Monthly archives: February 2020
Chief Executive’s Message – Friday 28 February
Covid-19 as we are coming to know it is still at the forefront of some people’s daily work. A handful of assessments each day are coming our way, and there is every reason to think in the weeks ahead that that will grow. On Connect, and if you cannot find it, say so, there is guidance not just on treating people who present, but also on your own symptoms and what to do is you need to self-quarantine. There is a balance to be struck between awareness raising and undue concern, and I think that our infection leaders, like Taran and Julie, are finding that balance. I want to thank them, teams in ED, and our emergency planning squad, for the hours of effort and time going in. We want to work together with the ambulance service, GPs and local pharmacies to support our community, with very many of us travelling, or having plans to do so in the coming weeks.
Monday next sees the launch of our first pilot in Body Worn Cameras. This is a direct result of your incident reporting and the focus this year on 21-day reports into those incidents. That produced a working group focused on violence and aggression, which reports direct to our Risk Management Committee. We are investing to use this technology, as other NHS bodies have successfully, both as deterrent and as an aid. That will help with tackling racism, discrimination and violence as we want to make sure that you can work safely here. I well appreciate that this launch brings its own challenges, and we have learnt from others about some of those, including issues of data privacy and patient confidentiality. Thank you to our security team for going first, and ED and some of our more complex wards, as well as teams working alone in community settings will come next.
Almost a month ago I wrote here about our emergency care team presenting to the Board about their plans for the future, both short term and long term, as staffing in the departments had sharply improved. As a Board we have moved slightly away from utter focus on the Four Hour quality standard. That is because we want to make sure that we meet other parallel goals around initial triage in 15 minutes, ambulance handover inside 30 minutes, and senior assessment in an hour. About two thirds of the patients over one hour are waiting in our wait rooms, and a third are inside the department. So the plan is simple, but fiendishly difficult to do. We need to make sure assessments are made, rounds if you like, for everyone inside the department with our senior clinicians, and that we do use ambulatory majors, to use our cubicles even if we then return lower risk patients back into the wait room. Of course when we move to Midland Met we will have cubicle numbers sized to meet demand. Until then the balance of risk lies in this model of care, recommended by medical and nursing leaders and used effectively in other Trusts.
Thank you to the ward teams who hit 100% for sepsis screening this week. We are back well into the 90s now as a Trust. However, around half of our screened indicated patients then waited over an hour for treatment including medication. You know by now that sepsis is our Number 1 Quality Priority, and over the next few weeks we will be working to find the right mix of staffing, structure, persuasion and insistence to drive that Golden Hour Treatment figure upwards. This is our chance to save lives and prevent harm and we need to seize it.
Most weekends, and every week, we see huge effort to address staffing shortfalls. You know that in 2017 and again in 2019 we set an ambition to try and be fully staffed. The data changes all the time, but it looks like we will go into April having HALVED vacancies in our Trust this last year. I cannot recall using capitals in a Friday message before in nearly 7 years’ service, but I do so to tackle the typical urban myth that everything is getting worse and all is managed decline. We have had success hiring nursing associates, ward nurses, specialty doctors in ED, theatre staff, and midwives.
There are just over 150 “hard to fill roles” which we are focusing on in April, May and June, which are perennially difficult to recruit to, here or indeed anywhere. At the same time, we are promoting from within. There are lots of examples of individual progressing in their careers at the Trust, and I am delighted that after external advertisement, and interview, Liam Kennedy has now been confirmed as our long term Chief Operating Officer, with Mel Roberts moving across to become a deputy chief operating officer. There are plenty of other moves and opportunities, and it is important to restate that we are on track to achieve our band 8 and above BME leadership ambitions, growing significantly the diversity of our senior leadership cadre. It is against this broad context that we will go into April absolutely bearing down hard on the £16m a year we still spend on agency costs, at least 40% of which disappears from staff pockets. The Trust has always invested to have better staffing ratios where we can than minimum, and that continues, which is why we need to recycle funds and try and get value for money from each hire.
Heartbeat is out next week! Now separate from payslips – you can look up what you got paid via ESR. Of course our monthly magazine focuses on our University Hospital announcement, as well as Year of the Midwife and Nurse. But it also includes some fantastic information about our work on weight, on wellbeing and on physical exercise. This weekend’s weather may not be conducive to taking a mindful walk, or time out for yoga. We do use the pages of Heartbeat to begin to talk through the real health consequences of weight, the impact on any of us psychologically, but also on our long term mortality and links to other conditions. From our work on smoking I do appreciate that there is real sensitivity to the Trust as our employer getting too close to someone’s personal health. However, in our view as a Board, we have a duty of care to make sure that our workplace and our working patterns support sleep, rest, wellbeing and fitness. Of course that helps effective work too, but our motive is about each of us thriving in our lives as well as in the NHS. Do get back to me, or to Ruth Wilkin, if you have ideas about weight management, great eating, more exercise, and wellbeing generally. We have teams in critical care, among our junior doctors, and across the Trust picking up the mantle of taking forward ideas which help us all to meet our own health goals. Work can make that harder. This workplace wants to help make it easier, although the rumour that we are getting a Trust dog, and a rota for walking it is, just a rumour….
To end this week with our latest Star of the Week, Advanced Physiotherapist, Fran D’Souza who was nominated for going above and beyond the call of the duty in supporting a frail and elderly patient to be discharged. Read Fran’s story on Connect https://connect2.swbh.nhs.uk/news/star-of-the-week-fran-dsouza-advanced-physiotherapist/
#hellomynameisToby
Maternal mortality study day: 27 March
The maternity risk and governance team (Mrs Thirumalaikumar and Dr Bawdon) will be hosting a multidisciplinary study day Friday 27 March at the Postgraduate Centre at City Hospital, 8.30am – 4.30pm.
The study day is on maternal mortality and the recently published National Maternal Mortality (MBRRACE-2019) report will be discussed and is aimed at all clinical colleagues.
The aim is to focus on the national recommendations and cascade the lessons learnt from the report to the team.
There will be mini lectures and workshops focusing on management of maternal collapse, recognition and care of critically ill woman and team work on massive obstetric haemorrhage. The small group discussions will be facilitated by specialists from midwifery and medical colleagues.
For further details please see Maternal Mortality Study Day information sheet.
If you wish to attend or would like more information please contact Ms Kamla Masih-Subrai on 0121 507 5209.
Star of the Week – Fran D’Souza, Advanced Physiotherapist
This week’s Star of the Week has been awarded to an advanced physiotherapist who went above and beyond the call of the duty in supporting a frail and elderly patient to be discharged.
Advanced Physiotherapist, Fran D’Souza was nominated for the weekly award by her colleague Hannah Jenns. Nominating Fran for the awards, she wrote, “Fran went the extra mile to ensure a frail elderly patient was able to be discharged home as planned, equipment needs changed at the last minute and it wasn’t possible for what was needed to go in on time. Fran kept everyone involved in the loop and reassured everyone. She went out of her way to collect and deliver equipment and then check in on the patient the morning after discharge to ensure all went smoothly.
“The patient involved was very pleased to be able to go home that day and it also prevented another unnecessary few days length of stay.”
[su_box title="Star of the Week Nomination Form" box_color="#25b393"][gravityform id="92" title="false" description="true" ajax="true"][/su_box]Hallam Street car park lighting repairs this Saturday
On Saturday 29 February the Hallam Street car park lights are scheduled to be repaired by the Black Country Partnership NHS Foundation Trust. The work is scheduled to take place throughout the day. Please can all colleagues be mindful of parking close to the lamposts as the contractors will be using a mobile working platform to carry out repairs.
In any case, can colleagues using the car park on Saturday please leave their contact details visible within the vehicle so that contact can be made if they are obstructing the work.
For more information please contact steven.wilcox@nhs.net.
Latest guidance on Coronavirus
Public Health England (PHE) is continuing to release updates on the current situation relating to coronavirus.
Clarification regarding isolation for negative results
- Patients from category 1 countries /areas : need to self-isolate even if they are asymptomatic or have a negative result .
- Patients from Category 2 countries /areas – patients with negative results need to isolate until asymptomatic
The H10 Costa Adeje Hotel, Tenerife has been included as a high risk (category 1) area and accordingly, symptomatic individuals who have returned from this hotel since the 17/2/2020 will need to be tested if they develop symptoms according to the clinical case definition
The Connect coronavirus page will continue to be updated with the latest news and guidance.
Moving and handling train the trainer course
The learning and development team are offering a manual handling, train the trainer course for both clinical and non-clinical colleagues.
The course is an IOSH recognised qualification and covers all aspects of moving and handling legislation such as how to carry out risk assessments, how to teach and how to move loads with and without equipment.
The benefits of having a local trainer on the ward saves time and money. Colleagues would not have to be released to attend generic training, away from the work environment.
The training course will take place at the Education Centre at Sandwell Hospital.
Note: To complete the course you must attend all the training dates listed below between 9am – 4pm:
- Tuesday 17 March
- Thursday 26 March
- Tuesday 31 March
- Wednesday 8 April
You can book your place via ESR. For more information please contact karen.morsley@nhs.net.
Heartbeat: Mum praises birthing team for continuity of care
New mum Jemma Clarke has praised a new team of midwives who ensure women receive the same care throughout their pregnancy.
The 31-year-old became the first woman to give birth under the care of the Willow team, which were formed in August. Little Ky’Asha Clarke-Hunter was born in September at City Hospital and was delivered by midwives from the team.
She said: “It’s a fantastic service and I was pleased with my care during the later stages of my pregnancy, the birth and the aftercare. I noticed a difference straight away. Previously I’d seen several different midwives and had to keep repeating myself.
“When I was introduced to the Willow team, things changed very quickly. They held a coffee morning which I attended along with other pregnant women. They gave an excellent presentation about what to expect during labour and birth. I found the session invaluable and the advice was spot on. It was lovely to meet all the team and we got to speak to them about any concerns we had.
“When my waters broke Chloe, one of the midwives was by my side, whilst Ifrah took over during the induction and Kym Fitzpatrick was there for the birth. I felt I was in control, in a more relaxed atmosphere. They were understanding, considerate and experienced. They knew all the details about my birth plan so they could accommodate it.
“Having midwives there who are fully aware of your needs makes such a difference.” Ky’Asha spent six days in neonatal due to low oxygen levels affecting her breathing and Jemma also praised them for their care.
“They were amazing and I also received great advice from the breastfeeding team.”
Clare Williams, Team Leader for the Willow team, said: “Caring for women, and their babies before, during and after birth is both beneficial to the women and the midwives.
“Building a relationship in the antenatal period allows midwives to get to know the woman and her family well. Trust builds and the midwife has an understanding of the woman’s needs in labour and following the birth. The birth of Ky’Asha in September saw the start of the undeniable success of Willow team, 22 more births have followed, all attended by Willow team members.
“Midwives in the team are extremely happy with this new way of working. Plus, the feedback we’ve received from the women in our care proves that knowing your midwife for the whole pregnancy and birth journey is the gold standard of maternity care. It’s something we’re all proud to be a part of.”
The Cedar team, the second continuity of care team, will be launching in February. The team will be based on Serenity and run antenatal clinics once a week. Women will see their named midwife for antenatal care and be cared for during labour by one of the team on Serenity.
Heartbeat: Podcasts improve education for 5th year medical students
Our medical doctors have embraced an innovative teaching programme for 5th year medical students with podcasting at the forefront of the teachings.
The aim is to deliver pharmacology teaching that is practical and more importantly, maximises retention of knowledge.
Students who attend the podcast sessions listen to the topics beforehand and then the teaching sessions themselves focus on the real-life prescribing scenarios and situations on that particular topic. This means that the students have lectures through a podcast before their actual teaching session.
“The podcasts empower our students with essential knowledge which better allows them to control the pace of their learning before attending the sessions,” said Vijaytha Muralidharan, Core Medical Trainee.
The sessions are delivered weekly to 5th year medical students at our Sandwell Medical Education Centre and are a collaborative teaching effort between both doctors and pharmacists.
“The doctors delivering the teaching provide students with cases based on real patients and can answer clinical questions and provide tips whilst the pharmacists are able to provide knowledge of doses, availability of medications and interactions,” explained Amardeep Singh, Lead Pharmacist HIV/GUM.
“The sessions allow students to prescribe on paper charts as well as ask pharmacists for input when required. This intends to simulate their roles as an F1 in terms of prescribing, and allows them to further understand the role of the pharmacists,” said Dr Piru Pathmarajah, who also helped develop this teaching initiative.
Saket Singhal, Consultant in Gastroenterology and Hepatology and Head of Undergraduate Academy, believes prior to the podcasting sessions, students were restricted to more traditional methods of learning. He said: “The students were limited to conventional methods of learning – a combination of study days at university and teaching on the acutely ill patient module.”
The podcasts were developed by Dr Shri Pathmakanthan, Gastroenterologist at University Hospital Birmingham and Vijaytha during her year as a Clinical Teaching Fellow. If you wish to find out more about learning topics within the podcast episodes you can by downloading “PodDoc” on the App Store on Apple devices and Google Play Store on Android devices for £3.99.
Drug safety notice: Epanutin supply disruption
There is currently a supply disruption with Epanutin 30mg in 5ml oral suspension. This is due to a delay in manufacturing. Normal supplies are expected to resume late June.
Please see drug safety notice Epanutin shortage sheet for further details and advice.
For more information please contact the pharmacy department on ext. 5259.
Narratives at the end of life event: 23 April
We’re hosting a special narratives at the end of life training event at Bethel Convention Centre, Kelvin Way, West Bromwich, B70 7JW on Thursday 23 April aimed at consultants, doctors, Junior doctors, advanced nurse practitioners and clinical nurse practitioners.
Please see documents below for details:
For booking and information please contact paulroberts6@nhs.net.
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