Reflecting on recent weeks

It’s hard to believe that so much has happened since my last blog.

We have all been saddened by the death of Her Majesty Queen Elizabeth II on 8 September. As a mark of respect, the whole NHS limited non-essential communications during the period of national mourning and in line with that, I postponed my blog until today.

Over the last three weeks everyone in the organisation has continued to work hard to respond to the demands we currently face. I know that everyone is constantly focussed on delivering for our patients and ensuring they get the best and most effective care.

I am grateful to everyone who helped mark our respect for the late Queen and to everyone who worked so hard to support staff and patients, and to make sure that our services continued over the additional bank holiday weekend.

I was moved to hear that we were represented at her majesty’s funeral by midwife Diane Buggy MBE who received a personal invitation to this historic event and earlier this year was appointed a Member of the British Empire in the Queen’s Platinum Jubilee Honours.

Diane said: “It was very surreal; I was so surprised to get a call inviting me. The funeral was beautiful, very dignified and I feel honoured to have been there. I felt I was there to represent my family, friends and work colleagues.”

Also of course we now have a new Prime Minister, a new Secretary of State for Health and Social Care and a new cabinet.  As I write this, we are anticipating health announcements being made imminently and I will reflect on those announcements next week.

The other important event that took place last week was the Great North Run.  Due to the period of national mourning, the run began with a two-minute silence and I know that this made an emotional experience even more poignant for the 60,000 runners on the start line.

The run is a huge event for the city, and also for Newcastle Hospitals Charity, and this year almost 500 runners donned their trainers to run 13.1 miles for us.  In doing so they raised many thousands of pounds for our funds linked to Newcastle Hospitals, the Great North Children’s Hospital and the Sir Bobby Robson Foundation. Among the runners was The Times senior sports writer Matt Dickinson who wrote about his experience of running for our charity.

Having taken on the GNR myself in 2019, I know how big a challenge and commitment it is.  I want to express my sincere thanks to everyone who took part and, also, to all of our volunteers who supported our runners ‘enroute’ and in the supporters’ tents at the end.

Visit to endoscopy

Earlier this week I was delighted to visit the endoscopy team at the RVI and open their new endoscopy suite.  It was fantastic to meet the team, including clinical lead Dr Chris Mountford and sisters Jill Doyle and Helen Wright.

The team showed me their new environment, which has been developed over the last few months and will enable them to provide significant additional capacity of around 100 gastroscopes each week to support patients as well as greatly enhanced training provision.

To the huge credit of the whole team as well as the contractors, estates team and other staff, the work took place without any loss of clinical service capacity for patients.  I was struck by the very clear vision the team had for their service – to provide high quality care to patients, to clear the backlog by providing fast access to treatment, and to train, recruit and retain staff in the trust and the wider region, and they were focussed on delivering those results.

Endoscopy is an increasingly busy and important specialty with 16,000 to 20,000 patients a year being seen in the department, around a third of whom are on a two-week wait pathway.  Like many other parts of the trust, they have seen a change in the pace and scale of new referrals since the pandemic.

The team described how focussing on pathway improvements and capturing the benefits of new technology was helping to increase their efficiency and effectiveness as a team and it was notable that there was very close working between the clinical team who were driving improvements, and the support services from IT and estates who provided responsive support for new ways of working.

For example, they have utilised new web-based software that links with both e-record and the national endoscopy database, allowing them to benchmark against national peers and interrogate data much more easily to drive up quality and learning.

Outpatient e-referrals on e-record has also made a huge difference and has reinforced that useable business intelligence is so essential in such a high throughput specialty.  In terms of patient experience, they have also recently introduced electronic pre-assessment to identify high risk patients and to streamline pathways.

Our new room is fitted with the latest ‘state of the art’ HD Olympus equipment and includes ‘Scopeguide’ technology which allows trainees to visualise the scope as they learn.

I heard how important this resource is for the region and our new facility has helped Newcastle to be recognised as a regional training academy, providing six-week training placements for medical trainees and nurse endoscopists, significantly increasing the capacity for high quality training in the region.  It also creates the opportunity for staff to extend their skills and become trainers for the future.

Finally, the team wanted to share their ‘Green endoscopy’ work, through which they are:

• drastically reducing unnecessary use of sterile water and the accompanying plastic bottles,
• swapping disposable cups with re-useable crockery, and
• swapping the 1,500 plastic containers they used each month for reusable metal ones.

They are proud of the steps they are taking to do the right thing for their patients, and for the environment and it was a real pleasure to visit them and learn about their fantastic work.

Robotic Assisted Surgery

I was also recently able to visit our theatres at the Freeman Hospital where I observed a laparoscopic (robot assisted) partial nephrectomy performed by Mr David Rix and saw how the whole theatre team works together to support the robotic approach.

When robotic assisted surgery was introduced into the Trust around a decade ago, we were one of the first in Europe to benefit from this technology which was initially focussed in urology.

It allows doctors to perform complex procedures with more precision, flexibility and control than is possible with conventional techniques, giving the surgeon high definition, 3D vision with a magnified view inside the patient’s body.

The system translates hand movements into smaller, precise movements of tiny instruments in the patient’s body allowing the surgeon to manipulate instruments from a nearby console with fine dexterity under magnification to make precise incisions. It’s important to stress that our robots are not able to make decisions – the surgeon is always in control of what happens inside the patient, but their movements are enhanced by the technology.

This was brought home to me as I went on to meet a patient who had robotic prostatectomy that morning.  He was doing well in the afternoon following his significant surgery, and I was reminded of working as a ward sister on a surgical ward much earlier in my career and caring for similar patients who were at high risk of complications.  It was fantastic to see how much our practice has developed with the introduction of this new technology.

Since 2012, we have expanded into colorectal, Hepato-Pancreato-Biliary (HPB), Ear, Nose and Throat (ENT), gynaecology and thoracic surgery. With the acquisition of a robotic system at the RVI in 2019, further roll-out of gynaecology and colorectal surgery followed along with upper gastrointestinal (upper GI) surgery.

The Newcastle Surgical Training Centre (NSTC) also offers a comprehensive multi-specialty robotic surgery programme. We need to build on these strengths and I’m grateful to Dr Gus Vincent, Professor Naeem Soomro and the Robotic Assisted Surgery Governance Group, for providing leadership and clinical advice on new robotic programmes.

However, the expanded range of surgery possible now means that the demand for our robots is more than the time we have available. I heard very clearly from surgeons and surgical staff that they could further improve care for patients – not to mention training the next generation of clinicians – if our robotic capacity was expanded.

They also articulated the clear clinical benefits for patients – reduced complications, blood loss, re-admissions and length of stay.

The future of surgery will see robotic procedures becoming more and more the norm – with the Royal College of Surgeons England Commission on the Future of Surgery (2019) outlining the move towards greater use of robotics and further advances in technology.

We need to stay at the cutting-edge, and that means that we need to seek ways to continue to invest to both keep technology up-to-date and expand its availability. This will be a challenge for us, but one which we need to face and that we are actively looking at.

Unfortunately, Professor Naeem Soomro, Director of Robotic Surgery at the Freeman was unable to join me for the visit, but he gave me a helpful summary which I share with you here:

‘There has been a paradigm shift in our attitude; It has gone from ‘why should it be done by robot?’ to ‘why shouldn’t it?’ The benefits are not just in surgery itself, but aftercare. It is expected that there will be further developments in future which would allow the surgeons to have access to multiple real-time inputs like MR /CT scans along with miniaturisation of the surgical robotic interface.’

Thank you to all the teams who have hosted me recently. I very much appreciate the time you take to share your knowledge and experience.  The whole executive team is keen to visit different areas of the trust, so please get in touch if you would like us to visit you.

New Dementia Care Plan 2022-26

A key priority for our new NMAHPs Strategy is to improve quality and reduce patient harms using evidence, research and best practice. This week we launched the new Newcastle Hospitals Dementia Care Plan 2022-26, to coincide with World Alzheimer’s Day which was held on Wednesday (21 September).

Harm Free Care Leader and Nurse Consultant Vulnerable Older Adults, Dr Clare Abley, explains:

“Over 3000 patients living with dementia are admitted to the Trust every year, to all adult wards and departments, and many more receive care from our community services. Our new plan outlines how we will provide the best possible care for patients with dementia, their families and carers, in all wards, teams and departments, over the next five years underpinned by three key priorities:

• to get to know every patient with dementia as a person and tailor the care we provide accordingly,
• to work in partnership with family/carers,
• to provide high quality staff education/training on dementia care.

“Together with a number of other priorities, we have developed performance targets and agreed on our key commitments, all of which were informed by the views and experience of our internal and external stakeholders, including over 50 carers of people with dementia in Newcastle.

For the first time the plan has an associated audit tool which will be used by wards and teams across the Trust to audit their practice against the standards set out in the plan.”

A full copy of the Trust Dementia Care Plan and the associated audit tool can be found here.

Our 10,000th Greatix

All of our staff will be familiar with ‘Greatix’ – a reporting tool which encourages learning from good practice – and we recently received our 10,000th nomination, which was in tribute to the work of the Nectar and critical care team.

The team dealt with a very challenging – but successful – transfer of a patient from the RVI to the Freeman Hospital which needed exceptional planning and the Greatix was awarded to James Watkin, Matt Faulds, Megan Williams, Sean Waldron, Alistair Gascoigne and Ian Clement for their contribution.

It also seemed quite fitting that our 10,000th Greatix was awarded in the month of World Patient Safety Day which aims to globally enhance patient safety and reduce patient harm.

Annual Members’ Meeting

Our Annual Members’ Meeting will be held this Tuesday (27 September) in the RVI Education Centre lecture theatre. Hosted by our Chairman, Professor Sir John Burn, it will include a review of the year and a summary of our Annual Report and Accounts for 2021/22.

The formal meeting begins at 2.30pm, but before this a number of our staff groups will be showcasing their innovative services at a marketplace event starting at 1.30pm. If you would like to attend, please contact [email protected]

Full details including the event agenda can be found here.

Thank You Month

This week we have restarted our Thank You month activities and I’m delighted to share that, thanks to support from Newcastle Hospitals Charity, treats will be available for staff today (Friday) as a small thank you for everything you do.

Over the course of today, ice cream vans will be located at the following places, simply show your NHS badge to claim your free ice cream:

• RVI (at Peacock Hall): 10am – 5pm
• Freeman (outside the Institute of Transplantation entrance): 10am – 5pm
• Regent Point (in the drop-off area near the entrance): 10am – 12pm
• Campus for Ageing and Vitality (in the horseshoe car park, in front of old A&E): 12.30pm – 2pm

For some of our teams who are unable to get to these sites a selection of cupcakes and muffins will be available for colleagues in the following areas:

• Community
• Theatres
• Our sites in Cumbria
• Centre for Life
• Lumen

There will also be additional cakes available for night shift staff at the reception areas at the RVI and Freeman. As part of Thank You Month – you and your teams can also come together to take part in the Great Newcastle Hospitals Bake Off until 26 September.

For more information on Thank you month, visit our website.

Newcastle Improvement – Learning and Sharing event

Newcastle Improvement recently hosted their latest Learning and Sharing event in which Rachel Fletcher (Deterioration and Sepsis Specialist Nurse) talked about the deteriorating patient and sepsis education to wards.  Advice on how to publish QI work was also shared by Dr Yincent Tse (Consultant Paediatric Nephrologist) and Annette Richardson (Quality Improvement Programme Manager). You can view the session here.

Finally…

I’d like to welcome Jackie Bilcliff who joined the Trust this month as our Chief Finance Officer. Jackie was previously Group Director of Finance and Digital at Gateshead Health NHS Foundation Trust since 2014 and was also Deputy Chief Executive there since January 2022.