproved.

Trainee clinical nurse specialist Tanya Butt said: “I’ve been withthe team for about nine months now and it has taught me a lot.I don’t think people realise exactly how important the team is topatients, and how much work we do.“

Who’s who in FTWilfred Carneiro is the trust’s equality and FT membershipmanager. Wearing his FT hat, Wilfred is responsible forthe delivery of the wider membership strategy, whichincludes linking with our local communities, preparing forthe election of governors and planning for a regular cycleof membership engagement and information events.

As FT membership officer, Adrienne Long is responsiblefor the implementation of the membership recruitmentstrategy and for the day-to-day liaison with FT members.

Esther Corcoran, senior communications officer, focuseson internal and external communication of the trust’s FTplans and membership recruitment.

The FT membership office also benefits from the work oftwo volunteers, Wendy Gaynair and Jasmine Taylor, whoassist with membership database administration andoffice work.

HIGH PRAISE: Sophie Mayo (right) and the acute pain management team

A St George’s nurse has been honoured for spending threemonths at the British military hospital at Camp Bastion inAfghanistan.

Officers from the Territorial Army Medical Services visited StGeorge’s during July to present a limited edition war print called

Safe Return, as way ofthanking the trust forreleasing staff nurse EmmaO’Reilly during her threemonth rotation.

Emma was mobilised inOctober 2009 and over thewinter she was dealing withcasualties from the war.

She said: “It was a real eye-opener, and it has benefitedmy practice at St George’s. Iwas in a lot of situations thatI wouldn’t usually encounter.I’d consider going again.”

Emma’s commanding officer, Colonel Gerry McBride, met trustchief executive David Astley, when he presented the hospital withthe print. He said: “Territorial Army medics are a vital part of themedical support provided by the army medical service, and thesupport of NHS trusts such as St George’s has been absolutelyfundamental to the continued running of the world-class fieldhospital at Camp Bastion.”

Martyn Willis joined the charity as chief executive inMay this year. The gazette caught up with him to findout more about his role and his vision for the future ofthe charity.

What does your role involve?The primary function is one of governance. This means that itis my job to ensure that the trustees have in place properpolicies and procedures to manage our resources effectively. Itis my job to keep them updated on changes to legislation andCharity Commission guidelines. It is also my responsibility tooversee that expenditure is within the rules of individualfunds.

Additionally, I have been tasked with increasing ourfundraising capacity, in light of the country’s currenteconomic situation and the impact it is having on all walks oflife, charities included.

What is your experience so far of the charity and St George’s as a whole?As a former cardiac patient I am the grateful recipient ofexcellent care and treatment from staff at St George’s and fromwhat I have witnessed since I have been here, there isimmense pride and dedication permeating right across the trust.

However what I do feel is that there is a distinct lack ofawareness of the role of the charity and the important andrewarding work that we do. It is my job along with Liz Woodsand her team in the fundraising office, to change that.

Could you clarify the role ofthe charity for us then? The role of the charity is to providemaximum benefit to patients andstaff of St George’s by supplementingand not substituting funding of thecore services of the NHS.

What is your vision for St George’s Hospital Charity?

It is my intention to spread the word about our work. I wantto grow our database with details of people willing to supportus. Our trustees are determined to increase the fundsavailable to enable them to provide grants for the trust toturn adequately funded schemes into five star projectswherever possible. But it is not just grand designs that wesupport, the trustees also wish to provide for the smallerthings that improve the welfare of patients and staff.

My vision is that staff and the community who rely on St George’s for their healthcare join us and help expand thework that we do in support of services and provisions outsidethe mainstream provision to make a significant difference tothe widest number of patients.

Anyone wishing to support us should either call in to ouroffice in the main entrance or call one of the team, Liz, Sheilaor Maribel on 020 8725 4522.

the gazette 5

St George’s Hospital Charitywelcomes new chief executive

Nurse honoured for Afghan rotation

MILITARY HONOURS: (l-r) Emma O’Reilly, David Astley and ColonelGerry McBride

$military connections

Martyn Willis

6 the gazette

%spotlight

Andy, who has been clinicaldirector of critical care at St George’s since 2009, talksabout the team effort made tostamp out hospital acquiredinfections among some of themost vulnerable patients at St George’s.

He said: ”The general intensive careunit has achieved an impressive andsustained reduction in infectionssuch as MRSA and Clostridiumdifficile (C diff), despite the fact thatICU patients are among the mostvulnerable to infections in thehospital, due to the majority of thembeing old, frail and seriously ill.

”This has not always been the case.Three years ago, the ICU had amajor problem, with more than 20MRSA bacteraemia cases beingrecorded in a single quarter.

“St George’s patients are seen bymore healthcare professionals onICU than on other wards, often withmany interventions taking placeevery hour. This makes it easier foran infection to spread from onepatient to the next if hygienestandards are not maintained.

“In 2007 we had a big problem with MRSA and C diff onthe ICUs, especially on the general unit, and it took a jointeffort from everybody in the critical care team to tackle the problem.

“We took it very seriously and adopted a zero toleranceapproach to hospital acquired infections. This included aconcerted effort to improve hand hygiene as well as a seriesof other infection control practices and interventions.

Meet Andy Rhodes,general intensive care unit consultant

The reduction in infection numbers cameabout towards the end of 2007 and we’vemaintained the improvement ever since.We see MRSA much less frequently now,which shows that we are doing somethingright, but that does not mean we can relax.

Infection control is nowadays far more apart of everyday life on ICU, and somethingthat we have to remain vigilant about.

Staff throughout critical care are building on theseachievements by taking part in a project to reduce the risk ofcentral venous catheter blood stream infections (CVC-BSI),called Matching Michigan.

Andy said: “The three adult ICUs and PICU are now part of anNational Patient Safety Agent project, led at St George’s byconsultant nurse in critical care Deborah Dawson, toreproduce the success achieved by hospitals in Michigan, USA.

He said: “ICU nurses and doctors have worked enthusiasticallyto ensure that CVC insertion and care practice is of thehighest standard.”

This involves the daily surveillance of all central lines ensuringthat they are required, are appropriately dressed and show nosigns of infection.

“In conjunction with Dr Peter Riley from microbiology, each ofthe units review every bacteraemia against the definitions forCVC blood stream infection to identify a monthly rate ofinfection for each unit. Since starting this project in December2009 we have seen a further decrease in CVC-BSI rates.”

Val Thomas is thedivisional chair for thechildren and women,diagnostics, therapeuticsand critical care divisionand a cellular pathologyconsultant. She talks tothe gazette about howshe balances her roles.

&

What does your role asdivisional chair involve?Perhaps unsurprisingly, this is a verydifficult question which I am still findingthe answer to! Each of the divisions isworking towards a model where each isessentially accountable and responsiblefor all the clinical and support activitieswithin the division, rather like threeparallel healthcare businesses. In orderto do this, the first part of my role hasbeen to really get to know the clinicalservices within the division; how theywork and how they fit together with therest of the trust. I work closely with ourdivisional director of operations, toreview each service’s strategy andbusiness plan to ensure that they notonly fit with the trust’s overall strategybut strive to deliver excellent services toour patients.

Another key aspect of my role is to workwith our divisional director of nursing,head of midwifery and governance leadto ensure that the services within thedivision are safe and comply withnational standards. In the background, Isit on consultant appointmentscommittees, help facilitate job planning,chair SUI panels and sit on a variety oftrust committees as a clinicalrepresentative.

How long have you been atSt George’s and where didyou start out?I trained as a student at St George’sMedical School and was in the secondyear of students to begin undergraduatetraining on the Tooting site. I undertookan intercalated BSc and then a PhD indevelopmental biology before goingback into clinical medical training.

During my PhD studies, I was luckyenough to spend some time in the USAwith the research team I was attachedto, at Harvard and MIT. I enjoyed basicresearch but for me it felt too far frommy original intent when I embarked onmedical training. After I qualified inmedicine, I was in a dilemma aboutwhich medical specialty career topursue. Pathology won narrowly overpsychiatry and I spent five years in leafyHampstead training in cellularpathology before successfully applyingfor a consultancy back at St George’swhere I have been since 1992.

What benefits do you thinkthe three divisional chairroles have brought to thestructure of the trust?St George’s is enormous and due to geteven bigger with the integration ofCommunity Services Wandsworth into afourth division. The sheer size makes itvery difficult for a single medicaldirector to really get to know peopleacross all services and to understandhow they work.

Each division is the size of a smallhospital giving the divisional chairs theopportunity to help develop a closersense of identity and community and abetter understanding of the roles andneeds of each of the teams in theirdivision. There is the opportunity forbetter communication between the

the gazette 7

&view from the top

clinical teams and the board via thedivisional chairs, as we meet regularlywith members of the division and theexecutive and can keep everyone up tospeed with ongoing changes anddevelopments.

How do you balance thiswith your role as a cellularpathology consultant?Cellular pathology largely involvesreviewing biopsies and cytologyspecimens down a microscope andwriting reports giving diagnostic andprognostic information so that physiciansand surgeons can plan a patient’streatment. This can be fitted in quiteflexibly as there are few fixed sessions aweek. The problem then is that I findmyself with too many managementcommitments as my diary seemsattractively empty to those who haveaccess, so I have learnt to pace thenumber of meetings and othercommitments and to say no!

What do you do to relax?Rather dull hobbies by today’s standards,though I did recently learn to scuba dive.I am a member of a book club and readnovels voraciously and fairlyindiscriminately. I belong to StreathamChoral Society which practices at StLeonard’s Church (Monday evenings7.30 – new members always welcome).Unlike many of my friends, I never intendto run a marathon!

What does the patient experiencemanager do? I oversee PALS and thehealth information centre, complaints andimprovements, voluntary services,bereavement services and patient andpublic involvement in the trust. I am verylucky to manage such hard working andpassionate teams, who are committed tomaking a real difference to the patientexperience.

What is the difference between PALSand complaints? Whenever I ask staffwhat PALS do, they say “deal withcomplaints”. To this I respond – no! PALSstaff help to sort out any problems orconcerns that patients may have about thetrust’s services by liaising with relevantstaff, as well as providing information topatients and listening to their views andcomments.

They also provide advice on how to accessinterpreters, signers and other services. Inaddition, PALS staff provide customer caretraining to staff throughout the trust.

Although PALS staff can offer advice onthe complaints process, they do not dealwith complaints.

Some staff are great at responding to PALSqueries quickly, but many do notunderstand how important this is. Anunresolved PALS query can develop into aformal complaint – this results in afrustrated patient and a lot of work for themanager who has to investigate.

What if a patient wants to make acomplaint? If a patient expresses, eitherverbally or in writing, that they want tomake a complaint about something that

has happened to them, this is dealt withby the staff in the complaints andimprovements (C&I) department.

Every complaint is logged onto ourdatabase and acknowledged within threeworking days. C&I staff then email thecomplaint to the general manager for therelevant area for action and investigation.They co-ordinate the sign-off and sendingof complaint responses via the chiefexecutive.

The team also provides various trainingsessions about responding to complaintsand give advice and guidance to staff, aswell as dealing with compliments.

Tell us about the compliments? During2009/2010 the trust received 270 lettersof thanks centrally. In addition to this,almost 4,000 forms of thanks werereceived locally by trust staff, such ascards, flowers and chocolates. We knowthat good news is under reported so staffshould always let the complaints andimprovements department know, so thesecan be recognised. You don’t have to sendthe flowers and the chocolates themselves(unless you want to!) just the numberreceived will be fine.

What can staff do to stop a concern orcomplaint developing? It’s about takingresponsibility for concerns when they areraised with you, even if you have to dosome running around to get the answersthat are needed – I can recite a story toillustrate this.

A patient went to the reception of a clinicto check in for his appointment and theclerk informed him that the clinic was

8 the gazette

SARAH DUNCAN: The trust’s patient experience manager

The patient experience – it’s everyone’sresponsibility

The gazette spoke to Sarah Duncan,patient experience manager, to findout more about her role and howstaff can help improve the patientexperience.

PALS TEAM: (l-r) Catherine Jones, PALSmanager; Joely Hampton, Peter Martin andGlenn Webb, PALS officers

COMPLAINTS AND IMPROVEMENTS: EliotMaunder, Jacqueline Ewers, Louise O’Connell;administrative officer and Ilse Vandenput,complaints and improvements coordinators

respectful

In August St George’s was featuredon ITV London Tonight in a reporthighlighting the trust’s abdominalaortic aneurism (AAA) screeningprogramme.

The programme is aimed at men agedbetween 65 and 74, an estimated80,000 of whom are affected by AAA,a condition which is caused when themain blood vessel in the abdomen -the aorta - weakens and starts toexpand.

People suffering with AAAs often don’texperience any symptoms and, if itremains undetected, it can be fatal. Onaverage around 6,000 men every yeardie from AAA.

The London Tonight report featuredpatient Terence McCarthy (see patientfeedback, left) whose life was saved bythe programme, and an interview withconsultant vascular surgeon Ian Loftus,lead for the NHS AAA ScreeningProgramme for St George’s andsouthwest London.

'in the news

the gazette 9

A service set up to provideanaesthetic support to pregnantwomen at high risk ofcomplications celebrates its fifthanniversary this year.

The high-risk obstetric anaestheticclinic was established in October2005, and is staffed by consultantanaesthetists Renate Wendler andFrank Schroeder and twoobstetricians, Amar Bhide and IngridWatt-Coote. It is supported bymidwives from the fetal medicineunit, cardiologists, haematologists,surgeons and radiologists within StGeorge’s.

The clinic is held every Thursday,providing a multidisciplinary approachto tackling the most complex casesamong the 5,000 women who givebirth at St George’s every year.

Patient numbers are rising year onyear, up 12.1 per cent during 2009and 50 per cent over the past fiveyears. The most common conditionswere haematological (blood) diseases,followed by cardiac disease inpregnancy.

The clinic provides advice andassessments for women who havehad previous difficulties withanalgesia and anaesthesia and helpfor those with medical conditionsbefore and after conception.

This includes regular assessments ofwomen as they progress throughpregnancy, with a robustmanagement plan for labour anddelivery. All high-risk women aretreated at a specialist high-dependency unit on the deliverysuite.

Consultant obstetric and cardiacanaesthetist, Wendler, said: “Ourexperience shows that carefulplanning in a multidisciplinary teamwill lead to successful maternal andneonatal outcomes in high-riskpatients.”

The team also provides training forsenior anaesthetic and obstetrictrainees who have an interest in highrisk pregnancy and maternalmedicine. A yearly report on clinicactivity and outcome can be foundon the St George’s intranetanaesthetic page.

AAA screening programmehits the headlines

Clinic for high-risk pregnanciescelebrates five successful years

A patient who referred himself to ascreening programme is so grateful tothe staff for saving his life that hewanted to “shout from the rooftops”to encourage more men to take partin the programme.

Terence McCarthy, of New Malden,decided to refer himself to the trust’sabdominal aortic aneurysm (AAA)screening programme in 2009, afterhis close friend died of an aneurysm.

The 79-year-old grandfather wasplaced under surveillance inNovember, and in May this year wasrushed into hospital for surgery afterhis aneurysm swelled to nearly 6.5cm.

He said: “There is no question at allhow close this was – two or threedoctors said how lucky I was. I am sograteful to everyone involved in thescreening programme, I would like tosay thank you to them all. I am goingto tell all my friends to have thescreening done.”

cancelled. The patient was very upsetand asked the clerk why he was notinformed. The clerk said “well, we musthave tried to contact you. Go to PALS!”

The patient then walked all the way toPALS where staff had to contact thesame clinic clerk to get the informationthe patient needed. He had been sent aletter which hadn’t been received. Anapology was offered and a newappointment arranged.

What a waste of everyone’s time – allof this could have been sorted out atthe clinic reception in the first place.Many complaints and concerns wouldnever be raised if staff would simplytake responsibility for issues when theyoccurs.

Why is good complaints handling soimportant the trust? Successfulbusinesses are all judged by theirreputation. We want people to chooseto come to St George’s. It is a fact thatif someone receives a good service andgood customer care from a shop,restaurant or hospital, they will mentionit to their friends and family. However, ifsomeone receives a poor service theyare even more likely to tell people. Thesame applies with handling complaintsand concerns. Nobody expects us toget it right every time, but it is how wedeal with the complaints and concernsthat do arise that defines us.

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St George’s has been rated the best inthe country in a stroke national auditreleased in August. The NationalSentinel Audit for Stroke, organisedby the Royal College of Physicians,assesses quality of care by looking atthe process of care in place forpatients and how the service isorganised.

More than 200 trusts in England, Wales andNorthern Ireland were assessed across eightcategories and the stroke service at StGeorge’s achieved the highest overall score.

In July St George’s began operating one ofeight specialist hyper-acute stroke units(HASU) in London, providing expertemergency care to stroke patients, includingaccess to CT scans and clot-busting drugswhich save lives and reduce long-termdisability.

The stroke service achieved top marks inthe audit for organisation of care forpatients, the coordination of teammeetings and the breadth of specialiststaff working on the unit. The service alsoscored very highly for its communicationwith patients and carers and themultidisciplinary approach to patient care.

The audit also recognised the service forcoordinating closely with a specialistcommunity rehabilitation team for longer-term care of both stroke and generalneurology patients – a care package

which is not provided by over half ofstroke services across the country.

Hugh Markus, professor of neurology andone of five consultants in the stroke team,said: “These results are a marvellousachievement for the team here. Theservice has been ranked among the topten in the country in the last few audits,so quality has been consistently high forsome time now. The fact that we are nowplaced top is a tribute to a huge amountof effort and enthusiasm from a large anddiverse multidisciplinary team.

“We now provide all three tiers of strokeservices at St George’s – a HASU, a stroke

unit and a TIA (mini-stroke) service. In thenext twelve months we are expecting toincrease our bed capacity and the numberof TIA clinics so that we can continue toprovide the very highest quality care forincreasing numbers of patients.”

The service was recently selected as oneof only eight hyper acute stroke researchunits in the country, securing funding foradvanced research into stroke care, whichaims to help increase understanding ofstroke and develop innovative treatmentsfor the condition.

This story hit the news during August,featuring on GMTV, BBC London News,BBC Radio London and Radio Jackie.

10 the gazette

Patients are benefiting from the latest technology at St George’swhere the next generation of MRI scanner has been installed.

The 3 Tesla MRI scanner (3T), housed in the Atkinson Morley Wing, is ajoint £2.5million purchase between the trust and St George’s Universityof London.

Tesla is the unit of measurement quantifying the strength of a magneticfield. Conventional MRI scanners operate at 1.5 Tesla, but the 3T operatesat twice that, and this is up to ten times the strength of low field or openMRI scanners.

The increased image clarity revealed by 3T is particularly beneficial for pathological conditions involving the brain, spine, andcardiac system. It takes extra slices when creating an image, allowing for a more detailed picture.

The hospital has access to five sessions per week, three for cardiac patients and two for neuro patients. The remaining sessionswill be used by the university for research into neurological and cardiac diseases. The new scanner will allow researchers toinvestigate the structure, function and chemical changes in the brain that occur with diseases such as stroke and dementia.

Stroke service rated best in the country

excellent

State-of-the-art scanner goes live

TEAM EFFORT: The stroke service achieved top marks for organization of care and thecoordination of team meetings and the range of specialist staff working on the unit

A team of pharmacists, nurses,doctors, pharmacy technicians andeducators is working to improvepatients’ understanding of theirmedicines. At the same timeclinicians and nurses are gaining abetter understanding of whatinformation they should provide topatients.

The patient experience task group wasset up after a survey in August 2009showed that patients were not beinggiven enough information about theirmedicines, how to take them and whatside effects to look out for.

Along with regular meetings, the groupworks to train clinicians and nursesabout the information they should giveto patients, and spend time on thewards helping to explain prescriptions.

Assistant chief pharmacist, WendyPullinger, said: “We have trained morethan 150 ward staff so far and coveredthree medical and six surgical wards. Thegroup’s multidisciplinary approach is

bringing about great benefits, as we areable to address the need for betterinformation and provide support on theward, throughout the patient pathway.”

Pharmacy technician Marina Timofeevasaid:“Research shows that the better wecommunicate with patients, the morelikely they are to take their medicinescorrectly and have a more successfulrecovery.

“We know that sometimes patientsdon’t read all the notes that come withtheir medicine. They end up payingmore attention to the advice of theirfriends or neighbours rather thanclinicians, so it is important to make surethey have as much information aspossible when they are at hospital.”

Kendra Caesar, discharge co-ordinatoron Cavell Ward, said: “The group hasmade a real difference on the ward,helping to reinforce best practice amongnurses and clinicians.”

Gladys Ada Maria Francis, 83, a patienton Cavell Ward, said: “I’ve had a goodexperience at St George’s and they havebeen very helpful explaining mymedicines to me.”

the gazette 11

Multi-disciplinaryapproach to informingpatients

Patients are benefiting fromeasier access toappointments at times thatsuit them, according tofigures gathered by thechoose and book service at St George’s.

The trust has consistently met itstarget of having fewer than fourper cent of patients unable tosecure an appointment at aconvenient time. This figure isdown from an average of 20 percent per month during 2009.

Jo Derbyshire, choose andbook manager, said: “There is agrowing number of GPs usingchoose and book to referpatients, and it is an easierprocess for everybody involved ifpatients can get the rightappointment the first time theycome into contact with theservice. Therefore have increasedcapacity and added newservices”.

In December 2009 an ambitiousproject started to ensure alloutpatients’ clinics that were notopen to choose and book wereidentified and included on thesystem.

As a result, an additional 40clinics are now available,including rapid access for theelderly, the rapid access chestpain clinic, restorative dentistry,the foot and ankle clinic and thehand clinic.

Patients are using the servicefrom across southwest Londonand beyond, with the majorityable to book their appointmentstraight away.

For advice andinformation about chooseand book call assistant

service manager Buddhi Pant on020 8725 4985.

St George’srecognised for choose and bookimprovements

responsible

"

GREATER UNDERSTANDING: Matthew Boardman, a member of the patient experience task group,talks Gladys through her medicine

Every day the patient transportservice at St George’s carries around350 passengers and covers morethan 2,000 miles.

The service has improved dramaticallysince the transport assessment andbooking (TAB) team was set up threeyears ago, with a mission to ensurefairness in the way patient transport isallocated.

The team provides a single point ofcontact for patients wishing to booktransport for outpatient appointments.

Patients can call the team withquestions they have about the service,have a medical assessment carried outover the phone and, if appropriate,arrange their transport. Once the teamagrees to provide transport aconfirmation letter is sent to the patientwith a transport time.

Since the TAB team launch there havebeen fewer complaints about patienttransport, and most journeys are nowcompleted on time.

To contact the TAB team, call 020 87250808.

12 the gazette

Wheels in motion

New agency balances staffingneedsThe trust’s new agency staffing groupbrings together colleagues from humanresources, divisional directorates,procurement and nursing. The aim of thegroup is to get the right balance betweenpermanent, bank and temporary staffacross the trust; implementing anelectronic rostering system; ensuring useof the the right agencies and value formoney.

Significant progress is already being madein the procurement of temporary stafffrom external agencies. Examples includeimproved control and coordination ofspend on medical locums; a newcollaborative deal in south London for ourallied health professionals and furtherefficiencies on our administrative andclerical expenditure.

In keeping with the procurementprogramme as a whole, the strategy is todeliver all of these improvements withoutcompromising patient care.

The agency staffing group is an exampleof how the trust is coordinating staffefforts to improve a key area ofexpenditure. For more information,contact Rebecca Coppock atrebecca.coppock@stgeorges.nhs.uk

Improving medical recordsstorageIn another procurement initiative StGeorge’s is working with the storage firmIron Mountain, which holds 69,000 boxesof historical medical records for the trust.The firm is looking at ways of linking upwith the hospital’s electronic patientrecords system, so that requests for theretrieval of old records can be automated.

Deals save time and moneyBetter procurement is saving time forclinicians while improving patient safetyand saving money, in a pilot project wherea new type of urinary catheter is beingused on two wards. Instead of orderingparts from different suppliers, completepacks are provided, which saves time forstaff and, if rolled out across the trust,could save £20,000 a year in costs. Toprovide feedback on the new catheters,download the feedback form from theprocurement page on the intranet.

The procurement team has also slashedthe cost of cochlear implants bynegotiating a better deal with its supplier,saving £86,000 per annum.

For information about theprogramme to modernise oursupply chain, email

procurement@stgeorges.nhs.uk

Around 80 stakeholders includingGPs, local councillors and patientgroup representatives attended anevent at the trust in July to learnmore about the plans for St George’sintegration with Community ServicesWandsworth. Attendees were toldabout the integration process so far andwere asked about their views on howplans to progress should be takenforward.

Suzanne Marsello, programme director,said, “The event was a great opportunityfor stakeholders to hear more about thisexciting development and also providedan important platform for us to seekeveryone’s views.”

The proposed plans will bring communityand acute services together to provideimproved care for local residents.

Following integration it is expected that St George’s will be responsible forproviding services including: districtnursing, health visiting, communityspecialist nursing, school nursing andmany of the services provided at QueenMary’s Hospital, Roehampton.

As the gazette went to print, finalapproval for intregration from the boardsof St George’s, NHS Wandsworth andNHS London was being determined.

Integrationstakeholder event

Procurement update

THE TAB TEAM: (l-r) Dawn Gregory, Daisy Allchurch, Jade Costan, Sonia Bryan and Victor Ayuko

!

Carcinogenic fumes, blocked fire exits,Legionnaires’ disease and crampedworkspaces aren’t topics that usuallyspring to mind during the averageworking day.

But this is exactly what Peter McDermott,health and safety manager, is confrontedwith on a daily basis.

As the gazette went on a walk-around thetrust with Peter, it was only a matter ofminutes before we were tripping overhealth and safety hazards. These hazardsaffect staff, patients, contractors andpublic on a daily basis. Trust-wide wedeclare three slips, trips and falls a day –thankfully the vast majority of these do notresult in any serious injury.

The key to preventing incidents isawareness of hazards and risks; takingnotice of the people, spaces, workequipment, the ward or working

environment and generally things aroundyou; learning to envisage and assess anypotential hazards before they happen,and then, most importantly, takingresponsibility to manage those risks whichare identified.

Peter said: “Health and safety is everyone’sjob – you need to look out for yourself,your team, patients and visitors too.”

To increase awareness, the health andsafety team at St George’s is offering staffthe chance to take part in a one-daycourse, which provides junior and middlemanagers, nurses and supervisors withthe right tools to undertake riskassessments.

The next courses are on Friday 15th

October or Monday 6th December, from9am-4.30pm.

There is also a four-day course, entitledManaging Safely, for middle and senior

staff and managers, which aims to linkstatutory health and safety requirementswith the work of the trust. On completionof a written exam and work-basedproject, attendees will receive an Instituteof Safety & Health (IOSH) certificaterecognising their training.

If you want to know what you can do tomake your workplace and team healthierand safer, look out for the monthly healthand safety calendar checklist themes,circulated via eG. You can also request acopy of the calendar.

For more information about risk or safetyissues call the health and safety team onext 2487.

To book, complete the registrationform on the intranet and return it

to the risk management office, Room 41,Fountain Suite, Knightsbridge Wing.

the gazette 13

Eyes open for health and safety hazards

a hospital

Staff took the chance to findout more about the trust’sgreen initiatives at the WasteAwareness Day in July.

The Hyde Park room was filledwith stands from partners andproviders including the trust’shealth and safety and infectioncontrol teams, Veolia domestic andrecycling waste, GW Butler, whichdeals with clinical waste, and the10:10 campaign. The total amountof waste produced by the trust in2009/10 was 2,960 tonnes –enough waste to fill the Tooting lidotwice each week.

Our comprehensive recyclingscheme saw the trust recycle morethan 333 tonnes of plastic, paper,cardboard, cans and glass in2009/10, a vast improvement onthe 35 tonnes we recycled in2004/5.

All domestic waste is now recycled andgoes towards providing power to 48,000homes across London.

Almost 80 per cent of the trust’salternative treated waste (orange bag

waste), once shredded, is used as fuel forthe cement industry.

These developments, along with staffawareness and knowledge about wheretrust waste goes is the key to meeting

three objectives: ensuring we complywith waste legislation; reducing coststhrough recycling and segregatingwaste and support St George’s being agreen organisation.

The continuing work also supports our10:10 commitment, to cut carbonemissions by ten per cent by the endof 2010.

Mary Prior, general manager forfacilities, said: “The trust has in anumber of initiatives aimed atimproving sustainability. Staff wantingto get involved or those with and ideasfor how we can be greener shouldemail Think.Green@stgeorges.nhs.uk“

In addition the bi-monthly wasteproject group is looking for newmembers to generate ideas aboutmaking the way we handle waste safefor our staff.

Look out for the next instalment of the10:10 campaign in the Decemberedition of the gazette, featuring an

article about the trust’s greendevelopments.

To learn more about recycling at thetrust, contact waste manager AlanHall on ext 3169.

Greener healthcare is no waste of space

WASTE AWARE: Amelia Floresca, infection control nurse,demonstrates what waste should be placed in the orangebin bags

"

!

herself, back slaps and theHeimlich manoeuvre finallysucceeded in dislodging theoffending vegetable after afrightening two minutes. “I was seconds away frompassing out, so was veryrelieved when it worked!” Sue says.

Sue has survived the ordealrelatively unscathed (she hassuffered a broken rib from theHeimlich manoeuvre) and is very gratefulto her colleagues. “I would like to extendmy sincere thanks to Karen and Yee Eanfor their help. Had it not been for theirassistance I would not have survived.” Sue

Medical secretary Sue Wichard hada hair raising experience in Augustwhen she nearly choked to deathat her desk as she munched on herlunchtime salad. Sue said: “I took abite of lettuce and as I bent over topick up something I felt the lettuceget lodged in the back of my throat.I knew it was really serious as Icould not breathe at all.”

Alone in the office, Sue went runningout in search of some assistance andfound respiratory nurse Karen Wright.Together with Yee Ean Ong, consultantin chest medicine, the pair attemptedto assist Sue. A combination of Suetrying to manually dislodge the lettuce

%staff news

As part of a new series the gazettewill dig deeper into the history of StGeorge’s and its people and wards.This month we look at Benjamin Weirand find out about his associationwith St George’s, and learn moreabout the work of the ward named inhonour of him today.

Benjamin Weir was a resident of southLondon and was known for his generosityin helping the less fortunate inWandsworth and Streatham. He was bornin Southwark in 1809, and becamewealthy through land and propertyinvestment. When the Bolingbroke wasbought for the development of a hospital,Benjamin Weir not only provided agenerous donation to help purchase theproperty, but also promised to financiallysupport the maintenance of the hospitaluntil his death in 1909.

In his will he requested that his house beturned into a healthcare facility and becalled the Weir Hospital. However, theproperty was not suitable for this so aWeir Hospital was eventually establishedin Weir Road, Streatham. The hospitalwas opened in 1913 and over the yearsevolved into a maternity hospital, until itwas closed and its services moved to thecurrent St George’s site in 1978.

Today, Benjamin Weir ward is located inAtkinson Morley Wing and ispredominantly a cardiothoracic surgical

ward; caring for patients pre and postheart surgery. The ward also looks aftercardiology patients and patients who havejust had heart attacks and interventionsand investigations into their cardiacdisease.

Kimberly O’Hara, matron on BenjaminWeir ward, has been working on theward for two and a half years and finds itextremely rewarding. She said, “I workwith a wonderful team of staff to ensurethat patient safety and quality is ourpriority. I am involved with all very sickpatients, attend the cardiac arrests tosupport the teams and ensure planned

14 the gazette

Benjamin Weir past and present

NEW FACES: Ben Weir, the class of 2010

care for all the patients. Benjamin Weirward runs extremely efficiently, the staffwork to ensure patients are discharged by11am and have just started on theproductive ward project.

“The senior sister ensures staff all haveannual individual performance reviews(IPRs) and they have an excellent teamwork approach to patient care. When I domy weekly matron rounds the patients areall extremely complimentary of the staffand how hard they work. The ward isalways clean and free of clutter and awelcoming place for patients and theirvisitors and a lovely environment for staffto work in.”

Lunchtime snack turns into attack

has also sworn off lettuce since theincident. She said: “Salads were part ofa diet I was on, but I will now havebuttered buns instead any day of theweek!”

CLOSE CALL: (l-r) Yee Ean Ong, Sue Wichard and Karen Wright

It’s often easy to ignore the importanceof the arts in a hospital environment,but as the gazette speaks to the trust’sart director, Belinda Harward, andadvocate for performing arts SarahWeatherall, we find out there is moreto healing arts than meets the eye.

“I would describe my job as taking stressout of spaces,” says Belinda, who has builtthe trust’s collection up to 450 works sinceshe joined in 2002.

“I consider the use of volume, daylight,colour, texture and art, bringing all theseelements together so that they serve thefunction of the space, either internal orexternal building projects.

“People walk into hospital loaded withexpectations – their emotional responsestend to be about apprehension, fear and ofcourse hope. My job is to recognise thatand to address it in how I approach thespace.”

Belinda, who hails from the west country,gained a masters in design at BrunelUniversity and has worked in marketing,communications and strategy at BritishAirways and in private sector advertisingand design, managing major nationalcampaigns.

“Well-designed spaces communicate at avisual level, leading people to believe thecare will be good. This is particularlyimportant here as people feel vulnerableand find illness difficult to grapple with.

“There is lots of research to prove that art,

design and performance allcontribute to reducing stresslevels and aid recovery, so it isa real privilege that I can usemy expertise to help thisprocess.”

Belinda is guided by the artscommittee, (AfTHE Arts for theTeaching and HealingEnvironment) of 18 members,which identifies projects anddiscusses how the budget,which like her role is fundedby St George’s HospitalCharity, will be spent. It hopesto make the trust’s art,including the popular gallery inthe Ingredients restaurant,widely available.

Future plans include expanding theperforming arts programme, a role fulfilledwith the appointment of Sarah Weatherall,an advocate for the performing arts, whobrings theatre, comedy and music to thebedside.

Sarah’s focus is on patients with longlengths of stay, or frequent inpatients. Shesaid: “Studies have shown good outcomesfor patients requiring, for instance, lessanalgesic or shorter stays in hospital. Ihope to be working with doctors andnurses to reach patients most in need.”

A programme of performing arts will relyheavily on volunteer actors, entertainersand musicians. “We are on the hunt fortalented individuals to come forward togive around three afternoons a year. Thisway I hope to build a programme on

limited resources.”

Sarah is also setting up a choir, along withmedical school students, so the hospitalcan benefit from its own musical talent. Itwill be led by Christopher Killerby whofounded the 75-strong community choir,Colliers Wood Chorus. Rehearsals will take place every Wednesday lunchtime.Everyone is welcome, regardless of abilityor experience.

Sarah continued: “The idea is thatrehearsals will take place in four weekblocks, so no-one will need to commit toa long period of time, and every fourweeks there will be a small concert on thewards.”

Email performingarts@stgeorges.nhs.ukto find out more about the choir and todiscuss ways performing arts mightimprove patients’ experience, wellbeingand mood.

the gazette 15

Art – the heart of a healing environment

ARTS GURUS: (l-r) Belinda Harward, art director and SarahWeatherall, advocate for performing arts are working totransform St George’s into a top-notch healing environment

The trust has announced that it is setto build a new breast diagnostic unit,which will screen women from acrosssouthwest London. St George’s hoststhe South West London BreastScreening Service and the St George’sNational Breast Screening TrainingCentre, as well as providing breastservices for symptomatic local women.

The antisoma building on the trust’sperimeter road will house the modernfacility, which will provide state-of-the-artequipment for the diagnosis and treatmentof breast cancer and other breast diseases.

Clinical results at the trust for breastscreening are among the best in London.By becoming fully digital the service willoffer more rapid access to diagnostic testsand all tests will be able to take place inthe same session.

“This announcement is really positive forwomen in southwest London.” Says DrLouise Wilkinson, director of screening atSt George’s. “Early detection of breastcancer is the key to successful treatmentand this unit will provide all the testswomen need in one place at one time, andgive them their results quickly. This will

help reduce anxiety for women and allowthe team to fully investigate any problemsmore efficiently.”

“This is going to be a sophisticated unit,providing women with a comfortable,modern, high-quality and efficientscreening and diagnostic service in a calmand caring environment.” Louise explains.“The quality of care at St George’s hasalways been of the highest standard andthe new environment will ensure thatwomen benefit from the best possibleservices in a building designed for thepurpose.”

St George’s to build state-of-the-art breast diagnostic unit

kind

16 the gazette

(

(fundraising

Floral affairSt George’s Hospital received a visit from localfamily run firm, Nelsons, in July, when it donatedvases of arranged flowers.

By way of marking its 150th anniversary, Nelsons, based in Wimbledon,donated eight vases of flowers arranged by its staff members. Theflowers were presented to Martyn Willis, chief executive of StGeorge’s Hospital Charity, and were displayed across the trust.

Bridget Streatfeild-James of Nelsons said: “We’re delighted to beable to make this donation to St George’s during our 150thanniversary year. We have many talented flower arrangers on ourstaff and they felt strongly about wanting to support their localhospital and its charity. This is a wonderful example of Nelsons inthe local community.”

St George’s Hospital Charity news

St George’s Hospital Charity was one oftwo charities to receive a donation frommoney raised at the 2010 cateringequipment distributors association (CEDA)conference. CEDA chairman Peter Kitchinchose the charity, following an inspirationalstory of father and son Ray and Stuart Coombe.Ray’s son Stuart had suffered complete kidneyfailure and required a transplant. Rayimmediately volunteered to be the donor andboth operations were successfully carried out atSt George’s. Ray recovered quickly, but Stuartsuffered complications, which were onlyovercome by the skill and dedication of theteam at St George’s. Stuart is now back to fullhealth, enjoying life and study at the Universityof Manchester.

(l-r) Martyn Willis, chief executive of

St George’s HospitalCharity; Marilyn Palmer-Williams; Kally Umanee;Fiona Chisholm; AraxiKaskanian and Amy

Lyddall-Fell

( Four members of staff tookpart in the British 10k London runin July raising money for StGeorge’s Hospital Charity. The 10kroute starts at Hyde Park Cornerand takes in Piccadilly, theEmbankment, Tower Bridge,Westminster Bridge and Whitehall.Congratulations to Abi Changer,Penny Neild, Niki Giatras and ChrisBurke who took part and raised£2,000 between them.

GENEROUS DONATION: (l-r) Iain MacPhee,consultant nephrologist; Jonathan Doughty FCSI;David Oliveira, consultant nephrologist; StuartCoombe; Ray Coombe; Helen Gregson, lead renaltransplant nurse; Mohamed Morsy, consultanttransplant surgeon; Nicos Kessaris, consultant renaland transplant surgeon; Joyce Popoola, consultantnephrologist; Liz Cording, clinical nurse specialist

CEDA conferencedonates £4,500 to renal unit

St George’s Dragons took on the cream ofLondon’s NHS finance departments in a five-a-

side tournament at Wembley in July. Despitecrashing out controversially in the group stage, the team

earned some valuable exposure for St George’s Hospital Charityon what turned out to be the hottest day of the summer.

Back row: (l-r) Tac Hau; KevinWedderburn; Silvan

Koterba; Tak Pang; PhilipMurray; Michael Armour

Front row: (l-r) Junes‘Nutmeg’ Mohamed;

Samuel Ridge

Dragons on fire