All in a day’s work
I’m continuing to highlight some of the investments we’re making across the trust that we hope will make a difference to our ability to support patients and relieve some of the current pressures on staff. These are investments in time, staffing, buildings, innovation, and of course effort.
In this blog and the next I will be focussing on elective surgery, starting with the impact that our Day Treatment Centre (DTC) is making.
I was very pleased to return to the DTC last week to see it in full swing. Since the centre opened at the end of September, they have built up their capability and all four theatres are now working at full capacity and are operating seven days a week.
The scale of the task ahead of us is significant – we have just over 19,000 people from across the North East currently waiting for surgery and around 14,000 of these are likely to be suitable to be treated as day cases.
Maximising the number of patients we can safely treat and discharge in a day is a huge priority, as it minimises inconvenience for them and is much more efficient for the NHS.
Day surgery has always, and will continue to be, a big percentage of our activity – around 70 per cent – and will likely continue to increase across the organisation. We are now the third largest provider of day case surgery in the country, with the most common specialties being dermatology, ophthalmology, ENT and urology.
Over the last few years, many teams have focussed hard on driving up the number of day cases. I remember visiting the day case services at the Freeman Hospital in 2021 and hearing about the very clear ambitions that teams held to improve our facilities and expand our day case offer.
What the DTC gives us is both much needed capacity – already providing well over 1,500 additional procedures in just four months. We know that demand will continue, and we expect to see at least 600 patients per month through the DTC. Equally importantly though, it enables us to look at new and more effective ways of working which we can potentially roll out to support other areas.
I spoke to matron Caoimhe Doherty, clinical lead David Rix and directorate manager Rachel Lonsdale who told me about the journey they have been on as they have led the development of the centre. Caoimhe told me about two key factors that have contributed to their success.
The first is their clear priority to support staff. She explained “we knew that we needed to make this a good environment to work in and that flexibility would be vital in getting full staffing. We’ve developed new working patterns, rotations and training opportunities, ensuring that everyone is trained and comfortable to go into any theatre. Each member of the team has core and sub-core specialist knowledge with rotation into other areas and we encourage each other to be curious and ask questions. Where particular areas need support, we have worked hard to provide it quickly.
“We have a diverse team – international recruits, staff who have joined us from elsewhere in the UK and Newcastle staff who wanted a new challenge. The whole team is enthusiastic and have gelled together very quickly – it already feels like family. I think that’s because we’re a new and smaller team and we all feel invested in the exciting opportunity we have.
“As a leadership team we pride ourselves on supporting our staff. We want them to be happy at work and to feel fulfilled – that’s how we get the best out of everyone and achieve the highest standards for our patients. It’s also been great to develop a close relationship with the peri-ops directorate. They have been incredibly supportive and I’m grateful for their advice, and for the joint working we’re now developing.
“We’ve now opened up shifts to staff working elsewhere in the trust and the feedback we have had from those staff members has been positive.”
The second area that Caoimhe highlighted was how the service operates to help promote safety and optimise human factors.
“We have an 8.20am prompt start for team brief, and everyone is clear about the role they play in maximising patient safety and our effectiveness. Whether that is from planning the correct equipment and surgical trays and starting lists promptly, or by speaking up quickly if something is not right. We have designed the DTC around human factors – for example every theatre, drawer and tray is exactly the same to minimise error and maximise efficiency.”
Rachel highlighted that the focus on correct case selection and efficiency starts long before a patient arrives in the centre.
“We’ve grown from having four specialties using the centre to eight, with 15 sub-specialties altogether, so our planning needs to be spot on,” she said.
“We know that we have more demand from directorates than we currently can meet, so we’re looking at how we can use the centre flexibly to maximise its use. For example, we’ve found that we don’t need as much discharge space as we expected, so we’ve been able to free up some of this space for vascular procedures.
“Over coming weeks we’re looking to firm up our theatre scheduling following a well-recognised ‘gold standard’ approach. We very much appreciate the support we’re getting as we talk to surgeons about this way of working.”
Clinical lead, David Rix, added: “The DTC is a fantastic environment to work in. Our four theatres are big, safe, and pleasant to work in. We have a vast range of equipment, including for laparoscopic procedures and endoscopy, which means we can use all our theatres flexibly. We also have quick access to blood testing and a Lumeria machine to test patients for covid (if needed) which hugely minimises delays.
“We’re now looking to increase the number of cancer operations we can do as we know this is a real pressure for many directorates. Of course, it’s also a priority for patients who want to be treated quickly, and they have a preference to get back home to recover in their own surroundings.
“So far, we’ve been cautious and have asked about 20 of our 1,500 patients to stay overnight in hospital – mainly as a precaution – but we debrief after each one and learn from those occasions.
“Our oldest patient so far was 92 and we’re just about to open to 16 and 17-year-olds so we can genuinely say that we are accessible to a huge proportion of patients from across the North East.”
Patient care is clearly at the heart of this service. It was evident that the team see their role as supporting patients throughout their whole pathway. Working with pre-assessment colleagues to make pre-admission calls to avoid on the day cancellations and set expectations about what will happen, is very much part of the job.
Learning from patient feedback is also integral to everyday work, with every single patient routinely being asked about their experience and their recovery to provide a safety net after they have gone home.
The team regularly receives positive feedback, which is shared with all staff and really helps with morale, including:
“I’ve had a faultless experience. The team of nurses were particularly impressive.”
“The layout of the centre is really noticeable. It flows well, from reception to admissions, theatre to recovery and discharge.”
“The centre feels modern and clean and the staff are fantastic. I felt confident with everything. The staff during the operation were like a family team, they were really at ease with one another.”
“Everyone was very attentive and made me feel very well looked after.”
They have also received practical suggestions to improve the service and the patient experience, which they have been able to implement quickly.
I was delighted that this new service has been embraced so warmly by the whole trust, and I could see the genuine pride that the team feels. Their confidence, positive energy and can-do attitude has stayed with me.
Thank you, team, for your hard work and brilliant results, and to everyone across our organisation and our partners who have helped to make this a success.
Shelford Chief Nurses Statement on industrial action
Newcastle Hospitals is part of the Shelford Group, an organisation that brings together ten of the largest research and teaching hospitals in England. This week, ahead of the RCN strike action on 6 and 7 February, the Shelford Chief Nurses – including our Executive Chief Nurse Maurya Cushlow – issued a joint statement on industrial action.
Their overarching message is that – for the sake of our patients and their profession – industrial action needs swift resolution.
North of Tyne devolution consultation
The leaders of County Durham, Gateshead, Newcastle, Northumberland, North Tyneside, South Tyneside and Sunderland councils have agreed, in principle, to a devolution deal which the Government has confirmed it is ‘minded to’ approve.
A devolution deal for the region means unlocking £4.2 billion of investment – over 30 years – and seeing additional powers transferred from Whitehall to local people with better knowledge and experience of our communities. The new authority would cover an area which is home to around 2 million people, will have the power to make decisions on areas such as transport, skills, housing, finance and economic development.
As the largest employer in Newcastle, it’s important that we work with our colleagues in local government so that we can drive up the health, wealth, and wellbeing of our communities.
The deal represents a significant opportunity to make a difference to people who live and work across the North East. I welcome this development to bring more jobs and investment to the region.
A consultation is now underway and provides an opportunity to have your say on these proposals. You can find our more information here
Learning and Sharing event
Newcastle Improvement’s next learning and sharing event will take place twice via Teams next Thursday (16 February) at 12noon and again at 5pm where district nursing sister, Lucy Pennington, will focus on a new ‘geographical approach’ to the provision of district nursing in Newcastle. To register your interest to attend email [email protected].
‘Skills for Life’ – National Apprenticeship Week
It’s National Apprenticeship Week which brings together organisations and apprentices from across the country to shine a light on the positive impact that apprenticeships make to individuals, organisations and the wider economy.
Across the trust we currently have 463 apprentices working in many different roles and you may recall last month I shared in my blog, the work of some of our estates apprentices which had been recognised locally and nationally.
This year’s theme is ‘Skills for Life’ and this week Stewart Findlay, an apprentice counter fraud investigator with Newcastle Hospitals, has shared his experiences of the apprenticeship. Stewart has also been shortlisted as an ‘Apprentice or Newcomer of the Year’ finalist in the Public Sector Counter Fraud Awards.
Staff networks – new co-chairs
Our staff networks support a fairer and more diverse NHS for everyone and actively engage and contribute towards promoting awareness of equality and inclusion within the trust. We have four in total – the others being our Race Equality and Equality Champions staff networks – and they are very much a safe space for everyone to come together to support each other, make change happen and learn from one another.
You do not need to identify as having a protected characteristic linked to the group, the networks are open to everyone (including allies) and those that simply want to learn more. You can join one, some or all the networks and can find out more information here.
We have now launched our new ‘sustainable suppliers’ webpage on our Flourish website where suppliers to Newcastle Hospitals can find all the information and support they need to work with us in our goal to be Net Zero Carbon by 2040. You can find out more here.
At our recent Board of Directors, we heard from a family who have worked with one of our specialist teams at the Great North Children’s Hospital to set up a lifechanging service on their doorstep. The Rich family have two young daughters who live with CLN2 Battens disease – a rare neurodegenerative disease – and they have campaigned for an enzyme replacement therapy, which was previously only provided at Great Ormond Street Hospital, to be made available here in Newcastle.
The family say that the improvement to their quality of life is beyond measure. Do take a few minutes to watch this inspirational video and find out how our staff worked with the family to develop this specialist service, which two other families living in the North East can now benefit from.
Awards and Achievements
Newcastle’s Hospital @ Night service has recently celebrated its 15th anniversary. Since its inception with one team at the Freeman Hospital, covering all surgical specialties, the service now supports around 1,200 beds, split into five teams supported by 17 nurse practitioners. You can find out more here.
Congratulations to Hazel Galloway, one of our most experienced and highly respected health visitors, who is celebrating two very special milestones – receiving the distinguished title of Queen’s Nurse, one of the highest accolades in the community nursing profession, as well as marking 50 years of working in the NHS.
Bright Ideas in Health Awards
I’m delighted that we have reached the finals for five categories in the Bright Ideas in Health Awards.
The awards recognise our contribution to innovation, research and collaboration which are at the heart of making a difference to our patients, both now, and crucially in the future. I’d like to congratulate everyone for getting this far and wish you the best of luck on the night of the awards 23 March 2023!
Our finalists are:
- Development of an Innovative device or technology – halo gravity traction device, Stuart Duffy, head of service, clinical technologist for the Regional Technical Aid Service.
- Outstanding industry collaboration – development of a new hazardous patient transport device, Allison Sykes, bank nurse (previously – senior nurse) infection prevention and control.
- Cross-organisation working to deliver research – a medley of methodologies across organisations to deliver high impact commercial research – the NCBD stoma programme, Richard Brady, honorary senior clinical lecturer and consultant colorectal surgeon.
- Cross-organisation working to deliver research – increasing research exposure to primary care practices and patient populations in north east England, Christina Tanney, Jill Deane, Dr Stuart McPherson, NENC LCRN Primary Care Research Nurses, SOLID study chief investigator.
- Innovation champion team award – from bench to bedside – collaboration between the NIHR Newcastle MIC and the North East Innovation Laboratory, part of Newcastle Hospitals, Rachel Dickinson, Communications and Engagement Manager and Amanda Winter, Diagnostic Evaluation Healthcare Scientist.