Heartbeat June 2020

June 2020
Innovation and learning: Special edition
Sandwell and West Birmingham
NHS Trust
The pulse of community health, Leasowes, Rowley Regis, City Hospital, Sandwell General and the Midland Metropolitan University Hospital
Issue 129
Let’s learn: Making changes
happen at pace
Pages 4-6
The
Recharge
Booth
contemplation, conversation, compassion : stand together
This month we are celebrating how we have used learning to change and innovate our practices, particularly throughout this
pandemic. Pictured clockwise from top left: During the peak of the pandemic we learned that proning (positioning COVID-19
patients on their front) could save lives; the Recharge Booth is allowing colleagues to come together with others to reflect,
recharge, decompress, and join a safe and confidential discussion; our new-look children's emergency care unit will lead to more
efficient and streamlined care for our young patients and Visionable is enabling us to conduct virtual consultations.
Our response
to Black Lives
Matter
A good death – a
Board level priority
Psychological
wellbeing - get
the right support
Flu campaign
starts now
Page 2
Pages 16-17
Page 19
Page 25

FROM THE CHAIR
Hello and welcome to a special edition
of Heartbeat! This month we bring you a
bumper research and innovation issue. As
we progress through this pandemic, we
keep you up to date with all the exciting
research trials happening across our Trust.
As it's a special edition, you will notice that this
month we do not have the group sections. This
month we are celebrating how we have used
learning to change and innovate our practices,
particularly throughout this pandemic. On
pages throughout this edition you'll find quotes
linked to learning to commemorate this.
We also shine a spotlight on colleagues from
across our Trust, including Susan Knight who
has become a Queen's Nurse and, Dominic Le
Gros who features as part of the International
Year of the Nurse and Midwife. Enjoy!
Contact us
Communications Team
Ext 5303
swbh.comms@nhs.net
Communications Department
Ground Floor, Trinity House
Sandwell Hospital
Published by
Communications Team
Sandwell and West Birmingham
Hospitals NHS Trust
Designed by
Medical Illustration,
Graphics Team
Sandwell and West Birmingham
Hospitals NHS Trust
Submit an idea
If you’d like to submit an idea
for an article, contact the
communications team
Ext 5303
swbh.comms@nhs.net
HELLO
Stay updated
We send out a Communications
Bulletin via email every day and you
can now read Heartbeat articles
throughout the month on Connect.
Don't forget you can follow us on:
Richard Samuda, Chairman, on
#blacklivesmatter
The protests around the Black Lives
Matter campaign have had a profound
impact right across the world, following
the appalling circumstances of the
death of George Floyd in Minneapolis.
The heartfelt, peaceful protests in
Birmingham highlighted how far
injustices can remain ingrained within
societies and institutions across the UK
as much as in the US.
Our organisation is blessed to serve a
vibrant, multicultural community from
which our workforce is largely drawn and
yet we know we have more to do to ensure
equality and inclusion for all people at all
levels in Sandwell and West Birmingham. I
want to thank the BME Staff Network for
their proactive awareness raising, helpful
challenge and participation in Trust-wide
initiatives to further enhance inclusion
and ensure that Black voices and BME
voices are heard and influence positive
change. During COVID-19 the network
participated in revising the risk assessments
for colleagues to take account of ethnicity
that has led to actions for individuals to
keep them safe at work including enhanced
PPE or redeployment to different areas. The
network continues to invite all colleagues to
participate in events and discussions about
race and ethnicity.
We need to do more to ensure BME
colleagues are more proportionately
represented in senior roles within our
organisation, albeit we have made progress
on this, as well as eliminate unconscious
bias or racism in how colleagues who
work here are treated. As always I would
urge you to speak up if you have issues of
concern that need addressing or ideas to
share.
At SWB Black lives do matter, and we must
make this true for our patients, who come
to us for help with a healthcare need. We
must engage with local communities, listen
and respond. We have done that when we
recognised that our complaints were underrepresented
from certain communities
and have been out to talk to a range of
local groups to understand if there are
any barriers to raising concerns. We have
strong links with partners such as the West
Bromwich African Caribbean Resource
Centre who co-provide the Sapphire Service
identifying and supporting patients at risk
of social isolation. During this pandemic
our Trust has been leading the way in
sharing and analysing the data of our
patients with COVID-19 which has helped
our clinicians and government leaders to
better understand the risk factors that can
lead to a poorer outcome. We recognise
that there has been concern among Black
communities in Birmingham about coming
into hospital. Our message is clear that
people should and must come to our Trust
for help with their health care needs. We
must live up to the expectations and rights
of everyone in our community so that
they can have confidence that they will be
treated equally with the utmost respect,
compassion and kindness.
Chairman, Richard Samuda

QIHD Accreditation – Are you
bronze, silver or gold?
Quality Improvement Half Days (QIHDs)
were introduced in the Trust back in
2015, with the strap line ‘Guaranteed
time for teams to talk, listen, learn
and act’. Since then, we have seen
the number of multi professional
teams grow and develop; focusing on
quality conversations and introducing
improvement and innovation spanning
the entire Trust.
To show how each QIHD team was using
their time, an accreditation programme was
developed that spanned from a basic entry
level all the way up to gold and teams were
asked to make sure that they had been
accredited to at least an entry level by the
end of April 2020.
League
Position
Gold
Silver
Current
Status
QIHD League Table: May 2020
QIHD League Table: May 2020
Bronze
Entry
Name of QIHD Team
1 Children's Therapies
2 Trauma and Orthopaedics
3 Palliative
4 Care Foot Health
5 Rheumatology
6
Community intermediate care and medically fit for discharge wards inc
Leasowes
7 Obstetrics and Gynaecology
8 Health Visiting
9 Stroke
10 New-born Hearing Services
11 Orthoptics/Ophthalmic Technicians
12 Urology
13 Rapid Response Team Medicine Therapies
14 Gastroenterology
15 General Surgery
16 Paediatrics
17 MSK
18 Care of the Elderly team
19 Imaging Group
20 Clinical Governance
21 Audiology
22 Anaesthetics, Critical Care and Pain Management
23 iCares and the District Nursing Team
24 Cardiology
25 ENT
26 Anticoagulant Services
27 Sandwell School Health Nursing
28 Financial Management
29 Integrated Sexual Health Department
30 Respiratory Therapies
31 Neurophysiology
32 Capacity Management
33 Speech and Language Therapy
"I never 34 lose. I Neonates either win or learn."
Nelson Mandela
NEW
NEW
So far in 2020 we have supported an
additional eight teams to entry level,
awarded seven bronze accreditations,
two silver accreditations and one gold
accreditation.
Congratulations go to Trauma and
Orthopaedics for becoming the second
team to reach gold, joining Children’s
Therapies at the top of the league table.
To find out how they achieved their
accreditation, Heartbeat caught up with
Associate Specialist Dr Boban Thomas.
He said: “Last year I applied on behalf
of the team and we achieved a bronze
accreditation, but this was just a trigger to
go for the top prize. We discussed it in our
QIHD and felt that the gold accreditation
was something we could strive for.
QIHD
“So at the beginning of last year we
set our sights on gold and got to work
setting targets and worked towards
that as a team. We identified a few
quality improvement projects and put
in steps to make measurable changes.
We monitored our progress by carrying
out regular audits and we were glad to
see we were showing definite objective
changes in a positive direction.
“To gain our accreditation we had to
have at least two identified projects.
These had to make an impact on the
performance of our department. We also
needed to have a multidisciplinary QIHD,
with time for everyone to voice their
opinions. We had combined meetings
with other departments to again
improve patient care and safety. We
also liaised with external stakeholders to
further improve the quality of our care
delivered to the community. Having a
link and ties with the Royal Orthopaedic
Hospital and Queen Elizabeth Hospital
helped in streamlining some issues with
tertiary referrals and getting easy inputs
from them on some complex issues in
patient management.
“We are now focused on areas such as
research and development, electronic
patient outcome measures and also
working to involve patient groups and
GP consortiums to widen our scope in
providing an exemplary service to our
community. Our T&O department has
grown over the last few years, we have
the potential and we will soon be a
centre of excellence in orthopaedic and
trauma surgery.”
Remember, achieving accreditation
does not take long and recognises
the improvement work that is being
undertaken in QIHD teams across the
Trust. If you would like to know more
about gaining accreditation for your
QIHD, contact Angharad MacGregor,
Head of Clinical Effectiveness
Angharad.Macgregor@nhs.net
3

Clinical Research Facility –
Are you ready to open a study?
COVID-19 RESEARCH
Just over a year ago, the brand
new clinical research facility (CRF)
celebrated its launch. The CRF
which boasts nine clinic rooms and
associated facilities is available for
research clinics and research related
procedures. During May this year,
new monitors with webcams were
installed to ready the facility for
Visionable web-clinics.
Prior to suspension of face to face
clinics, the CRF was regularly used to
approach and consent discussions and
follow up visits for a variety of research
projects for patients with a number
of health conditions including cardiac
problems and metabolic disorders,
gastroenterology and haematology.
Preparations to transfer in Dr Diana
Kavanagh’s Friday respiratory clinic had
been underway immediately prior to
the shutdown of non-essential face to
face clinics at the start of the pandemic.
There are also plans to move in some of
the haematology outpatients.
The CRF is available for research clinic and
research related procedures
“You don’t have to only see patients who are
going to be taking part in research to use the
clinical research facility,” said Gina Dutton,
Head of Research and Development. “Clinics
that are suitable to take place in the CRF are
those where a high proportion of patients are
suitable to take part in research. So we would
expect you to have a study open or ready to
open and a plan for pipeline of studies to use
the facility for a full clinic.
“The CRF has been an excellent investment
and has meant that we have the facilities
available to enable Sandwell and West
Birmingham NHS Trust to be chosen to deliver
staff research.
“We are keen for new investigators to
come forward and make grant applications
to expand both within Trust research and to
have a wider influence.”
The CRF is an ideal location to undertake
research where a new treatment modality
or intervention which can be delivered
in an outpatient setting can be tested.
There is a research laboratory with facilities
to process blood and other samples for
refrigeration and freezing for storage and
dispatch to analysis labs. The CRF is also
used for research project site initiation
visits and monitoring visits, where sponsors
visit the Trust to check source data for
licencing studies. Face to face external
visitor meetings are temporarily suspended
and so our new web equipment has
proved invaluable in making sure that these
important activities can continue.
Colleagues are encouraged to contact R&D
early in your discussions about new SWB
originated research. The team can show
you the facilities available as well as provide
advice on grant applications and ethics and
approvals processes. Contact Zaida Khalil on
zaida.khalil@nhs.net.
If you would like a tour of the
facilities you can contact Gina Dutton
at gina.dutton1@nhs.net.
New trial set to boost immune cells
in COVID-19 patients
The Trust is launching a new trial
which is looking at boosting T-cells
(immune cells) - to fight against
COVID-19 infection.
As we know, COVID-19 infection lowers
the body’s immune system and these
T-cells are reduced in number which is
called lymphopenia.
T-cells are one of the major components
of the immune system. Their role
includes directly killing infected host
cells, activating other immune cells,
producing cytokines and regulating the
immune response.
A new drug (CYT107 Interleukin-7) is
a manufactured version of a naturally
occurring substance in the body and
can improve the function and number
of T-cells. The hope is that this drug can
improve the T-cell function in COVID-19
so that the body can better fight the
infection and improve hospital stay and
survival.
It is hoped the ILIAD 7 trial will improve the
function of the immune system
The trial is called ILIAD 7 which stands for
Recombinant Human Interleukin-7 (CYT107)
to Improve Clinical Outcomes in Lymphopenia
in patients with COVID-19 Infection.
Co-ordinated by our intensive care and
haematology teams, Dr Jon Hulme,
Consultant Intensivist is the principal
investigator and Dr Farooq Wandroo,
Consultant Haematologist is the co-principal
investigator.
All patients who are COVID-19 positive can
be tested with the drug if they fulfil the
following criteria:
• Men and women aged 25 – 80
• Hospitalised patients with two
absolute lymphocyte count (ALC)
≤1000, at two time points at least
24 hours apart, after admission
• Hospitalised patients requiring oxygen
at > 4L/min nasal cannula to keep
SpO2 > 90%, or needing ventilation
(non-invasive or intubated) for
respiratory failure
• Confirmed infection with COVID-19.
All clinicians are urged to consider
recruiting patients for this important
trial. For more information contact the
R&D team - you can call Cecilia Ahmed
on 0121 507 3622 or Yvonne Nupa on
0121 507 3430.
4

Critical care at the forefront of
COVID-19 research
COVID-19 RESEARCH
of immune cells). This is universally seen
in all COVID-19 patients, often leads
to infections and is associated with
increased risk of death. We are trialling
a new drug called interleukin-7 which
will aim at improving the number of
these white cells or immune cells and
help fight COVID-19 infection better and
may reduce the risk of dying. We would
urge all clinicians to help promote this
important study.”
The newest study is a commercial
trial looking at whether Recombinant
Human Interleukin-7 can improve clinical
outcomes in patients in critical care
with severe COVID-19 infections and, in
particular, lymphopaenia. You can read
further about this trial on page four of
this edition of Heartbeat.
These studies are complex and
challenging to explain to patients,
particularly patients that are so ill.
Dr Jon Hulme, Consultant Intensivist and Dr Farooq Wandroo, Consultant Haematologist
are leading some of the COVID-19 research in critical care
Critical care has been at the centre
of the Trust’s research portfolio and
currently has four studies which the
team are actively recruiting to. They are
also delivering treatments for patients
who transfer from the wards who have
been recruited to the RECOVERY study.
Two of the studies are complex treatment
trials at the forefront of COVID-19 research.
REMAP-CAP is a complex treatment
trial which is testing multiple treatment
options simultaneously. This is known
as a platform study. In REMAP-CAP, the
treatments being tested are corticosteroids,
antivirals, immune modulation therapy,
immunoglobulin therapy (in the form of
convalescent plasma) and therapeutic
anticoagulation.
Within these therapy types there are several
randomisation arms. Most research is
intervention/drug a versus intervention/drug
b, so this study is much more complex than
usual.
Heartbeat caught up with Dr Jon Hulme,
Consultant Intensivist and Honorary Senior
Clinical Lecturer, who is the principal
investigator on the REMAP-CAP trial. He told
us: “The impact that COVID-19 has had on
some of our patients has been clear to see.
Large scale, robust trials to test which drugs
help, and importantly, which ones do not,
are hugely important for our patients and
those we will treat in the future. Whilst there
is the temptation that will be felt by many
to use treatments and drugs based on what
they think might work, it is only through
committing to trials like these that the real
answers will be uncovered that will save lives.
“Clinical trials are important as we have
shown by participating in the RECOVERY trial:
this found that dexamethasone, a steroid that
is cheap and widely available and is commonly
used to reduce inflammation in conditions
such as asthma, saves lives in those people
most affected by COVID-19. It reduces deaths
by one third in people on a ventilator and by
one fifth in patients receiving oxygen only.”
Dr Farooq Wandroo, Consultant
Haematologist and Honorary Senior Lecturer
is a co-principal investigator. He added:
“One of the characteristic findings we have
observed in COVID-19 patients is low white
cell count called lymphopenia (low number
“Learn as if you were not reaching your goal
and as though you were scared of missing it.”
Confucius
“One of the problems that we
often experience in intensive care or
emergency medicine research is that
patients are so ill that we cannot discuss
the studies with them. This current
research is considered so important that
sites have been given permission to enrol
patients even in these situations with
a senior doctor who is separate from
the study team taking the responsibility
to assess the situation and decide on
the patients’ behalf until they regain
capacity,” added Dr Hulme. “We
are also ensuring that patients who
have limited English can participate in
studies. Sometimes a lack of ability to
speak English is written as an exclusion
criterion for the study, in which case we
cannot approach non-English speaking
patients.
“The participant information sheet for
REMAP-CAP has been translated into
multiple languages (although a limited
number and not the full spectrum of
languages spoken by our patients)
alongside which patients still need the
research explaining to them. The whole
team of doctors, nurses, research team
and interpreters have worked together
with patients and their families to
ensure that all of our patients have the
opportunity to participate.”
For further information about:
REMAP-CAP visit https://player.
rcplondon.ac.uk/video/1_9wxiht1d
5

Spotlight on research midwives
COVID-19 RESEARCH
A research midwife may not be
something that you are entirely
familiar with, but the part they
play within our workplace is crucial.
The role of a research midwife can
be varied and includes procuring
studies, recruiting and gaining
consent, collecting and analysing
data and publicising results. We
spoke to research midwives, Sarah
Potter and Lavinia Henry to find out
more.
Sarah explained: “As part of our
role we seek out and assist with the
development and delivery of high-quality
research studies within our maternity
specialty. This includes disseminating
information regarding the current
research projects to the whole clinical
team. It also includes teaching and
training. In line with the Trust’s vision
that all patient-facing colleagues can
play a role in research activity, our goal
is to ensure that as many women as
possible have the opportunity to access
research.”
It is, in fact, their experience as midwives
that equips them with the knowledge
and skills to excel in research. Lavinia
told us: “Trusts that are research active
have better patient outcomes. We
work as part of clinical care teams in
all departments so that research is
integrated and a normal part of patient
care.
Research midwives Lavinia Henry and
Sarah Potter
“As midwives, we have expert knowledge
of our client group, clinical environment and
pathways, having worked in the maternity
department before moving into research.
This practical experience helps us to plan
recruitment strategies, identify and overcome
any potential barriers.”
She added: "An example of what we do
includes explaining studies to potential
recruits, whilst gaining and recruiting
individuals for different studies, e.g. recruiting
pregnant women, postnatal women and
neonates into studies. We also conduct
follow-ups, plus gather data and samples as
required.”
Currently, there are several maternity studies
ongoing all with the focus of developing and
improving the effectiveness of care. Some of
our current research trials include:
• Induction of labour, A RCT
comparing two different treatments
for induction and the effect of each
on outcome.
• Prevention of preterm labour, a trial
examining whether the choice of
materials for a cervical stitch.
procedure has any influence on
outcomes.
• Development of care pathways,
analysing the timing of delivery
for women whose babies are large
for gestational age.
• The donation of umbilical cord
samples at elective c/sections to be
used in the development and
improvement of treatment for
rheumatoid arthritis and
cardiovascular disease.
• Smoking cessation.
Since the outbreak of COVID-19, the team
have been actively involved in research trials
that are unique to the pandemic. Sarah
commented: “Though challenging, this
has been a unique opportunity for us to be
actively involved with live, rapidly evolving
studies examining the effectiveness of study
treatments for a condition where there
are no proven effective therapies. These
research trials involve stepping out of our
comfort zone to work in new areas, such as
ITU and AMU, to meet the demands of the
service.”
Sarah added: “Some of these studies are
also open to maternity patients, and the
experience gained on the wards means
we are ready to support the maternity
team with the delivery of these studies.
Maternity also has a registry study open for
women who have experienced COVID-19,
or its symptoms, during pregnancy or the
postnatal period. We are both looking
forward to spending some time back
‘home’ in maternity identifying patients for
this study.”
6

Platform studies – a new way to
do research
One of the principal features of the
urgent public health COVID-19 portfolio
has been the inclusion of a suite of
studies that can adapt to research
findings quickly. These are known as
platform studies. The advantage of this
type of research is that the study can
change quickly.
Traditional randomised research tends to
follow a simple model shown below.
COVID-19 RESEARCH
Suitable
patients
Randomise
Control arm
New treatment arm
At the start of the study the statisticians
will agree how many patients will need to
take part to find the answer to the question
being asked by the study. Commonly this
is, is the new treatment better than the old
one? These studies often take many years
to find the answer to the question.
Head of Research and Development, Gina
Dutton told Heartbeat: “At the start of the
COVID-19 pandemic, no-one knew which
treatments would work and so there was
a need to test multiple treatments at the
same time. Rather than have lots of different
studies, the favoured model has been to use a
platform study.
“In a platform study there will be many
arms and some will stop as soon as the
answer to a specific question has been
reached or a new treatment may be
added in, when some new information
becomes available.”
Control arm
New treatment A
New treatment B
Suitable
patients
Randomise
New treatment C
STOP
New treatment D
New treatment E
New treatment F
STOP
Using the RECOVERY study as a specific
example, since the study started several
new treatment options have been added
to the study. Two treatment options have
recently been stopped when sufficient
patients have been recruited to answer the
study question. The hydroxychloroquine arm
closed as there was no benefit for patients
taking it. The dexamethasone arm has
stopped as it has shown significant benefit
for patients receiving oxygen and those on
ventilation and will be adopted as standard
of care.
Other examples of the studies that we have
open that fall into this platform category
are the PRINCIPAL trial in general practice
and REMAP-CAP for patients who are
particularly poorly and admitted to critical
care. All of these studies already have
different treatment options from when they
first opened.
Gina Dutton added: “These studies can
seem complex for people who are new to
research. They certainly take more planning
to make sure that all treatments can be
delivered in the correct way. Everyone who
has worked on these studies, including
doctors, ward nurses, the medical infusion
suite team, pharmacy and the research
team have embraced working with this
innovative trial model and should be really
proud of their contribution to improving
treatments for patients with COVID-19.”
For more information about this type of
research you can read a Health Research
Authority blog https://bit.ly/3d0Q0jy.
7

Staff research vital in fight against
COVID-19
COVID-19 RESEARCH
Until recently the COVID-19 research
in our workplace has focused on
treating patients with coronavirus
and improving patient outcomes.
We are now preparing to undertake
research which involves colleagues. Our
organisation has a diverse multi-ethnic
workforce making it the perfect place
to conduct research and ensure that the
research participants are representative
of the wider community.
Dr Masood Aga, Consultant and
Specialty Lead in Occupational Medicine,
is principal investigator for some of
these research trials involving staff.
He said: “SIREN is a study looking to
recruit colleagues who have regular
contact with patients. It has a number
of aims but one of the principal ones is
to establish whether a prior COVID-19
infection (measured through an antibody
test) protects against future infection
(detection of virus on a swab). This
research is voluntary and colleagues who
agree to take part are expected to have
swabs and blood tests every two weeks
for at least one year. The frequency may
change throughout the year. We will be
creating a colleague sign-up page on
Connect so that appointments with R&D
Dr Masood Aga, Consultant and Specialty Lead
in Occupational Medicine is leading some of our
staff research trials
to discuss participation in the study can be
easily arranged.
“The second study that we will be taking
part in is called COPCOV. This is a prophylaxis
study which is looking to see whether taking
low dose of hydroxychloroquine will prevent
people from developing COVID-19 symptoms
or reduce the severity if they do develop
it. This latter study has been temporarily
paused whilst the central study team make
some changes to take into account recent
information about hydroxychloroquine. The
dose of drug required for this prevention
study is much lower than that used in current
clinical care."
The recent press interest in
hydroxychloroquine has highlighted the
importance of high quality randomised
controlled trials (one where patient
outcomes are rigorously compared to
patients matched for similar characteristics
such as age, ethnicity, gender, health
conditions) to ensure that we have the
evidence for decision making.
This Trust is recruiting to the RECOVERY
trial which has provided the best evidence
to date about hydroxychloroquine. This
treatment was found to have no beneficial
effect of hydroxychloroquine in patients
hospitalised with COVID-19, the trial also
found no indication of harm. On this basis
the regulators are happy for COPCOV, the
colleague study to proceed.
On the horizon it is expected there will
be more vaccine studies which will be
recruiting colleagues and members of the
public. Keep an eye on Connect for further
details.
Clinics will be set up in the Clinical Research
Facility at Sandwell initially and a suitable
location at City will also be used. More
information will be published through the
COVID-19 bulletins and on the dedicated
COVID-19 Connect pages.
A number of research projects are
underway that are using staff surveys.
These are being circulated via the
COVID-19 weekly bulletin.
Community outbreak team: Rapid
response to support our population
COVID-19
Thinking back to only a few short
months ago, Tammy Davies, Group
Director of Primary Care, Community
& Therapies, recalls her thoughts on
seeing news reports about the then
called ‘Wuhan flu’. She remembers: “I
must admit I didn’t anticipate just how
much of an impact it would have both
on our patients, local community and
service delivery.
“Towards the end of March when we saw
our first cases in the Trust, I realised that
this would probably be the biggest national
crisis the NHS would face in my lifetime.
We quickly formed a seven-day group
Tammy Davies, Group Director of Primary
Care, Community & Therapies
tactical response team to rapidly re-evaluate
how we deliver services and deal with the
changing picture.
“I felt apprehensive, and at times
overwhelmed but mostly really lucky to
have such an experienced and dedicated
team. We knew we had to act quickly to
meet the challenge, so turned one of our
large offices into a tactical response team
where the senior team all based themselves.
This helped with team bonding and moral
support. I ensured the entire group and
all staff were supported and prepared by
redirecting resources into essential and
urgent work and, ensuring colleagues had
rest and access to wellbeing services.
“The outbreak response team was set up
to undertake a same day response to areas
of the community who have suspected
outbreaks of COVID-19. Operating with a
minimum of two nurses – one senior - two
support workers, a driver and our contact
continued...
8

centre team, we are also supported by
women and child health colleagues for
outbreaks in children. The team also can
call on therapists and therapist assistants as
needed.
“The team aims to successfully swab
everyone who is suspected of having
COVID-19 and provide support
and reassurance when people are
understandably anxious. Our target is to
respond on the same day or within 24
hours.”
Covering the Sandwell area and operating
seven days a week, the team’s core hours
are 8am to 4pm, but they are flexible
and will work later if required. They are
ready should a community surge happen
and consider a surge to be any increase
in COVID-19 cases which may happen as
lockdown restrictions are relaxed. However,
they are also anticipating a surge in demand
for community services from people
COVID-19
Caring for our elderly patients
during COVID-19
Care, compassion and kindness have
been three buzzwords that have been
ringing through our hospitals ever
since COVID-19 came to our doors. And
whilst an unprecedented healthcare
crisis unfolded across the world,
colleagues continued to come to work,
ready to don their PPE and care for their
patients.
To find out more about how colleagues at
Sandwell dealt with COVID-19, Heartbeat
caught up with Consultant Geriatrician
Grace Shorthouse. Sharing her experience,
she said: “Elderly care was one of the first
wards to become 'hot', so the team had to
adapt very quickly to working in a COVID
positive environment. We needed to get
very familiar with our PPE and establish
correct areas for donning/doffing. It was a
real challenge to be able to communicate
with our patients - many of whom have
cognitive problems and trouble hearing and
seeing. We had to be able to think on our
feet and use different resources to help get
our messages across to patients.
“Although many of our clinics were quickly
converted to telephone clinics, this posed
its challenges as it can be quite tricky
when you are trying to assess things like
the neurological symptoms of Parkinson's
disease. However, patients were often
grateful that we were going the extra mile
to ensure they remained well looked after
and safe during the pandemic, even if it did
mean some of our assessments were slightly
limited.”
with chronic illness who may deteriorate
through a lack of medical/nursing and
therapy support due to the crisis creating
fear in patients about attending hospital
appointments and seeking help. The
team are also concerned that people may
have missed immunisations and cancer
screenings and this too may result in a later
surge.
Tammy continued: “I am proud of how the
group has quickly altered usual services
to respond to the changing picture. In
addition, the team have worked with the
local community, public health, CCG and
local authority to protect our patients and
the local population.”
Marian Long, Group Head of Nursing in
Community and Therapies clinical group,
added: “With a remit to deliver a seven-day
response service to support the control of
local outbreaks as part of the next phase
of test and trace, we’ve been working
Consultant Geriatrician Grace Shorthouse shares
her experience of COVID-19
She added: “My colleagues have been
wonderful! A lot of people were quite fearful,
especially at the beginning of the pandemic,
and we had contact with a lot of very frail
patients that did not survive. This was a very
stressful time so we all made an extra special
effort to be kind to each other and talk
through how we were feeling. There was a
lot of camaraderie and team spirit. We made
an extra effort to celebrate the small victories,
including a PPE themed birthday cake for
one of the consultants on the ward. We had
in partnership with our public health
partners. By identifying and containing
potential outbreaks, in workplaces, housing
complexes, care homes and schools as
well as supporting our Trust in ward-based
outbreaks we can mobilise our team and
respond promptly.
“This service is vital to help reduce the risk
of a second surge and we are proud of
our role in supporting this. Our task would
not have been achievable without our
fabulous contact centre, the energy of key
individuals, namely Andy Churm and Jo
Tonks, our very patient drivers Cash, Andy,
Malcolm and Peter and expert support form
Julie Booth and Dr Saluja.”
Kulwinder Johal, Clinical Directorate Lead
in Ambulatory Therapies and End of Life,
concluded: “As a group, the ethos has been
that we are all in it together, so all staff
in the group have supported the ask by
working flexibly around the demands of the
day to demonstrate our ‘can do’ attitude.”
Haiku poetry competitions, sunflower
growing competitions and a few (socially
distanced) meals on the ward - it was a
positive environment as we all went the
extra mile to make things as pleasant as
possible.
"Using WhatsApp to video conference
with families has been a bit of a
revelation. Most people would prefer to
see their loved one in person, but some
of the older patient relatives were often
too frail to visit, even before COVID-19.
I had one poorly patient who was
dying and his wife requested we video
conference with him so she could wish
him a happy birthday and say goodbye
one last time. He'd been unresponsive
for almost a day, but once he heard her
voice, he roused enough to open his
eyes and tell her he loved her. It was a
precious and beautiful moment - one
that she was so thankful to have had. As
sad as it was, it made my day!”
When asked about her tips for working
through a pandemic, Dr Shorthouse
said: "Take your time with PPE and
with your patients. A smile goes a long
way in communicating through a mask
and visor. Keep a sense of humour, talk
your concerns out with colleagues and
drink plenty of fluids! (but go to the loo
before you get dressed up in PPE!). Oh,
and if you struggle with wearing masks,
try sucking on a sweet underneath -
that helped me relax and breathe a bit
better!”
"For the things we have to learn before we can do them, we learn by doing them.”
Aristotle
9

10
Tackling COVID-19 – reflections
from the medicine cross-site team
COVID-19
By Dr Edward Fogden,
Consultant Gastroenterologist,
Clinical Lead for Gastroenterology
A lot has happened since Nick
Sherwood, Joint Clinical Lead, Critical
Care Services came to our joint
gastroenterology and acute medicine
QIHD in February to talk to us about
how to deal with a viral pandemic.
Since then COVID-19 has changed so
much of how we live and work that
it is difficult to predict what life will
be like even a few months ahead.
Looking back, I feel we need to give
credit to the positive approach shown by
our teams despite the underlying anxiety
about coming to work in the midst of a
pandemic, getting used to the PPE that
has become familiar to us all, and the
impact of lockdown removing the usual
pressure valve of social interaction with
family and friends. Everyone’s working
lives changed rapidly with different rotas,
changing job roles and often different
departments.
It has been a huge team effort – in
medicine where I work, our EDs, AMUs
and all the inpatient wards had to
rapidly and fundamentally change how
they worked. We have matrons and
ward managers leading new teams
with redeployed nursing staff, often
on different wards to usual; medical
specialty colleagues joined the wider
medicine and emergency care team to
cover wards and expand the on-call team
to provide expanded hot and cold seven
day cover across both sites; within days
all grades of medical staff were on new
rotas, and operational colleagues worked
long hours alongside clinical and nursing
leadership teams to make all of these
major changes happen, whilst keeping
everything running in the face of a what
felt like an ever-changing situation.
As medicine reconfigured itself ahead
of the surge, the whole patient-facing
workforce needed to have been FIT
tested, trained in PPE use and educated
in how to treat a new disease. This
posed its own challenges, particularly
how to distil down the volume of clinical
research that was being published
on a daily basis, but also to ensure
that everyone was able to access this.
Government guidelines also changed
Dr Edward Fogden, Consultant
Gastroenterologist
as often, and the Trust comms team had the
unenviable task of trying to get this everchanging
information to everyone in the
organisation. We also saw the birth of our very
own Youtube star, the trust’s face of PPE “Dr
Mark says…” rivalling Joe Wickes for public
service broadcasting.
There has been, and remains, understandable
anxiety about the risks to patients and
individual staff from COVID-19, given the
impact of COVID-19 on our population and
how hard Birmingham and the Black Country
have been hit by COVID-19 relative to other
parts of the country outside London. Better
data to help us understand the risks to staff,
including regarding ethnicity and underlying
health conditions, has guided the development
of risk assessments which are now available
for all staff via occupational health. I’m
very grateful that we didn’t experience the
significant gaps in PPE reported in other trusts
across the country, credit to the hard work of
Dinah McLannahan and her team.
Every available person in my specialty
(gastroenterology) worked in the Trust in the
response to COVID-19 including many staff
redeployed into the wards or ITU, or working
from home due to shielding, leaving our
mainly outpatient-based services running at
a tiny fraction of its usual service. We had
started a team WhatsApp chat a few years ago
during heavy snow to help coordinate work,
and found it really useful during Unity go-live
– it proved helpful again to keep in touch with
everyone as did the weekly Zoom call. I think
it has allowed us to keep everyone informed
as best we can about all the changes, support
staff who have been redeployed across
medicine including ITU and the wards, as well
as colleagues working from home.
Patients definitely do worry about coming
into contact with COVID-19, both in the
community and in hospital, and are concerned
about the risk of getting ill and dying from
"Leadership and learning are indispensable to each other.”
John F. Kennedy
it. The press have reported NHS figures of
10-20 per cent of inpatients with COVID-19
have caught it whilst in hospital – this is a
necessary reminder of the need for PPE to
protect our patients, colleagues as well as
ourselves. Nationwide the NHS has seen a
steep drop in attendances to ED, referrals
from GPs, and also GP attendances. This
worries us, as large numbers of patients
are not seeking medical attention for
symptoms that need investigating urgently.
We are going to see a rise in referrals
as the lockdown eases and are working
hard to deal with the challenges posed by
the backlog of elective work across the
NHS (outpatient clinics and endoscopy
procedures in gastroenterology) and the
impact this will have on our patients.The
press are reporting on NHS-wide delays
to elective care including outpatients,
procedures and operations, and the impact
on cancer care during the pandemic and
afterwards.
One of the greatest changes due to
COVID-19 has been around visiting, with
only a very small number of patients able to
have any visitors at all. Telephone calls and
video calls have provided a link to family at
home, and allow updates and discussions.
Unfortunately the visiting restrictions have
meant that patients have died in our care
without their loved ones being with them,
for example when relatives were themselves
at risk, shielding, or living with elderly
relatives and therefore unable to safely visit
the hospital. This is such a difficult thing for
staff as it is so alien to us as a society, yet
was the reality for patients whose relatives
were unable to visit or had to stay away
after balancing the risks to them and their
loved ones if they contracted COVID-19
whilst visiting.
As we re-form our teams, as life returns to
the new normal, we need to recognise that
everyone will have their own experiences
from the past three months, from work and
home. Now that the clapping has stopped,
and the dust begins to settle from the past
months, it is important that we support
each other as we work to get back to a
more normal existence and run our services
post COVID-19. We need a continued
focus on, and investment in health and
wellbeing services to support staff. Some
of us will experience mental health issues
as a consequence to our experiences over
the past months; we have seen great
support for trainee doctors through Mike
Blaber and the Three Squares Club and I
encourage colleagues to seek the support
that’s available for all staff via the health and
wellbeing pages on Connect.

Sheer sense of comradery brings
Rowley together
COVID-19
Working patterns of colleagues at Rowley changed in order to manage the pandemic
Gearing up to deal with a once-in-alifetime
pandemic, Justine Irish, Matron
for Primary Care, Communities and
Therapy gives us an insight into how
her team at Rowley responded to
the rapidly evolving need to change
working practices to maintain services
while keeping patients safe.
She told us: “The first task was preparing
the team for what was to come. For
example, it sounds simple on paper
designating hot wards for positive patients
and cold wards for those not suspected
of having the virus. We quickly realised
the reality of some patients on blue wards
exhibiting no symptoms but on testing
coming back positive. When you prepare
colleagues for working in a low-risk area,
they cannot guarantee it will remain that
way so it has been difficult. The Rowley
team is really special; they are a resilient
group who work as a family. The overall
mood at Rowley has always been one of we
are in it together so let’s get on with it.”
When the pandemic hit, the model of beds
on Rowley wards changed, to create a
The ward services team have made a huge
impact
mixed model of medically fit and intermediate
care beds all together. Colleagues stepped
up to cover other areas, away from where
they were most familiar with. However, with
lockdown, this inevitably changed, as most
services out of Rowley were relocated or
changed as opposed to stopped.
Justine continued: “For me, my working
week has changed. This is also true of
many members of our directorate who
have changed their working patterns too.
Alongside my colleague Natalie Whitton,
we have been cross covering all of our
community wards and providing a seven-day
matron cover between the two of us. We
also introduced an out-of-hours matron – Pal
Grewal - who has been providing support
during twilight shifts, which has also had a
positive impact.
“Over the last three months, what has stood
out for me has been the sheer sense of
comradery across some 200 plus colleagues,
seeing them assist each other with face
masks, bring in food for each other, shop for
each other and generally care more for each
other.
COVID-19 has brought the teams closer together
"If I had to call out one team, it would
be our domestic colleagues, as although
we have a smaller team at Rowley they
make a huge impact. They have turned
wards around that have been closed for
years, and have deep cleaned to within
an inch of their lives. They come in
early and go home late, and clean every
touchpoint so meticulously and I am sure
they are a huge part of the reason why
we have kept Rowley a blue site.
“Of course our patients have been
wonderful too, as no one has questioned
or disagreed with how things have had
to be. Our colleagues have all played
a role in this by keeping patients up
to date with ever-changing news. We
initiated a daily call home to next of
kin (with consent) and enabled those
patients who were able and wanted
to, to Facetime or call loved ones, to
maintain essential family contact. This
has been so well received; we are keen
to maintain it into the future as our
patients look forward to that contact.
“In the future, I think many changes
will become the norm for us at Rowley,
as technology has opened up a whole
new world of possibilities. I have spoken
to more people and met more people
during online meetings than I would
have done before the pandemic, and
that in turn has developed some pretty
good pathways around discharge and
our length of stay."
Annie Williams, Practice Education Nurse
iBeds, said: “The team have become
much closer across all departments
during COVID-19. It feels as though
we all know each other on a different
level – kindness has been at the heart of
the Trust’s pandemic response and that
message is evident in how staff interact
with each other – greeting each other
and asking “how are you today?” and
having true meaning behind it.”
Lady Ann Ordona, Senior Sister on
McCarthy Ward added: “The pandemic
has changed not only my way of
working but also my personal life. We
want to give the best nursing care to
our patients and facilitate their safe
discharge, but not knowing if any of my
patients have COVID-19 is a stress. One
thing I’m sure of and it’s not only here in
Rowley Regis, we’ve seen how the NHS
has come together and that makes me
proud to be a part of what they call the
frontline.”
11

Community frontline continue to
deliver high standards of care
COVID-19
During the COVID-19 pandemic, many of
us have found ourselves working in a way
that takes us completely out of our comfort
zone. An example of this is none other
than within our community midwives and
district nurses who working in difficult
circumstances to deliver a high standard of
care for our patients.
We caught up with Nicola Tomkins,
Community Midwifery Manager and Frances
Edwards, Student District Nurse to get their
perspective from the community frontline.
Nicola Tomkins, Community
Midwife Manager
How has COVID-19 affected the way
you work as a midwife within the
community?
The pandemic has meant that
antenatal and postnatal care has had
to be greatly modified to suit national
recommendations for social distancing.
What this meant for our women in
Sandwell and West Birmingham is that
instead of midwives providing care at
their GP clinic, or in homes they were
being asked to attend alternative venues
such as the local football stadiums.
We have been able to provide women with
increased telephone support which has been
incredibly successful. We have also continued
to conduct home visits for the most vulnerable
families by wearing the correct PPE (which has
been a learning curve, especially when trying
to put it on outside on a windy day).
How do you allay the fears of women
and the fears of your colleagues?
It is true to say that there are anxieties
surrounding COVID-19. Pregnancy in general
for some women can be an anxious time, and
the fear of leaving the house has propelled
anxiety levels for many women. However, a
robust telephone triaging system has meant
we have been able to stay in close contact
with our families to allay their concerns.
How do you feel about working within
the community and does the threat of
COVID-19 worry you?
Yes, it does along with my colleagues too.
We have held ‘practice sessions’ for donning
and doffing, we have a robust telephone
triage system which identifies women who are
unable to leave the home, are symptomatic,
are isolating or awaiting swabs for example.
How has your typical day changed since
the pandemic?
It has changed greatly. We have had to
completely change our way of working and,
to be honest in many aspects of our job it
has forced us into a better way of working.
It has identified areas of work that we hope
to continue using, such as virtual/telephone
consultations and postnatal clinics.
Is there a fear about coming into a
healthcare setting for appointments?
Absolutely yes at first, many patients
thought it was safer for us to see them
at home. However, attending a minimally
staffed clinical environment that is not
linked to the main hospital, practising social
distancing measures, with better access to
PPE and handwashing facilities, have all
proved to be much safer. Also, our clinics
at West Bromwich Albion and Aston Villa
Football clubs have been more successful
than ever due to the space and ability to
socially distance.
Frances Edwards – Student
District Nurse (DN) within the
care home team
How has COVID-19 affected how you
work as a DN?
It has meant a huge change in the way
we work in the community. We have
always strived for holistic care in what
can be challenging environments. We
are autonomous practitioners that
manage complex case management
and prevent hospital admissions. This
has remained the same throughout the
pandemic. What has changed is the way
in which we work. We are utilising technology
for meetings to enable social distancing,
alternative bases are being used and the new
DN care home team has been developed. We
aim to be a more integrated and streamlined
service for the benefit of our patients.
Like all staff across the Trust, we have battled
with anxiety about the pandemic. We have
appreciated the regular emails from our
directorate, raising mental health awareness
and signposting all the resources the Trust has
available. In this time of uncertainty, it is ok
not to be ok. Open discussion and dialogue
have been of great benefit to help us to
manage anxiety.
Do you find that patients are very
conscious and worried about the ongoing
situation?
Our patients are understandably worried
about the ongoing situation, their daily
lives and access to healthcare services.
Unfortunately, we have many patients who
are unable to see anyone at all and we try to
be a comfort to them. Building relationships
and rapport with patients is a very important
part of our work. We offer reassurance and
understanding - this has never been needed
more in care homes, for both our patients
and the staff that work within them.
How are patients reacting to you
wearing your PPE?
The majority of our patients are relieved to
see us wearing our PPE. We have had issues
with some dementia patients being scared
of us. With vision changes that occur with
dementia, it is understandable. We have
tried various reassurance techniques and,
the Trust has issued us all with wipeable
badges which features a large photograph
of the person in PPE and their job title. This
has helped our patients ‘see’ us.
How do you feel about working within
the community?
It is a privilege to work in our patients’
homes. It is a worry to think we could be
transmitting the virus; however, we are
strictly following PPE and handwashing
guidelines. We are protecting our patients
as much as we possibly can, plus we have
all had swabs and antibody tests.
12

Three Squares Club for wellbeing
and peer support
Working long days during this pandemic
has become something of the norm
for many colleagues. That’s why our
organisation has found lots of new and
innovative ways to ensure wellbeing
is at the top of our agenda. As well
as this, across the Trust teams are
developing ways to relax, recharge and
reflect.
One such area that has embraced staff
wellbeing on the frontline is among our
junior doctors, reflected in an initiative
called the ‘Three Squares Club.’ It
encourages regular opportunities for
refreshment, peer support and informal
debriefing. We caught up with Dr Vikranth
Venugopalan, Consultant Neonatologist,
who explained the part he has played as
one of the facilitators in this initiative.
He said: “We recognise the stresses and
strains COVID-19 places on us as medical
staff. That’s why it’s important to ensure
our wellbeing is something we take care
of both individually and collectively as a
team. Three times a week at both City and
A meeting of the Three Squares Club
Nursery provides essential support to
key workers during pandemic
As people across the UK have been
trying to hold onto a sense of normality
since lockdown began in March,
one place that has provided a sense
of familiarity throughout has been
Sandwell’s children’s nursery.
Sandwell nursery, like all other services, has
had to adapt how they operate and quickly
too. In Sandwell there are over 100 nurseries,
however, only 28 have remained open during
the pandemic. With up to 39 children of
NHS and key workers attending daily, the
team have thrived on the challenge. They
have continued to offer this essential service
meaning many colleagues and community
workers can continue to work where they are
needed the most.
Emma Collier, Sandwell Day Nursery Manager,
told us: “I am so proud of the team and how
they have come together during COVID-19.
They have worked extremely hard and,
we have taken on 30 additional children
in emergency places. This includes several
school-age children and children with no
nursery experience who are normally looked
after by relatives. Despite all of this, the
nursery has opened as normal from 7.15 am
– 6 pm, Monday to Friday as well as opening
over three bank holidays.
Sandwell hospitals, we facilitated sessions for
junior doctors where we talked openly about
different subjects, such as the emotional
impact of shifts. As the pressures of the
pandemic have changed, the frequency of
sessions has been reduced to once a week.
We now meet on Wellbeing Wednesdays.”
He added: “In these sessions, I emphasise
the importance of wellbeing both inside and
outside of work. It comes in many forms and
is not limited to sessions like the ones I hold.
I talk about healthy eating, getting adequate
rest, and I signpost colleagues to resources
available via the Trust. This includes things
such as the free yoga classes we can take
advantage of.”
Dr Michael Blaber, Specialty Doctor in
The nursery team
“Six of the emergency place parents have asked
for permanent places with us and many of the
parents say their children ask to come to their
new nursery. The feedback we have received
from parents about the care provided and the
support the hospital has given to our staff has
been lovely and appreciated by everyone”.
Opening during a pandemic has not been
without its challenges. Emma told us: “The team
have had to ensure that children have remained
socially distant while in our care, as well as deep
cleaning the nursery throughout and being
COVID-19
Palliative Medicine, is taking the lead
in championing wellbeing among
junior doctors. He has appreciated the
response from a wide team of colleagues
contributing to the wellbeing of others
through initiatives such as the ‘Three
Squares Club.’ He remarked: “The
pandemic has been a difficult time to
work through, but it has also led to
an enhanced sense of togetherness.
We’ve had more experienced clinicians
support junior doctors in engaging with
the ordinary human needs that we all
share in common, particularly at times of
heightened pressure.
“I would like to say a big thank you
to all who have made such a valuable
contribution to the peer support
sessions. It is a joy to work with so
many colleagues right across the Trust
committed to making SWB an excellent
place to work for all staff groups.”
vigilant with the children and their hand
hygiene. The team have stepped up and
ensured that the children in their care can
attend nursery every day without noticing
any considerable differences aside from a
few new faces.”
The nursery has made a conscious effort to
keep in touch with children who haven’t
been able to attend nursery. The team
have a Facebook group and app that
they actively use to share information.
Emma explained: “We have been posting
activities for children to do at home, we
have offered to post out worksheets, done
dance videos and posted online messages
to the children at home. We wanted to
let them all know we are still here and
missing them all.”
The team are looking forward to
welcoming children back. In preparation
for this, they have painted the nursery
throughout and decorated the outdoors
too. Emma remarked: “It has been
a testing time for everyone, but the
team have made working through
this pandemic a positive experience. I
am thankful to work alongside such a
dedicated team of people.”
13

Sepsis is still our number
one quality priority
COVID-19
Dr David Carruthers, Medical Director
The impact of COVID-19 has been
unprecedented as teams have had
to constantly adapt to the everchanging
environment. While
responding to the pandemic, clinical
teams have also been ensuring we
continue to reduce the number of
avoidable deaths which includes
keeping on top of our number one
quality priority – sepsis.
Medical Director, Dr David Carruthers
has been the driving force behind
implementing our quality plan and,
he spoke to Heartbeat about how our
organisation has been identifying and treating
sepsis during the pandemic.
He said: “Screening has remained stable
during the pandemic, so well done to
the teams for that with so many changes
occurring.
“Sepsis screenings are being done for 90 – 95
per cent of patients who require the screening
to be undertaken. On average, there are
about 700 patients who need screening
each week of which one out of six are screen
positive and require review for confirmation
of sepsis and institution of the sepsis 6.
Current data shows that 80 per cent of those
who screen positive subsequently receive
antibiotics. However, only 50 per cent get the
antibiotic within an hour, so we are working
with teams to ensure this improves.”
David explained that our target is 100 per
cent screening compliance which is being
achieved in some areas but not all.
“Colleagues need to recognise when a patient
is deteriorating using a NEWS2 score of five or
greater to undertake sepsis screening, but be
alert prior to this stage of patients becoming
increasingly unwell for early intervention.
“Team working between medical and
nursing staff is key here to get clinical reviews
undertaken when indicated. We are looking
Sandwell and
West Birmingham
Sepsis
is our number
one quality
priority
NHS Trust
to spread the best practice of those wards
that achieve near 100 per cent compliance
with wards that need improvement.
This would be for checks but also timely
treatment compliance.
“We are continuing to work with those
clinical areas that are not consistently at 100
per cent for screening and are asking each
ward area to identify where changes will
allow all components of the sepsis 6 to be
undertaken within an hour, especially the
administration of antibiotics. We know this
is one of the key components of improving
patient outcomes from sepsis.
“The overriding message to all colleagues
is to take the time to follow the screening
protocol. Caring for patients is key, but the
only way we can ensure that all patients are
being appropriately screened is by following
the protocol to save lives.”
Colleagues who are unsure of the sepsis
screening processes are encouraged to
speak to their ward matrons or contact
the deteriorating patients and resus
team on ext.5908.
14
COVID-19 BAME deaths analysis
The COVID-19 pandemic has required
a rapid change in pathways for our
patients. At the start of the pandemic
we set out to treat our patients with
the same care and kindness that
we pride ourselves on delivering,
and that has not changed. Our
approach to providing best practice
and reviewing mortality of cases is
discussed at our public board meeting
every month and we have been open
about our data and have shared it, in
the hope of sharing learning.
The main questions we consider are:
• How our care pathways have
compared to best practice?
• How our outcomes compare to
neighbouring providers and why?
• How well all populations served
by the Trust have been treated with
COVID-19 to date, and anything
we need to change in the coming
months?
Our Learning from Deaths team has
undertaken, alongside medical examiners
and clinical colleagues, a review of the
higher number of deaths than normal due
to COVID-19 deaths. Dr David Carruthers,
Medical Director, explained: “We consider
every patient lost to COVID-19 a tragedy.
Since the pandemic took hold in the middle of
March, we have identified through our data
that age, gender, hypertension and diabetes
are a risk factor in the outcome, with 67
per cent of patients who died of COVID-19
suffering hypertension whilst 44 per cent had
diabetes. This is in line with national data
which confirmed that patients with both Type
1 and Type 2 diabetes had significantly more
risk of mortality compared to the general
population. Other contributory factors include
poor diabetes control and obesity.
“Early on, we saw a trend of more people
dying from the black community, however,
this has changed over time, indicating that this
could relate to a geographical cluster rather
than an ethnicity-related concern. As our
figures for May show, we are not seeing
the same disproportionate death rate in
BAME communities. The median age of our
patients who have died of COVID-19 is 80
years old, with 96.2 per cent having complex
medical histories, and 61.8 per cent were
male.
“Overall across the Trust throughout March,
April and May, the combined mortality data
reveals the following breakdown:
• Asian 21 per cent
• Black British 16 per cent
• White 55 per cent
• Other 8 per cent.”
“Looking forward, as our ward base changes
to requiring a smaller number of wards for
COVID + patients, our understanding and
examination of hospital-acquired infection
will become all the more important to reduce
risk to non-COVID patients.”
“I am always doing that which I cannot do, in order that I may learn how to do it.”
Pablo Picasso

???
Using Unity in the battle
against COVID-19
CORPORATE AND GENERAL
NEWS
When hundreds of patients are
admitted with a potentially deadly and
highly contagious virus and you need
to be able to manage their treatment,
Unity our Electronic Patient Record, has
provided valuable functionality.
From managing patient records, to tracking
the status of beds and ordering tests, Unity
really did become an essential tool in the
fight against COVID-19 when the pandemic
reached the doors of our hospitals.
To find out more about how Unity helped
the Trust, Heartbeat caught up with Chief
Clinical Information Officer and Consultant
Ophthalmologist, Ash Sharma. He said,
“When you need to treat patients who
are acutely unwell or suffering from a
novel virus, you need as much information
as you can possibly get to make the
right decision in the treatment plan. You
need to be able to easily order tests and
manage their results centrally, so that at a
moment’s notice and at a glance you can
see how your patients are progressing.
This information then needs to be
communicated to all carers in the patient’s
journey. This is where Unity has really made
its mark.
“Previously, we used a range of systems for
ordering tests, managing bed allocations
and care records, so that every time
something changed for a patient, you
would have to login to another system
or record it on a paper document. This
fragments the information and significantly
slows down a department. Before long,
people become complacent, processes
aren’t followed and vital information or
tasks get omitted.
“With Unity, we fed all of our data into
one system so colleagues in capacity could
manage the flow of patients, ensuring
that we kept a separation of patients who
were COVID-19 symptomatic and those
that weren’t. We were also able to track
the results of patients so that we could
quickly act on results limiting exposure of
the virus to others and ensuring patients
got the right treatment at the right time.
The ‘banner bar’ at the top of every record
was utilised to highlight those patients
confirmed or suspected to have COVID-19.
“From an operational perspective,
Unity allowed us to very quickly change
our pathways and processes, to adopt
COVID-19 positive and negative channels
through our services as well as our
buildings; this is a change that was
unprecedented and had it not been for
the flexibility of Unity, it would have
been extremely difficult to implement
elsewhere.“
Regardless of the host of functions offered
by Unity, the most important thing is that
Acknowledging and endorsing results
all of our staff have embraced using the
system very well and continue to use it to its
fullest potential. Members of staff continue
to ask for additional functionality to help
with COVID-19 flagging, research and new
treatment plans. This should be encouraged
as regular users provide the best insight into
the improvements that can be made to help
with patient care.
Unity makes requesting diagnostic tests incredibly easy but tests are
worthless unless they’re acted upon. Acknowledging and endorsing
results takes seconds but it’s the only way to record that results from
imaging or pathology have been seen and acted on.
There are several ways to endorse results in Unity, please take the time
to familiarise yourself.
• PowerChart – For the requesting clinician, their results will appear
in yellow in PowerChart ready to be endorsed. For other clinicians,
they can view results which need endorsing by clicking the
“Endorse Results” button in each patient’s PowerChart record.
• Message Centre – A list of your unendorsed results in the results
endorsement home screen. Results in ‘Bold’ denote unread results.
Abnormal results are displayed in the abnormal section.
DID YOU KNOW?
Unity getting a code refresh
When endorsing results on Message Centre clicking
on the patient’s name to the left of the search bar will
take you straight to their record. Please remember to
also continue endorsing results as you review them
(e.g. during ward rounds).
In the very near future Unity will be going through one of its biggest
updates since we took it on, but don’t worry, everything that is changing
is under the hood, none of the processes or practices you have learnt will
be changing, the system itself at first glance will look almost completely
the same. However, much of the underlying code that manages Unity will
be updated to take advantage of improved processes delivering a much
slicker, stable and most importantly safer experience for patients and staff.
The upgrade will take place overnight and will be one of the few updates
that require elements of Unity to be taken offline for a short period. This
will mean a short period of business continuity for certain processes.
Details of the affected systems and date of the upgrade will be shared
through the communications bulletin.
15

End of
Life Care
As a healthcare organisation it is up to us
to provide the best degree of care we can
throughout the lives of each and every
resident of our area. That’s from even
before their birth, right through to their
death. The latter is, in itself a tricky matter.
A good death
The definition of what a “good death” is, unique
to each individual and can only be achieved by
communicating with patients and their carers to
ascertain their wishes, providing the information and
support necessary to make sure their choices are
informed ones.
On both a national level and within our organisation,
evidence shows that people cared for by a specialist
palliative care team have more positive experiences
at the end of their lives with fewer unnecessary
interventions and dying in a place of their choosing.
Yet access to palliative care is variable depending on
where you go, and evidence shows that it is significantly
less likely for people with non-cancer diagnoses who
are from BAME groups. It is therefore, imperative that
access to specialist palliative care is improved and that
for those within the palliative sphere and outside of it
to identify patients that require help and ask them their
wishes, offering compassion throughout.
“I can make the last stage of my life as good
as possible because everyone works together
confidently, honestly and consistently to help
me and the people who are important to me,
including my carers”. – ‘A Good Death’ as defined by
the National Palliative and End of Life Care Partnership
As much as we try, we cannot avoid the
prospect of death and in the end there
is, regretfully, sometimes only so much
which can be done.
So how does a care organisation such as ours
provide a “good death”, what is the thought
process that covers end of life care?
Dying matters
The Trust’s backing of Dying Matters Week, the 2020
edition of which was covered in depth in last month’s
Heartbeat magazine, is one way professionals are
trying to help change the narrative when it comes to
death, dying and the questions it brings up. There are
also misconceptions about supportive services that are
helped to be addressed.
This is sadly needed as public perception of end of life
care planning influences the willingness of clinicians to
engage in end of life discussions with fear of litigation.
Avoidance of communication and advance planning
frequently leads to rapid deterioration of patients during
out of hour’s periods, both in hospital and at home
only increasing a ‘rush’ on decisions due to a real or
perceived lack of time, and results in a poor experience
for all concerned.
“It’s important to not be discouraged by the topic, no
matter how hard or awkward it might be. Sometimes
people see the name ‘palliative’ and shy away from
what they think it represents,“ explains Palliative Care
Consultant Dr. Anna Lock. “But it’s not necessarily
about ‘imminent death’, more so about the quality of
life and the dignity of life in whatever time lies ahead.
That’s so important to us.”
Live as if you were to die tomorrow. Learn as if you were to live forever.”
Mahatma Gandhi
Work to do
The Trust recognises that, in spite of outperforming the
national rate there remains work to do. There remains
a significant difference between the experiences of
patients at the end of life for those with involvement
from the palliative care service compared to those
without – and that goes across all recorded metrics
including achieving preferred place of death.
There is an inequity of experience. Certain groups are
underrepresented in the current care caseload, in part
due to a lack of data – 68 per cent of cases come from
a white British background, but there are low numbers
of people from LGBTQ groups and only one per cent of
cases have learning or sensory disabilities.
Reflecting and decompressing
The mental wellbeing of colleagues continues to be a
concern, as part of a good death is also making sure
those caring for the patients are okay too. Colleagues
have faced an unprecedented amount of death and
illness over the recent months, it is only natural that this
is a strain. Especially when balancing it against the wider
world situation.
To that end the Trust offers a range of support for
health and wellbeing should you need it. Schemes
such as The Recharge Booth, a ‘virtual’ space hosted
by Richard Burnell every Thursday at 2pm that allows
you to come together with others, reflect, recharge,
decompress, and join a safe and confidential discussion.
“I didn’t come into healthcare to be a hero. I
came to try and make a difference and to help
people.” One colleague said at one session. “I am
uncomfortable with people making us heroes
and glorifying what we do. I don’t understand
why I don’t like it, part of me thinks it’s
because I feel the public have stood back and
ignored the issues the NHS faced across the
last few years and suddenly claim to love it.”
There’s also the COVID-19 Wellbeing Sanctuary based
at The Learning Works. The Sanctuary is accessible to all
colleagues and offers a range of health and wellbeing
activities from deep relaxation techniques, music therapy,
restorative clinical supervision and mindfulness awareness.
A colleague at the Sanctuary told Heartbeat: “I
have been off work with anxiety and the help
I am getting here is really helping me to get
my mind ready so I am able to return to work.
The colleagues here are wonderful, I would
definitely recommend it.”
You can book a session at the Sanctuary by calling
0121 507 5886. For more about the Recharge Booth
please contact Richard Burnell on 07747 144874 or
Claire Hubbard on 07866 004575.
COVID-19
As you might imagine, the ongoing pandemic which
has greatly affected the elderly population has meant
that numbers of patients admitted with COVID-19 had
multiple comorbidities and poor outcomes. However,
the demand on services and redistribution of resources
to support the pandemic necessitated focused support
from the palliative care team.
To this end, a proactive ‘pull’ model to identify patients
rather than wait for referrals enabled earlier specialist
intervention and decision making. There was also
frequent evidence of team-based decision making
within and across teams to support these actions.
Evolving Leasowes
To support good end of life care, Leasowes Intermediate
Care Centre has been transformed to provide a 20
bedded specialist end of life care ward with single
room, hospice style facilities and support from both the
specialist palliative care team and GPs from Your Health
Partnership.
The result of this change has proven to be a positive
one, based on what has been heard so far from both
reviews and anecdotally. Promoting better relative/
carer experiences which has in term resulted in better
outcomes for patients and overall better end of life
experiences. Deaths at Leasowes are reviewed and these
learnings are pushed back into the way care is being
given. Perhaps unsurprisingly, early results indicate
speed of action and an awareness of a patient’s needs
- both of which were enhanced by the changes – have
been key to this improvement.
“Of all the decisions made since early March the
proudest one we have made, in my view, is our decision
to create Leasowes as an end of life care centre able to
look after, in single rooms, both COVID+ and blue steam
people in a palliative state from heart failure, COPD or
cancer,” Chief Executive Toby Lewis told colleagues in a
recent bulletin. “This is our way to trying to make this
tragedy just a little more humane for people we will
lose. Please work with our palliative care hub to do your
best to make sure we use that asset well. With death at
distance, behind PPE, perhaps never has the notion of a
good death been more obviously important.”

The Sanctuary: Reduce your anxiety
and stress in a place of calm
COVID-19
In the last edition of Heartbeat, we
featured an article on the Wellbeing
Sanctuary, a place where colleagues
can share their stories and offload
about their anxieties and fears.
A month on, we are delighted to
report that many of you have been
taking advantage of the many
services on offer such as deep
relaxation and massage therapy.
Heartbeat caught up with Lawrence
Kelly, Learning Works Co-ordinator who
told us he is pleased to see colleagues
taking time out for their wellbeing. “We
have had 250 visits from colleagues
enjoying more than 420 sessions. It is
also pleasing to see colleagues returning
as they have enjoyed the benefits and
are seeing a real difference in the way
they are feeling.”
Lawrence said the sanctuary is seeing
colleagues from a wide range of
professions including senior clinicians
and wards service officers. He told
Heartbeat: “Colleagues are coming here,
seeing the benefit and then spreading
the word to their teams. We have also
recently extended the service to 30
nursing homes and local community GP
services.”
Kate Pilkington, Clinical Lead, Your
Health Partnership has used the
sanctuary. She remarked: “The sanctuary
is an extraordinary refuge of support
that I have found to be invaluable. It
helps me to manage my stress levels
and restore my sense of balance so that
I can be a better leader during these
challenging times. Actively choosing
to engage with the amazing staff at
the Sanctuary and taking the time to
decompress is one of the best decisions
I have made. I can see and feel the
difference immediately after a visit. I
would highly encourage all colleagues to
further explore how it could benefit them
as well.”
The psychological wellbeing of all
colleagues is of utmost importance and
our organisation wants us all to benefit
from the extended offer of wellbeing
Looking after you...
Sleep was not coming easy to Senior
Sister, Danielle Scott, and the more she
worried about it, the worse it got. Until
one morning after a particularly bad night
she knew she was unable to fulfil her
responsibilities in A&E at City Hospital
safely.
So she called her manager ED matron
Annabel Bottrill for support. Danielle
explained: “The last few months of
the pandemic have been particularly
hard on us on the frontline and I think
the constant vigilance and increased
workload has taken its toll on many of
us. I particularly felt it at night, after a
The Wellbeing Sanctuary is based at the
Learning Works, Unett Street, Smethwick
B66 3SY. Daily sanctuary sessions include:
• Deep Relaxation and Breathing
through Soundscape - Travel from
the peaks of the Himalayas to the
depth of the oceans of Bali relaxing
in a harmonious tranquillity.
• Music Therapy - A time to find
inner stillness through the
tranquillity of relaxing sound
vibrations.
and kindness. The new Thrive mental
health app is complementary to all the
relaxation therapies on offer. It is a chance
for colleagues to continue to use de-stress
techniques to improve health and wellness.
This includes cognitive behaviour therapy,
deep muscle relaxation and meditation.
long day, I would go home and then find
myself unable to switch off. After being at
the top of my game all day looking after
my patients, working in a tight knit family
with my colleagues and caring about the
wellbeing of my team, I really needed to
relax at home, to recharge for what the
next day would bring. I could see it was
not getting any easier, and when I spoke
to Annabel she suggested I turn to the
sanctuary for help.
“To be honest, I couldn’t see how it would
help, but I made an appointment and
went along just to say that I had tried.
What a revelation, I was so glad I went. I
was greeted by a welcoming environment
lit by pools of light from strategically
placed lamps in the reception. There
was ambient music playing low in the
background, and I was made to feel very
welcome. I went for relaxation and sleep
techniques, and when I went through
into the room for my session, I was
offered a huge bean bag to sink down
into. It was bliss. I really feel it has made
a huge difference to me, and I’m looking
forward to my second session. I’d urge
anyone who is having trouble sleeping or
switching off to take the opportunity to
visit sooner rather than later, so you can
get back on an even keel and get on with
your life.”
• Restorative Clinical Supervision
(Health and Wellbeing Lead) - A
safe and confidential space to
explore the impact of work
pressures.
• Unwind with Mindfulness -
Breath and Relax. Enjoy the session
of being present and the power of
connection and self-kindness.
A colleague receives therapy massage
To book an appointment contact the team
on 0121 507 5886. More information can be
found on Connect.
18

Psychological wellbeing: Ensuring you
get the right support at the right time
Our organisation is enhancing its approach
to staff wellbeing and in particular
psychological wellbeing during COVID-19
and beyond. We want to be able to support
colleagues to cope with psychological
deterioration that may occur following
our experiences, seeing or hearing about
situations that are stressful and challenging.
Our approach is multi-faceted across three
key areas:
1. Stress Risk Assessment – These are
completed via a simple confidential selfassessment,
you can access this using the
green button on Connect. These are
aimed at areas considered to have higher
levels of stress during June and July but
anyone can take an assessment at any
time and will be contacted with
appropriate interventions and support
from the wellbeing hub.
2. Trained staff in psychological
interventions – The Trust has developed
an internal capability to support
employees through psychological
interventions. Colleagues can access
training at three levels:
a. Level 1 – everyone can do this training
b. Level 2 – each area will have a
nominated trained person (Mental
Health First Aider)
c. TRiM – there are 32 TRiM trained
colleagues who are able to work with
staff affected by post-traumatic stress.
These levels of training enable signposting
to relevant support, alongside encouraging
individuals to take their own steps to
support their wellbeing.
3. The Wellbeing Hub and Thrive – The
wellbeing hub currently runs the Wellbeing
Sanctuary and will continue to provide
relaxation classes and appointments to
support mental wellbeing as well as physical
wellbeing in the future. The new Thrive
app is free to colleagues and has a CBT
(cognitive behavioural therapy) module help
you manage stress and anxiety levels.
COVID-19
These three areas will help us as a Trust
to prevent the deterioration of mental
health with good support networks and
signposting to make sure that individuals
get the right support at the right time.
The Wellbeing Hub will be the central
team who will coordinate this work and
work directly with employees to ensure
they have access to support to keep
themselves well both physically and
mentally.
The Trust is using a psychological
wellness scorecard to monitor how
prepared we are, to understand that
the interventions in place are making
the right impact.
Military training programme tackles
issues around stress
All of us may have been affected
by COVID-19 in some way and it’s
important to recognise that our
mental health may be affected by the
situations we’ve been part of, observed
or heard about over the last few
months.
The Trust has already trained some people
to support colleagues in React Plus which is
also known as mental health first aid.
However, we want to scale up that
support in frontline departments, and are
providing key staff with specific Trauma
Risk Management (TRiM) training, to tackle
issues like Post Traumatic Stress Disorder
(PTSD) which are predicted to arise in
coming weeks and months.
Nora Parsons, Learning and Development
Manager, said: “The Trust has partnered
with an organisation called ‘March on
Stress’ and are offering a tiered approach
to training people to undertake mental
wellbeing support roles. This includes all
line managers being trained to have a brief
‘psychologically savvy’ conversation with
colleagues, for example at the end of a
shift, to help identify if support is needed
and signpost to it.
“We are also encouraging all staff to access
this training, whether or not they are line
managers, so that they are able to support
colleagues at the first level by recognising
they may need help and referring them onto
further interventions if needed.”
The training is delivered remotely via video
and supporting material which takes less
than an hour to complete and can even be
accessed via your phone.
Toby Lewis, Chief Executive said: “We
are focused on the current and future
psychological wellbeing of our teams. We
have a local comprehensive wellbeing offer in
place, as well as making use of wider regional
and national mental health support. Learning
from Italy and elsewhere we have put in place
dedicated COVID-19 arrangements to provide
additional support for departments.
“We worked with healthcare and military
colleagues to consider what would be most
appropriate. From that has come a partnership
with March on Stress. Their help is focused on
delivering more advanced training in Trauma
Risk Management (TRiM) which is a traumafocused
peer support system designed to help
people who have experienced a traumatic,
or potentially traumatic, event. This
will be important as we come through
the recovery and restoration phase to
help people come to terms with their
experiences.”
Managing Director of March on Stress
Ltd, Professor Neil Greenberg, explained:
“We have been working with a number
of NHS organisations to help them to
ensure that they can implement a range
of evidence based psychological support
initiatives in order to help protect the
mental health of their staff.
“We are delighted to have been asked
by the Trust to help them roll out
training to their supervisors which will
help them carry out psychologically
savvy supportive conversations with their
teams. There is a great deal of evidence
showing that supervisors have a critical
role to play in supporting their team’s
mental health and the training we are
providing to SWB aims to help improve
supervisors confidence to have those
important conversations.”
See Connect for more information
about the training.
“Intellectual growth should commence at birth and cease only at death.”
Albert Einstein
19

New assessment to help reduce the
impact of stress
COVID-19
Our workplace is launching a new
way of completing stress risk
assessments in addition to the
retrospective assessments that
happen when colleagues are feeling
stressed and or have been off work
with stress. This new assessment is
able to be taken proactively at the
same time of year each year to check
the stress levels in departments and
to drive interventions to reduce
stress.
The new assessment tool is available as
an e-form that can be found by looking
for the green button on the right
hand side on the Connect homepage.
The form takes a few minutes to
complete and is sent confidentially to
the wellbeing hub. The wellbeing hub
will not forward information to your
manager without your consent.
The stress risk assessment is designed to
identify employees who require additional
support and to have supportive conversations
through the wellbeing hub to decrease the
impact of stress in those high risk areas.
If you are in an area deemed to be have
high levels of stress, you will have already
received an email asking you to complete the
assessment in June and July.
COVID-19 risk assessment
A risk assessment tool has been developed
and finalised for colleagues. The tool
assesses the risk level within the current
service /work setting as well as individual
risks including gender, ethnicity, age
and underlying health condition. The
outcomes of that assessment lead to clear
actions to reduce the risk of COVID-19 for
individuals. You should undertake this risk
assessment via occupational health if you
consider you are in a higher risk group.
In addition to staff working in areas
considered to be of high stress, any
employee is able to access this assessment
at any time and a member of the wellbeing
hub. The wellbeing hub will advise and
coach staff to the most appropriate action
to take and signpost employees to the most
relevant support for them.
This can be organised by email on swbh.
riskassessmentoh@nhs.net or via phone
on 0121 507 3306.
The Trust is determined to build on our
successful work to prioritise workplace
safety. That is all protections stay in place
but PPE is now truly personal.
We had undertaken over 130 assessments
by 12 June and continue to complete
assessments as they are requested by
colleagues.
Whether you’re 9, 19 or 91, the new
HEE COVID-19 library is for you
To battle the COVID-19; pandemic
knowledge is our most valuable
tool, the more we know about it,
the more medical colleagues around
the globe will be able to hunt
down the clues that will enable
the virus to be combatted and,
hopefully, eventually eradicated. But
knowledge in our hands is only part
of the solution – there also needs
to be an understanding in patients
and the public as to the nature of
the disease. Why what is being done
(in terms of social distancing) needs
to be done, and of course, the risks
involved to all, in particular, those
from vulnerable groups.
For patients and the general public, a
lot of information about COVID-19 can
be found on both the NHS website and
GOV.UK. As well as updates relating
to services, our organisation provides
information on our website and social
media channels about the pandemic.
There are several resources on the Health
Education England (HEE) website too.
HEE has produced a library of highquality
COVID-19 patient information
specifically for vulnerable groups. These
The latest Nurse Dotty book sees Dave the Dog
worried about coronavirus
resources are available in many different
formats appropriate to those groups and
are designed to be as accessible as possible.
With easy read options, support for sign
language, Makaton, a picture library for
those that struggle to communicate, videos,
and podcasts. There is a grouping specifically
for the risks older people face, with links to
guides and support from charities, such as
Age UK and Carers UK, as well as specialist
items produced by the likes of BBC Sounds.
For children and young people all the
changes that have been going on in the
world around them must be very confusing
– how do you explain a pandemic to
the very young? To help them better
understand the virus, they too have a
section which even includes pdf files of
illustrated children’s stories that tackles the
topic head-on.
“It is very easy to misunderstand the needs
to the lockdown and the consequences
of COVID-19,” an HEE representative told
Heartbeat. "As a result, HEE’s library and
knowledge services team has worked to
develop this new web portal. It collates
information about COVID-19, as well as
valuable insights from external companies,
charities and agencies that can be a benefit
to both patients and the public. This library
enables frontline health and care staff
who directly work with patients, clients,
and families to find, share and use reliable
COVID-19 information.”
The library is being updated as more
sources become available and those
who are interested should head to
https://library.nhs.uk/coronavirusresources/
to find out more.
20

Celebrating our
stars of the week
Star of the Week
Ribena Akhter
Paediatric Consultant
Star of the Week
Miriam Pappworth
Community Midwife
Star of the Week
Beata Wojtas
Sister
Ribena is known for always going above
and beyond and more importantly
supporting her colleagues. This was evident
when Ribena was one of the recent on call
consultants when the Trust had to create
new donning and doffing areas in our
blue and red COVID-19 areas. She played
a pivotal role ensuring many of our wards
could adapt to these changes out of hours.
Star of the Week
Joanne Tonks
Osteoporosis Nurse
Miriam has recently shown great
professionalism, empathy and care helping
a patient who was a victim of domestic
abuse. As a result, this case has now
been flagged by the police and relevant
authorities ensuring the safety and
wellbeing of the patient.
Miriam's tenacity, dedication and
professionalism has made an important
and significant difference to the care that
this pregnant lady will receive. This has
undoubtedly improved the outcome for
her and her unborn child. Miriam has gone
above and beyond to support a vulnerable
person who was at significant risk.
In the absence of Leasowes ward manager,
Beata has been amazing by taking on the
role of manager and has thrived in this
position. Ever since Leasowes changed from
rehabilitation to a palliative care centre for
patients with COVID-19, colleagues have
experienced a great deal of challenges
in adjusting. Beata has provided a lot of
support and reassurance and positive
thinking to get Leasowes through with the
changes and running of the centre on a day
to day basis. On numerous occasions, Beata
has made sacrifices and come in on her days
off, as well as her recent birthday, she even
missed her anniversary to ensure the centre
was covered to maintain patient safety.
Joanne was nominated by numerous
colleagues for the way she has coordinated
the Trust’s COVID-19 community
swabbing teams. Joanne has been praised
for her support to all colleagues who have
been deployed into the swabbing response,
ensuring that they are suitably trained and
kept up to date with the latest guidance.
She has always been available for help and
has made sure that we continue to provide
an excellent swabbing service for colleagues
who have symptoms, their family members
and care home colleagues.
Star of the Week
Dr Rebecca Edwards
Core Medical Trainee, Rebecca Edwards
has been working on the frontline of
COVID-19 and has been a shining light
in supporting dying patients as well as
supporting families. Nominating Rebecca
for the award, Consultant, Huma Naqvi
said, “Rebecca has always been a caring
and compassionate doctor, but in recent
times and especially managing a cohort
of patients who have been seriously
unwell and dying with COVID, she has
taken the time and has been particularly
compassionate and caring in her approach.
She took the extra effort with these
patients and their families, ensuring they
understood the nature of this illness and
also taking special efforts with one family
to have a final conversation with their
mother. It made all the difference and went
that extra mile. Bec is one of a kind, she
epitomises the essence of how any health
care professional should care for patients.
That should be recognised and hopefully
serve as an example to her peers (be that
junior or senior doctors). We all have a lot
to learn from doctors like herself.”
If you have someone in your team that has gone above and beyond the call of duty, put them
forward as a Star of the Week. Visit Connect to find out more.
21

CORPORATE AND GENERAL
NEWS
Shout out has been a regular feature
in Heartbeat and it is fantastic to see
colleagues regularly taking the time
to give positive feedback to each
other.
We regularly receive positive feedback
from our patients too, and this month
we wanted to share some of those
heart-warming messages which have
been sent via our website and social
media platforms.
To – Childrens Community Nursing and
Therapy Teams
The children's ccn and continuing care
teams have continued to provide essential
care to our children within the community.
The children's therapy team have embraced
new ways of working to ensure ongoing
support for our children in the community.
From – Cheryl Newton
To – Sophie Hodgson
Sophie is a newly appointed midwifery
support worker, she is in her first few
months of working with the midwives
at this difficult time. She very kindly
contacted her previous employer at Ikea
who generously donated eight changing
tables and mats for our postnatal clinics.
Thank you Sophie!
From – Nicola Tomkins
To – D30
To all staff on D30 for making my
redeployment onto your ward so
rewarding. Thanks for being so kind and
caring to a very unsure HCA - it means a
lot.
From – Maggie Moore
To – Amy Hunt
Amy is currently working as part of the
safety compliance team, over the past
few weeks she has played a vital role
in supporting Lyndon 2 with our safety
plan compliance and our percentage
has improved massively. Thank you from
everyone at Lyndon 2 for your hard work
and support!
From – Rachael Currie
To – Linda Parkes
For supporting and helping me during
my redeployment. I was very nervous and
anxious at the beginning, but with your
quick actions I am now being supported
into a specialist team. They have welcomed
me into my new role, supporting me with
every aspect of my training.
From – Gurjit Kaur
To – Staff on AMUA and Lyndon 5
A massive thank you to all the staff on
AMUA and Lyndon 5, my dad was an
impatient due to this nasty virus a couple
of weeks ago and I cannot thank you all
enough for the care he received. He cannot
praise you all enough, your hard work and
dedication to your jobs is outstanding.
Thank you so much for everything you did
and continue to do for so many patients it
doesn't go unnoticed.
From – Kerry Ruston
To – OPD HCAs
A massive thank you to all the HCAs in
BTC for embracing the new system to
enable our patients to return for face to
face appointments. They have set up the
entrance/exit stations and worked really
hard to ensure the process is robust.
From – Trish Kehoe
To – Keni Sulaj, Todd Morris, Jeevan Bahia
and Imran Ravat - IT
A massive thank you all for your recent
support, we experienced some IT
challenges within our team recently,
however, you were all very helpful and
professional and are a credit to the second
line IT support.
From – Nayna Patel
To – Mandeep Lalli
Mandeep has been exceptionally
responsive to help me work to a tight
deadline. She listened to what was needed
and delivered. Lots of communication
and nothing was ever too much. Totally
fabulous help and support. Thank you!
From – Claire Hubbard
To – Charlie Ammerlaan
For introducing the daily 3 minutes at 3pm
of meditation on the labour ward for all
available staff to join in with. It has been
really beneficial particularly during this
daunting time. Thank you.
From – Rosie Day
To – Randeep Degun
Thank you for arranging for the protective
screen on Sandwell outpatients main
reception desk. The reception team are
very happy and say they feel so much more
safe and protected.
From – Fay Williams
To – Sam Sohal
Sam has been an absolute star in sorting
out things relating to bank staff, she is
always quick to respond and extremely
helpful.
From – Dawn Hall
To – Portering Team at Sandwell
First I would like to introduce myself,
my name is Tina Viney and I work
with learning and development based
at Sandwell Hospital. My name was
put forward by my manager to do
some brigade work to support other
departments whilst COVID-19 is still active.
I have been working on blue brigade for
a few weeks now supporting the porters
in their roles. The team deserve a BIG
shout out for all the work they do on a
daily basis, coming into the role of porter
as given me a better understanding of
their role and work they have to do. I
have learnt so much from them already,
the team are very supportive and taking
time out showing us what we need to do
to support them as volunteers. I feel that
the team isn't recognised as much as what
they should be, and at the end of the day
we are all working to achieve the same
goals. It would be nice to see some sort of
recognition for the part they play within
the organisation so giving them a shout
out would be great.
From – Tina Viney
22

Queen’s Nurse Susan Knight –
By royal appointment!
Then and now. Susan pictured at the start of her career in 1987 and today as a Queen's Nurse.
Being recognised as a Queen’s Nurse is
one of the most prestigious accolades
anyone can receive in the nursing
profession. It is awarded to nurses
who demonstrate the highest level
of commitment to patient care and
nursing practice. Earlier this month, this
coveted title was bestowed upon Susan
Knight, Practice Education Lead.
It all began back in 1982 when Susan
embarked on her nursing career. She told
us: “I started my training in May 1982, and
this marks my 38th year in nursing. District
nursing wasn’t a field I had any prior
knowledge of or had considered, but the
placement I had with the district nurses had
the ‘wow’ factor. I knew from the outset
that this was going to be the path I would
pursue. I felt the impact district nurses had
on the lives of patients, their families and
carers. The skill demonstrated in holistic
care and flexibility, the way they worked to
meet the patient needs seemingly with ease
was inspirational. I knew without hesitation
I had to become a district nurse.”
Susan went on to work as a community
practice teacher for 10 years, teaching
and inspiring future district nurses. In
that time, she continued to further her
education so that she could keep up to
date with the latest developments. “I
completed a BA (Hons) degree via the
Open University. I then trained as a health
visitor. It gave me the invaluable experience
of working as a specialist public health
professional. I extended my role by working
as a contraceptive nurse specialist, a role
that I still undertake. During my health
visiting years, I held the position of an
executive committee member for children
and maternity services, and I was a nurse
representative on the Trust board.”
Over the years, Susan’s career has
continued to evolve as she has taken on
different roles and responsibilities. This
has been underpinned by her thirst for
learning. “With my passion for training
and education, I later transferred to a
professional development unit. I went on
to complete a Master of Science degree in
Health Studies and a PGCE. My desire has
always been to develop myself and learn, so
in turn, I can develop others to uphold the
principles that are central to being a nurse.”
In October 2019, Susan became practice
education lead for district nursing. The
purpose of this position is to enhance the
district nursing service. “I’m responsible
for ensuring the provision of high quality
multi-professional learning environments
within the community. My role focuses
on enhancing nursing practice in terms of
education and morale, as well as improving
health outcomes to help prevent hospital
admissions and enrich patient experiences.”
Another key aspect of Susan’s career has
been supporting district nurse students.
She is a key stakeholder in respect of
the university curriculum including the
revalidation of the specialist practitioner
programme and was invited to the last
CORPORATE AND GENERAL
NEWS
graduation ceremony as a VIP procession
member. In November 2019, she was
invited by a previous student to attend
the London Royal College of Nursing
round table event.
Returning more recently to district
nursing and leading a team, Susan
put herself forward to join the ranks
of the Queen’s Nurses and backed
by her manager, senior lecturer at
Wolverhampton University and a fellow
Queen’s Nurse, sent in her application.
“Working in this setting reinstated what
I already knew, that district nurses are
extremely passionate about their work,
and it’s so inspiring to be part of such a
culture.
“My team received two great
acknowledgements in 2019 that we
were so proud of. Michelle Melo, Deputy
Director of Workforce Development and
National Clinical Lead for Personalised
Care from NHS England undertook a
day shadowing the team. She highly
commended our work stating her visit
had demonstrated a high standard of
personalised care, excellent relationships
with the GPs and integrated care to
improve patients’ experiences.
“At the 2019 Star Awards, our team
won the local primary care award.
No district nurse team had ever won
this award before, and we were
overwhelmed. Receiving these types of
recognition gave me the confidence and
inspiration to apply for the honorary title
of Queen’s Nurse.”
Now that Susan is officially a Queen’s
Nurse, she looks forward to attending
annual meetings and developmental
learning and leadership programmes. “I
feel privileged to be part of a community
nursing organisation that has the same
values and passion for the profession
as I do, this truly is the pinnacle of my
career.”
Colleagues have been quick to praise
Susan’s achievement. Line Manager,
Louise Johnson, commented: “This is
excellent news and very well deserved,”
whilst another colleague said: “I couldn’t
think of anyone more deserving, you are
such an inspiration.”
We couldn’t agree more!
Congratulations, Susan.
“The beautiful thing about learning is that nobody can take it away from you.”
B.B. King
23

International Year of the Nurse
and Midwife - June 2020
As you may be aware, this year marks International
Year of the Nurse and Midwife, a campaign by the
World Health Organisation in honour of the 200th
birthday of Florence Nightingale.
CORPORATE AND GENERAL
NEWS
Nurses and midwives play a vital role in providing
health services in our workplace. They devote their lives
to caring for mothers and children; giving lifesaving
immunisations and health advice; looking after older
people and generally meeting everyday essential health
needs. They are often the first and only point of care
You may be thinking what exactly
does a business relationship manager
have to do with nursing, but don’t
be fooled - Dominic LeGros has been
nursing since the nineties!
Dominic LeGros
Business Relationship Manager, Unity EPR
Dominic LeGros – from nurse to business
relationship manager
“I first qualified as a nurse in 1998 at
Princess Alexandra Hospital, Harlow
and started working in their emergency
department,” said Dominic. “Three years
later in 2001 is when I joined the Trust as
a senior staff nurse working on the West
Midlands Poisons Unit up until 2004.”
Dominic would briefly move away from
the Trust to work at Selly Oak Hospital,
making a return to emergency nursing.
However, in 2008 he returned to our Trust.
“I always felt at home at SWB, which is
why in 2008 I returned to the Trust, more
specifically to City Hospital A&E. Whilst
in A&E, I trained as an emergency nurse
in their communities. Throughout the year, we will be
highlighting some of our nurses, HCAs and midwives
who are making a difference to our patients.
Each month we profile some of our wonderful nurses
as part of our 2020 Year of the Nurse and Midwife
celebrations.
Read on to find out about the career pathway of
Business Relationship Manager – Unity EPR, Dominic
LeGros.
practitioner and eventually qualified as an
independent prescriber.”
A decade later, Dominic would seek yet
another challenge where he combined
a lifelong interest in technology with a
passion for delivering quality care. “I have
always had a second passion for tech which
is why it made perfect sense for me to join
the Unity team as an informatics nurse.”
Dominic played a pivotal role in the launch
of our electronic patient record, Unity and,
subsequently went on to win the award
for Digital Leader of the Year Award at the
2018 Star Awards.
#swbawards20
Thank you for sending in your nominations for this year’s
Star Awards. The judging will now begin and the shortlist
will be announced on Monday 3 August.
24
Although our awards ceremony may be different this year, we
will still be recognising outstanding achievement. We have 21
categories this year including a special award for this year only
that recognises nurse/midwife of the year, as this year is the special
International Year of the Midwife and Nurse.

Flu-per troopers – Preparing
for battle
It’s lovely and sunny outside and the
last thing on your mind is the flu
vaccination programme but you’d
be surprised to know that work has
already begun to prepare for our next
battle with flu.
Last year’s campaign was a huge hit; we
managed to vaccinate 5,027 colleagues
across the Trust, 4,454 of whom were front
line staff. Bethan Downing, Deputy Director
of People and OD, said: “Last year, we
managed to surpass our 80 per cent herd
immunity target, but it took us longer than
we had expected. Timing is everything,
and the flu vaccination is no exception. It’s
important to be protected early, to give
your body time to build up its defences
and to generate some antibodies so when
the flu season begins to peak, you can be
safe in the knowledge that you have some
protection ready and waiting."
This year, we’ll be out and about offering
the vaccine from October and, we‘re hoping
that by Christmas, everyone will have taken
up the jab. We have seen the impact of
COVID-19 – a virus we have no vaccine
for yet, however, we do have a vaccine for
flu - it’s a vaccine that covers four different
strains of the virus. With the COVID-19
situation, preventing flu is more important
than ever this winter. We're not going to
let a preventable infection take hold of our
colleagues.”
Coughs and sneezes aren’t the only way to
pass on the flu; we know that approximately
70 per cent of flu cases have no symptoms.
People carry on with their day as they
would do, and unbeknownst to them, every
surface they touch is spreading the disease
CORPORATE AND GENERAL
NEWS
to everyone around them, whether they
are at home, at work or visiting friends
and family.
Flu doesn’t discriminate, it affects
everyone equally and a common myth
that circulates every year is that the
vaccine contains porcine products; this is
false. A lot of time, effort and research
every year goes into making sure that the
vaccine is appropriate for everyone and
no porcine products are used in the flu
vaccines provided by our Trust.
To become a flu-per trooper,
get in touch with us at
swbh.seasonal-flu@nhs.net.
Final days to complete
your PDR: All you
need to know
Performance Development Review
(PDR) season is upon us once again and
it’s vital all colleagues have completed
their PDRs by 31 July.
PDRs are the chosen assessment tool
used by the Trust to evaluate colleague
performance across the last 12 months.
Everyone from our chief executive to our
ward services officers completes a PDR.
Nora Parsons, Learning and Development
Manager, is urging colleagues to complete
their PDRs by the end of July as it enables
you to objectively review your previous year
and think about the future.
She said: “The PDR is important for
everyone within our organisation to
complete. It provides an excellent
opportunity to reflect on the year that has
passed and plan for the one ahead. It also
gives the opportunity to discuss your career
progression aims and your development
plan.”
She added: “A lot of people forget some
of the good things they have done over
the year – your PDR discussion is a chance
to recognise where you are performing
well, and it could also be used to help you
improve in areas where you may be struggling,
get additional support if needed and address
any potential concerns you may have. The
PDR is also a fantastic opportunity to give
feedback to your manager and have an open
conversation.”
The PDR itself is broken down into five distinct
sections which are:
1. Section A – Your performance over the
past 12 months
2. Section B – What’s gone well and
what’s not gone so well including
scoring
3. Section C – Objectives for the next
12 months
4. Section D – Your future aspirations
and personal development plan
5. Section E – Final score and sign off
With the COVID-19 pandemic, it’s vital that
we focus on the mental health and wellness of
everyone across the organisation. With this in
mind, it is important to also have chat about
your wellbeing.
Nora added: “I encourage all managers
to have a conversation around mental
health and wellbeing as this will help
break down barriers and remove the
stigma around mental illness. There
is a lot of support for staff wellbeing
including the Wellbeing Hub. I also
recommend everybody to download
the Thrive mental health app. The
app tackles common stressors such
as sleep, bereavements, work issues
and more. It also signposts to external
support services with users able to seek
immediate help directly from the app.”
If you wish to download the app or find
out more, please visit https://connect2.
swbh.nhs.uk/od/occupationalhealth-and-wellbeing-service/
download-the-thrive-mentalwellbeing-app/.
For more information around your
PDR, please contact swbh.landd@
nhs.net and please check that your
managers have entered your PDR
score and objectives onto Connect.
25

Staying connected
from home
CORPORATE AND GENERAL
NEWS
COVID-19 has changed so many of
the things we all took for granted
and we’ve all had to adapt the way
we do things, not least the way
we work. Luckily at our workplace,
we have the flexibility to allow some
colleagues to work remotely at home.
Working from home may be a different
experience for some, and, it’s not always
without its challenges, but at this moment in
time it’s the right thing to do for some of our
people. But how are clinical colleagues able to
work from home? Heartbeat caught up with
two colleagues who are doing just that.
Lesley McDonagh
Clinical Lead Nurse, Tissue Viability Team
Lesley McDonagh, Clinical Lead Nurse, Tissue Viability Team
Lesley has been working from home
since the start of the pandemic as she
has to shield due to a medical condition.
She told Heartbeat when she first started
to shield she felt guilty about not being
in the office and also missed her team.
“It was difficult to get my head round
things at first,” recalled Lesley. “We were
working very hard during the surge, and
I was glad I could still support the team
while working from home. I was able
to get on with the background work,
in particular setting up the mobile skin
clinic, handling referrals and arranging
future training options. I was also able
to continue to provide HR support to the
team and help with their concerns and
worries in a rapidly changing climate.”
Lesley told us even though she is
shielding, she is still very much in contact
with the team. She said: “We use the
phone for quick communication as
we would do normally and WebEx for
meetings, one to ones, PDRS or just a chat.
Now that we have mastered using WebEx it
has been really useful to keep in touch face
to face, it has also cut down on traveling
cross site to meetings.
The tissue viability team have recently been
recognised for their work in supporting
colleagues who have suffered facial injuries
due to wearing PPE. Lesley explained how
she was able to support that work from
home.
“During the early days of COVID-19 we
found that colleagues started to suffer skin
damage and irritation from wearing PPE,”
explained Lesley. “I knew the team had
the skills to offer support and advice so we
decided to set up the skin clinics. As I was
working from home I was able to dedicate
time to set up the clinics very quickly, along
with other colleagues in the team who are
also shielding.
“Because we were at home with little
distractions, we were able to set up the
mobile skin clinics much quicker than we
would have done, if we were at work.
I am delighted the clinics have been so
well received and that we have managed
to support so many colleagues. While
working from home I am able to triage
initial referrals when colleagues contact us
for skin advice. I can offer initial advice and
then arrange for one of my team to meet
them if this is required.”
Heartbeat asked Lesley how she gets herself
in a frame of mind to be able to work from
home. “I work my normal hours, I am lucky
to have a desk in a room which is quiet
and a comfortable chair is a must,” she
smiled. “I try to take breaks and finish at a
set time. I find I get a lot done as there are
fewer interruptions. I enjoy coffee breaks
with colleagues – now we have mastered
WebEx it is good to catch up and feel part
of things.
“As I am shielding, it’s for my benefit to try
and maintain my mental wellbeing so I try
to think positive. It can be lonely sometimes
– I miss the chatter from the team and
other colleagues in corporate nursing. I
also miss the exercise – just walking from
the car park to the hospital! I have made
myself do exercise at home but it’s not like
being outside. I am grateful to the whole
corporate nursing team in acknowledging
that I am shielding and still working. It’s
been lovely to have their support and still be
included in conversations and meetings as
normal.”
26

Geeta Shetty
Consultant Oncoplastic and Reconstructive Breast Surgeon
26 new to 12 in the clinics. One of the
reasons for heavy drop in referrals was
due to adhering to 2WW criterial strictly
and heavily policing the referral to see only
patients with a high index of suspicion
of cancer. This longer turnaround was
essential for social distancing and cleaning
between the patients”.
Geeta Shetty, Consultant Oncoplastic and Reconstructive Breast Surgeon
Geeta has been working from home
since the start of the lockdown. She told
us it has been challenging during this
unprecedented period. It is interesting how
COVID-19 has changed our mind set to
work differently.
She has been keeping in touch with her
team by having regular meetings via WebEx
and Zoom. She told us: “It’s been good to
be able to keep in touch with the team,
although sometimes it can be frustrating
when the technology does not work
well, particularly during multi-disciplinary
meetings and QIHD.
“Working from home has certainly been
made easier by the availability of the
various digital platforms. Being able to
see colleagues while working remotely
is a boost for morale and wellbeing. My
colleagues have been very supportive and
tend to call pretty much every other day to
keep me up to date about departmental
activities. Of course you have email
communication too.”
Being a surgeon, Geeta’s role is very much
hands on with the patient, she told us how
this has changed now since she is working
from home.
“My role has been quite different since
working from home,” said Geeta “Due
to COVID-19 and decrease in staff
capacity, we could not have managed to
see all 2 week wait (2WW) referrals in
our outpatient clinics. I took up the role
of triaging 2WW patients and helping
my team by reducing the numbers in
outpatients. I am also available to do
telephone clinics. A four week audit
showed that the numbers of cancers
detected didn’t fall compared to pre
COVID-19 and the pick-up rate in clinic
was high. Our capacity went down from
She continued “The audit results have
made a real difference in our outpatient
clinic. During pre COVID-19 the breast
unit were running with more than 100 per
cent capacity with some extra adhoc lists.
COVID-19 is going to stay with us for a
while and we have to look into our new
ways of working as a part of restoration
and recovery plan. It is not possible to go
back to the pre COVID-19 era considering
the social distancing, cleanliness, health
and safety precautions. We do not have
enough resources to cope with the new
ways of working standards. Hence, I am
trying to run a model to have virtual triage
clinics so as to screen these referrals which
will hopefully reduce numbers in our
one stop clinic and also provide support
to GPs. This will help us uphold current
slogan “see a right patient at right time by
a right person”.
“However, the down side of working
from home is; my operating role has been
affected. I miss being in the theatre and I
hope to be able to do so again very soon”.
“At home, I tend to have set virtual triage
and telephone clinic sessions. If I feel
anyone needs a face to face consultation
then I am able to refer them to one of my
colleagues.
“Being at home gives you a lot of
flexibility, however at times I feel I am
never off work as I find myself checking
emails and doing work late into the
evenings. Despite that, I always try to
maintain a healthy frame of mind and I am
grateful for what I have. I have been also
involved in overseas educational activities,
being an Adjunct Professor of Manipal
Academy of Higher Education, India and
National Vice President of ACCCI which
keeps me academically active. My family
has supported me a lot and they are my
strength. I am just glad for opportunity to
be able to continue to perform my duties
in different ways.”
"I am still learning."
Michelangelo aged 87
27

Children’s ED receives £1.2m facelift
CORPORATE AND GENERAL
NEWS
Our new-look children’s emergency
department (ED) and assessment
unit officially opened earlier
this month. The £1.2 million
development has taken eight
months to build and is based at City
Hospital.
The facility, named the Children’s
Emergency Care Unit (CECU) will lead
to more efficient and streamlined care
for our young patients. All children will
be seen in one area which will mean
patients will have access to paediatric
and ED colleagues in a timelier manner.
Plus, the area is separate from the
emergency department where adults
are treated, so it is more child friendly.
The updated facility boasts an animal theme
with facts about each one in the cubicles and
waiting areas making it a more comfortable
and interesting environment for youngsters.
Your Trust Charity has funded and sourced
wall sensory toys and table bead toys for the
area along with smart TVs for six cubicles.
The Trust invested in the new facility to ensure
the best care is delivered in line with national
guidelines. It replaces a separate paediatrics
assessment unit (PAU) based on D19 and
children’s ED which was co-located within the
main accident and emergency department.
The unit will be led by nurse, Marie Hinks and
it is estimated that 18,000 children will use
the facility a year.
Acute Paediatric Matron, Bren Taylor, said:
“This is a change from the previous paediatric
provision that was at City ED. It has gone
from a 12-hour unit to a 24-hour unit,
incorporating the PAU into the footprint.
“It will mean a more cohesive working
relationship and pathway for children
and families. We are very pleased with
this much-needed facility. Colleagues are
looking forward to delivering excellent
care to our young patients in a more
modern setting.”
Each shift will have four nurses and
several ED and paediatric doctors
working together. All patients will have
a quick initial assessment (triage) at main
reception and then be sent to a red
(COVID-19 positive) or blue (COVID-19
negative) area depending on risk. Those
children who need to stay longer than
18 hours, or who need to see specialist
teams will be transferred to Sandwell
Hospital or another appropriate hospital.
Colleagues gather for the official opening of the Children’s Emergency Care Unit
How would you like to receive ?
Since the outbreak of COVID-19 there has been a major shift in the way we work with
many of us working from home. Let us know if you would like to receive your copy of
Heartbeat directly to your home. Email the team at swbh.comms@nhs.net
28

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Melanie Griffiths
Head of Improvement
This month we give a very warm
welcome to Melanie Griffiths, our
new Head of Improvement. She joins
us from Kettering General Hospital,
where she worked as the Head of
Transformation & PMO.
Melanie is enthusiastic about joining SWB
and brings a wealth of experience into her
new role. In 1988, Melanie graduated from
Sunderland Polytechnic with a first class
chemistry and physiology degree and joined
the NHS working as a laboratory assistant
supporting the development of a fertility
unit, at Newcastle Royal Victoria Infirmary.
From there she completed a PhD in male
infertility, in Sheffield, with her work being
published in peer-reviewed journals. In 1993
she was appointed as the clinical andrology
laboratory manager at the Coventry Centre
for Reproductive Medicine and went on
to work at a national level in the field of
Melanie, our new Head of Improvement
pictured with her family
andrology. In 2004 she transitioned to
working in improvement science, going on
to gain experience delivering and leading
improvements to healthcare services in
both acute and community settings across
Coventry and Warwickshire, and more
recently in Kettering.
She told Heartbeat that she is really looking
forward to taking on the new challenges
that await her at SWB. She remarked: “I’m
passionate about supporting the Trust
to deliver its vision for the community
of Sandwell and West Birmingham. I’m
looking forward to getting to know the
organisation, the people and of course my
new colleagues in the improvement team.”
Outside of work, Melanie enjoys spending
time with her husband, Gary and two
grown up children, Luke and Anna. She also
likes walking the family dog Reggie, pilates,
attending music concerts and travelling.
When not working and keeping up with her
family, Melanie also finds time to challenge
herself outside of work and has completed
two moonwalk marathons for breast cancer
charities.
Wave goodbye to…
Paula Gardner
Chief Nurse
This month we say goodbye to our
talented and big-hearted Chief Nurse,
Paula Gardner. With a career that spans
almost four decades under her belt, she
has made an immense contribution to
the nursing profession and indeed our
Trust.
When Paula began her nursing career 37
years ago things were somewhat different.
The technology wasn’t as advanced as it is
today, and nurses wore white hats and blue
belts. Paula's focus was and has remained,
in all that time on how we care for patients
within the NHS. She explained: “The care
and attention we give a patient hasn’t
shifted. We can still bed bath a patient,
dress them, comb their hair and brush their
teeth. There’s a real sense of achievement
by doing the simplest of things to help
patients feel better.”
Paula began her nursing career in 1983
at Worcester School of Nursing. After
qualifying in 1986, Paula held many roles
across Staffordshire and the Black Country.
Looking back at her career, becoming a
sister was a real highlight for Paula. “I
became a sister at the age of 24. In those
days it took a long time to become senior
sister but I did it three years after qualifying.
I have been a matron, a group director of
Paula Gardner pictured at her retirement
gathering
nursing, a deputy chief nurse and a chief
nurse. I’ve been through every stage of
what it’s like to be a nurse at different times
of my life. Without a doubt, the pinnacle of
my career is being a chief nurse. It's what I
always wanted to be.”
Paula has nothing but admiration for the
staff within our organisation. “In the time
I’ve worked here, I have always been blown
away by the dedication of both clinical and
non-clinical staff. It has never been clearer
than it has been in the situation we find
ourselves in right now. Everyone has pulled
together to fight COVID-19, and I couldn’t
be prouder to say I’ve been your chief nurse
at this time.”
She added: “I am leaving on a high at the
point in my career where I’ve achieved
everything I set out to achieve. I am looking
forward to taking some time out to enjoy
being with my husband, daughters and
family. I'd like to say thank you to everyone
that has supported me. I will remember the
kindness and warmth of the people I have
had the pleasure of working alongside at
SWB.”
David Carruthers, Medical Director,
commented: “Paula is a force of nature.
She is determined and dedicated in equal
measure. Paula is an exceptional leader
– I’ve always found her to be energetic,
engaging and accessible to her team. She is
strategic and delivery focused - something
you need to be in her role. Paula has been
a pleasure to work with and we all wish her
nothing but the best.”
29

Letters, of less than 200 words please, can be sent to the Communications Department,
Trust Headquarters, Sandwell Hospital or by email to swb–tr.SWBH–GM–Heartbeat@nhs.net
YOUR RIGHT TO BE HEARD
Black Lives Matter… got me
thinking
Dear Heartbeat,
With the Black Lives Matter at the forefront of
a lot of people’s minds at the moment, it got
me thinking about our Trust and if a form of
institutional racism or unintentional bias exists.
On a surface level, we do recruit lots of BME
staff and the Trust as a whole has a variety of
ethnicities, however, when you look deeper does
it really? Yes on a clinical level there are BME
colleagues, and on all levels/bands, however,
when you look at the non-clinical staff, I’m not
sure this is the case. Yes, we have lots of staff at
entry-level and some in management but as you
go further up the ladder past some management
roles and into more senior/executive roles do we
have adequate BME representation there?
I know the Trust encourages BME staff by
having the BME Network and the Stepping Up
Programme but is that enough? Are these just
tick-box exercises to mask what is really going
on? How many non-clinical people from the
Stepping Up Programme go on to achieve higher
paid and more senior roles? I know the Trust is
always working to achieve more equality and
diversity, but it just seems when you look deeper,
it is only at a clinical level and this is not evenly
spread in non-clinical roles unless I’m mistaken…
Kind regards
Anon
Dear colleague,
Thank you for writing and raising some
important points which I agree are critically
important to for our BME colleagues and
patients. The Board have acknowledged
that we do not have adequate levels
of BME representation at a senior non
clinical level as yet. Four years ago we put
in place a number of actions in line with
our Workforce Race Equality Action Plan
(WRES) to start to address this inequality.
For example we have a BME panellist on
every recruitment interview; we have
launched our mentoring and coaching
programme which was publicised to all staff
but targeted to our BME Staff Network,
and we were the first organisation to
launch the Stepping Up Programme which
is a leadership development programme
for BME colleagues at Band 5 and Band 7s,
which we have successfully hosted onsite
for the last two years with around 90 of our
BME colleagues taking part.
You asked about the Stepping Up
programme and our non- clinical
participants. So far we have had 25 non
clinical SWB staff who have completed the
course and of these a quarter have moved
to a higher banded role. Four have left the
Trust for promotion and development.
I feel strongly that the Stepping Up
programme and our BME Staff Network are
not a ‘tick box exercise’, our chief executive
sponsors the network and the whole Board
take the views of our BME colleagues and
the inequalities very seriously. Although we
do recognise that more needs to be done to
ensure our organisation fully addresses our
inequalities. I would encourage any colleague
from a BME background who feels they can
be a positive force for change and play a part
in helping our workplace to be the fairest and
most representative of our local population we
can be at every level, to consider joining the
BME Staff Network. Please visit their web page
on Connect or contact the network chair Donna
Mighty if you need more information.
Kind regards
Raffaela Goodby, Director of People and
Organisation Development
What happens after the peak?
Dear Heartbeat,
It’s been great to see the Trust be so accommodating
during the coronavirus crisis, from flexible working
to one to one therapy sessions, it’s been amazing to
see and experience all of the good will.
It’s fair to say that COVID-19 has affected more than
those patients who have been unwell in our care,
staff at our trust have come to work knowing that
they’ll be around something they could potentially
take home to their families, but we’ve all come in
none the less. The Trust has been very generous
in providing hotel rooms and accommodation and
we’re all thankful for that and understand that some
elements aren’t sustainable long-term but will the
other support mechanisms remain in place?
Are there plans for the onsite shop to remain for
staff? Even without COVID-19 we struggle to juggle
long shift and home life and the shops been a
lifeline to many. The therapy sessions at the learning
works and all of the information that’s been coming
out to staff has been great, can we expect these to
remain?
Also, our culture in the Trust has completely
changed, and changed for the better, before
COVID-19 I wouldn’t have had a clue who to talk
to about making sure I had the right PPE, where
to get gloves or masks, and you would rarely have
seen an antibacterial gel bottle in any of the meeting
rooms. But now they’re all there and we have all of
these provisions in easy reach, we’re worried that
you’ll start to take them away again one by one.
And should coronavirus come back, we’ll be back to
step one.
Kind regards
Anon
Dear colleague,
I’m pleased to see that you feel that our Trust
has changed for the better. It is evident that
people have all worked together as a team,
with kindness, to manage our response to the
pandemic. We have been greatly supported
by our local community and further afield be
that be through businesses coming to our aid
relating to PPE supplies, provision of meals
and local fundraising efforts. Many of these
people have supported us at times when they
themselves have been struggling through
economic uncertainty and it is right that
we should stop accepting their donations at
present. The wellbeing activities and resources
have certainly increased and we are looking
to see how we can take forward the majority
of these. Our working from home long-term
arrangements will be consulted upon and we
expect this to become a much more standard
part of our working practices. Similarly, working
flexibly has been a necessity as people have
had to manage care of children or older people
at home. This is all in line with our flexible
working policy, but the experience of COVID-19
has demonstrated how we can make this
work in many teams. COVID-19 remains a real
threat and we will ensure that our infection
control equipment and procedures are in place
including hand sanitiser and the right PPE. I am
pleased that you have been able to have these
provisions in easy reach.
Kind regards
Bethan Downing, Deputy Director of People and
Organisation Development
Where are our domestics?
Dear Heartbeat,
Today in The Birmingham and Midland Eye Centre
29/5/20 in the staff toilets there are –
• No hand towels
• One toilet roll dispenser almost empty
• One completely empty
• No soap in any of the dispensers.
Move along to the staff kitchen there are no hand
towels in either dispensers. Rubbish has accumulated
in all areas for in my office for three days.
I have telephoned the domestics and the domestic
supervisors and also asked switchboard to put me
through but no response.
With all the emphasis on hand hygiene this is not
acceptable.
Kind regards
Anon
Dear colleague,
I am sorry to hear your frustrations regarding
the cleanliness of the staff toilets at BMEC.
You will recall earlier this year, we made some
changes to the cleaning schedule in staff areas.
This meant that the facilities were no longer
cleaned every day.
The cleaning schedule has been temporarily
reviewed due to the current situation so
presently the staff toilets at BMEC are cleaned
once daily Monday to Friday. Outside of that
you are able to replenish stock from the store
room located on the admin corridor.
In the event that the toilets require cleaning
urgently then please contact the team on ext.
4316 and the team can also be contacted on
their mobile phones via IVOR.
If there are any further issues, please do not
hesitate to contact me.
Kind regards
Janet Clarke, Head of Support Services
30

David talks about: The importance of education
and learning
Professor David Carruthers, Medical Director and Acting Chief Executive
Toby Lewis is away
DAVID’S LAST WORD
It is fantastic to see the range of
stories in this special edition of
Heartbeat that demonstrate the
Trust’s commitment to quality
improvement through learning.
Education and learning have
long been at the heart of my
values which is why this Trust
has, for me, been such a good
place to build my career.
Our Trust has a clear five year
plan, our 2020 vision, which
culminates this year. One of
the pillars of that vision has
been our education, learning
and development plan. At the
start of our 2020 vision, my role
within the Trust was as director
of medical education. During
the past five years I have seen
our education remit flourish
across and beyond the medical
workforce.
It is great that our Trust continue
to invest in the education and
learning of our staff through
a protected training budget in
excess of £1m each year. This
training resource has supported
hundreds of apprenticeships, the
CESR (Certificate of Eligibility
for Specialist Registration) in
Emergency Care, and our nurse
escalator scheme, to name just
a few. Other
colleagues
have benefited
from additional
learning and
development
support funded
through the Trust,
enabling them to
progress through
their careers.
Additional
support for
learning is evidenced in the
monthly Quality Improvement Half
Day (QIHD) programme which
provides protected time for teams
to learn and reflect, away from
non-urgent clinical commitments.
Over the past few months
the COVID-19 content of the
shared learning topics has been
particularly valuable in enabling
us to respond quickly to evidencebased
learning as you can see
through throughout Heartbeat this
month.
The focus on research, and the
willingness of so many of you
to contribute by signing up
patients, or taking part yourself
is reassuring and will enable
Last year's QIHD poster competition
winner and runners up.
treatment and support to be
tested quickly and introduced
in clinical settings. We have
already seen the benefits of
this research in the usage of
dexamethasone for certain
coronavirus patients.
This month has also seen
the launch of our annual
quality improvement poster
competition where we get
to display our improvement
stories of excellence that take
place right across the Trust.
Each year it is a delight to look
at these examples of changes
that have happened to make
a difference to the service
we provide to the Trust or to
patient outcomes. The stories
provide great visibility for all
of us, so we can review, adapt
and adopt this learning. Make
sure you get your entries in
this year in good time. As
well as the obvious kudos in
your work being on display
right across the Trust, the
£5,000 prize for the winning
entry will, I know, act as an
additional incentive for you to
compile your learning stories.
Good luck!
31

We are Metropolitan – Support us
@SWBHCharity To donate
to the Your Trust Charity text
“SWBH16 £5” to 70070
Your Trust Charity has officially
launched their fundraising campaign
‘We are Metropolitan’ as the buzz of
builders back on site brings the new
hospital site to life.
The charity campaign calls on local
businesses across the region to support
raising funds for vital research nurses
as well as the much-needed equipment
to make the new university hospital
truly one of a kind. Balfour Beatty who
are our construction partners for the
development have been hard at work
throughout the pandemic, working with
us to minimise any delays as a result of
COVID-19.
“Though the bricks and mortar cost
of building the Midland Metropolitan
University Hospital is covered, the charity
team have been hard at work building
partnerships with local business to make
Midland Met more than a hospital,” said
Johnny Shah, Head of Your Trust Charity.
“So far the local community and business
leaders have pledged £780,000 which
is a fantastic amount, but we still have a
way to go to meet our £2 million target.
This money will go towards exceptional
care, funding play areas for our younger
patients, creating beautiful gardens
where people can rest, relax, reflect and
recuperate as well as recruiting research
nurses to help develop new trials and
treatments for our patients.”
“The charity’s mission has always been
to enhance the experience of all people
using our services including staff, patients
and their families by providing additional
facilities and supporting innovative
projects that create a comfortable and
secure environment which is what we
hope to achieve with the campaign. The
challenges of tackling COVID-19, and its
disproportionate effect on the communities
we serve, has only strengthened our desire
to create a world-class facility.”
In addition to this, there will also be an
arts and culture programme, which will be
supported not just through visual exhibits,
but through summer concerts, plays, stage
shows and other examples of the performing
arts put on by schools and community
groups.
He added, “Every penny raised will go into
making the Midland Metropolitan University
Hospital a beacon, supporting research and
Our big thank you
June 2020 staff lottery results
YOUR TRUST CHARITY
development and delivering worldleading
healthcare to the residents of
Sandwell and West Birmingham.”
How you can help: Your Trust
Charity can only achieve its
fundraising goals with the help of
the local community. So whether
you want to run, cycle, dine, dance,
organise a virtual event, or come
up with your own fundraising ideas
then we are here to help you. Just
call the team on ext. 5196 or email
midlandmet@nhs.net.
You can also make an online
donation at https://donorbox.org/
your-trust-charity
Throughout the pandemic our local communities and businesses have provided
invaluable support to our Trust – be that through donations of food, supplies and
fundraising. These donations came at a time when many people were experiencing
significant economic hardship and struggling with the impact of lockdown. On the
NHS Birthday, 5 July, we will be shining a light in our windows to pay tribute to
those communities who have stood by us. We have stopped accepting donations of
food and free supplies, recognising that it is our turn to give back. Please join us in
thanking our communities for their overwhelming support.
Midland Metropolitan University Hospital
1st £187.75
Jennifer Donovan
2nd £112.65
Helen Ralley
3rd £75.10
Jennifer Ikwo
Don’t forget that Your Trust Charity lottery costs just £1 a month and anyone
who works for the Trust can join. Payment is deducted from your wages each
month. To take part email amanda.winwood@nhs.net.