GP Bulletin - Issue Five - Bradford Teaching Hospitals NHS ...

4Update onOncologyDevelopmentwith AiredaleIn the December issue of GP Bulletin, webrought you an update of the plans to movespecialist oncology inpatient care from AiredaleNHS Trust to Bradford Royal Infirmary. Moreinformation about this is detailed below. Somechanges have been made since December.One integrated service across Bradford and Airedale, with increasedmedical oncologist site specialisation is set to be implemented. Bothtrusts will recruit an additional medical oncology consultant. Therewill be outpatient and multi-disciplinary sessions on both sites, withthe specialist inpatient base at Bradford.Both trusts will provide day care chemotherapy when clinicallyappropriate, increasing the provision of day-case chemotherapyacross the integrated service.There will be a single inpatient medical oncology bed withdedicated nursing and junior clinical staff at Bradford RoyalInfirmary. Planned complex elective chemotherapy requiringinpatient treatment will only be undertaken at BRI under the care ofthe supervising clinician.Both trusts are looking at identifying adequate transportationarrangements and putting them in place for patients and carersincluding return home for carers if required.Patients treated at Airedale and Bradford will be able to contact a24-hour helpline - ‘in-hours’ within the day case chemotherapy unitof their normal treating hospital. The out-of-hours helpline will bebased on ward 15 at BRI.Patients requiring admission for treatment will be advised of theneed for doing so and supported in making an informed choice overadmission to the Airedale medical admissions unit, with transfer tothe care of the medical oncologist the following day where requiredor direct admission to ward 15 at BRI.For the group of patients deemed to require specialist inpatientmedical oncology care for any complications, transfer to Bradfordwill occur either immediately following assessment or as soon asmedically stable.The consultant on-call rota supporting the out-of-hours carearrangements will require consultants to cover the whole service,including telephone advice to patients in beds at Airedale GeneralHospital. All district consultants are therefore able to advise on allpatients across the area.An evaluation of urgent care medical oncology provision will takeplace, which will inform future arrangements.For more information contact Maria Neary, general managerfor cancer services, on 01274 382535 or email maria.neary@bradfordhospitals.nhs.ukEar Trust andDaisy AppealUpdateBoth the Listening for Life and Daisy Appealsare progressing well - with building workbeginning on their respective new centres.A sod-cutting ceremony by Bradford’s Lord Mayor, Councillor RobinOwens, took place at Bradford Royal Infirmary in January signifyingthe start of a building programme, which will see the constructionof the country’s first dedicated state-of-the-art cochlear implantcentre - the £2.5m Listening for Life Centre.The Ear Trust provides support to profoundly deaf people, buysequipment and assesses patient’s needs for a cochlear implant - aservice based at the foundation trust - for the whole of Yorkshire.The Lord Mayor also took part in another sod-cutting ceremony- this time the start of building work for the new Bradford CancerSupport Centre, based at Bradford Royal Infirmary. The new centrewill provide support, aromatherapy and massage, counselling, freetransport to hospital and welfare benefits advice.For more information about the Ear Trust go to www.ycis.org.ukFor more information about the Daisy Appeal go towww.bradfordcancersupport.org.ukGo SmokefreeThe foundation trust continues to besmokefree and is encouraging patients toquit smoking to coincide with nationalNo Smoking day.Patients coming in for surgery are advised to stop smokingeight weeks before their operation to reduce the risk of anycomplications.The foundation trust supports patients who wish to give up.Eight out of ten smokers who wish to stop succeed withhelp from staff. People are four times more likely to quitwith support and treatment. Free nicotine replacementtherapy may be available to patients if they want to quit.For more information contact Sue Wilson,senior stop smoking specialist, on01535 295 320.New AppointmentsDr Sarah Jane Birchenough, consultant in geriatric medicine, hasbeen appointed.Dr James Atkinson, consultant anaesthetist and Dr OluremilekunAkerele, consultant anaesthetist have been appointed.Dr David Robinson, A&E consultant has been appointed.Bradford Teaching HospitalsNHS Foundation TrustGP BULLETINMarch 08Foundation TrustBecomes LaparoscopicTraining CentreKeyhole SurgeryThe foundation trust is set to become one of onlytwo centres in the north of England, which will trainconsultant surgeons from other institutions in colorectallaparoscopic techniques.The foundation trust is one of only ten ofthese laparoscopic training centres acrossthe country. The training centres are part ofa drive by Professor Mike Richards, nationalcancer director, to ensure more patientswith colorectal cancer, who need colorectalresections, are offered laparoscopic surgeryby 2012.A pilot monitored-training programme inthese techniques for colorectal surgery hasalready successfully taken place in Bradford.Mr Jon Ausobsky, clinical director for acutesurgery, said: “All consultant colorectaland upper GI surgeons at the foundationtrust are trained in laparoscopic techniquesand we offer it more routinely than manyother trusts. This means we are in an idealposition to train other consultants andwe put in a very strong bid to become atraining centre, which was approved by theDepartment of Health in January.“Laparoscopic surgery is much better forthe patient - it can mean less scarring, ashorter hospital stay and a reduced risk ofinfection. We offer all suitable patients thechance to have their operations using thismethod and generally most patients muchprefer this to open surgery.”At the foundation trust many of ouroperations are now done routinelyas laparoscopic surgery. Most boweloperations, anti-reflux operations, removingthe gall bladder and weight-loss surgery areusually done as laparoscopic surgery.For more information contact JonAusobsky on 01274 364266 or emailjon.ausobsky@bradfordhospitals.nhs.ukContents1 Welcome to GP Bulletin1 Foundation Trust Becomes LaparoscopicTraining Centre2 Focus On Orthopaedics2 Annette Fox Day Care Unit Opens3 Healthcare Commission Review3 Foundation Trust Goes Live with DirectBooking System4 Update on Oncology Development withAiredale4 Ear Trust and Daisy Appeal Update4 Go Smokefree4 New AppointmentsWelcome toGP BULLETINWelcome to the March edition of GP Bulletin,the newsletter for GPs produced by BradfordTeaching Hospitals NHS Foundation Trust.We produce and send GP Bulletin everyquarter. It will also be available on ourwebsite - www.bradfordhospitals.nhs.ukIt is designed to provide information aboutour services and news about the foundationtrust. It will also feature news about newappointments.Please send any feedback or suggestionsfor content by contacting Leanne Wilson,communications officer, on 01274 364022,or email leanne.wilson@bradfordhospitals.nhs.ukIf you would prefer to receive GP Bulletin byemail or if you would like to request morecopies then please let us know by contactingLeanne Wilson, as above.I hope that you find thisedition informative andenjoyable and please dolet us know if you haveany feedback.Miles ScottChief Executive

2Focus On OrthopaedicsThe foundation trust’s orthopaedic service offers a service forthe diagnosis and treatment of musculoskeletal disorders. Theorthopaedics team is made up of consultants, other doctors,technicians, nursing and support staff and nurse specialists. All of theorthopaedic surgeons are sub-specialists. All inpatient treatment isbased at Bradford Royal Infirmary, with some outpatient clinics at StLuke’s Hospital. See below for an overview of the services we provide:Arthroscopy ServicesArthroscopic (keyhole) surgery has revolutionised the treatment ofmany joint conditions or injuries, reducing scarring and allowingmore rapid recovery. Our surgeons have expertise in keyhole surgeryof shoulder, elbow, wrist, hip, knee and ankle and offer advancedtechniques for shoulder and knee reconstruction (including acuteand chronic complex knee ligament injury and revision surgery) aswell as all common pathologies.The surgeons for this service are Mr Bollen, Mr Taggart, Mr de Jager,Mr Schilders, Mr Radcliffe, Mr Shaw, Mr Mann, Mr Grogan, MrShanker, Mr Watters, Mr Kluge, Mr Veysi and Mr Boome.Joint Replacement SurgeryThe foundation trust was one of the first centres in the UK tointroduce computer assisted hip and knee joint replacement. Ourteam of surgeons offer minimally invasive and joint preservingsurgery and offer training to other surgeons in these techniques.The team carries out cemented and uncemented hip replacementand hip resurfacing. In the knee, there is expertise in standard kneereplacement, uni-compartmental and patello-femoral replacement.The service also regularly carries out complex and revision jointsurgery and limb reconstruction. In the upper limb, shoulder andelbow replacement are available.The surgeons for this service are Mr Taggart, Mr Kluge, Mr Radcliffe,Mr Grogan, Mr Jha. Mr Vesyi and Mr ShawSports InjuriesThere is considerable expertise within the department in all aspectsof sports injuries but particularly shoulder, groin, knee and ankleinjuries where the surgeons have national reputations in their field.The surgeons for this service are Mr Bollen and Mr Schilders.The refurbished Annette Fox haematologyday care unit at Bradford Royal Infirmaryhas recently been opened.The new facilities include new treatment rooms, a waiting room,a counselling room, sluice room and a kitchen. New, comfy chairshave been purchased and a bed added for patients who areparticularly ill.The whole refurbishment was funded by the Annette FoxLeukaemia Research Fund, which celebrates its twenty-fifthanniversary this year. More than £2 million has been raised by thefund, with the latest refurbishment costing £165,000.A new fridge to store blood has also been donated by the BingleyAiredale Rotary Club, which has made the Annette Fox Fund theircharity of the year.Foot and AnkleSurgeryThe foot and ankle service offersa comprehensive service forthe management of the wholespectrum of disorders affectingthe foot and ankle. Both surgeonsconcentrate exclusively on treatingfoot and ankle disorders. Specialfootwear that offloads theforefoot is routinely supplied topatients having hallux valgussurgery and other forefoot osteotomies andfusions, minimising or eliminating the need for crutches or plastercasts in many cases.Special interests include the primary and subsequent secondarymanagement of complex hindfoot trauma, including calcaneal fractures,therapeutic ankle arthroscopy, tendon and ankle ligament disorders andsurgery for the rheumatoid foot and ankle. A recent development is theintroduction of ankle joint replacement surgery in selected cases.The surgeons for this service are Mr Shanker and Mr Mann.Hand SurgeryThe hand and peripheral nerve service is provided by twoorthopaedic hand surgeons in conjunction with two of their plasticsurgical colleagues. Areas of special interest and experience includethe reconstruction of peripheral nerve injuries, tendon transfers andthe arthritic hand. An emergency on-call hand service is available.Post-operative rehabilitation is performed by dedicated handphysiotherapists.The surgeons are Mr Boome and Mr de Jager.To refer to the service GPs can use the Choose and Book service ifavailable or direct referral by letter to the appropriate consultant.Urgent referrals can be telephoned or faxed through to theconsultant’s secretary.For more information contact Beverley Routh, orthopaedicsgeneral manager, on 01274 364040.Annette Fox Day Care Unit OpensPatients were full of praise for the unit. One patient, Nicky, who isundergoing chemotherapy said: “The treatment in here is fabulous.The nurses are fantastic - as soon as you walk through the door youare treated like a person, not just a patient.”Dr Parapia, consultant haematologist, said: “The unit provides anexcellent environment for patients to receive treatment during avery difficult time.”The unit now sees up to 20patients a day and treats patientshaving chemotherapy andtreatment for blood disorders.For more information contactMaria Neary, cancer servicesgeneral manager, on01274 382535.Princess Opens NewBone Density UnitHRH The Princess Royal opened a newstate-of-the-art bone density unit atBradford Royal Infirmary on February 26.The Princess Royal saw how the bone density unit works, scannedimages on screen and met patients, governors and members of staff.The Princess Royal met staff from Bradford and Airedale teachingPrimary Care Trust. The Lord Lieutenant Dr Ingrid M Roscoe, theLord Mayor, Cllr Robin Owens and Lady Mayoress, Janet Owens andthe High-Sheriff of West Yorkshire, Gay Hartley also attended.David Richardson, chairman, said: “It was a real honour to have ThePrincess Royal open the bone density unit. It is a fantastic piece ofequipment and is the most accurate way to detect osteoporosis.“The visit of The Princess Royal was a great opportunity to showcasethe clinical excellence and quality of the osteoporosis and falls teams”The above teams have developed care pathways for osteoporosismanagement and falls prevention, which span primary and secondarycare osteoporosis management in the district, led by Dr Katharina Sokoll.Dr Anne Connolly and Claire Elener, advamced nurse practitioner.One in three women and one in five men over 50 haveosteoporosis. Osteoporosis is caused by loss of bone mass, whichmakes the bone architecture weaker and more susceptible tofractures. Osteoporosis has many causes including the ageingprocess, the menopause, renal disease, inflammatory diseases,various endocrine disorders and drugs such as corticosteroids oraromatase inhibitors (used to treat breast and prostate cancers).Foundation Trust Goes Live withDirect Booking SystemPatients will now be able to book theirhospital appointment before they leave theirGP practice, as the foundation trust movestowards a Direct Booking System (DBS).This means that GPs will be able to electronically book appointmentslots straight onto the foundation trust’s patient administrationsystem. Currently, the system used means that patients need totelephone the hospitals to make their appointments.Patients will benefit from this system because, not only will theyhave a choice of which hospital they would like to be treated at,they will also be able to choose the method for booking their ownoutpatient appointments. They can book their appointment:• At their GP practice and leave knowing when their hospitalappointment will be• On the internet after their GP appointment if they wish todiscuss any arrangements with family or friends• By telephoning NHS Direct, who will book the appointment ontheir behalfBone densitometry using Dual Energy X-ray Absorptiometry (DXA)of the spine and hip is the technique of choice for diagnosing andmonitoring osteoporosis and evaluating the risk of osteoporoticfracture. Those found most at risk can then be treated to helpprevent further fractures.The new scanner can scan a higher number of patients, whichmeans the waiting time is now only four weeks. In addition, thescanner can produce lateral images of the spine so that deformitiesof the vertebra can be assessed for fractures at the same time andusing a much lower dose of radiation than conventional x-rays.Other recent openings at the foundation trust have included a newClinical Research Facility as part of the Bradford Institute for HeathResearch, a newly refurbished ward 23, which deals with traumaand orthopaedics and a refurbished day care unit in the Annette Foxhaematology unit.For more information contact Frances Armes, quality managerand clinical scientist, on 01274 364144 or email frances.armes@bradfordhospitals.nhs.ukAs an initial step, the foundation trust has been piloting a jointreplacement service within orthopaedics for the last few months.This has enabled us to gain understanding and confidence in thetechnology before we roll-out to other services.We are then planning to implement a triage system for all our fasttrack (suspected cancer) referrals. GPs will be able to book directlyinto a designated clinic, enabling our staff to look at the referraldetails immediately. By adopting this system we are aiming to improveefficiency. The electronic transfer of referrals will provide improvementson the current faxing system and should be less time consuming.Finally, all the medical specialties have been holding initial meetingsduring the last few weeks so that the foundation trust can developa robust roll-out plan. Once this has been developed it will becommunicated to Bradford and Airedale Teaching Primary Care Trustso they can plan the necessary support required for GP practicesduring the implementation period.For more information contact Jayne Farrar, Choose and Bookproject coordinator, on 01274 382519 or emailjayne.farrar@bradfordhospitals.nhs.uk3