Annual report 2010/11 - East Cheshire NHS Trust

IA new surgical procedure which could transform thelives of breast cancer patients was unveiled atMacclesfield District General Hospital in July 2010. The newtechnique, called Lipomodelling, uses liposuction to extractthe excess fat from the stomach and thighs. The fat is thencentrifuged to separate out the fat cells ready forreinjection. This technique allows breast cancer patients tohave the contour irregularities caused by surgery to becorrected using natural fatty tissue from their ownabdomen or thigh. Macclesfield District General Hospital isone of the first hospitals in the Cheshire and Stockport areato offer this operation.PREVENTIONPEast Cheshire NHS Trust (ECT) and Cheshire EastCommunity Health (CECH) have worked jointly to bethe lead provider of Intermediate Bed Based Services (IBBS).The aim of the IBBS is to avoid unnecessary hospitaladmissions and support early discharge from an acutehospital bed. The development of an integrated electronicbed bureau for all community intermediate service beds hasenabled patients to be fast tracked to the most appropriateavailable bed. It has also enabled patient throughput tocommunity support at home to be more clearly managed.PIn 2010/11 the provision of social services andintermediate care services out of hours was extended.A night response team to reduce avoidable admissions wasestablished and additional intermediate care beds in thecommunity have been purchased on a temporary agreement.26PA Pre-conception and Recurrent Miscarriage Service isnow available at Macclesfield District GeneralHospital which aims to help women in planning for a futurepregnancy. The service aims to optimise maternal health togive the best chance of a successful birth. Women areinvestigated to identify possible causes for recurrentmiscarriages and provided with counselling and informationregarding pre-conception.PA preconception clinic has been established duringthe year in order to maximise health outcomes forwomen with co morbidities who may be consideringpregnancy.PA day case area has been developed on the EgertonUnit (formerly the Emergency Floor). This is a smallbut comfortable area where patients requiring treatment orinvestigations can be managed without the need to beadmitted to an inpatient bed.PService improvement work within the operatingtheatres has facilitated new ways of working tomaximise efficiencies within existing resource.PRODUCTIVITYPrDuring summer 2010 two new integrated posts acrossEast Cheshire NHS Trust and Cheshire East CommunityHealth were appointed to Children’s Services to ensureseamless care for children and families moving in and out ofacute and community settings. The children’s servicemanager and advanced paediatric nurse practitioner andmatron have worked across acute and community servicesdeveloping integrated services and care pathways for theindividual child or family.PrThe working day and week has been extended in theOutpatient Department, Physiotherapy Departmentand Audiology Department at Macclesfield District GeneralHospital. This is to give patients a greater choice ofappointments to suit them.PrChanges to the administrative teams have beenimplemented leading to a more team based approachto medical secretarial support.PrThe productive ward initiative helps staff across theacute sector to significantly increase their time spenton direct patient care. Antenatal patients are benefitingfrom a service redesign programme centred on theproductive ward. The Experience Based Design approachwas used to find out how patients’ experience of using theservice made them feel. Patients were asked how they feltat each stage of their care. Repeat surveys and audits aftersix months provide evidence that patients are feelinghappier, safer and less worried, and that clinic waiting timeshave decreased. This has led to a reduction in informalverbal complaints by 50%, and a 4.4% reduction in patientsnot attending appointments. A total of 13 changes wereimplemented including:a.the provision of a patient information leaflet;b.information boards in patient and staff areas; andc. more frequent delivery of blood results.Plans are in place to introduce the productive ward onto thematernity ward in 2011/12.PrThe trust has achieved the Public Service Agreement(PSA) targets in relation to smoking at delivery, breastfeeding initiation and full health and social needs assessmentwhich all require completion by 12 weeks of pregnancy.PrThe trust has introduced the Resident ConsultantModel for obstetric staffing on a two year trial. Thismodel increases the consultant presence on the labour wardand an increase in a consultant delivered service rather thana consultant led service. Monday to Friday, nine to five thereis always a consultant based on the labour ward. In additionthere is a consultant on call 24 hours per day, seven days perweek. This reduces time waiting for specialist care when it isrequired by patients and increases medical expertise andlearning outcomes for all medical staff.PrThe trust has undertaken a review in GynaecologyServices to explore the opportunity for revisingcurrent practices in light of technological advances. TheGynaecology Service at the trust began a service reviewduring the year of new operating equipment, which willprovide the following patient benefits:• Reduced operating time• An increase in day case surgery thus reducing the need forgeneral anaesthetic• Reduced recovery time for patients• Less requirement for inpatient stay so that they can gohome to recover the same day.PrThe Emergency Floor area has been re-named theEgerton Unit after a local dignitary Lord Egerton whoopened Macclesfield Infirmary in the 1800’s. The unit hascontinued to develop to improve efficiency and quality ofcare. Staffing has been reconfigured to enable staff to workmore effectively. New technology has been implementedwith ambulance screens installed to alert staff of emergencyarrivals and an automated drug cabinet improves stockcontrol and security.27