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<strong>June</strong> <strong>2020</strong><br />
Innovation and learning: Special edition<br />
Sandwell and West Birmingham<br />
NHS Trust<br />
The pulse of community health, Leasowes, Rowley Regis, City Hospital, Sandwell General and the Midland Metropolitan University Hospital<br />
Issue 129<br />
Let’s learn: Making changes<br />
happen at pace<br />
Pages 4-6<br />
The<br />
Recharge<br />
Booth<br />
contemplation, conversation, compassion : stand together<br />
This month we are celebrating how we have used learning to change and innovate our practices, particularly throughout this<br />
pandemic. Pictured clockwise from top left: During the peak of the pandemic we learned that proning (positioning COVID-19<br />
patients on their front) could save lives; the Recharge Booth is allowing colleagues to come together with others to reflect,<br />
recharge, decompress, and join a safe and confidential discussion; our new-look children's emergency care unit will lead to more<br />
efficient and streamlined care for our young patients and Visionable is enabling us to conduct virtual consultations.<br />
Our response<br />
to Black Lives<br />
Matter<br />
A good death – a<br />
Board level priority<br />
Psychological<br />
wellbeing - get<br />
the right support<br />
Flu campaign<br />
starts now<br />
Page 2<br />
Pages 16-17<br />
Page 19<br />
Page 25
FROM THE CHAIR<br />
Hello and welcome to a special edition<br />
of <strong>Heartbeat</strong>! This month we bring you a<br />
bumper research and innovation issue. As<br />
we progress through this pandemic, we<br />
keep you up to date with all the exciting<br />
research trials happening across our Trust.<br />
As it's a special edition, you will notice that this<br />
month we do not have the group sections. This<br />
month we are celebrating how we have used<br />
learning to change and innovate our practices,<br />
particularly throughout this pandemic. On<br />
pages throughout this edition you'll find quotes<br />
linked to learning to commemorate this.<br />
We also shine a spotlight on colleagues from<br />
across our Trust, including Susan Knight who<br />
has become a Queen's Nurse and, Dominic Le<br />
Gros who features as part of the International<br />
Year of the Nurse and Midwife. Enjoy!<br />
Contact us<br />
Communications Team<br />
Ext 5303<br />
swbh.comms@nhs.net<br />
Communications Department<br />
Ground Floor, Trinity House<br />
Sandwell Hospital<br />
Published by<br />
Communications Team<br />
Sandwell and West Birmingham<br />
Hospitals NHS Trust<br />
Designed by<br />
Medical Illustration,<br />
Graphics Team<br />
Sandwell and West Birmingham<br />
Hospitals NHS Trust<br />
Submit an idea<br />
If you’d like to submit an idea<br />
for an article, contact the<br />
communications team<br />
Ext 5303<br />
swbh.comms@nhs.net<br />
HELLO<br />
Stay updated<br />
We send out a Communications<br />
Bulletin via email every day and you<br />
can now read <strong>Heartbeat</strong> articles<br />
throughout the month on Connect.<br />
Don't forget you can follow us on:<br />
Richard Samuda, Chairman, on<br />
#blacklivesmatter<br />
The protests around the Black Lives<br />
Matter campaign have had a profound<br />
impact right across the world, following<br />
the appalling circumstances of the<br />
death of George Floyd in Minneapolis.<br />
The heartfelt, peaceful protests in<br />
Birmingham highlighted how far<br />
injustices can remain ingrained within<br />
societies and institutions across the UK<br />
as much as in the US.<br />
Our organisation is blessed to serve a<br />
vibrant, multicultural community from<br />
which our workforce is largely drawn and<br />
yet we know we have more to do to ensure<br />
equality and inclusion for all people at all<br />
levels in Sandwell and West Birmingham. I<br />
want to thank the BME Staff Network for<br />
their proactive awareness raising, helpful<br />
challenge and participation in Trust-wide<br />
initiatives to further enhance inclusion<br />
and ensure that Black voices and BME<br />
voices are heard and influence positive<br />
change. During COVID-19 the network<br />
participated in revising the risk assessments<br />
for colleagues to take account of ethnicity<br />
that has led to actions for individuals to<br />
keep them safe at work including enhanced<br />
PPE or redeployment to different areas. The<br />
network continues to invite all colleagues to<br />
participate in events and discussions about<br />
race and ethnicity.<br />
We need to do more to ensure BME<br />
colleagues are more proportionately<br />
represented in senior roles within our<br />
organisation, albeit we have made progress<br />
on this, as well as eliminate unconscious<br />
bias or racism in how colleagues who<br />
work here are treated. As always I would<br />
urge you to speak up if you have issues of<br />
concern that need addressing or ideas to<br />
share.<br />
At SWB Black lives do matter, and we must<br />
make this true for our patients, who come<br />
to us for help with a healthcare need. We<br />
must engage with local communities, listen<br />
and respond. We have done that when we<br />
recognised that our complaints were underrepresented<br />
from certain communities<br />
and have been out to talk to a range of<br />
local groups to understand if there are<br />
any barriers to raising concerns. We have<br />
strong links with partners such as the West<br />
Bromwich African Caribbean Resource<br />
Centre who co-provide the Sapphire Service<br />
identifying and supporting patients at risk<br />
of social isolation. During this pandemic<br />
our Trust has been leading the way in<br />
sharing and analysing the data of our<br />
patients with COVID-19 which has helped<br />
our clinicians and government leaders to<br />
better understand the risk factors that can<br />
lead to a poorer outcome. We recognise<br />
that there has been concern among Black<br />
communities in Birmingham about coming<br />
into hospital. Our message is clear that<br />
people should and must come to our Trust<br />
for help with their health care needs. We<br />
must live up to the expectations and rights<br />
of everyone in our community so that<br />
they can have confidence that they will be<br />
treated equally with the utmost respect,<br />
compassion and kindness.<br />
Chairman, Richard Samuda
QIHD Accreditation – Are you<br />
bronze, silver or gold?<br />
Quality Improvement Half Days (QIHDs)<br />
were introduced in the Trust back in<br />
2015, with the strap line ‘Guaranteed<br />
time for teams to talk, listen, learn<br />
and act’. Since then, we have seen<br />
the number of multi professional<br />
teams grow and develop; focusing on<br />
quality conversations and introducing<br />
improvement and innovation spanning<br />
the entire Trust.<br />
To show how each QIHD team was using<br />
their time, an accreditation programme was<br />
developed that spanned from a basic entry<br />
level all the way up to gold and teams were<br />
asked to make sure that they had been<br />
accredited to at least an entry level by the<br />
end of April <strong>2020</strong>.<br />
League<br />
Position<br />
Gold<br />
Silver<br />
Current<br />
Status<br />
QIHD League Table: May <strong>2020</strong><br />
QIHD League Table: May <strong>2020</strong><br />
Bronze<br />
Entry<br />
Name of QIHD Team<br />
1 Children's Therapies<br />
2 Trauma and Orthopaedics<br />
3 Palliative<br />
4 Care Foot Health<br />
5 Rheumatology<br />
6<br />
Community intermediate care and medically fit for discharge wards inc<br />
Leasowes<br />
7 Obstetrics and Gynaecology<br />
8 Health Visiting<br />
9 Stroke<br />
10 New-born Hearing Services<br />
11 Orthoptics/Ophthalmic Technicians<br />
12 Urology<br />
13 Rapid Response Team Medicine Therapies<br />
14 Gastroenterology<br />
15 General Surgery<br />
16 Paediatrics<br />
17 MSK<br />
18 Care of the Elderly team<br />
19 Imaging Group<br />
20 Clinical Governance<br />
21 Audiology<br />
22 Anaesthetics, Critical Care and Pain Management<br />
23 iCares and the District Nursing Team<br />
24 Cardiology<br />
25 ENT<br />
26 Anticoagulant Services<br />
27 Sandwell School Health Nursing<br />
28 Financial Management<br />
29 Integrated Sexual Health Department<br />
30 Respiratory Therapies<br />
31 Neurophysiology<br />
32 Capacity Management<br />
33 Speech and Language Therapy<br />
"I never 34 lose. I Neonates either win or learn."<br />
Nelson Mandela<br />
NEW<br />
NEW<br />
So far in <strong>2020</strong> we have supported an<br />
additional eight teams to entry level,<br />
awarded seven bronze accreditations,<br />
two silver accreditations and one gold<br />
accreditation.<br />
Congratulations go to Trauma and<br />
Orthopaedics for becoming the second<br />
team to reach gold, joining Children’s<br />
Therapies at the top of the league table.<br />
To find out how they achieved their<br />
accreditation, <strong>Heartbeat</strong> caught up with<br />
Associate Specialist Dr Boban Thomas.<br />
He said: “Last year I applied on behalf<br />
of the team and we achieved a bronze<br />
accreditation, but this was just a trigger to<br />
go for the top prize. We discussed it in our<br />
QIHD and felt that the gold accreditation<br />
was something we could strive for.<br />
QIHD<br />
“So at the beginning of last year we<br />
set our sights on gold and got to work<br />
setting targets and worked towards<br />
that as a team. We identified a few<br />
quality improvement projects and put<br />
in steps to make measurable changes.<br />
We monitored our progress by carrying<br />
out regular audits and we were glad to<br />
see we were showing definite objective<br />
changes in a positive direction.<br />
“To gain our accreditation we had to<br />
have at least two identified projects.<br />
These had to make an impact on the<br />
performance of our department. We also<br />
needed to have a multidisciplinary QIHD,<br />
with time for everyone to voice their<br />
opinions. We had combined meetings<br />
with other departments to again<br />
improve patient care and safety. We<br />
also liaised with external stakeholders to<br />
further improve the quality of our care<br />
delivered to the community. Having a<br />
link and ties with the Royal Orthopaedic<br />
Hospital and Queen Elizabeth Hospital<br />
helped in streamlining some issues with<br />
tertiary referrals and getting easy inputs<br />
from them on some complex issues in<br />
patient management.<br />
“We are now focused on areas such as<br />
research and development, electronic<br />
patient outcome measures and also<br />
working to involve patient groups and<br />
GP consortiums to widen our scope in<br />
providing an exemplary service to our<br />
community. Our T&O department has<br />
grown over the last few years, we have<br />
the potential and we will soon be a<br />
centre of excellence in orthopaedic and<br />
trauma surgery.”<br />
Remember, achieving accreditation<br />
does not take long and recognises<br />
the improvement work that is being<br />
undertaken in QIHD teams across the<br />
Trust. If you would like to know more<br />
about gaining accreditation for your<br />
QIHD, contact Angharad MacGregor,<br />
Head of Clinical Effectiveness<br />
Angharad.Macgregor@nhs.net<br />
3
Clinical Research Facility –<br />
Are you ready to open a study?<br />
COVID-19 RESEARCH<br />
Just over a year ago, the brand<br />
new clinical research facility (CRF)<br />
celebrated its launch. The CRF<br />
which boasts nine clinic rooms and<br />
associated facilities is available for<br />
research clinics and research related<br />
procedures. During May this year,<br />
new monitors with webcams were<br />
installed to ready the facility for<br />
Visionable web-clinics.<br />
Prior to suspension of face to face<br />
clinics, the CRF was regularly used to<br />
approach and consent discussions and<br />
follow up visits for a variety of research<br />
projects for patients with a number<br />
of health conditions including cardiac<br />
problems and metabolic disorders,<br />
gastroenterology and haematology.<br />
Preparations to transfer in Dr Diana<br />
Kavanagh’s Friday respiratory clinic had<br />
been underway immediately prior to<br />
the shutdown of non-essential face to<br />
face clinics at the start of the pandemic.<br />
There are also plans to move in some of<br />
the haematology outpatients.<br />
The CRF is available for research clinic and<br />
research related procedures<br />
“You don’t have to only see patients who are<br />
going to be taking part in research to use the<br />
clinical research facility,” said Gina Dutton,<br />
Head of Research and Development. “Clinics<br />
that are suitable to take place in the CRF are<br />
those where a high proportion of patients are<br />
suitable to take part in research. So we would<br />
expect you to have a study open or ready to<br />
open and a plan for pipeline of studies to use<br />
the facility for a full clinic.<br />
“The CRF has been an excellent investment<br />
and has meant that we have the facilities<br />
available to enable Sandwell and West<br />
Birmingham NHS Trust to be chosen to deliver<br />
staff research.<br />
“We are keen for new investigators to<br />
come forward and make grant applications<br />
to expand both within Trust research and to<br />
have a wider influence.”<br />
The CRF is an ideal location to undertake<br />
research where a new treatment modality<br />
or intervention which can be delivered<br />
in an outpatient setting can be tested.<br />
There is a research laboratory with facilities<br />
to process blood and other samples for<br />
refrigeration and freezing for storage and<br />
dispatch to analysis labs. The CRF is also<br />
used for research project site initiation<br />
visits and monitoring visits, where sponsors<br />
visit the Trust to check source data for<br />
licencing studies. Face to face external<br />
visitor meetings are temporarily suspended<br />
and so our new web equipment has<br />
proved invaluable in making sure that these<br />
important activities can continue.<br />
Colleagues are encouraged to contact R&D<br />
early in your discussions about new SWB<br />
originated research. The team can show<br />
you the facilities available as well as provide<br />
advice on grant applications and ethics and<br />
approvals processes. Contact Zaida Khalil on<br />
zaida.khalil@nhs.net.<br />
If you would like a tour of the<br />
facilities you can contact Gina Dutton<br />
at gina.dutton1@nhs.net.<br />
New trial set to boost immune cells<br />
in COVID-19 patients<br />
The Trust is launching a new trial<br />
which is looking at boosting T-cells<br />
(immune cells) - to fight against<br />
COVID-19 infection.<br />
As we know, COVID-19 infection lowers<br />
the body’s immune system and these<br />
T-cells are reduced in number which is<br />
called lymphopenia.<br />
T-cells are one of the major components<br />
of the immune system. Their role<br />
includes directly killing infected host<br />
cells, activating other immune cells,<br />
producing cytokines and regulating the<br />
immune response.<br />
A new drug (CYT107 Interleukin-7) is<br />
a manufactured version of a naturally<br />
occurring substance in the body and<br />
can improve the function and number<br />
of T-cells. The hope is that this drug can<br />
improve the T-cell function in COVID-19<br />
so that the body can better fight the<br />
infection and improve hospital stay and<br />
survival.<br />
It is hoped the ILIAD 7 trial will improve the<br />
function of the immune system<br />
The trial is called ILIAD 7 which stands for<br />
Recombinant Human Interleukin-7 (CYT107)<br />
to Improve Clinical Outcomes in Lymphopenia<br />
in patients with COVID-19 Infection.<br />
Co-ordinated by our intensive care and<br />
haematology teams, Dr Jon Hulme,<br />
Consultant Intensivist is the principal<br />
investigator and Dr Farooq Wandroo,<br />
Consultant Haematologist is the co-principal<br />
investigator.<br />
All patients who are COVID-19 positive can<br />
be tested with the drug if they fulfil the<br />
following criteria:<br />
• Men and women aged 25 – 80<br />
• Hospitalised patients with two<br />
absolute lymphocyte count (ALC)<br />
≤1000, at two time points at least<br />
24 hours apart, after admission<br />
• Hospitalised patients requiring oxygen<br />
at > 4L/min nasal cannula to keep<br />
SpO2 > 90%, or needing ventilation<br />
(non-invasive or intubated) for<br />
respiratory failure<br />
• Confirmed infection with COVID-19.<br />
All clinicians are urged to consider<br />
recruiting patients for this important<br />
trial. For more information contact the<br />
R&D team - you can call Cecilia Ahmed<br />
on 0121 507 3622 or Yvonne Nupa on<br />
0121 507 3430.<br />
4
Critical care at the forefront of<br />
COVID-19 research<br />
COVID-19 RESEARCH<br />
of immune cells). This is universally seen<br />
in all COVID-19 patients, often leads<br />
to infections and is associated with<br />
increased risk of death. We are trialling<br />
a new drug called interleukin-7 which<br />
will aim at improving the number of<br />
these white cells or immune cells and<br />
help fight COVID-19 infection better and<br />
may reduce the risk of dying. We would<br />
urge all clinicians to help promote this<br />
important study.”<br />
The newest study is a commercial<br />
trial looking at whether Recombinant<br />
Human Interleukin-7 can improve clinical<br />
outcomes in patients in critical care<br />
with severe COVID-19 infections and, in<br />
particular, lymphopaenia. You can read<br />
further about this trial on page four of<br />
this edition of <strong>Heartbeat</strong>.<br />
These studies are complex and<br />
challenging to explain to patients,<br />
particularly patients that are so ill.<br />
Dr Jon Hulme, Consultant Intensivist and Dr Farooq Wandroo, Consultant Haematologist<br />
are leading some of the COVID-19 research in critical care<br />
Critical care has been at the centre<br />
of the Trust’s research portfolio and<br />
currently has four studies which the<br />
team are actively recruiting to. They are<br />
also delivering treatments for patients<br />
who transfer from the wards who have<br />
been recruited to the RECOVERY study.<br />
Two of the studies are complex treatment<br />
trials at the forefront of COVID-19 research.<br />
REMAP-CAP is a complex treatment<br />
trial which is testing multiple treatment<br />
options simultaneously. This is known<br />
as a platform study. In REMAP-CAP, the<br />
treatments being tested are corticosteroids,<br />
antivirals, immune modulation therapy,<br />
immunoglobulin therapy (in the form of<br />
convalescent plasma) and therapeutic<br />
anticoagulation.<br />
Within these therapy types there are several<br />
randomisation arms. Most research is<br />
intervention/drug a versus intervention/drug<br />
b, so this study is much more complex than<br />
usual.<br />
<strong>Heartbeat</strong> caught up with Dr Jon Hulme,<br />
Consultant Intensivist and Honorary Senior<br />
Clinical Lecturer, who is the principal<br />
investigator on the REMAP-CAP trial. He told<br />
us: “The impact that COVID-19 has had on<br />
some of our patients has been clear to see.<br />
Large scale, robust trials to test which drugs<br />
help, and importantly, which ones do not,<br />
are hugely important for our patients and<br />
those we will treat in the future. Whilst there<br />
is the temptation that will be felt by many<br />
to use treatments and drugs based on what<br />
they think might work, it is only through<br />
committing to trials like these that the real<br />
answers will be uncovered that will save lives.<br />
“Clinical trials are important as we have<br />
shown by participating in the RECOVERY trial:<br />
this found that dexamethasone, a steroid that<br />
is cheap and widely available and is commonly<br />
used to reduce inflammation in conditions<br />
such as asthma, saves lives in those people<br />
most affected by COVID-19. It reduces deaths<br />
by one third in people on a ventilator and by<br />
one fifth in patients receiving oxygen only.”<br />
Dr Farooq Wandroo, Consultant<br />
Haematologist and Honorary Senior Lecturer<br />
is a co-principal investigator. He added:<br />
“One of the characteristic findings we have<br />
observed in COVID-19 patients is low white<br />
cell count called lymphopenia (low number<br />
“Learn as if you were not reaching your goal<br />
and as though you were scared of missing it.”<br />
Confucius<br />
“One of the problems that we<br />
often experience in intensive care or<br />
emergency medicine research is that<br />
patients are so ill that we cannot discuss<br />
the studies with them. This current<br />
research is considered so important that<br />
sites have been given permission to enrol<br />
patients even in these situations with<br />
a senior doctor who is separate from<br />
the study team taking the responsibility<br />
to assess the situation and decide on<br />
the patients’ behalf until they regain<br />
capacity,” added Dr Hulme. “We<br />
are also ensuring that patients who<br />
have limited English can participate in<br />
studies. Sometimes a lack of ability to<br />
speak English is written as an exclusion<br />
criterion for the study, in which case we<br />
cannot approach non-English speaking<br />
patients.<br />
“The participant information sheet for<br />
REMAP-CAP has been translated into<br />
multiple languages (although a limited<br />
number and not the full spectrum of<br />
languages spoken by our patients)<br />
alongside which patients still need the<br />
research explaining to them. The whole<br />
team of doctors, nurses, research team<br />
and interpreters have worked together<br />
with patients and their families to<br />
ensure that all of our patients have the<br />
opportunity to participate.”<br />
For further information about:<br />
REMAP-CAP visit https://player.<br />
rcplondon.ac.uk/video/1_9wxiht1d<br />
5
Spotlight on research midwives<br />
COVID-19 RESEARCH<br />
A research midwife may not be<br />
something that you are entirely<br />
familiar with, but the part they<br />
play within our workplace is crucial.<br />
The role of a research midwife can<br />
be varied and includes procuring<br />
studies, recruiting and gaining<br />
consent, collecting and analysing<br />
data and publicising results. We<br />
spoke to research midwives, Sarah<br />
Potter and Lavinia Henry to find out<br />
more.<br />
Sarah explained: “As part of our<br />
role we seek out and assist with the<br />
development and delivery of high-quality<br />
research studies within our maternity<br />
specialty. This includes disseminating<br />
information regarding the current<br />
research projects to the whole clinical<br />
team. It also includes teaching and<br />
training. In line with the Trust’s vision<br />
that all patient-facing colleagues can<br />
play a role in research activity, our goal<br />
is to ensure that as many women as<br />
possible have the opportunity to access<br />
research.”<br />
It is, in fact, their experience as midwives<br />
that equips them with the knowledge<br />
and skills to excel in research. Lavinia<br />
told us: “Trusts that are research active<br />
have better patient outcomes. We<br />
work as part of clinical care teams in<br />
all departments so that research is<br />
integrated and a normal part of patient<br />
care.<br />
Research midwives Lavinia Henry and<br />
Sarah Potter<br />
“As midwives, we have expert knowledge<br />
of our client group, clinical environment and<br />
pathways, having worked in the maternity<br />
department before moving into research.<br />
This practical experience helps us to plan<br />
recruitment strategies, identify and overcome<br />
any potential barriers.”<br />
She added: "An example of what we do<br />
includes explaining studies to potential<br />
recruits, whilst gaining and recruiting<br />
individuals for different studies, e.g. recruiting<br />
pregnant women, postnatal women and<br />
neonates into studies. We also conduct<br />
follow-ups, plus gather data and samples as<br />
required.”<br />
Currently, there are several maternity studies<br />
ongoing all with the focus of developing and<br />
improving the effectiveness of care. Some of<br />
our current research trials include:<br />
• Induction of labour, A RCT<br />
comparing two different treatments<br />
for induction and the effect of each<br />
on outcome.<br />
• Prevention of preterm labour, a trial<br />
examining whether the choice of<br />
materials for a cervical stitch.<br />
procedure has any influence on<br />
outcomes.<br />
• Development of care pathways,<br />
analysing the timing of delivery<br />
for women whose babies are large<br />
for gestational age.<br />
• The donation of umbilical cord<br />
samples at elective c/sections to be<br />
used in the development and<br />
improvement of treatment for<br />
rheumatoid arthritis and<br />
cardiovascular disease.<br />
• Smoking cessation.<br />
Since the outbreak of COVID-19, the team<br />
have been actively involved in research trials<br />
that are unique to the pandemic. Sarah<br />
commented: “Though challenging, this<br />
has been a unique opportunity for us to be<br />
actively involved with live, rapidly evolving<br />
studies examining the effectiveness of study<br />
treatments for a condition where there<br />
are no proven effective therapies. These<br />
research trials involve stepping out of our<br />
comfort zone to work in new areas, such as<br />
ITU and AMU, to meet the demands of the<br />
service.”<br />
Sarah added: “Some of these studies are<br />
also open to maternity patients, and the<br />
experience gained on the wards means<br />
we are ready to support the maternity<br />
team with the delivery of these studies.<br />
Maternity also has a registry study open for<br />
women who have experienced COVID-19,<br />
or its symptoms, during pregnancy or the<br />
postnatal period. We are both looking<br />
forward to spending some time back<br />
‘home’ in maternity identifying patients for<br />
this study.”<br />
6
Platform studies – a new way to<br />
do research<br />
One of the principal features of the<br />
urgent public health COVID-19 portfolio<br />
has been the inclusion of a suite of<br />
studies that can adapt to research<br />
findings quickly. These are known as<br />
platform studies. The advantage of this<br />
type of research is that the study can<br />
change quickly.<br />
Traditional randomised research tends to<br />
follow a simple model shown below.<br />
COVID-19 RESEARCH<br />
Suitable<br />
patients<br />
Randomise<br />
Control arm<br />
New treatment arm<br />
At the start of the study the statisticians<br />
will agree how many patients will need to<br />
take part to find the answer to the question<br />
being asked by the study. Commonly this<br />
is, is the new treatment better than the old<br />
one? These studies often take many years<br />
to find the answer to the question.<br />
Head of Research and Development, Gina<br />
Dutton told <strong>Heartbeat</strong>: “At the start of the<br />
COVID-19 pandemic, no-one knew which<br />
treatments would work and so there was<br />
a need to test multiple treatments at the<br />
same time. Rather than have lots of different<br />
studies, the favoured model has been to use a<br />
platform study.<br />
“In a platform study there will be many<br />
arms and some will stop as soon as the<br />
answer to a specific question has been<br />
reached or a new treatment may be<br />
added in, when some new information<br />
becomes available.”<br />
Control arm<br />
New treatment A<br />
New treatment B<br />
Suitable<br />
patients<br />
Randomise<br />
New treatment C<br />
STOP<br />
New treatment D<br />
New treatment E<br />
New treatment F<br />
STOP<br />
Using the RECOVERY study as a specific<br />
example, since the study started several<br />
new treatment options have been added<br />
to the study. Two treatment options have<br />
recently been stopped when sufficient<br />
patients have been recruited to answer the<br />
study question. The hydroxychloroquine arm<br />
closed as there was no benefit for patients<br />
taking it. The dexamethasone arm has<br />
stopped as it has shown significant benefit<br />
for patients receiving oxygen and those on<br />
ventilation and will be adopted as standard<br />
of care.<br />
Other examples of the studies that we have<br />
open that fall into this platform category<br />
are the PRINCIPAL trial in general practice<br />
and REMAP-CAP for patients who are<br />
particularly poorly and admitted to critical<br />
care. All of these studies already have<br />
different treatment options from when they<br />
first opened.<br />
Gina Dutton added: “These studies can<br />
seem complex for people who are new to<br />
research. They certainly take more planning<br />
to make sure that all treatments can be<br />
delivered in the correct way. Everyone who<br />
has worked on these studies, including<br />
doctors, ward nurses, the medical infusion<br />
suite team, pharmacy and the research<br />
team have embraced working with this<br />
innovative trial model and should be really<br />
proud of their contribution to improving<br />
treatments for patients with COVID-19.”<br />
For more information about this type of<br />
research you can read a Health Research<br />
Authority blog https://bit.ly/3d0Q0jy.<br />
7
Staff research vital in fight against<br />
COVID-19<br />
COVID-19 RESEARCH<br />
Until recently the COVID-19 research<br />
in our workplace has focused on<br />
treating patients with coronavirus<br />
and improving patient outcomes.<br />
We are now preparing to undertake<br />
research which involves colleagues. Our<br />
organisation has a diverse multi-ethnic<br />
workforce making it the perfect place<br />
to conduct research and ensure that the<br />
research participants are representative<br />
of the wider community.<br />
Dr Masood Aga, Consultant and<br />
Specialty Lead in Occupational Medicine,<br />
is principal investigator for some of<br />
these research trials involving staff.<br />
He said: “SIREN is a study looking to<br />
recruit colleagues who have regular<br />
contact with patients. It has a number<br />
of aims but one of the principal ones is<br />
to establish whether a prior COVID-19<br />
infection (measured through an antibody<br />
test) protects against future infection<br />
(detection of virus on a swab). This<br />
research is voluntary and colleagues who<br />
agree to take part are expected to have<br />
swabs and blood tests every two weeks<br />
for at least one year. The frequency may<br />
change throughout the year. We will be<br />
creating a colleague sign-up page on<br />
Connect so that appointments with R&D<br />
Dr Masood Aga, Consultant and Specialty Lead<br />
in Occupational Medicine is leading some of our<br />
staff research trials<br />
to discuss participation in the study can be<br />
easily arranged.<br />
“The second study that we will be taking<br />
part in is called COPCOV. This is a prophylaxis<br />
study which is looking to see whether taking<br />
low dose of hydroxychloroquine will prevent<br />
people from developing COVID-19 symptoms<br />
or reduce the severity if they do develop<br />
it. This latter study has been temporarily<br />
paused whilst the central study team make<br />
some changes to take into account recent<br />
information about hydroxychloroquine. The<br />
dose of drug required for this prevention<br />
study is much lower than that used in current<br />
clinical care."<br />
The recent press interest in<br />
hydroxychloroquine has highlighted the<br />
importance of high quality randomised<br />
controlled trials (one where patient<br />
outcomes are rigorously compared to<br />
patients matched for similar characteristics<br />
such as age, ethnicity, gender, health<br />
conditions) to ensure that we have the<br />
evidence for decision making.<br />
This Trust is recruiting to the RECOVERY<br />
trial which has provided the best evidence<br />
to date about hydroxychloroquine. This<br />
treatment was found to have no beneficial<br />
effect of hydroxychloroquine in patients<br />
hospitalised with COVID-19, the trial also<br />
found no indication of harm. On this basis<br />
the regulators are happy for COPCOV, the<br />
colleague study to proceed.<br />
On the horizon it is expected there will<br />
be more vaccine studies which will be<br />
recruiting colleagues and members of the<br />
public. Keep an eye on Connect for further<br />
details.<br />
Clinics will be set up in the Clinical Research<br />
Facility at Sandwell initially and a suitable<br />
location at City will also be used. More<br />
information will be published through the<br />
COVID-19 bulletins and on the dedicated<br />
COVID-19 Connect pages.<br />
A number of research projects are<br />
underway that are using staff surveys.<br />
These are being circulated via the<br />
COVID-19 weekly bulletin.<br />
Community outbreak team: Rapid<br />
response to support our population<br />
COVID-19<br />
Thinking back to only a few short<br />
months ago, Tammy Davies, Group<br />
Director of Primary Care, Community<br />
& Therapies, recalls her thoughts on<br />
seeing news reports about the then<br />
called ‘Wuhan flu’. She remembers: “I<br />
must admit I didn’t anticipate just how<br />
much of an impact it would have both<br />
on our patients, local community and<br />
service delivery.<br />
“Towards the end of March when we saw<br />
our first cases in the Trust, I realised that<br />
this would probably be the biggest national<br />
crisis the NHS would face in my lifetime.<br />
We quickly formed a seven-day group<br />
Tammy Davies, Group Director of Primary<br />
Care, Community & Therapies<br />
tactical response team to rapidly re-evaluate<br />
how we deliver services and deal with the<br />
changing picture.<br />
“I felt apprehensive, and at times<br />
overwhelmed but mostly really lucky to<br />
have such an experienced and dedicated<br />
team. We knew we had to act quickly to<br />
meet the challenge, so turned one of our<br />
large offices into a tactical response team<br />
where the senior team all based themselves.<br />
This helped with team bonding and moral<br />
support. I ensured the entire group and<br />
all staff were supported and prepared by<br />
redirecting resources into essential and<br />
urgent work and, ensuring colleagues had<br />
rest and access to wellbeing services.<br />
“The outbreak response team was set up<br />
to undertake a same day response to areas<br />
of the community who have suspected<br />
outbreaks of COVID-19. Operating with a<br />
minimum of two nurses – one senior - two<br />
support workers, a driver and our contact<br />
continued...<br />
8
centre team, we are also supported by<br />
women and child health colleagues for<br />
outbreaks in children. The team also can<br />
call on therapists and therapist assistants as<br />
needed.<br />
“The team aims to successfully swab<br />
everyone who is suspected of having<br />
COVID-19 and provide support<br />
and reassurance when people are<br />
understandably anxious. Our target is to<br />
respond on the same day or within 24<br />
hours.”<br />
Covering the Sandwell area and operating<br />
seven days a week, the team’s core hours<br />
are 8am to 4pm, but they are flexible<br />
and will work later if required. They are<br />
ready should a community surge happen<br />
and consider a surge to be any increase<br />
in COVID-19 cases which may happen as<br />
lockdown restrictions are relaxed. However,<br />
they are also anticipating a surge in demand<br />
for community services from people<br />
COVID-19<br />
Caring for our elderly patients<br />
during COVID-19<br />
Care, compassion and kindness have<br />
been three buzzwords that have been<br />
ringing through our hospitals ever<br />
since COVID-19 came to our doors. And<br />
whilst an unprecedented healthcare<br />
crisis unfolded across the world,<br />
colleagues continued to come to work,<br />
ready to don their PPE and care for their<br />
patients.<br />
To find out more about how colleagues at<br />
Sandwell dealt with COVID-19, <strong>Heartbeat</strong><br />
caught up with Consultant Geriatrician<br />
Grace Shorthouse. Sharing her experience,<br />
she said: “Elderly care was one of the first<br />
wards to become 'hot', so the team had to<br />
adapt very quickly to working in a COVID<br />
positive environment. We needed to get<br />
very familiar with our PPE and establish<br />
correct areas for donning/doffing. It was a<br />
real challenge to be able to communicate<br />
with our patients - many of whom have<br />
cognitive problems and trouble hearing and<br />
seeing. We had to be able to think on our<br />
feet and use different resources to help get<br />
our messages across to patients.<br />
“Although many of our clinics were quickly<br />
converted to telephone clinics, this posed<br />
its challenges as it can be quite tricky<br />
when you are trying to assess things like<br />
the neurological symptoms of Parkinson's<br />
disease. However, patients were often<br />
grateful that we were going the extra mile<br />
to ensure they remained well looked after<br />
and safe during the pandemic, even if it did<br />
mean some of our assessments were slightly<br />
limited.”<br />
with chronic illness who may deteriorate<br />
through a lack of medical/nursing and<br />
therapy support due to the crisis creating<br />
fear in patients about attending hospital<br />
appointments and seeking help. The<br />
team are also concerned that people may<br />
have missed immunisations and cancer<br />
screenings and this too may result in a later<br />
surge.<br />
Tammy continued: “I am proud of how the<br />
group has quickly altered usual services<br />
to respond to the changing picture. In<br />
addition, the team have worked with the<br />
local community, public health, CCG and<br />
local authority to protect our patients and<br />
the local population.”<br />
Marian Long, Group Head of Nursing in<br />
Community and Therapies clinical group,<br />
added: “With a remit to deliver a seven-day<br />
response service to support the control of<br />
local outbreaks as part of the next phase<br />
of test and trace, we’ve been working<br />
Consultant Geriatrician Grace Shorthouse shares<br />
her experience of COVID-19<br />
She added: “My colleagues have been<br />
wonderful! A lot of people were quite fearful,<br />
especially at the beginning of the pandemic,<br />
and we had contact with a lot of very frail<br />
patients that did not survive. This was a very<br />
stressful time so we all made an extra special<br />
effort to be kind to each other and talk<br />
through how we were feeling. There was a<br />
lot of camaraderie and team spirit. We made<br />
an extra effort to celebrate the small victories,<br />
including a PPE themed birthday cake for<br />
one of the consultants on the ward. We had<br />
in partnership with our public health<br />
partners. By identifying and containing<br />
potential outbreaks, in workplaces, housing<br />
complexes, care homes and schools as<br />
well as supporting our Trust in ward-based<br />
outbreaks we can mobilise our team and<br />
respond promptly.<br />
“This service is vital to help reduce the risk<br />
of a second surge and we are proud of<br />
our role in supporting this. Our task would<br />
not have been achievable without our<br />
fabulous contact centre, the energy of key<br />
individuals, namely Andy Churm and Jo<br />
Tonks, our very patient drivers Cash, Andy,<br />
Malcolm and Peter and expert support form<br />
Julie Booth and Dr Saluja.”<br />
Kulwinder Johal, Clinical Directorate Lead<br />
in Ambulatory Therapies and End of Life,<br />
concluded: “As a group, the ethos has been<br />
that we are all in it together, so all staff<br />
in the group have supported the ask by<br />
working flexibly around the demands of the<br />
day to demonstrate our ‘can do’ attitude.”<br />
Haiku poetry competitions, sunflower<br />
growing competitions and a few (socially<br />
distanced) meals on the ward - it was a<br />
positive environment as we all went the<br />
extra mile to make things as pleasant as<br />
possible.<br />
"Using WhatsApp to video conference<br />
with families has been a bit of a<br />
revelation. Most people would prefer to<br />
see their loved one in person, but some<br />
of the older patient relatives were often<br />
too frail to visit, even before COVID-19.<br />
I had one poorly patient who was<br />
dying and his wife requested we video<br />
conference with him so she could wish<br />
him a happy birthday and say goodbye<br />
one last time. He'd been unresponsive<br />
for almost a day, but once he heard her<br />
voice, he roused enough to open his<br />
eyes and tell her he loved her. It was a<br />
precious and beautiful moment - one<br />
that she was so thankful to have had. As<br />
sad as it was, it made my day!”<br />
When asked about her tips for working<br />
through a pandemic, Dr Shorthouse<br />
said: "Take your time with PPE and<br />
with your patients. A smile goes a long<br />
way in communicating through a mask<br />
and visor. Keep a sense of humour, talk<br />
your concerns out with colleagues and<br />
drink plenty of fluids! (but go to the loo<br />
before you get dressed up in PPE!). Oh,<br />
and if you struggle with wearing masks,<br />
try sucking on a sweet underneath -<br />
that helped me relax and breathe a bit<br />
better!”<br />
"For the things we have to learn before we can do them, we learn by doing them.”<br />
Aristotle<br />
9
10<br />
Tackling COVID-19 – reflections<br />
from the medicine cross-site team<br />
COVID-19<br />
By Dr Edward Fogden,<br />
Consultant Gastroenterologist,<br />
Clinical Lead for Gastroenterology<br />
A lot has happened since Nick<br />
Sherwood, Joint Clinical Lead, Critical<br />
Care Services came to our joint<br />
gastroenterology and acute medicine<br />
QIHD in February to talk to us about<br />
how to deal with a viral pandemic.<br />
Since then COVID-19 has changed so<br />
much of how we live and work that<br />
it is difficult to predict what life will<br />
be like even a few months ahead.<br />
Looking back, I feel we need to give<br />
credit to the positive approach shown by<br />
our teams despite the underlying anxiety<br />
about coming to work in the midst of a<br />
pandemic, getting used to the PPE that<br />
has become familiar to us all, and the<br />
impact of lockdown removing the usual<br />
pressure valve of social interaction with<br />
family and friends. Everyone’s working<br />
lives changed rapidly with different rotas,<br />
changing job roles and often different<br />
departments.<br />
It has been a huge team effort – in<br />
medicine where I work, our EDs, AMUs<br />
and all the inpatient wards had to<br />
rapidly and fundamentally change how<br />
they worked. We have matrons and<br />
ward managers leading new teams<br />
with redeployed nursing staff, often<br />
on different wards to usual; medical<br />
specialty colleagues joined the wider<br />
medicine and emergency care team to<br />
cover wards and expand the on-call team<br />
to provide expanded hot and cold seven<br />
day cover across both sites; within days<br />
all grades of medical staff were on new<br />
rotas, and operational colleagues worked<br />
long hours alongside clinical and nursing<br />
leadership teams to make all of these<br />
major changes happen, whilst keeping<br />
everything running in the face of a what<br />
felt like an ever-changing situation.<br />
As medicine reconfigured itself ahead<br />
of the surge, the whole patient-facing<br />
workforce needed to have been FIT<br />
tested, trained in PPE use and educated<br />
in how to treat a new disease. This<br />
posed its own challenges, particularly<br />
how to distil down the volume of clinical<br />
research that was being published<br />
on a daily basis, but also to ensure<br />
that everyone was able to access this.<br />
Government guidelines also changed<br />
Dr Edward Fogden, Consultant<br />
Gastroenterologist<br />
as often, and the Trust comms team had the<br />
unenviable task of trying to get this everchanging<br />
information to everyone in the<br />
organisation. We also saw the birth of our very<br />
own Youtube star, the trust’s face of PPE “Dr<br />
Mark says…” rivalling Joe Wickes for public<br />
service broadcasting.<br />
There has been, and remains, understandable<br />
anxiety about the risks to patients and<br />
individual staff from COVID-19, given the<br />
impact of COVID-19 on our population and<br />
how hard Birmingham and the Black Country<br />
have been hit by COVID-19 relative to other<br />
parts of the country outside London. Better<br />
data to help us understand the risks to staff,<br />
including regarding ethnicity and underlying<br />
health conditions, has guided the development<br />
of risk assessments which are now available<br />
for all staff via occupational health. I’m<br />
very grateful that we didn’t experience the<br />
significant gaps in PPE reported in other trusts<br />
across the country, credit to the hard work of<br />
Dinah McLannahan and her team.<br />
Every available person in my specialty<br />
(gastroenterology) worked in the Trust in the<br />
response to COVID-19 including many staff<br />
redeployed into the wards or ITU, or working<br />
from home due to shielding, leaving our<br />
mainly outpatient-based services running at<br />
a tiny fraction of its usual service. We had<br />
started a team WhatsApp chat a few years ago<br />
during heavy snow to help coordinate work,<br />
and found it really useful during Unity go-live<br />
– it proved helpful again to keep in touch with<br />
everyone as did the weekly Zoom call. I think<br />
it has allowed us to keep everyone informed<br />
as best we can about all the changes, support<br />
staff who have been redeployed across<br />
medicine including ITU and the wards, as well<br />
as colleagues working from home.<br />
Patients definitely do worry about coming<br />
into contact with COVID-19, both in the<br />
community and in hospital, and are concerned<br />
about the risk of getting ill and dying from<br />
"Leadership and learning are indispensable to each other.”<br />
John F. Kennedy<br />
it. The press have reported NHS figures of<br />
10-20 per cent of inpatients with COVID-19<br />
have caught it whilst in hospital – this is a<br />
necessary reminder of the need for PPE to<br />
protect our patients, colleagues as well as<br />
ourselves. Nationwide the NHS has seen a<br />
steep drop in attendances to ED, referrals<br />
from GPs, and also GP attendances. This<br />
worries us, as large numbers of patients<br />
are not seeking medical attention for<br />
symptoms that need investigating urgently.<br />
We are going to see a rise in referrals<br />
as the lockdown eases and are working<br />
hard to deal with the challenges posed by<br />
the backlog of elective work across the<br />
NHS (outpatient clinics and endoscopy<br />
procedures in gastroenterology) and the<br />
impact this will have on our patients.The<br />
press are reporting on NHS-wide delays<br />
to elective care including outpatients,<br />
procedures and operations, and the impact<br />
on cancer care during the pandemic and<br />
afterwards.<br />
One of the greatest changes due to<br />
COVID-19 has been around visiting, with<br />
only a very small number of patients able to<br />
have any visitors at all. Telephone calls and<br />
video calls have provided a link to family at<br />
home, and allow updates and discussions.<br />
Unfortunately the visiting restrictions have<br />
meant that patients have died in our care<br />
without their loved ones being with them,<br />
for example when relatives were themselves<br />
at risk, shielding, or living with elderly<br />
relatives and therefore unable to safely visit<br />
the hospital. This is such a difficult thing for<br />
staff as it is so alien to us as a society, yet<br />
was the reality for patients whose relatives<br />
were unable to visit or had to stay away<br />
after balancing the risks to them and their<br />
loved ones if they contracted COVID-19<br />
whilst visiting.<br />
As we re-form our teams, as life returns to<br />
the new normal, we need to recognise that<br />
everyone will have their own experiences<br />
from the past three months, from work and<br />
home. Now that the clapping has stopped,<br />
and the dust begins to settle from the past<br />
months, it is important that we support<br />
each other as we work to get back to a<br />
more normal existence and run our services<br />
post COVID-19. We need a continued<br />
focus on, and investment in health and<br />
wellbeing services to support staff. Some<br />
of us will experience mental health issues<br />
as a consequence to our experiences over<br />
the past months; we have seen great<br />
support for trainee doctors through Mike<br />
Blaber and the Three Squares Club and I<br />
encourage colleagues to seek the support<br />
that’s available for all staff via the health and<br />
wellbeing pages on Connect.
Sheer sense of comradery brings<br />
Rowley together<br />
COVID-19<br />
Working patterns of colleagues at Rowley changed in order to manage the pandemic<br />
Gearing up to deal with a once-in-alifetime<br />
pandemic, Justine Irish, Matron<br />
for Primary Care, Communities and<br />
Therapy gives us an insight into how<br />
her team at Rowley responded to<br />
the rapidly evolving need to change<br />
working practices to maintain services<br />
while keeping patients safe.<br />
She told us: “The first task was preparing<br />
the team for what was to come. For<br />
example, it sounds simple on paper<br />
designating hot wards for positive patients<br />
and cold wards for those not suspected<br />
of having the virus. We quickly realised<br />
the reality of some patients on blue wards<br />
exhibiting no symptoms but on testing<br />
coming back positive. When you prepare<br />
colleagues for working in a low-risk area,<br />
they cannot guarantee it will remain that<br />
way so it has been difficult. The Rowley<br />
team is really special; they are a resilient<br />
group who work as a family. The overall<br />
mood at Rowley has always been one of we<br />
are in it together so let’s get on with it.”<br />
When the pandemic hit, the model of beds<br />
on Rowley wards changed, to create a<br />
The ward services team have made a huge<br />
impact<br />
mixed model of medically fit and intermediate<br />
care beds all together. Colleagues stepped<br />
up to cover other areas, away from where<br />
they were most familiar with. However, with<br />
lockdown, this inevitably changed, as most<br />
services out of Rowley were relocated or<br />
changed as opposed to stopped.<br />
Justine continued: “For me, my working<br />
week has changed. This is also true of<br />
many members of our directorate who<br />
have changed their working patterns too.<br />
Alongside my colleague Natalie Whitton,<br />
we have been cross covering all of our<br />
community wards and providing a seven-day<br />
matron cover between the two of us. We<br />
also introduced an out-of-hours matron – Pal<br />
Grewal - who has been providing support<br />
during twilight shifts, which has also had a<br />
positive impact.<br />
“Over the last three months, what has stood<br />
out for me has been the sheer sense of<br />
comradery across some 200 plus colleagues,<br />
seeing them assist each other with face<br />
masks, bring in food for each other, shop for<br />
each other and generally care more for each<br />
other.<br />
COVID-19 has brought the teams closer together<br />
"If I had to call out one team, it would<br />
be our domestic colleagues, as although<br />
we have a smaller team at Rowley they<br />
make a huge impact. They have turned<br />
wards around that have been closed for<br />
years, and have deep cleaned to within<br />
an inch of their lives. They come in<br />
early and go home late, and clean every<br />
touchpoint so meticulously and I am sure<br />
they are a huge part of the reason why<br />
we have kept Rowley a blue site.<br />
“Of course our patients have been<br />
wonderful too, as no one has questioned<br />
or disagreed with how things have had<br />
to be. Our colleagues have all played<br />
a role in this by keeping patients up<br />
to date with ever-changing news. We<br />
initiated a daily call home to next of<br />
kin (with consent) and enabled those<br />
patients who were able and wanted<br />
to, to Facetime or call loved ones, to<br />
maintain essential family contact. This<br />
has been so well received; we are keen<br />
to maintain it into the future as our<br />
patients look forward to that contact.<br />
“In the future, I think many changes<br />
will become the norm for us at Rowley,<br />
as technology has opened up a whole<br />
new world of possibilities. I have spoken<br />
to more people and met more people<br />
during online meetings than I would<br />
have done before the pandemic, and<br />
that in turn has developed some pretty<br />
good pathways around discharge and<br />
our length of stay."<br />
Annie Williams, Practice Education Nurse<br />
iBeds, said: “The team have become<br />
much closer across all departments<br />
during COVID-19. It feels as though<br />
we all know each other on a different<br />
level – kindness has been at the heart of<br />
the Trust’s pandemic response and that<br />
message is evident in how staff interact<br />
with each other – greeting each other<br />
and asking “how are you today?” and<br />
having true meaning behind it.”<br />
Lady Ann Ordona, Senior Sister on<br />
McCarthy Ward added: “The pandemic<br />
has changed not only my way of<br />
working but also my personal life. We<br />
want to give the best nursing care to<br />
our patients and facilitate their safe<br />
discharge, but not knowing if any of my<br />
patients have COVID-19 is a stress. One<br />
thing I’m sure of and it’s not only here in<br />
Rowley Regis, we’ve seen how the NHS<br />
has come together and that makes me<br />
proud to be a part of what they call the<br />
frontline.”<br />
11
Community frontline continue to<br />
deliver high standards of care<br />
COVID-19<br />
During the COVID-19 pandemic, many of<br />
us have found ourselves working in a way<br />
that takes us completely out of our comfort<br />
zone. An example of this is none other<br />
than within our community midwives and<br />
district nurses who working in difficult<br />
circumstances to deliver a high standard of<br />
care for our patients.<br />
We caught up with Nicola Tomkins,<br />
Community Midwifery Manager and Frances<br />
Edwards, Student District Nurse to get their<br />
perspective from the community frontline.<br />
Nicola Tomkins, Community<br />
Midwife Manager<br />
How has COVID-19 affected the way<br />
you work as a midwife within the<br />
community?<br />
The pandemic has meant that<br />
antenatal and postnatal care has had<br />
to be greatly modified to suit national<br />
recommendations for social distancing.<br />
What this meant for our women in<br />
Sandwell and West Birmingham is that<br />
instead of midwives providing care at<br />
their GP clinic, or in homes they were<br />
being asked to attend alternative venues<br />
such as the local football stadiums.<br />
We have been able to provide women with<br />
increased telephone support which has been<br />
incredibly successful. We have also continued<br />
to conduct home visits for the most vulnerable<br />
families by wearing the correct PPE (which has<br />
been a learning curve, especially when trying<br />
to put it on outside on a windy day).<br />
How do you allay the fears of women<br />
and the fears of your colleagues?<br />
It is true to say that there are anxieties<br />
surrounding COVID-19. Pregnancy in general<br />
for some women can be an anxious time, and<br />
the fear of leaving the house has propelled<br />
anxiety levels for many women. However, a<br />
robust telephone triaging system has meant<br />
we have been able to stay in close contact<br />
with our families to allay their concerns.<br />
How do you feel about working within<br />
the community and does the threat of<br />
COVID-19 worry you?<br />
Yes, it does along with my colleagues too.<br />
We have held ‘practice sessions’ for donning<br />
and doffing, we have a robust telephone<br />
triage system which identifies women who are<br />
unable to leave the home, are symptomatic,<br />
are isolating or awaiting swabs for example.<br />
How has your typical day changed since<br />
the pandemic?<br />
It has changed greatly. We have had to<br />
completely change our way of working and,<br />
to be honest in many aspects of our job it<br />
has forced us into a better way of working.<br />
It has identified areas of work that we hope<br />
to continue using, such as virtual/telephone<br />
consultations and postnatal clinics.<br />
Is there a fear about coming into a<br />
healthcare setting for appointments?<br />
Absolutely yes at first, many patients<br />
thought it was safer for us to see them<br />
at home. However, attending a minimally<br />
staffed clinical environment that is not<br />
linked to the main hospital, practising social<br />
distancing measures, with better access to<br />
PPE and handwashing facilities, have all<br />
proved to be much safer. Also, our clinics<br />
at West Bromwich Albion and Aston Villa<br />
Football clubs have been more successful<br />
than ever due to the space and ability to<br />
socially distance.<br />
Frances Edwards – Student<br />
District Nurse (DN) within the<br />
care home team<br />
How has COVID-19 affected how you<br />
work as a DN?<br />
It has meant a huge change in the way<br />
we work in the community. We have<br />
always strived for holistic care in what<br />
can be challenging environments. We<br />
are autonomous practitioners that<br />
manage complex case management<br />
and prevent hospital admissions. This<br />
has remained the same throughout the<br />
pandemic. What has changed is the way<br />
in which we work. We are utilising technology<br />
for meetings to enable social distancing,<br />
alternative bases are being used and the new<br />
DN care home team has been developed. We<br />
aim to be a more integrated and streamlined<br />
service for the benefit of our patients.<br />
Like all staff across the Trust, we have battled<br />
with anxiety about the pandemic. We have<br />
appreciated the regular emails from our<br />
directorate, raising mental health awareness<br />
and signposting all the resources the Trust has<br />
available. In this time of uncertainty, it is ok<br />
not to be ok. Open discussion and dialogue<br />
have been of great benefit to help us to<br />
manage anxiety.<br />
Do you find that patients are very<br />
conscious and worried about the ongoing<br />
situation?<br />
Our patients are understandably worried<br />
about the ongoing situation, their daily<br />
lives and access to healthcare services.<br />
Unfortunately, we have many patients who<br />
are unable to see anyone at all and we try to<br />
be a comfort to them. Building relationships<br />
and rapport with patients is a very important<br />
part of our work. We offer reassurance and<br />
understanding - this has never been needed<br />
more in care homes, for both our patients<br />
and the staff that work within them.<br />
How are patients reacting to you<br />
wearing your PPE?<br />
The majority of our patients are relieved to<br />
see us wearing our PPE. We have had issues<br />
with some dementia patients being scared<br />
of us. With vision changes that occur with<br />
dementia, it is understandable. We have<br />
tried various reassurance techniques and,<br />
the Trust has issued us all with wipeable<br />
badges which features a large photograph<br />
of the person in PPE and their job title. This<br />
has helped our patients ‘see’ us.<br />
How do you feel about working within<br />
the community?<br />
It is a privilege to work in our patients’<br />
homes. It is a worry to think we could be<br />
transmitting the virus; however, we are<br />
strictly following PPE and handwashing<br />
guidelines. We are protecting our patients<br />
as much as we possibly can, plus we have<br />
all had swabs and antibody tests.<br />
12
Three Squares Club for wellbeing<br />
and peer support<br />
Working long days during this pandemic<br />
has become something of the norm<br />
for many colleagues. That’s why our<br />
organisation has found lots of new and<br />
innovative ways to ensure wellbeing<br />
is at the top of our agenda. As well<br />
as this, across the Trust teams are<br />
developing ways to relax, recharge and<br />
reflect.<br />
One such area that has embraced staff<br />
wellbeing on the frontline is among our<br />
junior doctors, reflected in an initiative<br />
called the ‘Three Squares Club.’ It<br />
encourages regular opportunities for<br />
refreshment, peer support and informal<br />
debriefing. We caught up with Dr Vikranth<br />
Venugopalan, Consultant Neonatologist,<br />
who explained the part he has played as<br />
one of the facilitators in this initiative.<br />
He said: “We recognise the stresses and<br />
strains COVID-19 places on us as medical<br />
staff. That’s why it’s important to ensure<br />
our wellbeing is something we take care<br />
of both individually and collectively as a<br />
team. Three times a week at both City and<br />
A meeting of the Three Squares Club<br />
Nursery provides essential support to<br />
key workers during pandemic<br />
As people across the UK have been<br />
trying to hold onto a sense of normality<br />
since lockdown began in March,<br />
one place that has provided a sense<br />
of familiarity throughout has been<br />
Sandwell’s children’s nursery.<br />
Sandwell nursery, like all other services, has<br />
had to adapt how they operate and quickly<br />
too. In Sandwell there are over 100 nurseries,<br />
however, only 28 have remained open during<br />
the pandemic. With up to 39 children of<br />
NHS and key workers attending daily, the<br />
team have thrived on the challenge. They<br />
have continued to offer this essential service<br />
meaning many colleagues and community<br />
workers can continue to work where they are<br />
needed the most.<br />
Emma Collier, Sandwell Day Nursery Manager,<br />
told us: “I am so proud of the team and how<br />
they have come together during COVID-19.<br />
They have worked extremely hard and,<br />
we have taken on 30 additional children<br />
in emergency places. This includes several<br />
school-age children and children with no<br />
nursery experience who are normally looked<br />
after by relatives. Despite all of this, the<br />
nursery has opened as normal from 7.15 am<br />
– 6 pm, Monday to Friday as well as opening<br />
over three bank holidays.<br />
Sandwell hospitals, we facilitated sessions for<br />
junior doctors where we talked openly about<br />
different subjects, such as the emotional<br />
impact of shifts. As the pressures of the<br />
pandemic have changed, the frequency of<br />
sessions has been reduced to once a week.<br />
We now meet on Wellbeing Wednesdays.”<br />
He added: “In these sessions, I emphasise<br />
the importance of wellbeing both inside and<br />
outside of work. It comes in many forms and<br />
is not limited to sessions like the ones I hold.<br />
I talk about healthy eating, getting adequate<br />
rest, and I signpost colleagues to resources<br />
available via the Trust. This includes things<br />
such as the free yoga classes we can take<br />
advantage of.”<br />
Dr Michael Blaber, Specialty Doctor in<br />
The nursery team<br />
“Six of the emergency place parents have asked<br />
for permanent places with us and many of the<br />
parents say their children ask to come to their<br />
new nursery. The feedback we have received<br />
from parents about the care provided and the<br />
support the hospital has given to our staff has<br />
been lovely and appreciated by everyone”.<br />
Opening during a pandemic has not been<br />
without its challenges. Emma told us: “The team<br />
have had to ensure that children have remained<br />
socially distant while in our care, as well as deep<br />
cleaning the nursery throughout and being<br />
COVID-19<br />
Palliative Medicine, is taking the lead<br />
in championing wellbeing among<br />
junior doctors. He has appreciated the<br />
response from a wide team of colleagues<br />
contributing to the wellbeing of others<br />
through initiatives such as the ‘Three<br />
Squares Club.’ He remarked: “The<br />
pandemic has been a difficult time to<br />
work through, but it has also led to<br />
an enhanced sense of togetherness.<br />
We’ve had more experienced clinicians<br />
support junior doctors in engaging with<br />
the ordinary human needs that we all<br />
share in common, particularly at times of<br />
heightened pressure.<br />
“I would like to say a big thank you<br />
to all who have made such a valuable<br />
contribution to the peer support<br />
sessions. It is a joy to work with so<br />
many colleagues right across the Trust<br />
committed to making SWB an excellent<br />
place to work for all staff groups.”<br />
vigilant with the children and their hand<br />
hygiene. The team have stepped up and<br />
ensured that the children in their care can<br />
attend nursery every day without noticing<br />
any considerable differences aside from a<br />
few new faces.”<br />
The nursery has made a conscious effort to<br />
keep in touch with children who haven’t<br />
been able to attend nursery. The team<br />
have a Facebook group and app that<br />
they actively use to share information.<br />
Emma explained: “We have been posting<br />
activities for children to do at home, we<br />
have offered to post out worksheets, done<br />
dance videos and posted online messages<br />
to the children at home. We wanted to<br />
let them all know we are still here and<br />
missing them all.”<br />
The team are looking forward to<br />
welcoming children back. In preparation<br />
for this, they have painted the nursery<br />
throughout and decorated the outdoors<br />
too. Emma remarked: “It has been<br />
a testing time for everyone, but the<br />
team have made working through<br />
this pandemic a positive experience. I<br />
am thankful to work alongside such a<br />
dedicated team of people.”<br />
13
Sepsis is still our number<br />
one quality priority<br />
COVID-19<br />
Dr David Carruthers, Medical Director<br />
The impact of COVID-19 has been<br />
unprecedented as teams have had<br />
to constantly adapt to the everchanging<br />
environment. While<br />
responding to the pandemic, clinical<br />
teams have also been ensuring we<br />
continue to reduce the number of<br />
avoidable deaths which includes<br />
keeping on top of our number one<br />
quality priority – sepsis.<br />
Medical Director, Dr David Carruthers<br />
has been the driving force behind<br />
implementing our quality plan and,<br />
he spoke to <strong>Heartbeat</strong> about how our<br />
organisation has been identifying and treating<br />
sepsis during the pandemic.<br />
He said: “Screening has remained stable<br />
during the pandemic, so well done to<br />
the teams for that with so many changes<br />
occurring.<br />
“Sepsis screenings are being done for 90 – 95<br />
per cent of patients who require the screening<br />
to be undertaken. On average, there are<br />
about 700 patients who need screening<br />
each week of which one out of six are screen<br />
positive and require review for confirmation<br />
of sepsis and institution of the sepsis 6.<br />
Current data shows that 80 per cent of those<br />
who screen positive subsequently receive<br />
antibiotics. However, only 50 per cent get the<br />
antibiotic within an hour, so we are working<br />
with teams to ensure this improves.”<br />
David explained that our target is 100 per<br />
cent screening compliance which is being<br />
achieved in some areas but not all.<br />
“Colleagues need to recognise when a patient<br />
is deteriorating using a NEWS2 score of five or<br />
greater to undertake sepsis screening, but be<br />
alert prior to this stage of patients becoming<br />
increasingly unwell for early intervention.<br />
“Team working between medical and<br />
nursing staff is key here to get clinical reviews<br />
undertaken when indicated. We are looking<br />
Sandwell and<br />
West Birmingham<br />
Sepsis<br />
is our number<br />
one quality<br />
priority<br />
NHS Trust<br />
to spread the best practice of those wards<br />
that achieve near 100 per cent compliance<br />
with wards that need improvement.<br />
This would be for checks but also timely<br />
treatment compliance.<br />
“We are continuing to work with those<br />
clinical areas that are not consistently at 100<br />
per cent for screening and are asking each<br />
ward area to identify where changes will<br />
allow all components of the sepsis 6 to be<br />
undertaken within an hour, especially the<br />
administration of antibiotics. We know this<br />
is one of the key components of improving<br />
patient outcomes from sepsis.<br />
“The overriding message to all colleagues<br />
is to take the time to follow the screening<br />
protocol. Caring for patients is key, but the<br />
only way we can ensure that all patients are<br />
being appropriately screened is by following<br />
the protocol to save lives.”<br />
Colleagues who are unsure of the sepsis<br />
screening processes are encouraged to<br />
speak to their ward matrons or contact<br />
the deteriorating patients and resus<br />
team on ext.5908.<br />
14<br />
COVID-19 BAME deaths analysis<br />
The COVID-19 pandemic has required<br />
a rapid change in pathways for our<br />
patients. At the start of the pandemic<br />
we set out to treat our patients with<br />
the same care and kindness that<br />
we pride ourselves on delivering,<br />
and that has not changed. Our<br />
approach to providing best practice<br />
and reviewing mortality of cases is<br />
discussed at our public board meeting<br />
every month and we have been open<br />
about our data and have shared it, in<br />
the hope of sharing learning.<br />
The main questions we consider are:<br />
• How our care pathways have<br />
compared to best practice?<br />
• How our outcomes compare to<br />
neighbouring providers and why?<br />
• How well all populations served<br />
by the Trust have been treated with<br />
COVID-19 to date, and anything<br />
we need to change in the coming<br />
months?<br />
Our Learning from Deaths team has<br />
undertaken, alongside medical examiners<br />
and clinical colleagues, a review of the<br />
higher number of deaths than normal due<br />
to COVID-19 deaths. Dr David Carruthers,<br />
Medical Director, explained: “We consider<br />
every patient lost to COVID-19 a tragedy.<br />
Since the pandemic took hold in the middle of<br />
March, we have identified through our data<br />
that age, gender, hypertension and diabetes<br />
are a risk factor in the outcome, with 67<br />
per cent of patients who died of COVID-19<br />
suffering hypertension whilst 44 per cent had<br />
diabetes. This is in line with national data<br />
which confirmed that patients with both Type<br />
1 and Type 2 diabetes had significantly more<br />
risk of mortality compared to the general<br />
population. Other contributory factors include<br />
poor diabetes control and obesity.<br />
“Early on, we saw a trend of more people<br />
dying from the black community, however,<br />
this has changed over time, indicating that this<br />
could relate to a geographical cluster rather<br />
than an ethnicity-related concern. As our<br />
figures for May show, we are not seeing<br />
the same disproportionate death rate in<br />
BAME communities. The median age of our<br />
patients who have died of COVID-19 is 80<br />
years old, with 96.2 per cent having complex<br />
medical histories, and 61.8 per cent were<br />
male.<br />
“Overall across the Trust throughout March,<br />
April and May, the combined mortality data<br />
reveals the following breakdown:<br />
• Asian 21 per cent<br />
• Black British 16 per cent<br />
• White 55 per cent<br />
• Other 8 per cent.”<br />
“Looking forward, as our ward base changes<br />
to requiring a smaller number of wards for<br />
COVID + patients, our understanding and<br />
examination of hospital-acquired infection<br />
will become all the more important to reduce<br />
risk to non-COVID patients.”<br />
“I am always doing that which I cannot do, in order that I may learn how to do it.”<br />
Pablo Picasso
???<br />
Using Unity in the battle<br />
against COVID-19<br />
CORPORATE AND GENERAL<br />
NEWS<br />
When hundreds of patients are<br />
admitted with a potentially deadly and<br />
highly contagious virus and you need<br />
to be able to manage their treatment,<br />
Unity our Electronic Patient Record, has<br />
provided valuable functionality.<br />
From managing patient records, to tracking<br />
the status of beds and ordering tests, Unity<br />
really did become an essential tool in the<br />
fight against COVID-19 when the pandemic<br />
reached the doors of our hospitals.<br />
To find out more about how Unity helped<br />
the Trust, <strong>Heartbeat</strong> caught up with Chief<br />
Clinical Information Officer and Consultant<br />
Ophthalmologist, Ash Sharma. He said,<br />
“When you need to treat patients who<br />
are acutely unwell or suffering from a<br />
novel virus, you need as much information<br />
as you can possibly get to make the<br />
right decision in the treatment plan. You<br />
need to be able to easily order tests and<br />
manage their results centrally, so that at a<br />
moment’s notice and at a glance you can<br />
see how your patients are progressing.<br />
This information then needs to be<br />
communicated to all carers in the patient’s<br />
journey. This is where Unity has really made<br />
its mark.<br />
“Previously, we used a range of systems for<br />
ordering tests, managing bed allocations<br />
and care records, so that every time<br />
something changed for a patient, you<br />
would have to login to another system<br />
or record it on a paper document. This<br />
fragments the information and significantly<br />
slows down a department. Before long,<br />
people become complacent, processes<br />
aren’t followed and vital information or<br />
tasks get omitted.<br />
“With Unity, we fed all of our data into<br />
one system so colleagues in capacity could<br />
manage the flow of patients, ensuring<br />
that we kept a separation of patients who<br />
were COVID-19 symptomatic and those<br />
that weren’t. We were also able to track<br />
the results of patients so that we could<br />
quickly act on results limiting exposure of<br />
the virus to others and ensuring patients<br />
got the right treatment at the right time.<br />
The ‘banner bar’ at the top of every record<br />
was utilised to highlight those patients<br />
confirmed or suspected to have COVID-19.<br />
“From an operational perspective,<br />
Unity allowed us to very quickly change<br />
our pathways and processes, to adopt<br />
COVID-19 positive and negative channels<br />
through our services as well as our<br />
buildings; this is a change that was<br />
unprecedented and had it not been for<br />
the flexibility of Unity, it would have<br />
been extremely difficult to implement<br />
elsewhere.“<br />
Regardless of the host of functions offered<br />
by Unity, the most important thing is that<br />
Acknowledging and endorsing results<br />
all of our staff have embraced using the<br />
system very well and continue to use it to its<br />
fullest potential. Members of staff continue<br />
to ask for additional functionality to help<br />
with COVID-19 flagging, research and new<br />
treatment plans. This should be encouraged<br />
as regular users provide the best insight into<br />
the improvements that can be made to help<br />
with patient care.<br />
Unity makes requesting diagnostic tests incredibly easy but tests are<br />
worthless unless they’re acted upon. Acknowledging and endorsing<br />
results takes seconds but it’s the only way to record that results from<br />
imaging or pathology have been seen and acted on.<br />
There are several ways to endorse results in Unity, please take the time<br />
to familiarise yourself.<br />
• PowerChart – For the requesting clinician, their results will appear<br />
in yellow in PowerChart ready to be endorsed. For other clinicians,<br />
they can view results which need endorsing by clicking the<br />
“Endorse Results” button in each patient’s PowerChart record.<br />
• Message Centre – A list of your unendorsed results in the results<br />
endorsement home screen. Results in ‘Bold’ denote unread results.<br />
Abnormal results are displayed in the abnormal section.<br />
DID YOU KNOW?<br />
Unity getting a code refresh<br />
When endorsing results on Message Centre clicking<br />
on the patient’s name to the left of the search bar will<br />
take you straight to their record. Please remember to<br />
also continue endorsing results as you review them<br />
(e.g. during ward rounds).<br />
In the very near future Unity will be going through one of its biggest<br />
updates since we took it on, but don’t worry, everything that is changing<br />
is under the hood, none of the processes or practices you have learnt will<br />
be changing, the system itself at first glance will look almost completely<br />
the same. However, much of the underlying code that manages Unity will<br />
be updated to take advantage of improved processes delivering a much<br />
slicker, stable and most importantly safer experience for patients and staff.<br />
The upgrade will take place overnight and will be one of the few updates<br />
that require elements of Unity to be taken offline for a short period. This<br />
will mean a short period of business continuity for certain processes.<br />
Details of the affected systems and date of the upgrade will be shared<br />
through the communications bulletin.<br />
15
End of<br />
Life Care<br />
As a healthcare organisation it is up to us<br />
to provide the best degree of care we can<br />
throughout the lives of each and every<br />
resident of our area. That’s from even<br />
before their birth, right through to their<br />
death. The latter is, in itself a tricky matter.<br />
A good death<br />
The definition of what a “good death” is, unique<br />
to each individual and can only be achieved by<br />
communicating with patients and their carers to<br />
ascertain their wishes, providing the information and<br />
support necessary to make sure their choices are<br />
informed ones.<br />
On both a national level and within our organisation,<br />
evidence shows that people cared for by a specialist<br />
palliative care team have more positive experiences<br />
at the end of their lives with fewer unnecessary<br />
interventions and dying in a place of their choosing.<br />
Yet access to palliative care is variable depending on<br />
where you go, and evidence shows that it is significantly<br />
less likely for people with non-cancer diagnoses who<br />
are from BAME groups. It is therefore, imperative that<br />
access to specialist palliative care is improved and that<br />
for those within the palliative sphere and outside of it<br />
to identify patients that require help and ask them their<br />
wishes, offering compassion throughout.<br />
“I can make the last stage of my life as good<br />
as possible because everyone works together<br />
confidently, honestly and consistently to help<br />
me and the people who are important to me,<br />
including my carers”. – ‘A Good Death’ as defined by<br />
the National Palliative and End of Life Care Partnership<br />
As much as we try, we cannot avoid the<br />
prospect of death and in the end there<br />
is, regretfully, sometimes only so much<br />
which can be done.<br />
So how does a care organisation such as ours<br />
provide a “good death”, what is the thought<br />
process that covers end of life care?<br />
Dying matters<br />
The Trust’s backing of Dying Matters Week, the <strong>2020</strong><br />
edition of which was covered in depth in last month’s<br />
<strong>Heartbeat</strong> magazine, is one way professionals are<br />
trying to help change the narrative when it comes to<br />
death, dying and the questions it brings up. There are<br />
also misconceptions about supportive services that are<br />
helped to be addressed.<br />
This is sadly needed as public perception of end of life<br />
care planning influences the willingness of clinicians to<br />
engage in end of life discussions with fear of litigation.<br />
Avoidance of communication and advance planning<br />
frequently leads to rapid deterioration of patients during<br />
out of hour’s periods, both in hospital and at home<br />
only increasing a ‘rush’ on decisions due to a real or<br />
perceived lack of time, and results in a poor experience<br />
for all concerned.<br />
“It’s important to not be discouraged by the topic, no<br />
matter how hard or awkward it might be. Sometimes<br />
people see the name ‘palliative’ and shy away from<br />
what they think it represents,“ explains Palliative Care<br />
Consultant Dr. Anna Lock. “But it’s not necessarily<br />
about ‘imminent death’, more so about the quality of<br />
life and the dignity of life in whatever time lies ahead.<br />
That’s so important to us.”<br />
Live as if you were to die tomorrow. Learn as if you were to live forever.”<br />
Mahatma Gandhi<br />
Work to do<br />
The Trust recognises that, in spite of outperforming the<br />
national rate there remains work to do. There remains<br />
a significant difference between the experiences of<br />
patients at the end of life for those with involvement<br />
from the palliative care service compared to those<br />
without – and that goes across all recorded metrics<br />
including achieving preferred place of death.<br />
There is an inequity of experience. Certain groups are<br />
underrepresented in the current care caseload, in part<br />
due to a lack of data – 68 per cent of cases come from<br />
a white British background, but there are low numbers<br />
of people from LGBTQ groups and only one per cent of<br />
cases have learning or sensory disabilities.<br />
Reflecting and decompressing<br />
The mental wellbeing of colleagues continues to be a<br />
concern, as part of a good death is also making sure<br />
those caring for the patients are okay too. Colleagues<br />
have faced an unprecedented amount of death and<br />
illness over the recent months, it is only natural that this<br />
is a strain. Especially when balancing it against the wider<br />
world situation.<br />
To that end the Trust offers a range of support for<br />
health and wellbeing should you need it. Schemes<br />
such as The Recharge Booth, a ‘virtual’ space hosted<br />
by Richard Burnell every Thursday at 2pm that allows<br />
you to come together with others, reflect, recharge,<br />
decompress, and join a safe and confidential discussion.<br />
“I didn’t come into healthcare to be a hero. I<br />
came to try and make a difference and to help<br />
people.” One colleague said at one session. “I am<br />
uncomfortable with people making us heroes<br />
and glorifying what we do. I don’t understand<br />
why I don’t like it, part of me thinks it’s<br />
because I feel the public have stood back and<br />
ignored the issues the NHS faced across the<br />
last few years and suddenly claim to love it.”<br />
There’s also the COVID-19 Wellbeing Sanctuary based<br />
at The Learning Works. The Sanctuary is accessible to all<br />
colleagues and offers a range of health and wellbeing<br />
activities from deep relaxation techniques, music therapy,<br />
restorative clinical supervision and mindfulness awareness.<br />
A colleague at the Sanctuary told <strong>Heartbeat</strong>: “I<br />
have been off work with anxiety and the help<br />
I am getting here is really helping me to get<br />
my mind ready so I am able to return to work.<br />
The colleagues here are wonderful, I would<br />
definitely recommend it.”<br />
You can book a session at the Sanctuary by calling<br />
0121 507 5886. For more about the Recharge Booth<br />
please contact Richard Burnell on 07747 144874 or<br />
Claire Hubbard on 07866 004575.<br />
COVID-19<br />
As you might imagine, the ongoing pandemic which<br />
has greatly affected the elderly population has meant<br />
that numbers of patients admitted with COVID-19 had<br />
multiple comorbidities and poor outcomes. However,<br />
the demand on services and redistribution of resources<br />
to support the pandemic necessitated focused support<br />
from the palliative care team.<br />
To this end, a proactive ‘pull’ model to identify patients<br />
rather than wait for referrals enabled earlier specialist<br />
intervention and decision making. There was also<br />
frequent evidence of team-based decision making<br />
within and across teams to support these actions.<br />
Evolving Leasowes<br />
To support good end of life care, Leasowes Intermediate<br />
Care Centre has been transformed to provide a 20<br />
bedded specialist end of life care ward with single<br />
room, hospice style facilities and support from both the<br />
specialist palliative care team and GPs from Your Health<br />
Partnership.<br />
The result of this change has proven to be a positive<br />
one, based on what has been heard so far from both<br />
reviews and anecdotally. Promoting better relative/<br />
carer experiences which has in term resulted in better<br />
outcomes for patients and overall better end of life<br />
experiences. Deaths at Leasowes are reviewed and these<br />
learnings are pushed back into the way care is being<br />
given. Perhaps unsurprisingly, early results indicate<br />
speed of action and an awareness of a patient’s needs<br />
- both of which were enhanced by the changes – have<br />
been key to this improvement.<br />
“Of all the decisions made since early March the<br />
proudest one we have made, in my view, is our decision<br />
to create Leasowes as an end of life care centre able to<br />
look after, in single rooms, both COVID+ and blue steam<br />
people in a palliative state from heart failure, COPD or<br />
cancer,” Chief Executive Toby Lewis told colleagues in a<br />
recent bulletin. “This is our way to trying to make this<br />
tragedy just a little more humane for people we will<br />
lose. Please work with our palliative care hub to do your<br />
best to make sure we use that asset well. With death at<br />
distance, behind PPE, perhaps never has the notion of a<br />
good death been more obviously important.”
The Sanctuary: Reduce your anxiety<br />
and stress in a place of calm<br />
COVID-19<br />
In the last edition of <strong>Heartbeat</strong>, we<br />
featured an article on the Wellbeing<br />
Sanctuary, a place where colleagues<br />
can share their stories and offload<br />
about their anxieties and fears.<br />
A month on, we are delighted to<br />
report that many of you have been<br />
taking advantage of the many<br />
services on offer such as deep<br />
relaxation and massage therapy.<br />
<strong>Heartbeat</strong> caught up with Lawrence<br />
Kelly, Learning Works Co-ordinator who<br />
told us he is pleased to see colleagues<br />
taking time out for their wellbeing. “We<br />
have had 250 visits from colleagues<br />
enjoying more than 420 sessions. It is<br />
also pleasing to see colleagues returning<br />
as they have enjoyed the benefits and<br />
are seeing a real difference in the way<br />
they are feeling.”<br />
Lawrence said the sanctuary is seeing<br />
colleagues from a wide range of<br />
professions including senior clinicians<br />
and wards service officers. He told<br />
<strong>Heartbeat</strong>: “Colleagues are coming here,<br />
seeing the benefit and then spreading<br />
the word to their teams. We have also<br />
recently extended the service to 30<br />
nursing homes and local community GP<br />
services.”<br />
Kate Pilkington, Clinical Lead, Your<br />
Health Partnership has used the<br />
sanctuary. She remarked: “The sanctuary<br />
is an extraordinary refuge of support<br />
that I have found to be invaluable. It<br />
helps me to manage my stress levels<br />
and restore my sense of balance so that<br />
I can be a better leader during these<br />
challenging times. Actively choosing<br />
to engage with the amazing staff at<br />
the Sanctuary and taking the time to<br />
decompress is one of the best decisions<br />
I have made. I can see and feel the<br />
difference immediately after a visit. I<br />
would highly encourage all colleagues to<br />
further explore how it could benefit them<br />
as well.”<br />
The psychological wellbeing of all<br />
colleagues is of utmost importance and<br />
our organisation wants us all to benefit<br />
from the extended offer of wellbeing<br />
Looking after you...<br />
Sleep was not coming easy to Senior<br />
Sister, Danielle Scott, and the more she<br />
worried about it, the worse it got. Until<br />
one morning after a particularly bad night<br />
she knew she was unable to fulfil her<br />
responsibilities in A&E at City Hospital<br />
safely.<br />
So she called her manager ED matron<br />
Annabel Bottrill for support. Danielle<br />
explained: “The last few months of<br />
the pandemic have been particularly<br />
hard on us on the frontline and I think<br />
the constant vigilance and increased<br />
workload has taken its toll on many of<br />
us. I particularly felt it at night, after a<br />
The Wellbeing Sanctuary is based at the<br />
Learning Works, Unett Street, Smethwick<br />
B66 3SY. Daily sanctuary sessions include:<br />
• Deep Relaxation and Breathing<br />
through Soundscape - Travel from<br />
the peaks of the Himalayas to the<br />
depth of the oceans of Bali relaxing<br />
in a harmonious tranquillity.<br />
• Music Therapy - A time to find<br />
inner stillness through the<br />
tranquillity of relaxing sound<br />
vibrations.<br />
and kindness. The new Thrive mental<br />
health app is complementary to all the<br />
relaxation therapies on offer. It is a chance<br />
for colleagues to continue to use de-stress<br />
techniques to improve health and wellness.<br />
This includes cognitive behaviour therapy,<br />
deep muscle relaxation and meditation.<br />
long day, I would go home and then find<br />
myself unable to switch off. After being at<br />
the top of my game all day looking after<br />
my patients, working in a tight knit family<br />
with my colleagues and caring about the<br />
wellbeing of my team, I really needed to<br />
relax at home, to recharge for what the<br />
next day would bring. I could see it was<br />
not getting any easier, and when I spoke<br />
to Annabel she suggested I turn to the<br />
sanctuary for help.<br />
“To be honest, I couldn’t see how it would<br />
help, but I made an appointment and<br />
went along just to say that I had tried.<br />
What a revelation, I was so glad I went. I<br />
was greeted by a welcoming environment<br />
lit by pools of light from strategically<br />
placed lamps in the reception. There<br />
was ambient music playing low in the<br />
background, and I was made to feel very<br />
welcome. I went for relaxation and sleep<br />
techniques, and when I went through<br />
into the room for my session, I was<br />
offered a huge bean bag to sink down<br />
into. It was bliss. I really feel it has made<br />
a huge difference to me, and I’m looking<br />
forward to my second session. I’d urge<br />
anyone who is having trouble sleeping or<br />
switching off to take the opportunity to<br />
visit sooner rather than later, so you can<br />
get back on an even keel and get on with<br />
your life.”<br />
• Restorative Clinical Supervision<br />
(Health and Wellbeing Lead) - A<br />
safe and confidential space to<br />
explore the impact of work<br />
pressures.<br />
• Unwind with Mindfulness -<br />
Breath and Relax. Enjoy the session<br />
of being present and the power of<br />
connection and self-kindness.<br />
A colleague receives therapy massage<br />
To book an appointment contact the team<br />
on 0121 507 5886. More information can be<br />
found on Connect.<br />
18
Psychological wellbeing: Ensuring you<br />
get the right support at the right time<br />
Our organisation is enhancing its approach<br />
to staff wellbeing and in particular<br />
psychological wellbeing during COVID-19<br />
and beyond. We want to be able to support<br />
colleagues to cope with psychological<br />
deterioration that may occur following<br />
our experiences, seeing or hearing about<br />
situations that are stressful and challenging.<br />
Our approach is multi-faceted across three<br />
key areas:<br />
1. Stress Risk Assessment – These are<br />
completed via a simple confidential selfassessment,<br />
you can access this using the<br />
green button on Connect. These are<br />
aimed at areas considered to have higher<br />
levels of stress during <strong>June</strong> and July but<br />
anyone can take an assessment at any<br />
time and will be contacted with<br />
appropriate interventions and support<br />
from the wellbeing hub.<br />
2. Trained staff in psychological<br />
interventions – The Trust has developed<br />
an internal capability to support<br />
employees through psychological<br />
interventions. Colleagues can access<br />
training at three levels:<br />
a. Level 1 – everyone can do this training<br />
b. Level 2 – each area will have a<br />
nominated trained person (Mental<br />
Health First Aider)<br />
c. TRiM – there are 32 TRiM trained<br />
colleagues who are able to work with<br />
staff affected by post-traumatic stress.<br />
These levels of training enable signposting<br />
to relevant support, alongside encouraging<br />
individuals to take their own steps to<br />
support their wellbeing.<br />
3. The Wellbeing Hub and Thrive – The<br />
wellbeing hub currently runs the Wellbeing<br />
Sanctuary and will continue to provide<br />
relaxation classes and appointments to<br />
support mental wellbeing as well as physical<br />
wellbeing in the future. The new Thrive<br />
app is free to colleagues and has a CBT<br />
(cognitive behavioural therapy) module help<br />
you manage stress and anxiety levels.<br />
COVID-19<br />
These three areas will help us as a Trust<br />
to prevent the deterioration of mental<br />
health with good support networks and<br />
signposting to make sure that individuals<br />
get the right support at the right time.<br />
The Wellbeing Hub will be the central<br />
team who will coordinate this work and<br />
work directly with employees to ensure<br />
they have access to support to keep<br />
themselves well both physically and<br />
mentally.<br />
The Trust is using a psychological<br />
wellness scorecard to monitor how<br />
prepared we are, to understand that<br />
the interventions in place are making<br />
the right impact.<br />
Military training programme tackles<br />
issues around stress<br />
All of us may have been affected<br />
by COVID-19 in some way and it’s<br />
important to recognise that our<br />
mental health may be affected by the<br />
situations we’ve been part of, observed<br />
or heard about over the last few<br />
months.<br />
The Trust has already trained some people<br />
to support colleagues in React Plus which is<br />
also known as mental health first aid.<br />
However, we want to scale up that<br />
support in frontline departments, and are<br />
providing key staff with specific Trauma<br />
Risk Management (TRiM) training, to tackle<br />
issues like Post Traumatic Stress Disorder<br />
(PTSD) which are predicted to arise in<br />
coming weeks and months.<br />
Nora Parsons, Learning and Development<br />
Manager, said: “The Trust has partnered<br />
with an organisation called ‘March on<br />
Stress’ and are offering a tiered approach<br />
to training people to undertake mental<br />
wellbeing support roles. This includes all<br />
line managers being trained to have a brief<br />
‘psychologically savvy’ conversation with<br />
colleagues, for example at the end of a<br />
shift, to help identify if support is needed<br />
and signpost to it.<br />
“We are also encouraging all staff to access<br />
this training, whether or not they are line<br />
managers, so that they are able to support<br />
colleagues at the first level by recognising<br />
they may need help and referring them onto<br />
further interventions if needed.”<br />
The training is delivered remotely via video<br />
and supporting material which takes less<br />
than an hour to complete and can even be<br />
accessed via your phone.<br />
Toby Lewis, Chief Executive said: “We<br />
are focused on the current and future<br />
psychological wellbeing of our teams. We<br />
have a local comprehensive wellbeing offer in<br />
place, as well as making use of wider regional<br />
and national mental health support. Learning<br />
from Italy and elsewhere we have put in place<br />
dedicated COVID-19 arrangements to provide<br />
additional support for departments.<br />
“We worked with healthcare and military<br />
colleagues to consider what would be most<br />
appropriate. From that has come a partnership<br />
with March on Stress. Their help is focused on<br />
delivering more advanced training in Trauma<br />
Risk Management (TRiM) which is a traumafocused<br />
peer support system designed to help<br />
people who have experienced a traumatic,<br />
or potentially traumatic, event. This<br />
will be important as we come through<br />
the recovery and restoration phase to<br />
help people come to terms with their<br />
experiences.”<br />
Managing Director of March on Stress<br />
Ltd, Professor Neil Greenberg, explained:<br />
“We have been working with a number<br />
of NHS organisations to help them to<br />
ensure that they can implement a range<br />
of evidence based psychological support<br />
initiatives in order to help protect the<br />
mental health of their staff.<br />
“We are delighted to have been asked<br />
by the Trust to help them roll out<br />
training to their supervisors which will<br />
help them carry out psychologically<br />
savvy supportive conversations with their<br />
teams. There is a great deal of evidence<br />
showing that supervisors have a critical<br />
role to play in supporting their team’s<br />
mental health and the training we are<br />
providing to SWB aims to help improve<br />
supervisors confidence to have those<br />
important conversations.”<br />
See Connect for more information<br />
about the training.<br />
“Intellectual growth should commence at birth and cease only at death.”<br />
Albert Einstein<br />
19
New assessment to help reduce the<br />
impact of stress<br />
COVID-19<br />
Our workplace is launching a new<br />
way of completing stress risk<br />
assessments in addition to the<br />
retrospective assessments that<br />
happen when colleagues are feeling<br />
stressed and or have been off work<br />
with stress. This new assessment is<br />
able to be taken proactively at the<br />
same time of year each year to check<br />
the stress levels in departments and<br />
to drive interventions to reduce<br />
stress.<br />
The new assessment tool is available as<br />
an e-form that can be found by looking<br />
for the green button on the right<br />
hand side on the Connect homepage.<br />
The form takes a few minutes to<br />
complete and is sent confidentially to<br />
the wellbeing hub. The wellbeing hub<br />
will not forward information to your<br />
manager without your consent.<br />
The stress risk assessment is designed to<br />
identify employees who require additional<br />
support and to have supportive conversations<br />
through the wellbeing hub to decrease the<br />
impact of stress in those high risk areas.<br />
If you are in an area deemed to be have<br />
high levels of stress, you will have already<br />
received an email asking you to complete the<br />
assessment in <strong>June</strong> and July.<br />
COVID-19 risk assessment<br />
A risk assessment tool has been developed<br />
and finalised for colleagues. The tool<br />
assesses the risk level within the current<br />
service /work setting as well as individual<br />
risks including gender, ethnicity, age<br />
and underlying health condition. The<br />
outcomes of that assessment lead to clear<br />
actions to reduce the risk of COVID-19 for<br />
individuals. You should undertake this risk<br />
assessment via occupational health if you<br />
consider you are in a higher risk group.<br />
In addition to staff working in areas<br />
considered to be of high stress, any<br />
employee is able to access this assessment<br />
at any time and a member of the wellbeing<br />
hub. The wellbeing hub will advise and<br />
coach staff to the most appropriate action<br />
to take and signpost employees to the most<br />
relevant support for them.<br />
This can be organised by email on swbh.<br />
riskassessmentoh@nhs.net or via phone<br />
on 0121 507 3306.<br />
The Trust is determined to build on our<br />
successful work to prioritise workplace<br />
safety. That is all protections stay in place<br />
but PPE is now truly personal.<br />
We had undertaken over 130 assessments<br />
by 12 <strong>June</strong> and continue to complete<br />
assessments as they are requested by<br />
colleagues.<br />
Whether you’re 9, 19 or 91, the new<br />
HEE COVID-19 library is for you<br />
To battle the COVID-19; pandemic<br />
knowledge is our most valuable<br />
tool, the more we know about it,<br />
the more medical colleagues around<br />
the globe will be able to hunt<br />
down the clues that will enable<br />
the virus to be combatted and,<br />
hopefully, eventually eradicated. But<br />
knowledge in our hands is only part<br />
of the solution – there also needs<br />
to be an understanding in patients<br />
and the public as to the nature of<br />
the disease. Why what is being done<br />
(in terms of social distancing) needs<br />
to be done, and of course, the risks<br />
involved to all, in particular, those<br />
from vulnerable groups.<br />
For patients and the general public, a<br />
lot of information about COVID-19 can<br />
be found on both the NHS website and<br />
GOV.UK. As well as updates relating<br />
to services, our organisation provides<br />
information on our website and social<br />
media channels about the pandemic.<br />
There are several resources on the Health<br />
Education England (HEE) website too.<br />
HEE has produced a library of highquality<br />
COVID-19 patient information<br />
specifically for vulnerable groups. These<br />
The latest Nurse Dotty book sees Dave the Dog<br />
worried about coronavirus<br />
resources are available in many different<br />
formats appropriate to those groups and<br />
are designed to be as accessible as possible.<br />
With easy read options, support for sign<br />
language, Makaton, a picture library for<br />
those that struggle to communicate, videos,<br />
and podcasts. There is a grouping specifically<br />
for the risks older people face, with links to<br />
guides and support from charities, such as<br />
Age UK and Carers UK, as well as specialist<br />
items produced by the likes of BBC Sounds.<br />
For children and young people all the<br />
changes that have been going on in the<br />
world around them must be very confusing<br />
– how do you explain a pandemic to<br />
the very young? To help them better<br />
understand the virus, they too have a<br />
section which even includes pdf files of<br />
illustrated children’s stories that tackles the<br />
topic head-on.<br />
“It is very easy to misunderstand the needs<br />
to the lockdown and the consequences<br />
of COVID-19,” an HEE representative told<br />
<strong>Heartbeat</strong>. "As a result, HEE’s library and<br />
knowledge services team has worked to<br />
develop this new web portal. It collates<br />
information about COVID-19, as well as<br />
valuable insights from external companies,<br />
charities and agencies that can be a benefit<br />
to both patients and the public. This library<br />
enables frontline health and care staff<br />
who directly work with patients, clients,<br />
and families to find, share and use reliable<br />
COVID-19 information.”<br />
The library is being updated as more<br />
sources become available and those<br />
who are interested should head to<br />
https://library.nhs.uk/coronavirusresources/<br />
to find out more.<br />
20
Celebrating our<br />
stars of the week<br />
Star of the Week<br />
Ribena Akhter<br />
Paediatric Consultant<br />
Star of the Week<br />
Miriam Pappworth<br />
Community Midwife<br />
Star of the Week<br />
Beata Wojtas<br />
Sister<br />
Ribena is known for always going above<br />
and beyond and more importantly<br />
supporting her colleagues. This was evident<br />
when Ribena was one of the recent on call<br />
consultants when the Trust had to create<br />
new donning and doffing areas in our<br />
blue and red COVID-19 areas. She played<br />
a pivotal role ensuring many of our wards<br />
could adapt to these changes out of hours.<br />
Star of the Week<br />
Joanne Tonks<br />
Osteoporosis Nurse<br />
Miriam has recently shown great<br />
professionalism, empathy and care helping<br />
a patient who was a victim of domestic<br />
abuse. As a result, this case has now<br />
been flagged by the police and relevant<br />
authorities ensuring the safety and<br />
wellbeing of the patient.<br />
Miriam's tenacity, dedication and<br />
professionalism has made an important<br />
and significant difference to the care that<br />
this pregnant lady will receive. This has<br />
undoubtedly improved the outcome for<br />
her and her unborn child. Miriam has gone<br />
above and beyond to support a vulnerable<br />
person who was at significant risk.<br />
In the absence of Leasowes ward manager,<br />
Beata has been amazing by taking on the<br />
role of manager and has thrived in this<br />
position. Ever since Leasowes changed from<br />
rehabilitation to a palliative care centre for<br />
patients with COVID-19, colleagues have<br />
experienced a great deal of challenges<br />
in adjusting. Beata has provided a lot of<br />
support and reassurance and positive<br />
thinking to get Leasowes through with the<br />
changes and running of the centre on a day<br />
to day basis. On numerous occasions, Beata<br />
has made sacrifices and come in on her days<br />
off, as well as her recent birthday, she even<br />
missed her anniversary to ensure the centre<br />
was covered to maintain patient safety.<br />
Joanne was nominated by numerous<br />
colleagues for the way she has coordinated<br />
the Trust’s COVID-19 community<br />
swabbing teams. Joanne has been praised<br />
for her support to all colleagues who have<br />
been deployed into the swabbing response,<br />
ensuring that they are suitably trained and<br />
kept up to date with the latest guidance.<br />
She has always been available for help and<br />
has made sure that we continue to provide<br />
an excellent swabbing service for colleagues<br />
who have symptoms, their family members<br />
and care home colleagues.<br />
Star of the Week<br />
Dr Rebecca Edwards<br />
Core Medical Trainee, Rebecca Edwards<br />
has been working on the frontline of<br />
COVID-19 and has been a shining light<br />
in supporting dying patients as well as<br />
supporting families. Nominating Rebecca<br />
for the award, Consultant, Huma Naqvi<br />
said, “Rebecca has always been a caring<br />
and compassionate doctor, but in recent<br />
times and especially managing a cohort<br />
of patients who have been seriously<br />
unwell and dying with COVID, she has<br />
taken the time and has been particularly<br />
compassionate and caring in her approach.<br />
She took the extra effort with these<br />
patients and their families, ensuring they<br />
understood the nature of this illness and<br />
also taking special efforts with one family<br />
to have a final conversation with their<br />
mother. It made all the difference and went<br />
that extra mile. Bec is one of a kind, she<br />
epitomises the essence of how any health<br />
care professional should care for patients.<br />
That should be recognised and hopefully<br />
serve as an example to her peers (be that<br />
junior or senior doctors). We all have a lot<br />
to learn from doctors like herself.”<br />
If you have someone in your team that has gone above and beyond the call of duty, put them<br />
forward as a Star of the Week. Visit Connect to find out more.<br />
21
CORPORATE AND GENERAL<br />
NEWS<br />
Shout out has been a regular feature<br />
in <strong>Heartbeat</strong> and it is fantastic to see<br />
colleagues regularly taking the time<br />
to give positive feedback to each<br />
other.<br />
We regularly receive positive feedback<br />
from our patients too, and this month<br />
we wanted to share some of those<br />
heart-warming messages which have<br />
been sent via our website and social<br />
media platforms.<br />
To – Childrens Community Nursing and<br />
Therapy Teams<br />
The children's ccn and continuing care<br />
teams have continued to provide essential<br />
care to our children within the community.<br />
The children's therapy team have embraced<br />
new ways of working to ensure ongoing<br />
support for our children in the community.<br />
From – Cheryl Newton<br />
To – Sophie Hodgson<br />
Sophie is a newly appointed midwifery<br />
support worker, she is in her first few<br />
months of working with the midwives<br />
at this difficult time. She very kindly<br />
contacted her previous employer at Ikea<br />
who generously donated eight changing<br />
tables and mats for our postnatal clinics.<br />
Thank you Sophie!<br />
From – Nicola Tomkins<br />
To – D30<br />
To all staff on D30 for making my<br />
redeployment onto your ward so<br />
rewarding. Thanks for being so kind and<br />
caring to a very unsure HCA - it means a<br />
lot.<br />
From – Maggie Moore<br />
To – Amy Hunt<br />
Amy is currently working as part of the<br />
safety compliance team, over the past<br />
few weeks she has played a vital role<br />
in supporting Lyndon 2 with our safety<br />
plan compliance and our percentage<br />
has improved massively. Thank you from<br />
everyone at Lyndon 2 for your hard work<br />
and support!<br />
From – Rachael Currie<br />
To – Linda Parkes<br />
For supporting and helping me during<br />
my redeployment. I was very nervous and<br />
anxious at the beginning, but with your<br />
quick actions I am now being supported<br />
into a specialist team. They have welcomed<br />
me into my new role, supporting me with<br />
every aspect of my training.<br />
From – Gurjit Kaur<br />
To – Staff on AMUA and Lyndon 5<br />
A massive thank you to all the staff on<br />
AMUA and Lyndon 5, my dad was an<br />
impatient due to this nasty virus a couple<br />
of weeks ago and I cannot thank you all<br />
enough for the care he received. He cannot<br />
praise you all enough, your hard work and<br />
dedication to your jobs is outstanding.<br />
Thank you so much for everything you did<br />
and continue to do for so many patients it<br />
doesn't go unnoticed.<br />
From – Kerry Ruston<br />
To – OPD HCAs<br />
A massive thank you to all the HCAs in<br />
BTC for embracing the new system to<br />
enable our patients to return for face to<br />
face appointments. They have set up the<br />
entrance/exit stations and worked really<br />
hard to ensure the process is robust.<br />
From – Trish Kehoe<br />
To – Keni Sulaj, Todd Morris, Jeevan Bahia<br />
and Imran Ravat - IT<br />
A massive thank you all for your recent<br />
support, we experienced some IT<br />
challenges within our team recently,<br />
however, you were all very helpful and<br />
professional and are a credit to the second<br />
line IT support.<br />
From – Nayna Patel<br />
To – Mandeep Lalli<br />
Mandeep has been exceptionally<br />
responsive to help me work to a tight<br />
deadline. She listened to what was needed<br />
and delivered. Lots of communication<br />
and nothing was ever too much. Totally<br />
fabulous help and support. Thank you!<br />
From – Claire Hubbard<br />
To – Charlie Ammerlaan<br />
For introducing the daily 3 minutes at 3pm<br />
of meditation on the labour ward for all<br />
available staff to join in with. It has been<br />
really beneficial particularly during this<br />
daunting time. Thank you.<br />
From – Rosie Day<br />
To – Randeep Degun<br />
Thank you for arranging for the protective<br />
screen on Sandwell outpatients main<br />
reception desk. The reception team are<br />
very happy and say they feel so much more<br />
safe and protected.<br />
From – Fay Williams<br />
To – Sam Sohal<br />
Sam has been an absolute star in sorting<br />
out things relating to bank staff, she is<br />
always quick to respond and extremely<br />
helpful.<br />
From – Dawn Hall<br />
To – Portering Team at Sandwell<br />
First I would like to introduce myself,<br />
my name is Tina Viney and I work<br />
with learning and development based<br />
at Sandwell Hospital. My name was<br />
put forward by my manager to do<br />
some brigade work to support other<br />
departments whilst COVID-19 is still active.<br />
I have been working on blue brigade for<br />
a few weeks now supporting the porters<br />
in their roles. The team deserve a BIG<br />
shout out for all the work they do on a<br />
daily basis, coming into the role of porter<br />
as given me a better understanding of<br />
their role and work they have to do. I<br />
have learnt so much from them already,<br />
the team are very supportive and taking<br />
time out showing us what we need to do<br />
to support them as volunteers. I feel that<br />
the team isn't recognised as much as what<br />
they should be, and at the end of the day<br />
we are all working to achieve the same<br />
goals. It would be nice to see some sort of<br />
recognition for the part they play within<br />
the organisation so giving them a shout<br />
out would be great.<br />
From – Tina Viney<br />
22
Queen’s Nurse Susan Knight –<br />
By royal appointment!<br />
Then and now. Susan pictured at the start of her career in 1987 and today as a Queen's Nurse.<br />
Being recognised as a Queen’s Nurse is<br />
one of the most prestigious accolades<br />
anyone can receive in the nursing<br />
profession. It is awarded to nurses<br />
who demonstrate the highest level<br />
of commitment to patient care and<br />
nursing practice. Earlier this month, this<br />
coveted title was bestowed upon Susan<br />
Knight, Practice Education Lead.<br />
It all began back in 1982 when Susan<br />
embarked on her nursing career. She told<br />
us: “I started my training in May 1982, and<br />
this marks my 38th year in nursing. District<br />
nursing wasn’t a field I had any prior<br />
knowledge of or had considered, but the<br />
placement I had with the district nurses had<br />
the ‘wow’ factor. I knew from the outset<br />
that this was going to be the path I would<br />
pursue. I felt the impact district nurses had<br />
on the lives of patients, their families and<br />
carers. The skill demonstrated in holistic<br />
care and flexibility, the way they worked to<br />
meet the patient needs seemingly with ease<br />
was inspirational. I knew without hesitation<br />
I had to become a district nurse.”<br />
Susan went on to work as a community<br />
practice teacher for 10 years, teaching<br />
and inspiring future district nurses. In<br />
that time, she continued to further her<br />
education so that she could keep up to<br />
date with the latest developments. “I<br />
completed a BA (Hons) degree via the<br />
Open University. I then trained as a health<br />
visitor. It gave me the invaluable experience<br />
of working as a specialist public health<br />
professional. I extended my role by working<br />
as a contraceptive nurse specialist, a role<br />
that I still undertake. During my health<br />
visiting years, I held the position of an<br />
executive committee member for children<br />
and maternity services, and I was a nurse<br />
representative on the Trust board.”<br />
Over the years, Susan’s career has<br />
continued to evolve as she has taken on<br />
different roles and responsibilities. This<br />
has been underpinned by her thirst for<br />
learning. “With my passion for training<br />
and education, I later transferred to a<br />
professional development unit. I went on<br />
to complete a Master of Science degree in<br />
Health Studies and a PGCE. My desire has<br />
always been to develop myself and learn, so<br />
in turn, I can develop others to uphold the<br />
principles that are central to being a nurse.”<br />
In October 2019, Susan became practice<br />
education lead for district nursing. The<br />
purpose of this position is to enhance the<br />
district nursing service. “I’m responsible<br />
for ensuring the provision of high quality<br />
multi-professional learning environments<br />
within the community. My role focuses<br />
on enhancing nursing practice in terms of<br />
education and morale, as well as improving<br />
health outcomes to help prevent hospital<br />
admissions and enrich patient experiences.”<br />
Another key aspect of Susan’s career has<br />
been supporting district nurse students.<br />
She is a key stakeholder in respect of<br />
the university curriculum including the<br />
revalidation of the specialist practitioner<br />
programme and was invited to the last<br />
CORPORATE AND GENERAL<br />
NEWS<br />
graduation ceremony as a VIP procession<br />
member. In November 2019, she was<br />
invited by a previous student to attend<br />
the London Royal College of Nursing<br />
round table event.<br />
Returning more recently to district<br />
nursing and leading a team, Susan<br />
put herself forward to join the ranks<br />
of the Queen’s Nurses and backed<br />
by her manager, senior lecturer at<br />
Wolverhampton University and a fellow<br />
Queen’s Nurse, sent in her application.<br />
“Working in this setting reinstated what<br />
I already knew, that district nurses are<br />
extremely passionate about their work,<br />
and it’s so inspiring to be part of such a<br />
culture.<br />
“My team received two great<br />
acknowledgements in 2019 that we<br />
were so proud of. Michelle Melo, Deputy<br />
Director of Workforce Development and<br />
National Clinical Lead for Personalised<br />
Care from NHS England undertook a<br />
day shadowing the team. She highly<br />
commended our work stating her visit<br />
had demonstrated a high standard of<br />
personalised care, excellent relationships<br />
with the GPs and integrated care to<br />
improve patients’ experiences.<br />
“At the 2019 Star Awards, our team<br />
won the local primary care award.<br />
No district nurse team had ever won<br />
this award before, and we were<br />
overwhelmed. Receiving these types of<br />
recognition gave me the confidence and<br />
inspiration to apply for the honorary title<br />
of Queen’s Nurse.”<br />
Now that Susan is officially a Queen’s<br />
Nurse, she looks forward to attending<br />
annual meetings and developmental<br />
learning and leadership programmes. “I<br />
feel privileged to be part of a community<br />
nursing organisation that has the same<br />
values and passion for the profession<br />
as I do, this truly is the pinnacle of my<br />
career.”<br />
Colleagues have been quick to praise<br />
Susan’s achievement. Line Manager,<br />
Louise Johnson, commented: “This is<br />
excellent news and very well deserved,”<br />
whilst another colleague said: “I couldn’t<br />
think of anyone more deserving, you are<br />
such an inspiration.”<br />
We couldn’t agree more!<br />
Congratulations, Susan.<br />
“The beautiful thing about learning is that nobody can take it away from you.”<br />
B.B. King<br />
23
International Year of the Nurse<br />
and Midwife - <strong>June</strong> <strong>2020</strong><br />
As you may be aware, this year marks International<br />
Year of the Nurse and Midwife, a campaign by the<br />
World Health Organisation in honour of the 200th<br />
birthday of Florence Nightingale.<br />
CORPORATE AND GENERAL<br />
NEWS<br />
Nurses and midwives play a vital role in providing<br />
health services in our workplace. They devote their lives<br />
to caring for mothers and children; giving lifesaving<br />
immunisations and health advice; looking after older<br />
people and generally meeting everyday essential health<br />
needs. They are often the first and only point of care<br />
You may be thinking what exactly<br />
does a business relationship manager<br />
have to do with nursing, but don’t<br />
be fooled - Dominic LeGros has been<br />
nursing since the nineties!<br />
Dominic LeGros<br />
Business Relationship Manager, Unity EPR<br />
Dominic LeGros – from nurse to business<br />
relationship manager<br />
“I first qualified as a nurse in 1998 at<br />
Princess Alexandra Hospital, Harlow<br />
and started working in their emergency<br />
department,” said Dominic. “Three years<br />
later in 2001 is when I joined the Trust as<br />
a senior staff nurse working on the West<br />
Midlands Poisons Unit up until 2004.”<br />
Dominic would briefly move away from<br />
the Trust to work at Selly Oak Hospital,<br />
making a return to emergency nursing.<br />
However, in 2008 he returned to our Trust.<br />
“I always felt at home at SWB, which is<br />
why in 2008 I returned to the Trust, more<br />
specifically to City Hospital A&E. Whilst<br />
in A&E, I trained as an emergency nurse<br />
in their communities. Throughout the year, we will be<br />
highlighting some of our nurses, HCAs and midwives<br />
who are making a difference to our patients.<br />
Each month we profile some of our wonderful nurses<br />
as part of our <strong>2020</strong> Year of the Nurse and Midwife<br />
celebrations.<br />
Read on to find out about the career pathway of<br />
Business Relationship Manager – Unity EPR, Dominic<br />
LeGros.<br />
practitioner and eventually qualified as an<br />
independent prescriber.”<br />
A decade later, Dominic would seek yet<br />
another challenge where he combined<br />
a lifelong interest in technology with a<br />
passion for delivering quality care. “I have<br />
always had a second passion for tech which<br />
is why it made perfect sense for me to join<br />
the Unity team as an informatics nurse.”<br />
Dominic played a pivotal role in the launch<br />
of our electronic patient record, Unity and,<br />
subsequently went on to win the award<br />
for Digital Leader of the Year Award at the<br />
2018 Star Awards.<br />
#swbawards20<br />
Thank you for sending in your nominations for this year’s<br />
Star Awards. The judging will now begin and the shortlist<br />
will be announced on Monday 3 August.<br />
24<br />
Although our awards ceremony may be different this year, we<br />
will still be recognising outstanding achievement. We have 21<br />
categories this year including a special award for this year only<br />
that recognises nurse/midwife of the year, as this year is the special<br />
International Year of the Midwife and Nurse.
Flu-per troopers – Preparing<br />
for battle<br />
It’s lovely and sunny outside and the<br />
last thing on your mind is the flu<br />
vaccination programme but you’d<br />
be surprised to know that work has<br />
already begun to prepare for our next<br />
battle with flu.<br />
Last year’s campaign was a huge hit; we<br />
managed to vaccinate 5,027 colleagues<br />
across the Trust, 4,454 of whom were front<br />
line staff. Bethan Downing, Deputy Director<br />
of People and OD, said: “Last year, we<br />
managed to surpass our 80 per cent herd<br />
immunity target, but it took us longer than<br />
we had expected. Timing is everything,<br />
and the flu vaccination is no exception. It’s<br />
important to be protected early, to give<br />
your body time to build up its defences<br />
and to generate some antibodies so when<br />
the flu season begins to peak, you can be<br />
safe in the knowledge that you have some<br />
protection ready and waiting."<br />
This year, we’ll be out and about offering<br />
the vaccine from October and, we‘re hoping<br />
that by Christmas, everyone will have taken<br />
up the jab. We have seen the impact of<br />
COVID-19 – a virus we have no vaccine<br />
for yet, however, we do have a vaccine for<br />
flu - it’s a vaccine that covers four different<br />
strains of the virus. With the COVID-19<br />
situation, preventing flu is more important<br />
than ever this winter. We're not going to<br />
let a preventable infection take hold of our<br />
colleagues.”<br />
Coughs and sneezes aren’t the only way to<br />
pass on the flu; we know that approximately<br />
70 per cent of flu cases have no symptoms.<br />
People carry on with their day as they<br />
would do, and unbeknownst to them, every<br />
surface they touch is spreading the disease<br />
CORPORATE AND GENERAL<br />
NEWS<br />
to everyone around them, whether they<br />
are at home, at work or visiting friends<br />
and family.<br />
Flu doesn’t discriminate, it affects<br />
everyone equally and a common myth<br />
that circulates every year is that the<br />
vaccine contains porcine products; this is<br />
false. A lot of time, effort and research<br />
every year goes into making sure that the<br />
vaccine is appropriate for everyone and<br />
no porcine products are used in the flu<br />
vaccines provided by our Trust.<br />
To become a flu-per trooper,<br />
get in touch with us at<br />
swbh.seasonal-flu@nhs.net.<br />
Final days to complete<br />
your PDR: All you<br />
need to know<br />
Performance Development Review<br />
(PDR) season is upon us once again and<br />
it’s vital all colleagues have completed<br />
their PDRs by 31 July.<br />
PDRs are the chosen assessment tool<br />
used by the Trust to evaluate colleague<br />
performance across the last 12 months.<br />
Everyone from our chief executive to our<br />
ward services officers completes a PDR.<br />
Nora Parsons, Learning and Development<br />
Manager, is urging colleagues to complete<br />
their PDRs by the end of July as it enables<br />
you to objectively review your previous year<br />
and think about the future.<br />
She said: “The PDR is important for<br />
everyone within our organisation to<br />
complete. It provides an excellent<br />
opportunity to reflect on the year that has<br />
passed and plan for the one ahead. It also<br />
gives the opportunity to discuss your career<br />
progression aims and your development<br />
plan.”<br />
She added: “A lot of people forget some<br />
of the good things they have done over<br />
the year – your PDR discussion is a chance<br />
to recognise where you are performing<br />
well, and it could also be used to help you<br />
improve in areas where you may be struggling,<br />
get additional support if needed and address<br />
any potential concerns you may have. The<br />
PDR is also a fantastic opportunity to give<br />
feedback to your manager and have an open<br />
conversation.”<br />
The PDR itself is broken down into five distinct<br />
sections which are:<br />
1. Section A – Your performance over the<br />
past 12 months<br />
2. Section B – What’s gone well and<br />
what’s not gone so well including<br />
scoring<br />
3. Section C – Objectives for the next<br />
12 months<br />
4. Section D – Your future aspirations<br />
and personal development plan<br />
5. Section E – Final score and sign off<br />
With the COVID-19 pandemic, it’s vital that<br />
we focus on the mental health and wellness of<br />
everyone across the organisation. With this in<br />
mind, it is important to also have chat about<br />
your wellbeing.<br />
Nora added: “I encourage all managers<br />
to have a conversation around mental<br />
health and wellbeing as this will help<br />
break down barriers and remove the<br />
stigma around mental illness. There<br />
is a lot of support for staff wellbeing<br />
including the Wellbeing Hub. I also<br />
recommend everybody to download<br />
the Thrive mental health app. The<br />
app tackles common stressors such<br />
as sleep, bereavements, work issues<br />
and more. It also signposts to external<br />
support services with users able to seek<br />
immediate help directly from the app.”<br />
If you wish to download the app or find<br />
out more, please visit https://connect2.<br />
swbh.nhs.uk/od/occupationalhealth-and-wellbeing-service/<br />
download-the-thrive-mentalwellbeing-app/.<br />
For more information around your<br />
PDR, please contact swbh.landd@<br />
nhs.net and please check that your<br />
managers have entered your PDR<br />
score and objectives onto Connect.<br />
25
Staying connected<br />
from home<br />
CORPORATE AND GENERAL<br />
NEWS<br />
COVID-19 has changed so many of<br />
the things we all took for granted<br />
and we’ve all had to adapt the way<br />
we do things, not least the way<br />
we work. Luckily at our workplace,<br />
we have the flexibility to allow some<br />
colleagues to work remotely at home.<br />
Working from home may be a different<br />
experience for some, and, it’s not always<br />
without its challenges, but at this moment in<br />
time it’s the right thing to do for some of our<br />
people. But how are clinical colleagues able to<br />
work from home? <strong>Heartbeat</strong> caught up with<br />
two colleagues who are doing just that.<br />
Lesley McDonagh<br />
Clinical Lead Nurse, Tissue Viability Team<br />
Lesley McDonagh, Clinical Lead Nurse, Tissue Viability Team<br />
Lesley has been working from home<br />
since the start of the pandemic as she<br />
has to shield due to a medical condition.<br />
She told <strong>Heartbeat</strong> when she first started<br />
to shield she felt guilty about not being<br />
in the office and also missed her team.<br />
“It was difficult to get my head round<br />
things at first,” recalled Lesley. “We were<br />
working very hard during the surge, and<br />
I was glad I could still support the team<br />
while working from home. I was able<br />
to get on with the background work,<br />
in particular setting up the mobile skin<br />
clinic, handling referrals and arranging<br />
future training options. I was also able<br />
to continue to provide HR support to the<br />
team and help with their concerns and<br />
worries in a rapidly changing climate.”<br />
Lesley told us even though she is<br />
shielding, she is still very much in contact<br />
with the team. She said: “We use the<br />
phone for quick communication as<br />
we would do normally and WebEx for<br />
meetings, one to ones, PDRS or just a chat.<br />
Now that we have mastered using WebEx it<br />
has been really useful to keep in touch face<br />
to face, it has also cut down on traveling<br />
cross site to meetings.<br />
The tissue viability team have recently been<br />
recognised for their work in supporting<br />
colleagues who have suffered facial injuries<br />
due to wearing PPE. Lesley explained how<br />
she was able to support that work from<br />
home.<br />
“During the early days of COVID-19 we<br />
found that colleagues started to suffer skin<br />
damage and irritation from wearing PPE,”<br />
explained Lesley. “I knew the team had<br />
the skills to offer support and advice so we<br />
decided to set up the skin clinics. As I was<br />
working from home I was able to dedicate<br />
time to set up the clinics very quickly, along<br />
with other colleagues in the team who are<br />
also shielding.<br />
“Because we were at home with little<br />
distractions, we were able to set up the<br />
mobile skin clinics much quicker than we<br />
would have done, if we were at work.<br />
I am delighted the clinics have been so<br />
well received and that we have managed<br />
to support so many colleagues. While<br />
working from home I am able to triage<br />
initial referrals when colleagues contact us<br />
for skin advice. I can offer initial advice and<br />
then arrange for one of my team to meet<br />
them if this is required.”<br />
<strong>Heartbeat</strong> asked Lesley how she gets herself<br />
in a frame of mind to be able to work from<br />
home. “I work my normal hours, I am lucky<br />
to have a desk in a room which is quiet<br />
and a comfortable chair is a must,” she<br />
smiled. “I try to take breaks and finish at a<br />
set time. I find I get a lot done as there are<br />
fewer interruptions. I enjoy coffee breaks<br />
with colleagues – now we have mastered<br />
WebEx it is good to catch up and feel part<br />
of things.<br />
“As I am shielding, it’s for my benefit to try<br />
and maintain my mental wellbeing so I try<br />
to think positive. It can be lonely sometimes<br />
– I miss the chatter from the team and<br />
other colleagues in corporate nursing. I<br />
also miss the exercise – just walking from<br />
the car park to the hospital! I have made<br />
myself do exercise at home but it’s not like<br />
being outside. I am grateful to the whole<br />
corporate nursing team in acknowledging<br />
that I am shielding and still working. It’s<br />
been lovely to have their support and still be<br />
included in conversations and meetings as<br />
normal.”<br />
26
Geeta Shetty<br />
Consultant Oncoplastic and Reconstructive Breast Surgeon<br />
26 new to 12 in the clinics. One of the<br />
reasons for heavy drop in referrals was<br />
due to adhering to 2WW criterial strictly<br />
and heavily policing the referral to see only<br />
patients with a high index of suspicion<br />
of cancer. This longer turnaround was<br />
essential for social distancing and cleaning<br />
between the patients”.<br />
Geeta Shetty, Consultant Oncoplastic and Reconstructive Breast Surgeon<br />
Geeta has been working from home<br />
since the start of the lockdown. She told<br />
us it has been challenging during this<br />
unprecedented period. It is interesting how<br />
COVID-19 has changed our mind set to<br />
work differently.<br />
She has been keeping in touch with her<br />
team by having regular meetings via WebEx<br />
and Zoom. She told us: “It’s been good to<br />
be able to keep in touch with the team,<br />
although sometimes it can be frustrating<br />
when the technology does not work<br />
well, particularly during multi-disciplinary<br />
meetings and QIHD.<br />
“Working from home has certainly been<br />
made easier by the availability of the<br />
various digital platforms. Being able to<br />
see colleagues while working remotely<br />
is a boost for morale and wellbeing. My<br />
colleagues have been very supportive and<br />
tend to call pretty much every other day to<br />
keep me up to date about departmental<br />
activities. Of course you have email<br />
communication too.”<br />
Being a surgeon, Geeta’s role is very much<br />
hands on with the patient, she told us how<br />
this has changed now since she is working<br />
from home.<br />
“My role has been quite different since<br />
working from home,” said Geeta “Due<br />
to COVID-19 and decrease in staff<br />
capacity, we could not have managed to<br />
see all 2 week wait (2WW) referrals in<br />
our outpatient clinics. I took up the role<br />
of triaging 2WW patients and helping<br />
my team by reducing the numbers in<br />
outpatients. I am also available to do<br />
telephone clinics. A four week audit<br />
showed that the numbers of cancers<br />
detected didn’t fall compared to pre<br />
COVID-19 and the pick-up rate in clinic<br />
was high. Our capacity went down from<br />
She continued “The audit results have<br />
made a real difference in our outpatient<br />
clinic. During pre COVID-19 the breast<br />
unit were running with more than 100 per<br />
cent capacity with some extra adhoc lists.<br />
COVID-19 is going to stay with us for a<br />
while and we have to look into our new<br />
ways of working as a part of restoration<br />
and recovery plan. It is not possible to go<br />
back to the pre COVID-19 era considering<br />
the social distancing, cleanliness, health<br />
and safety precautions. We do not have<br />
enough resources to cope with the new<br />
ways of working standards. Hence, I am<br />
trying to run a model to have virtual triage<br />
clinics so as to screen these referrals which<br />
will hopefully reduce numbers in our<br />
one stop clinic and also provide support<br />
to GPs. This will help us uphold current<br />
slogan “see a right patient at right time by<br />
a right person”.<br />
“However, the down side of working<br />
from home is; my operating role has been<br />
affected. I miss being in the theatre and I<br />
hope to be able to do so again very soon”.<br />
“At home, I tend to have set virtual triage<br />
and telephone clinic sessions. If I feel<br />
anyone needs a face to face consultation<br />
then I am able to refer them to one of my<br />
colleagues.<br />
“Being at home gives you a lot of<br />
flexibility, however at times I feel I am<br />
never off work as I find myself checking<br />
emails and doing work late into the<br />
evenings. Despite that, I always try to<br />
maintain a healthy frame of mind and I am<br />
grateful for what I have. I have been also<br />
involved in overseas educational activities,<br />
being an Adjunct Professor of Manipal<br />
Academy of Higher Education, India and<br />
National Vice President of ACCCI which<br />
keeps me academically active. My family<br />
has supported me a lot and they are my<br />
strength. I am just glad for opportunity to<br />
be able to continue to perform my duties<br />
in different ways.”<br />
"I am still learning."<br />
Michelangelo aged 87<br />
27
Children’s ED receives £1.2m facelift<br />
CORPORATE AND GENERAL<br />
NEWS<br />
Our new-look children’s emergency<br />
department (ED) and assessment<br />
unit officially opened earlier<br />
this month. The £1.2 million<br />
development has taken eight<br />
months to build and is based at City<br />
Hospital.<br />
The facility, named the Children’s<br />
Emergency Care Unit (CECU) will lead<br />
to more efficient and streamlined care<br />
for our young patients. All children will<br />
be seen in one area which will mean<br />
patients will have access to paediatric<br />
and ED colleagues in a timelier manner.<br />
Plus, the area is separate from the<br />
emergency department where adults<br />
are treated, so it is more child friendly.<br />
The updated facility boasts an animal theme<br />
with facts about each one in the cubicles and<br />
waiting areas making it a more comfortable<br />
and interesting environment for youngsters.<br />
Your Trust Charity has funded and sourced<br />
wall sensory toys and table bead toys for the<br />
area along with smart TVs for six cubicles.<br />
The Trust invested in the new facility to ensure<br />
the best care is delivered in line with national<br />
guidelines. It replaces a separate paediatrics<br />
assessment unit (PAU) based on D19 and<br />
children’s ED which was co-located within the<br />
main accident and emergency department.<br />
The unit will be led by nurse, Marie Hinks and<br />
it is estimated that 18,000 children will use<br />
the facility a year.<br />
Acute Paediatric Matron, Bren Taylor, said:<br />
“This is a change from the previous paediatric<br />
provision that was at City ED. It has gone<br />
from a 12-hour unit to a 24-hour unit,<br />
incorporating the PAU into the footprint.<br />
“It will mean a more cohesive working<br />
relationship and pathway for children<br />
and families. We are very pleased with<br />
this much-needed facility. Colleagues are<br />
looking forward to delivering excellent<br />
care to our young patients in a more<br />
modern setting.”<br />
Each shift will have four nurses and<br />
several ED and paediatric doctors<br />
working together. All patients will have<br />
a quick initial assessment (triage) at main<br />
reception and then be sent to a red<br />
(COVID-19 positive) or blue (COVID-19<br />
negative) area depending on risk. Those<br />
children who need to stay longer than<br />
18 hours, or who need to see specialist<br />
teams will be transferred to Sandwell<br />
Hospital or another appropriate hospital.<br />
Colleagues gather for the official opening of the Children’s Emergency Care Unit<br />
How would you like to receive ?<br />
Since the outbreak of COVID-19 there has been a major shift in the way we work with<br />
many of us working from home. Let us know if you would like to receive your copy of<br />
<strong>Heartbeat</strong> directly to your home. Email the team at swbh.comms@nhs.net<br />
28
???<br />
???<br />
???<br />
Melanie Griffiths<br />
Head of Improvement<br />
This month we give a very warm<br />
welcome to Melanie Griffiths, our<br />
new Head of Improvement. She joins<br />
us from Kettering General Hospital,<br />
where she worked as the Head of<br />
Transformation & PMO.<br />
Melanie is enthusiastic about joining SWB<br />
and brings a wealth of experience into her<br />
new role. In 1988, Melanie graduated from<br />
Sunderland Polytechnic with a first class<br />
chemistry and physiology degree and joined<br />
the NHS working as a laboratory assistant<br />
supporting the development of a fertility<br />
unit, at Newcastle Royal Victoria Infirmary.<br />
From there she completed a PhD in male<br />
infertility, in Sheffield, with her work being<br />
published in peer-reviewed journals. In 1993<br />
she was appointed as the clinical andrology<br />
laboratory manager at the Coventry Centre<br />
for Reproductive Medicine and went on<br />
to work at a national level in the field of<br />
Melanie, our new Head of Improvement<br />
pictured with her family<br />
andrology. In 2004 she transitioned to<br />
working in improvement science, going on<br />
to gain experience delivering and leading<br />
improvements to healthcare services in<br />
both acute and community settings across<br />
Coventry and Warwickshire, and more<br />
recently in Kettering.<br />
She told <strong>Heartbeat</strong> that she is really looking<br />
forward to taking on the new challenges<br />
that await her at SWB. She remarked: “I’m<br />
passionate about supporting the Trust<br />
to deliver its vision for the community<br />
of Sandwell and West Birmingham. I’m<br />
looking forward to getting to know the<br />
organisation, the people and of course my<br />
new colleagues in the improvement team.”<br />
Outside of work, Melanie enjoys spending<br />
time with her husband, Gary and two<br />
grown up children, Luke and Anna. She also<br />
likes walking the family dog Reggie, pilates,<br />
attending music concerts and travelling.<br />
When not working and keeping up with her<br />
family, Melanie also finds time to challenge<br />
herself outside of work and has completed<br />
two moonwalk marathons for breast cancer<br />
charities.<br />
Wave goodbye to…<br />
Paula Gardner<br />
Chief Nurse<br />
This month we say goodbye to our<br />
talented and big-hearted Chief Nurse,<br />
Paula Gardner. With a career that spans<br />
almost four decades under her belt, she<br />
has made an immense contribution to<br />
the nursing profession and indeed our<br />
Trust.<br />
When Paula began her nursing career 37<br />
years ago things were somewhat different.<br />
The technology wasn’t as advanced as it is<br />
today, and nurses wore white hats and blue<br />
belts. Paula's focus was and has remained,<br />
in all that time on how we care for patients<br />
within the NHS. She explained: “The care<br />
and attention we give a patient hasn’t<br />
shifted. We can still bed bath a patient,<br />
dress them, comb their hair and brush their<br />
teeth. There’s a real sense of achievement<br />
by doing the simplest of things to help<br />
patients feel better.”<br />
Paula began her nursing career in 1983<br />
at Worcester School of Nursing. After<br />
qualifying in 1986, Paula held many roles<br />
across Staffordshire and the Black Country.<br />
Looking back at her career, becoming a<br />
sister was a real highlight for Paula. “I<br />
became a sister at the age of 24. In those<br />
days it took a long time to become senior<br />
sister but I did it three years after qualifying.<br />
I have been a matron, a group director of<br />
Paula Gardner pictured at her retirement<br />
gathering<br />
nursing, a deputy chief nurse and a chief<br />
nurse. I’ve been through every stage of<br />
what it’s like to be a nurse at different times<br />
of my life. Without a doubt, the pinnacle of<br />
my career is being a chief nurse. It's what I<br />
always wanted to be.”<br />
Paula has nothing but admiration for the<br />
staff within our organisation. “In the time<br />
I’ve worked here, I have always been blown<br />
away by the dedication of both clinical and<br />
non-clinical staff. It has never been clearer<br />
than it has been in the situation we find<br />
ourselves in right now. Everyone has pulled<br />
together to fight COVID-19, and I couldn’t<br />
be prouder to say I’ve been your chief nurse<br />
at this time.”<br />
She added: “I am leaving on a high at the<br />
point in my career where I’ve achieved<br />
everything I set out to achieve. I am looking<br />
forward to taking some time out to enjoy<br />
being with my husband, daughters and<br />
family. I'd like to say thank you to everyone<br />
that has supported me. I will remember the<br />
kindness and warmth of the people I have<br />
had the pleasure of working alongside at<br />
SWB.”<br />
David Carruthers, Medical Director,<br />
commented: “Paula is a force of nature.<br />
She is determined and dedicated in equal<br />
measure. Paula is an exceptional leader<br />
– I’ve always found her to be energetic,<br />
engaging and accessible to her team. She is<br />
strategic and delivery focused - something<br />
you need to be in her role. Paula has been<br />
a pleasure to work with and we all wish her<br />
nothing but the best.”<br />
29
Letters, of less than 200 words please, can be sent to the Communications Department,<br />
Trust Headquarters, Sandwell Hospital or by email to swb–tr.SWBH–GM–<strong>Heartbeat</strong>@nhs.net<br />
YOUR RIGHT TO BE HEARD<br />
Black Lives Matter… got me<br />
thinking<br />
Dear <strong>Heartbeat</strong>,<br />
With the Black Lives Matter at the forefront of<br />
a lot of people’s minds at the moment, it got<br />
me thinking about our Trust and if a form of<br />
institutional racism or unintentional bias exists.<br />
On a surface level, we do recruit lots of BME<br />
staff and the Trust as a whole has a variety of<br />
ethnicities, however, when you look deeper does<br />
it really? Yes on a clinical level there are BME<br />
colleagues, and on all levels/bands, however,<br />
when you look at the non-clinical staff, I’m not<br />
sure this is the case. Yes, we have lots of staff at<br />
entry-level and some in management but as you<br />
go further up the ladder past some management<br />
roles and into more senior/executive roles do we<br />
have adequate BME representation there?<br />
I know the Trust encourages BME staff by<br />
having the BME Network and the Stepping Up<br />
Programme but is that enough? Are these just<br />
tick-box exercises to mask what is really going<br />
on? How many non-clinical people from the<br />
Stepping Up Programme go on to achieve higher<br />
paid and more senior roles? I know the Trust is<br />
always working to achieve more equality and<br />
diversity, but it just seems when you look deeper,<br />
it is only at a clinical level and this is not evenly<br />
spread in non-clinical roles unless I’m mistaken…<br />
Kind regards<br />
Anon<br />
Dear colleague,<br />
Thank you for writing and raising some<br />
important points which I agree are critically<br />
important to for our BME colleagues and<br />
patients. The Board have acknowledged<br />
that we do not have adequate levels<br />
of BME representation at a senior non<br />
clinical level as yet. Four years ago we put<br />
in place a number of actions in line with<br />
our Workforce Race Equality Action Plan<br />
(WRES) to start to address this inequality.<br />
For example we have a BME panellist on<br />
every recruitment interview; we have<br />
launched our mentoring and coaching<br />
programme which was publicised to all staff<br />
but targeted to our BME Staff Network,<br />
and we were the first organisation to<br />
launch the Stepping Up Programme which<br />
is a leadership development programme<br />
for BME colleagues at Band 5 and Band 7s,<br />
which we have successfully hosted onsite<br />
for the last two years with around 90 of our<br />
BME colleagues taking part.<br />
You asked about the Stepping Up<br />
programme and our non- clinical<br />
participants. So far we have had 25 non<br />
clinical SWB staff who have completed the<br />
course and of these a quarter have moved<br />
to a higher banded role. Four have left the<br />
Trust for promotion and development.<br />
I feel strongly that the Stepping Up<br />
programme and our BME Staff Network are<br />
not a ‘tick box exercise’, our chief executive<br />
sponsors the network and the whole Board<br />
take the views of our BME colleagues and<br />
the inequalities very seriously. Although we<br />
do recognise that more needs to be done to<br />
ensure our organisation fully addresses our<br />
inequalities. I would encourage any colleague<br />
from a BME background who feels they can<br />
be a positive force for change and play a part<br />
in helping our workplace to be the fairest and<br />
most representative of our local population we<br />
can be at every level, to consider joining the<br />
BME Staff Network. Please visit their web page<br />
on Connect or contact the network chair Donna<br />
Mighty if you need more information.<br />
Kind regards<br />
Raffaela Goodby, Director of People and<br />
Organisation Development<br />
What happens after the peak?<br />
Dear <strong>Heartbeat</strong>,<br />
It’s been great to see the Trust be so accommodating<br />
during the coronavirus crisis, from flexible working<br />
to one to one therapy sessions, it’s been amazing to<br />
see and experience all of the good will.<br />
It’s fair to say that COVID-19 has affected more than<br />
those patients who have been unwell in our care,<br />
staff at our trust have come to work knowing that<br />
they’ll be around something they could potentially<br />
take home to their families, but we’ve all come in<br />
none the less. The Trust has been very generous<br />
in providing hotel rooms and accommodation and<br />
we’re all thankful for that and understand that some<br />
elements aren’t sustainable long-term but will the<br />
other support mechanisms remain in place?<br />
Are there plans for the onsite shop to remain for<br />
staff? Even without COVID-19 we struggle to juggle<br />
long shift and home life and the shops been a<br />
lifeline to many. The therapy sessions at the learning<br />
works and all of the information that’s been coming<br />
out to staff has been great, can we expect these to<br />
remain?<br />
Also, our culture in the Trust has completely<br />
changed, and changed for the better, before<br />
COVID-19 I wouldn’t have had a clue who to talk<br />
to about making sure I had the right PPE, where<br />
to get gloves or masks, and you would rarely have<br />
seen an antibacterial gel bottle in any of the meeting<br />
rooms. But now they’re all there and we have all of<br />
these provisions in easy reach, we’re worried that<br />
you’ll start to take them away again one by one.<br />
And should coronavirus come back, we’ll be back to<br />
step one.<br />
Kind regards<br />
Anon<br />
Dear colleague,<br />
I’m pleased to see that you feel that our Trust<br />
has changed for the better. It is evident that<br />
people have all worked together as a team,<br />
with kindness, to manage our response to the<br />
pandemic. We have been greatly supported<br />
by our local community and further afield be<br />
that be through businesses coming to our aid<br />
relating to PPE supplies, provision of meals<br />
and local fundraising efforts. Many of these<br />
people have supported us at times when they<br />
themselves have been struggling through<br />
economic uncertainty and it is right that<br />
we should stop accepting their donations at<br />
present. The wellbeing activities and resources<br />
have certainly increased and we are looking<br />
to see how we can take forward the majority<br />
of these. Our working from home long-term<br />
arrangements will be consulted upon and we<br />
expect this to become a much more standard<br />
part of our working practices. Similarly, working<br />
flexibly has been a necessity as people have<br />
had to manage care of children or older people<br />
at home. This is all in line with our flexible<br />
working policy, but the experience of COVID-19<br />
has demonstrated how we can make this<br />
work in many teams. COVID-19 remains a real<br />
threat and we will ensure that our infection<br />
control equipment and procedures are in place<br />
including hand sanitiser and the right PPE. I am<br />
pleased that you have been able to have these<br />
provisions in easy reach.<br />
Kind regards<br />
Bethan Downing, Deputy Director of People and<br />
Organisation Development<br />
Where are our domestics?<br />
Dear <strong>Heartbeat</strong>,<br />
Today in The Birmingham and Midland Eye Centre<br />
29/5/20 in the staff toilets there are –<br />
• No hand towels<br />
• One toilet roll dispenser almost empty<br />
• One completely empty<br />
• No soap in any of the dispensers.<br />
Move along to the staff kitchen there are no hand<br />
towels in either dispensers. Rubbish has accumulated<br />
in all areas for in my office for three days.<br />
I have telephoned the domestics and the domestic<br />
supervisors and also asked switchboard to put me<br />
through but no response.<br />
With all the emphasis on hand hygiene this is not<br />
acceptable.<br />
Kind regards<br />
Anon<br />
Dear colleague,<br />
I am sorry to hear your frustrations regarding<br />
the cleanliness of the staff toilets at BMEC.<br />
You will recall earlier this year, we made some<br />
changes to the cleaning schedule in staff areas.<br />
This meant that the facilities were no longer<br />
cleaned every day.<br />
The cleaning schedule has been temporarily<br />
reviewed due to the current situation so<br />
presently the staff toilets at BMEC are cleaned<br />
once daily Monday to Friday. Outside of that<br />
you are able to replenish stock from the store<br />
room located on the admin corridor.<br />
In the event that the toilets require cleaning<br />
urgently then please contact the team on ext.<br />
4316 and the team can also be contacted on<br />
their mobile phones via IVOR.<br />
If there are any further issues, please do not<br />
hesitate to contact me.<br />
Kind regards<br />
Janet Clarke, Head of Support Services<br />
30
David talks about: The importance of education<br />
and learning<br />
Professor David Carruthers, Medical Director and Acting Chief Executive<br />
Toby Lewis is away<br />
DAVID’S LAST WORD<br />
It is fantastic to see the range of<br />
stories in this special edition of<br />
<strong>Heartbeat</strong> that demonstrate the<br />
Trust’s commitment to quality<br />
improvement through learning.<br />
Education and learning have<br />
long been at the heart of my<br />
values which is why this Trust<br />
has, for me, been such a good<br />
place to build my career.<br />
Our Trust has a clear five year<br />
plan, our <strong>2020</strong> vision, which<br />
culminates this year. One of<br />
the pillars of that vision has<br />
been our education, learning<br />
and development plan. At the<br />
start of our <strong>2020</strong> vision, my role<br />
within the Trust was as director<br />
of medical education. During<br />
the past five years I have seen<br />
our education remit flourish<br />
across and beyond the medical<br />
workforce.<br />
It is great that our Trust continue<br />
to invest in the education and<br />
learning of our staff through<br />
a protected training budget in<br />
excess of £1m each year. This<br />
training resource has supported<br />
hundreds of apprenticeships, the<br />
CESR (Certificate of Eligibility<br />
for Specialist Registration) in<br />
Emergency Care, and our nurse<br />
escalator scheme, to name just<br />
a few. Other<br />
colleagues<br />
have benefited<br />
from additional<br />
learning and<br />
development<br />
support funded<br />
through the Trust,<br />
enabling them to<br />
progress through<br />
their careers.<br />
Additional<br />
support for<br />
learning is evidenced in the<br />
monthly Quality Improvement Half<br />
Day (QIHD) programme which<br />
provides protected time for teams<br />
to learn and reflect, away from<br />
non-urgent clinical commitments.<br />
Over the past few months<br />
the COVID-19 content of the<br />
shared learning topics has been<br />
particularly valuable in enabling<br />
us to respond quickly to evidencebased<br />
learning as you can see<br />
through throughout <strong>Heartbeat</strong> this<br />
month.<br />
The focus on research, and the<br />
willingness of so many of you<br />
to contribute by signing up<br />
patients, or taking part yourself<br />
is reassuring and will enable<br />
Last year's QIHD poster competition<br />
winner and runners up.<br />
treatment and support to be<br />
tested quickly and introduced<br />
in clinical settings. We have<br />
already seen the benefits of<br />
this research in the usage of<br />
dexamethasone for certain<br />
coronavirus patients.<br />
This month has also seen<br />
the launch of our annual<br />
quality improvement poster<br />
competition where we get<br />
to display our improvement<br />
stories of excellence that take<br />
place right across the Trust.<br />
Each year it is a delight to look<br />
at these examples of changes<br />
that have happened to make<br />
a difference to the service<br />
we provide to the Trust or to<br />
patient outcomes. The stories<br />
provide great visibility for all<br />
of us, so we can review, adapt<br />
and adopt this learning. Make<br />
sure you get your entries in<br />
this year in good time. As<br />
well as the obvious kudos in<br />
your work being on display<br />
right across the Trust, the<br />
£5,000 prize for the winning<br />
entry will, I know, act as an<br />
additional incentive for you to<br />
compile your learning stories.<br />
Good luck!<br />
31
We are Metropolitan – Support us<br />
@SWBHCharity To donate<br />
to the Your Trust Charity text<br />
“SWBH16 £5” to 70070<br />
Your Trust Charity has officially<br />
launched their fundraising campaign<br />
‘We are Metropolitan’ as the buzz of<br />
builders back on site brings the new<br />
hospital site to life.<br />
The charity campaign calls on local<br />
businesses across the region to support<br />
raising funds for vital research nurses<br />
as well as the much-needed equipment<br />
to make the new university hospital<br />
truly one of a kind. Balfour Beatty who<br />
are our construction partners for the<br />
development have been hard at work<br />
throughout the pandemic, working with<br />
us to minimise any delays as a result of<br />
COVID-19.<br />
“Though the bricks and mortar cost<br />
of building the Midland Metropolitan<br />
University Hospital is covered, the charity<br />
team have been hard at work building<br />
partnerships with local business to make<br />
Midland Met more than a hospital,” said<br />
Johnny Shah, Head of Your Trust Charity.<br />
“So far the local community and business<br />
leaders have pledged £780,000 which<br />
is a fantastic amount, but we still have a<br />
way to go to meet our £2 million target.<br />
This money will go towards exceptional<br />
care, funding play areas for our younger<br />
patients, creating beautiful gardens<br />
where people can rest, relax, reflect and<br />
recuperate as well as recruiting research<br />
nurses to help develop new trials and<br />
treatments for our patients.”<br />
“The charity’s mission has always been<br />
to enhance the experience of all people<br />
using our services including staff, patients<br />
and their families by providing additional<br />
facilities and supporting innovative<br />
projects that create a comfortable and<br />
secure environment which is what we<br />
hope to achieve with the campaign. The<br />
challenges of tackling COVID-19, and its<br />
disproportionate effect on the communities<br />
we serve, has only strengthened our desire<br />
to create a world-class facility.”<br />
In addition to this, there will also be an<br />
arts and culture programme, which will be<br />
supported not just through visual exhibits,<br />
but through summer concerts, plays, stage<br />
shows and other examples of the performing<br />
arts put on by schools and community<br />
groups.<br />
He added, “Every penny raised will go into<br />
making the Midland Metropolitan University<br />
Hospital a beacon, supporting research and<br />
Our big thank you<br />
<strong>June</strong> <strong>2020</strong> staff lottery results<br />
YOUR TRUST CHARITY<br />
development and delivering worldleading<br />
healthcare to the residents of<br />
Sandwell and West Birmingham.”<br />
How you can help: Your Trust<br />
Charity can only achieve its<br />
fundraising goals with the help of<br />
the local community. So whether<br />
you want to run, cycle, dine, dance,<br />
organise a virtual event, or come<br />
up with your own fundraising ideas<br />
then we are here to help you. Just<br />
call the team on ext. 5196 or email<br />
midlandmet@nhs.net.<br />
You can also make an online<br />
donation at https://donorbox.org/<br />
your-trust-charity<br />
Throughout the pandemic our local communities and businesses have provided<br />
invaluable support to our Trust – be that through donations of food, supplies and<br />
fundraising. These donations came at a time when many people were experiencing<br />
significant economic hardship and struggling with the impact of lockdown. On the<br />
NHS Birthday, 5 July, we will be shining a light in our windows to pay tribute to<br />
those communities who have stood by us. We have stopped accepting donations of<br />
food and free supplies, recognising that it is our turn to give back. Please join us in<br />
thanking our communities for their overwhelming support.<br />
Midland Metropolitan University Hospital<br />
1st £187.75<br />
Jennifer Donovan<br />
2nd £112.65<br />
Helen Ralley<br />
3rd £75.10<br />
Jennifer Ikwo<br />
Don’t forget that Your Trust Charity lottery costs just £1 a month and anyone<br />
who works for the Trust can join. Payment is deducted from your wages each<br />
month. To take part email amanda.winwood@nhs.net.