Heartbeat January 2021
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<strong>January</strong> <strong>2021</strong><br />
Sandwell and West Birmingham<br />
NHS Trust<br />
The pulse of community health, Leasowes, Rowley Regis, City Hospital, Sandwell General and the Midland Metropolitan University Hospital<br />
Issue 137<br />
– innovation, evidence and actions<br />
lead to success at annual poster competition<br />
Page 3<br />
Our annual quality improvement poster competition was celebrated online in a socially distanced event earlier this month<br />
Making your<br />
wellbeing a<br />
priority in <strong>2021</strong><br />
Getting frank about<br />
bereavement<br />
Celebrating the<br />
success of the<br />
COVID-19 vaccination<br />
Be inspired by<br />
Heidi's incredible<br />
journey<br />
Page 5<br />
Page 6<br />
Pages 16-17<br />
Page 19
FROM THE CHAIR<br />
HELLO<br />
New Year, New Start:<br />
New chance to get the vaccine!<br />
Welcome to your <strong>January</strong> <strong>2021</strong><br />
edition of <strong>Heartbeat</strong>.<br />
We kick off the new year with the<br />
good news that our vaccination<br />
hubs are in full swing - an important<br />
step forward in our battle against<br />
COVID-19.<br />
We also bring you inspirational stories<br />
such as Heidi's weightloss journey,<br />
news of relaxation rooms in the<br />
community and a chance to win an<br />
Apple watch!<br />
Enjoy :)<br />
Contact us<br />
Communications Team<br />
Ext 5303<br />
swbh.comms@nhs.net<br />
Communications Department<br />
Ground Floor, Trinity House<br />
Sandwell Hospital<br />
Published by<br />
Communications Team<br />
Sandwell and West Birmingham<br />
Hospitals NHS Trust<br />
Designed by<br />
Medical Illustration,<br />
Graphics Team<br />
Sandwell and West Birmingham<br />
Hospitals NHS Trust<br />
Submit an idea<br />
If you’d like to submit an idea<br />
for an article, contact the<br />
communications team<br />
Ext 5303<br />
swbh.comms@nhs.net<br />
Stay updated<br />
We send out a Communications<br />
Bulletin via email every day and you<br />
can now read <strong>Heartbeat</strong> articles<br />
throughout the month on Connect.<br />
Don't forget you can follow us on:<br />
It is probably not a surprise that I begin the<br />
first edition of our <strong>2021</strong> <strong>Heartbeat</strong> with<br />
positive encouragement to all of you, to<br />
get the vaccine against COVID-19. The<br />
centre spread in this edition shows how<br />
quickly our partners and our Trust teams<br />
have responded to getting vaccine centres<br />
up and running. I am pleased to see the<br />
fantastic partnership working across<br />
primary care in our communities and at<br />
our acute hospital sites. We have made a<br />
fantastic start in vaccinating first our most<br />
vulnerable staff and patients, those working<br />
in high-risk areas, care home and home<br />
care workers and are now vaccinating every<br />
employee.<br />
If you have not yet had your vaccination,<br />
please take the time to book in to one of<br />
the clinics. Up to date availability, locations,<br />
times and guidance is regularly shared in<br />
Trust communications. The vaccination<br />
programme, we know, is a marathon<br />
and not a sprint and we must put all our<br />
efforts behind vaccinating as many in our<br />
SWBH community and the wider Sandwell<br />
and West Birmingham area. Achieving<br />
protection for the majority of people who<br />
are at risk from COVID-19 is vital in ending<br />
the restrictions we have been living with to<br />
some extent over the past nine months. The<br />
vaccine gives us hope for the future.<br />
I know there is a lot of misinformation out<br />
there and some people are reluctant to<br />
receive their dose of a vaccine developed<br />
remarkably quickly. But I want to stress<br />
that our leading clinical experts are fully<br />
supportive of the vaccines that have been<br />
approved by the MHRA for use in the UK.<br />
No step was missed in the development<br />
of the vaccine. We know that it offers<br />
protection and will do so for months ahead.<br />
COVID-19 is a real and present danger<br />
which is why I join you in your frustrations<br />
over news stories of COVID deniers sharing<br />
images of so-called “empty” hospitals. No<br />
hospital in the country is free from COVID,<br />
and all are battling within their current<br />
facilities to treat the patients who need<br />
them, and most are continuing to expand to<br />
meet the serious increase in those who are<br />
critically unwell. My thanks and admiration<br />
goes to all of you who are facing these<br />
pressures day in, day out. The physical and<br />
emotional toll on you is significant, and I<br />
hope you are getting the wellbeing support<br />
you need. Please get in touch if you think<br />
there is more we could do.<br />
The risks of COVID-19 are serious. The<br />
vaccine is proven to be safe and effective.<br />
So I implore you, if you are worried about<br />
the vaccine or want more information, have<br />
a look at the information we have in this<br />
magazine. You can also go to our COVID-19<br />
vaccine page on Connect, talk to your<br />
clinical leads and look at the information<br />
published nationally by the NHS, the trusted<br />
source for up to date clinical information.<br />
We have staff Q&A sessions dedicated<br />
to the COVID vaccine - please join one<br />
of these as they allow you to raise your<br />
queries. Alternatively, have a look at the<br />
recordings of the sessions or the FAQs we<br />
have published on Connect.<br />
Vaccination means protection for you,<br />
your colleagues and your patients, as<br />
well as your family and friends. And it<br />
will, in time, mean an end to the cycle of<br />
lockdowns, closures, educational disruption,<br />
travel restrictions and impact on our local<br />
businesses and employment. We need this<br />
vaccine for the health of our population.<br />
Please take up your opportunity.<br />
Richard Samuda, Trust Chairman<br />
Chairman, Richard Samuda
Radical trachelectomy<br />
Removal of cervix, upper vagina<br />
and proximal parametrium plus<br />
pelvic lymphadenectomy<br />
Cervical isthmic glands<br />
The junction between the uterine corpus and the cervix is termed the isthmus. It is<br />
defined histologically by its deficient muscle layer and the presence of isthmic glands and<br />
endometrium. The presence of endometrial tissue or isthmic glands within the<br />
trachelectomy specimen denotes complete amputation of the cervix.<br />
27/36<br />
attempted<br />
conception<br />
13/43 (30.2%)<br />
simple<br />
trachelectomy<br />
10<br />
5<br />
0<br />
52 trachelectomy<br />
patients<br />
43 patients included<br />
Obstetric outcomes<br />
for 36 patients<br />
15/27<br />
conceived<br />
(55.6%)<br />
Isthmic glands<br />
Conceived<br />
30/43 (69.8%)<br />
radical<br />
trachelectomy<br />
21<br />
pregnancies<br />
1 excluded as 8 weeks<br />
gestation at data collection<br />
No isthmic glands<br />
Did not conceive<br />
9 excluded:<br />
- radical hysterectomy (n=4)<br />
- progressive disease and died (n=2)<br />
- pathology slides missing (n=3)<br />
7 excluded:<br />
- lost to follow-up (n=5)<br />
- declined participation (n=1)<br />
- premature ovarian failure (n=1)<br />
2 miscarriages<br />
1 termination<br />
17/20 (85.0%)<br />
live births<br />
References<br />
1) F. Bray et al. (2018) ‘Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries’. CA:<br />
Cancer Journal for Clinicians. 68(6), pp. 394-424. 2) Cancer Research UK. Available from: https://www.cancerresearchuk.org/health-professional/cancerstatistics/statistics-by-cancer-type/cervical-cancer#heading-Zero<br />
3) M.J. Halaska et al. (2015) ‘The role of trachelectomy in cervical cancer’.<br />
Ecancermedicalscience. 9, pp. 506 4) F. Novak (1952) Radical abdominal subcorporeal extirpation of the cervix with bilateral pelvic lymph nodes<br />
dissection in cancer in situ of the cervix uteri’. Acta Medical Lugoslavica. 6(1), pp. 59-71. 5) E. Bentivegna et al. (2016) ‘Fertility results and pregnancy<br />
outcomes after conservative treatment of cervical cancer: a systematic review of the literature’. Fertility and Sterility. 106(5), pp. 1195-1211. 6) F.J.<br />
Bruinsma et al. (2011) ‘The risk of preterm birth following treatment for precancerous changes in the cervix: A systematic review and meta-analysis’.<br />
BJOG. 118(9), pp. 1031-1041. 7) L.C.Y. Poon et al. (2012) ‘Large loop excision of transformation zone and cervical length in the prediction of spontaneous<br />
preterm delivery’. BJOG. 119(6), pp. 692-698. 8). S. Pils et al. (2014). ‘Sequential cervical length screening in pregnancies after loop excision of the<br />
transformation zone conisation: A retrospective analysis’. BJOG. 121(4), pp. 457-462. 9) F. Terms (1952). ‘II: the anatomy of the uterine cervix and<br />
isthmus’. Acta Radiologica. 91, pp. 9-12.<br />
Specialist<br />
input<br />
Targeted support<br />
including training<br />
Universal Support<br />
including screening<br />
welearn – innovation , evidence and<br />
actions lead poster competition<br />
Our annual poster competition<br />
culminated in a socially distanced<br />
online ceremony earlier this month<br />
when the contestants came together<br />
to showcase their hard work with a<br />
hope to be the lucky winner of a £5,000<br />
grand prize.<br />
From just shy of 100 posters submitted,<br />
11 shortlisted finalists had the opportunity<br />
to present their poster to an audience of<br />
their peers and judges, highlighting how<br />
their work shows good practice, provide<br />
quality improvements, supports innovation,<br />
research or partnership working, and<br />
most importantly how it has resulted in<br />
improvements for patients, relatives and<br />
colleagues.<br />
Announcing the results of the staff voted<br />
for ‘People’s Choice Award’ fell to Chief<br />
Finance Officer, Dinah McLannahan who<br />
awarded it to Louise Tromans for her poster<br />
entitled ‘A well timed innovation in imageguided<br />
pre-operative breast localisation’.<br />
Presenting the award, Dinah highlighted<br />
how the innovative work deploying the use<br />
of RFID tags had made a significant impact<br />
to breast cancer patients, improving their<br />
surgical outcomes and allowing procedure<br />
to continue even throughout the disruption<br />
brought on by COVID-19.<br />
Announcing the first of the highly<br />
commended runners up fell to Non-<br />
Executive Director, Professor Kate Thomas<br />
who awarded Jason Yap and the Gynaeoncology<br />
team for their poster titled, ‘An<br />
innovative surgery which offers women<br />
with cervical cancer the opportunity to<br />
preserve fertility’. Awarding the team, Kate<br />
said: “This poster tells a very clear story<br />
through illustrations, graphs and text, it’s a<br />
fantastic story of how gynaecologists in this<br />
Trust have implemented a fantastic surgery<br />
that allows women with cervical cancer a<br />
chance to preserve their fertility. The poster<br />
shows how the proportion of women<br />
undergoing the surgery and going on to<br />
have at least one live baby is greater than<br />
that of published literature.”<br />
The last highly commended award was<br />
presented by Head of Improvement,<br />
Melanie Griffith to Diya Baker from the<br />
Department of Ophthalmology for their<br />
poster ‘Assessing patient perspective of<br />
pre-printed forms in vitreo-retinal surgery’.<br />
Announcing her awards, Melanie said: “This<br />
poster is one that was very data driven,<br />
involved patients, took the time to gather<br />
data and took the time to design the test<br />
and from improvement terms did a fantastic<br />
job. Patients are really benefiting from this<br />
improvement with this work".<br />
The winner of the £5,000 grand prize was<br />
announced by Acting Chief Executive and<br />
Medical Director, Dr David Carruthers and<br />
went to Kathryn Dunn from the Department<br />
of Speech and Language Therapy for her<br />
poster entitled ‘Service Improvement – Speech<br />
and Language Therapy Services to mainstream<br />
schools’. Commending the poster, David said:<br />
“This poster showed evidence based change<br />
in practice, with engagement with service<br />
users, collaboration across systems and efforts<br />
targeted where the need was greatest.”<br />
12 welearn2020<br />
Sandwell and<br />
West Birmingham<br />
NHS<br />
NHS<br />
Trust<br />
Trust<br />
A well timed innovation in image-guided<br />
pre-operative A well timed innovation breast in image-guided<br />
localisation<br />
pre-operative breast localisation<br />
INTRODUCTION<br />
One third of breast cancers are not palpable at diagnosis (McGugin et al,<br />
2019); accurate excision and the minimum number of surgical procedures<br />
is reliant on pre-operative image guided localisation. Hook wires deployed<br />
on the day of surgery protruding from the skin have been the<br />
established technique, but the many disadvantages lead us to consider<br />
the latest alternatives. In November 2019 the Breast Imaging and<br />
Surgical team collaborated to evaluate Radiofrequency identification<br />
(RFID) tags.<br />
Improve<br />
theatre<br />
efficiency<br />
Improve<br />
efficiency<br />
of Rapid<br />
Access<br />
clinic<br />
Scheduling<br />
not limited<br />
to day of<br />
surgery<br />
Why go<br />
‘wireless’?<br />
Flexibility in<br />
surgical<br />
incision<br />
RFID TAGS – How do they work?<br />
The tag is deployed percutaneously using a 12G pre-loaded applicator,<br />
similar to a marker clip placed at the time of biopsy. The procedure may be<br />
performed any time in advance of the surgery date. The tag is radiation<br />
free and passive. A reader emits radio waves and receives information<br />
from the tag. An audible noise that increases in pitch as the reader is<br />
moved closer to the tags location is an additional feature.<br />
REFERENCES<br />
Cheang et al (2018) ‘Innovations in image-guided preoperative breast lesion<br />
localisation’ British Journal of Radiology. 91(1085), 20170740<br />
McGugin et al (2019) ‘Radiofrequency identification tag localization is comparable to<br />
wire localization for non-palpable breast lesions’ Breast Cancer Research &<br />
Treatment. 177(3), pp. 735-739.<br />
SWBH (2017) ‘Cavity Shave Audit’ Conducted by Dr Ian Rea Specialty Doctor<br />
L. Tromans Consultant Radiographer<br />
Less patient<br />
anxiety and<br />
discomfort<br />
IMPLEMENTATION<br />
All Breast Surgeons and Imaging Consultants were involved in training<br />
sessions to ensure competency. Single lesions were selected in the first<br />
instance and mammograms were performed on the day of surgery to<br />
check for any migration. A prospective data base was devised to log all<br />
patients and record our experiences. The familiar concepts and<br />
technology resulted in a short learning curve. The technique was<br />
accepted by the team and welcomed even more so when surgery was<br />
forced to take place off site due to Covid-19.<br />
RESULTS<br />
117 under<br />
Ultrasound control<br />
22 X-ray guided<br />
95%<br />
accurately<br />
sited<br />
6 patients still<br />
needed wire<br />
139 tags deployed<br />
in 129 patients<br />
IMPROVEMENTS<br />
Data Period<br />
19/11/19 –<br />
30/9/20<br />
113 patients with<br />
final histology<br />
available<br />
107 malignant<br />
lesions<br />
5 surgical excision<br />
biopsy<br />
1 lymph node<br />
Malignant<br />
lesions:<br />
16 patients with<br />
positive margins<br />
Re-excision rate<br />
of 15%<br />
Visibility on<br />
ultrasound, ease<br />
of use and<br />
procedure time<br />
recorded by<br />
Imaging for first<br />
40 cases<br />
97% graded good<br />
or very good<br />
visibility on<br />
ultrasound<br />
65% graded easy<br />
or very easy to<br />
deploy<br />
Average imaging<br />
procedure time =<br />
12 mins<br />
• Un-coupling of localisation and surgery - delays in surgical schedule<br />
due to pre-operative procedures are eliminated<br />
• Flexible scheduling in Imaging department that does not impact on the<br />
flow of patients through Rapid Access Clinic (RAC)<br />
• Placement of tag well tolerated by patients and adverse reactions less<br />
likely - vasovagal reactions are reported in 10-20% of patients having<br />
wires who would be nil by mouth at the time (Cheang et al, 2018)<br />
• Potential reduction in re-excision rate – 15% for this data period,<br />
compared with 20% previously (SWBH Audit 2017)<br />
• Flexibility for surgeon in skin incision site, ability to perform own skin<br />
marking in theatre as opposed to in the Imaging department,<br />
improved cosmesis<br />
• Off-site surgery during Covid-19 pandemic much less<br />
problematic, tag insertion co-ordinated with pre-admission<br />
appointments to minimise visits, resulting in minimal delays in<br />
breast cancer treatment<br />
THEATRE &<br />
RAC<br />
EFFICIENCY<br />
PATIENT<br />
EXPERIENCE<br />
CONTINUED<br />
TREATMENT<br />
DURING COVID<br />
L. Tromans Consultant Radiographer Breast Imaging<br />
Popular Vote winner<br />
21 welearn2020<br />
Breast Imaging<br />
Sandwell and<br />
West Birmingham<br />
NHS<br />
NHS<br />
Trust<br />
Trust<br />
Quality Improvement Project: Assessing patient perspective<br />
of pre-printed consent forms in vitreo-retinal surgery<br />
Introduction<br />
Autonomy is a pillar of medical ethics. The consenting process, of which<br />
the consent form is an integral part, is where patient autonomy is directly<br />
exercised. Therefore, it should be undertaken vigilantly and should not be a<br />
tick-box exercise as ruled in the Montgomery v Lancashire Health Board case 1 .<br />
Retinal detachment surgery conducted at the Birmingham Midlands Eye<br />
Centre (BMEC) is consented with hand-written consent forms. These often<br />
have issues with legibility, missing information and high variability resulting in<br />
increased errors in the consenting process. The MDU states ‘Allegations often<br />
centre on inadequate consent, unexpected intra-operative and post-operative<br />
complications’ in ophthalmology 2 .<br />
This Quality Improvement Project (QIP) aimed:<br />
‘To improve patient understanding of retinal detachment procedure by<br />
introducing consent form, which is legible, contains correct information<br />
and fulfils other GMC standards’<br />
Methodology<br />
Cycle 1:<br />
• A hospital-based cross-sectional survey was carried out over 30 days at a<br />
tertiary eye hospital where hand-written consent forms are employed in<br />
retinal detachment surgery.<br />
• Patients were offered an anonymous questionnaire with 29 items to assess<br />
understanding of the consent process, consent form information and<br />
procedure specific risks.<br />
• These 29 items were simplified standards of GMC guidance on consent.<br />
• Additional questions were asked regarding the patient experience of the<br />
consenting process.<br />
• A randomised selection of 50 patients across the hospital completed the<br />
questionnaire and were analysed in a blinded fashion.<br />
GMC standards 3 :<br />
44. ‘ Before accepting a patient’s consent, you must consider whether they<br />
have been given the information they want or need, and how well<br />
they understand the details and implications of what is proposed.’<br />
28. ‘ Clear, accurate information about the risks of any proposed<br />
investigation or treatment, presented in a way patients can<br />
understand, can help them make informed decisions.’<br />
Noteworthy Results for Cycle 1<br />
28/50 (56%) understood the consent form wholly<br />
Only 24/50 (48%) felt the form was entirely legible.<br />
Only 21/50 (42%) thought consent form made clear the risks of the operation<br />
11/50 (22%) agreed that not all risks of the<br />
procedure discussed were documented<br />
Only 9/50 (18%) agreed that the consent<br />
form documented the patients’ wishes<br />
Average score of 57% when quizzed about the consenting process<br />
Improvement<br />
A pre-printed consent form was designed by the senior author aiming to<br />
address the issues highlighted by the patients; namely: absence of risks, issues<br />
with legibility and absence of patient wishes.<br />
D. Baker, M. Hamzah Amin, R. Chaudhary and S. Ch’ng<br />
Cycle 2:<br />
Highly commended poster<br />
• This new pre-printed consent form was then employed in the<br />
consenting process.<br />
• Another cross-sectional survey was conducted where patient<br />
perspectives of the new consent form were obtained via a<br />
questionnaire.<br />
• The questionnaire was the same as the one in the first cycle except a<br />
few questions were added.<br />
• There were all based on GMC standards listed in cycle 1.<br />
Noteworthy Results for Cycle 2<br />
38/50 (76%) were able to read/understand the consent form wholly<br />
Data Comparison<br />
47/50 (94%) found pre-printed consent forms<br />
more useful than hand-written consent forms.<br />
49/50 (98%) concurred that the consent form<br />
made clear the risks of the operation<br />
7/50 (14%) agreed that not all risks of the<br />
procedure discussed were documented<br />
33/50 (66%) agreed that the consent form<br />
documented the patients’ wishes<br />
Average score of 62% when quizzed about the consenting process<br />
Discussion<br />
• Pre-printed consent forms have been shown to improve patient<br />
understanding of retinal detachment procedure including its risks and<br />
other GMC standards.<br />
• These new consent forms are now used in the consenting process of all<br />
retinal detachment procedures.<br />
• There are still improvements to be made which would be trialled in<br />
future QIPs.<br />
• Pre-printed consent forms can be used in other surgical procedures in<br />
ophthalmology and outside ophthalmology as we believe the results<br />
could be generalised.<br />
References<br />
Court T. Montgomery (Appellant) v Lanarkshire Health Board (Respondent)<br />
(Scotland) - The Supreme Court [Internet]. Supremecourt.uk. 2020 [cited 11 October<br />
2020]. Available from: https://www.supremecourt.uk/cases/uksc-2013-0136.html<br />
Claims in ophthalmology - The MDU [Internet]. Themdu.com. 2020 [cited 11 October<br />
2020]. Available from: https://www.themdu.com/guidance-and-advice/guides/claimsin-ophthalmology<br />
GMC. [Internet]. Gmc-uk.org. 2020 [cited 11 October 2020]. Available from: https://<br />
www.gmc-uk.org/-/media/documents/gmc-guidance-for-doctors---consent---english_<br />
pdf-48903482.pdf?la=en&hash=588792FBA39749E57D881FD2E33A851918F4CE7E<br />
Department of Ophthalmology<br />
COVID-19<br />
If you haven’t yet seen the posters, they<br />
will remain on display in the Education<br />
Centre at Sandwell. If you have the<br />
opportunity to do so, you can find out<br />
about the great quality improvement<br />
initiatives taking place across the Trust.<br />
You can also see the posters on<br />
Connect in the welearn section.<br />
42 welearn2020<br />
R. R. Pounds, D. D. O’Neill, N. N. Scully, N. N. Marriott, J. Balega, R. Ganesan,<br />
K. J. Singh, Balega, J. R. Yap Ganesan, K. Singh, J. Yap<br />
Sandwell and<br />
West Birmingham<br />
NHS Trust<br />
An innovative An innovative surgery surgery which which offers offers women with<br />
Cervical Cancer the opportunity to preserve Fertility<br />
women with Cervical Cancer the opportunity to preserve Fertility<br />
Introduction<br />
Cervical cancer is the fourth most common cancer amongst women worldwide<br />
and usually affects young women of child-bearing age. [1,2] In countries with a<br />
robust screening programme, most women are diagnosed with early stage<br />
disease. [2,3] Those with FIGO stage IB1 disease or less [3] and who desire<br />
fertility may be suitable for fertility sparing surgery (FSS). This involves removal<br />
of the cervix (simple trachelectomy) or removal of the cervix, upper vagina,<br />
proximal parametrium and pelvic lymph nodes (radical trachelectomy). [4] Our<br />
centre established FFS for women with early cervical cancer in 2010 and FSS can<br />
be undertaken through vaginal, laparotomy or laparoscopic approach.<br />
How does FSS influence obstetric outcomes?<br />
Adverse obstetric outcomes, such as the ability to conceive, miscarriage and<br />
pre-term labour, [5] are believed to be influenced by the residual cervical length<br />
following trachelectomy. [6-8] However, there is no defined cervical<br />
measurement associated with these risks and it is often difficult to establish the<br />
amount of cervix amputated as tissues contract when placed in formalin and<br />
many have had prior cervical surgery (cold knife excision biopsy or large loop<br />
excision of the transformation zone).<br />
Does complete amputation of the cervix influence outcomes?<br />
The cervix is joined to the corpus uteri by the isthmus, the narrowest portion of<br />
the uterine canal and marks the lowest aspect of the uterus. [9] The presence of<br />
isthmic glands in pathology specimens indicates the entire cervix has been<br />
completely removed.<br />
Objectives and Methods<br />
Primary objective: To evaluate patients’ conception rate and pregnancy<br />
outcomes in women who successfully had FFS.<br />
Secondary objectives:<br />
1. To determine if complete cervical amputation (presence of isthmic glands in<br />
histological specimen) influences fertility and obstetric outcomes compared<br />
to partial cervical amputation (isthmic glands not observed).<br />
2. To evaluate if disease recurrence and survival is affected by complete<br />
cervical amputation<br />
Methods: Consecutive patients referred to the Pan Birmingham Gynaecological<br />
Cancer Centre (PBGCC) with early stage (≤ FIGO stage IB1) cervical cancer<br />
between 1st August 2010 and 31st May 2018 were identified. Those who<br />
underwent FSS were included and retrospectively analysed. All patients had a<br />
cervical cerclage inserted following FSS. Specialist gynaecological oncology<br />
histopathologists determined whether isthmic glands were present in<br />
trachelectomy specimens.<br />
Patients completed a standardised questionnaire about their fertility and<br />
obstetric history prior to FSS and completed another questionnaire postoperatively<br />
in May 2020.<br />
61 welearn2020<br />
Results<br />
• Isthmic glands present in 26/43 cases (60.5%)<br />
• No difference in complete amputation rates between surgical approach<br />
(laparoscopic n=22, vaginal n=17, open abdominal n=4; p=0.6690) or<br />
between radical and simple procedures (p=0.9245)<br />
Obstetric outcomes<br />
• Live birth rate reported in our cohort was 85%<br />
• 44.4% (12/27) referred to fertility services<br />
• Miscarriage rate of those attempting pregnancy: 7.4% (2/27)<br />
• 48.1% (13/27) of women attempting pregnancy had at least one live<br />
birth<br />
• Pre-term delivery (
Research is everyone’s business<br />
COVID-19<br />
Research improves all aspects of care,<br />
and our patients have a right to be<br />
informed about research relevant to<br />
them<br />
In the last ten months or so, research<br />
has been centre stage. It has led<br />
to the vaccinations that are now<br />
available to prevent COVID-19 and<br />
the treatments that we know work<br />
best for our patients who have the<br />
infection. Research improves all<br />
aspects of care, and our patients<br />
have a right to be informed about<br />
research relevant to them and their<br />
health condition. It is just one reason<br />
why research is everyone’s business<br />
was <strong>January</strong>’s QIHD shared learning<br />
topic.<br />
To get a better understanding of<br />
why research is everyone’s business,<br />
<strong>Heartbeat</strong> caught up with Gina Dutton,<br />
Head of Research and Development.<br />
She told us: “We know that patients<br />
want to be informed about research<br />
opportunities, and they can then freely<br />
choose whether they wish to take part<br />
or not. To help patients be more aware<br />
of the option to participate in research<br />
as part of their care, it is vital that we all<br />
feel comfortable talking about research.<br />
“We have 543 members of staff taking<br />
part as participants in the SIREN study.<br />
If each of us in the study tells two other<br />
people they are taking part, nearly<br />
1100 will know about research. If we<br />
Gina Dutton - Head of Research and<br />
Development<br />
all tell four people - more than 2000 people<br />
will become more familiar with research. It<br />
is a simple yet effective way of spreading<br />
awareness around this topic.”<br />
DID YOU KNOW?<br />
• Our Trust takes part in lots of different<br />
research projects all of the time.<br />
• What do we mean by research? Research<br />
might be a clinical trial looking at<br />
improved drugs. It could also be a short<br />
questionnaire about how you manage<br />
your health condition, or as we have<br />
been doing during the pandemic, asking<br />
patients for a blood sample to look at<br />
genetic factors which might determine<br />
why some people get COVID-19 worse<br />
than others.<br />
• Our patients are protected. Research<br />
is regulated and reviewed by an ethics<br />
committee, the Health Research<br />
Gina has shared her experience of being a<br />
research participant on BBC radio several<br />
times. She told us: “Many people are<br />
unaware that they might be able to take<br />
part in research when they attend their GP<br />
or hospital. We must talk about research<br />
involvement so patients know that it is an<br />
optional part of their care and they can<br />
discuss this with their families in the same<br />
way as they may discuss whether to have<br />
blood tests, x-rays or treatments.”<br />
Want to understand more so that you can<br />
support research within our organisation?<br />
There are some short courses are available<br />
online that are suitable for all colleagues:<br />
• What is health research?<br />
www.futurelearn.com/courses/<br />
what-is-health-research<br />
• Improving healthcare through<br />
clinical research www.futurelearn.<br />
com/courses/clinical-research<br />
If you would like someone from R&D<br />
to talk to you or your team about<br />
improving your understanding of<br />
research, please contact Gina Dutton at<br />
G.Dutton1@nhs.net.<br />
Authority, funders and for studies<br />
involving medicines, the Medicines and<br />
Healthcare products Regulatory Agency,<br />
to make sure that the research is high<br />
quality.<br />
• Often people with the condition are also<br />
involved in developing the research,<br />
which makes it more relevant.<br />
• Be Part of Research is a national website<br />
which provides information for patients<br />
about research - https://bepartofresearch.<br />
nihr.ac.uk/index. Taking a few minutes<br />
to look at this website will help you feel<br />
more confident about taking part<br />
yourself if asked, and helping our patients<br />
understand that research is part of our<br />
care.<br />
Want to relax and unwind in a safe place? Visit the<br />
Wellbeing Sanctuary and enjoy a range of free treatments<br />
including a massage, meditation and relaxation hypnotherapy.<br />
Call 0121 507 5886 to book<br />
your free session today.<br />
Wellbeing<br />
4
Better Health – Every Mind Matters<br />
On the frontline and in the thick of it,<br />
working long shifts clad from head to<br />
toe in PPE and constantly reminded of<br />
the devastating effects of COVID you<br />
wouldn’t be human if it didn’t affect<br />
you. But you’re not alone.<br />
Recently, a new study commissioned by<br />
Public Health England (PHE) found that<br />
COVID-19 has had a devastating impact<br />
on the mental health of adults across the<br />
country as they battle to keep themselves<br />
safe and long to return to normality.<br />
The research found that almost half (49<br />
per cent) felt that the pandemic had<br />
impacted negatively on their mental health<br />
and wellbeing (53 per cent of women and<br />
45 per cent of men). Of those surveyed,<br />
significant proportions of the population<br />
said they had been experiencing more<br />
anxiety (46 per cent), stress (44 per cent),<br />
sleep problems (34 per cent) and low<br />
mood (46 per cent) over the course of the<br />
pandemic. The following were the most<br />
common reasons people thought the<br />
lockdown had negatively impacted their<br />
mental health:<br />
• 56 per cent missing friends<br />
and family; and loneliness<br />
33 per cent<br />
• 53 per cent uncertainty<br />
about the future; with<br />
financial and employment<br />
worries 27 per cent<br />
• 53 per cent worried about<br />
family’s safety and health<br />
However, at the same time 3 in 5 (60 per<br />
cent) of those asked say they feel hopeful<br />
about the future. Many adults (75 per cent)<br />
reported that they are planning to take or<br />
have taken steps to look after their mental<br />
wellbeing, with exercising regularly (32 per<br />
cent) eating well (29 per cent) and talking<br />
more to family and friends (28 per cent)<br />
being the main actions.<br />
To support people during this time, PHE has<br />
launched a nationwide Better Health - Every<br />
Mind Matters campaign to support people<br />
to take action to look after their mental<br />
health and wellbeing and help support<br />
others such as family and friends.<br />
The campaign encourages people to get<br />
a free NHS-approved Mind Plan from the<br />
Every Mind Matters website. By answering<br />
five simple questions, adults will get a<br />
personalised action plan with practical tips<br />
to help them deal with stress and anxiety,<br />
boost their mood, sleep better and feel<br />
more in control. Over 2.6 million mind<br />
plans have been created since it launched in<br />
October 2019.<br />
Locally, since the beginning of the pandemic,<br />
the team at Black Country Healthcare<br />
NHS Foundation Trust (BCHFT) have been<br />
supporting people across the Black Country<br />
with mental health, learning disabilities<br />
and children’s services – all of which have<br />
remained in operation, allowing service users<br />
to maintain usual routes of contact.<br />
The Trust’s Improving Access to Psychological<br />
Therapies (IAPT) service helps those who are<br />
experiencing mental health problems such<br />
as low mood, depression, anxiety, and stress.<br />
IAPT Clinical Lead, Susan van Genderen and<br />
IAPT Manager shared her top tips and advice<br />
for managing wellbeing, keeping healthy, and<br />
remaining positive during lockdown.<br />
Susan commented: “Firstly, I think it’s really<br />
important that we hold onto the hope that<br />
things will be better soon. Making loose plans<br />
for the future, such as thinking about holidays<br />
and Christmas gives us something to focus on<br />
For IAPT services:<br />
Sandwell Healthy Minds<br />
www.sandwellhealthyminds.nhs.uk<br />
0303 033 9903<br />
Wolverhampton Healthy Minds<br />
www.wolverhamptonhealthyminds.nhs.uk<br />
0800 923 0222 or 01902 441 856<br />
Alongside BCHFT’s services, they also<br />
launched a new mental health helpline in<br />
April last year, to give people across the<br />
Black Country access to urgent mental<br />
health, learning disability and/or autism<br />
support. The phone line is available 24<br />
hours a day, 7 days a week for all ages,<br />
COVID-19<br />
and keeps us moving forward.<br />
“Limiting access to the news is also<br />
beneficial for our mental health – we<br />
only need to listen to the headlines once<br />
a day otherwise it can become very<br />
overwhelming.<br />
“Exercise – even 10 minutes will lift<br />
your mood if you are short on time.<br />
It will allow you to use all your visual<br />
perception senses and stimulate your<br />
brain. When you stay in, your eyes only<br />
focus on things close to you, and that<br />
doesn’t give as much stimulation as<br />
being able to look at things far away.<br />
We need the variety.”<br />
She continued: “Keep talking, whether<br />
it’s a phone call to a colleague instead of<br />
an email, a video call with a loved one<br />
or a catch-up with a friend – everyone<br />
needs this connection.<br />
“Finally, there can be lots of feelings of<br />
frustration and anger during this time<br />
– but this doesn’t make us feel good.<br />
Focus on the people who are helping<br />
others and showing kindness, and try<br />
and be kind in your views of others.”<br />
Dudley IAPT<br />
www.dihc.nhs.uk/find-a-service/dudley-talking-therapy-service<br />
0800 953 0404<br />
Walsall IAPT<br />
www.blackcountryhealthcare.nhs.uk/our-services/talking-therapies-healthyminds-services/walsall-talking-therapies<br />
0800 953 0995<br />
Free online cognitive behavioural therapy programmes are available via:<br />
• Dudley - www.dihc.nhs.uk/find-a-service/dudley-talking-therapy-service<br />
• Walsall - walsalltalkingtherapy.silvercloudhealth.com/signup/<br />
• Sandwell and Wolverhampton - bcpft.silvercloudhealth.com/signup/<br />
and particularly suited to those who feel<br />
like they need urgent help. The helpline<br />
is manned by specialist mental health<br />
staff who will provide advice, support and<br />
signposting over the phone.<br />
The 24/7 phone line can be accessed by<br />
calling 0800 0086516.<br />
5
Getting to grips with grief<br />
COVID-19<br />
At home or at work, many of us are<br />
thinking about loved ones’ lost or<br />
deeply unwell. We watch as patients<br />
succumb to diseases despite our very<br />
best efforts, and we triumph when we<br />
see patients recuperate and recover.<br />
It’s often the tragedies that take the<br />
greatest toll but it’s really important to<br />
find space and scope to talk, think and<br />
get to grips with your grief.<br />
Grief is absolutely not a taboo subject in<br />
our Trust, it’s incredibly important that<br />
colleagues take the time to talk to each<br />
other and share the compassionate care<br />
that we often save for patients, for each<br />
other in this difficult time.<br />
COVID-19 has deeply affected many and<br />
there are a host of services now available<br />
to support with feelings of grief and<br />
bereavement. If you feel you need to speak<br />
to a professional, you can call occupational<br />
health on 0121 507 3306. Alternatively,<br />
there are a whole host of national resources<br />
that are available, all at end of a phone and<br />
completely confidential.<br />
Grief is not a taboo subject<br />
Confidential support by phone:<br />
• General:<br />
0800 06 96 222 (7am-11pm)<br />
• Bereavement:<br />
0300 303 4434 (8am-8pm)<br />
Support by text message:<br />
• Text ‘FRONTLINE’ to 85258 –<br />
24 hours a day, seven days a week<br />
If you are a manager and you would like<br />
to build upon your understanding of grief<br />
and bereavement, you can access a brand<br />
new resource that has been developed by<br />
NHS England and NHS Improvement with<br />
support from a wide range of organisations.<br />
Visit https://www.england.nhs.<br />
uk/publication/our-nhs-peopleunderstanding-different-bereavementpractices-and-how-our-colleagues-mayexperience-grief/<br />
This resource enables line managers to be<br />
able to confidently start conversations with<br />
staff who have experienced loss in a more<br />
compassionate way, as a result of gaining a<br />
deeper understanding of the different ways<br />
in which our colleagues may experience<br />
bereavement, noting the varying practices<br />
different religions and cultures may follow.<br />
Members of the bereavement team<br />
Did you know that you can download<br />
treatment-specific patient information<br />
leaflets from the EIDO Healthcare<br />
website for FREE?<br />
EIDO has hundreds of patient leaflets for different procedures that<br />
are being carried out across the Trust.<br />
They are available in an easy-to-read format and<br />
in different languages.<br />
Patient information for hundreds of procedures carried out across<br />
the Trust can be downloaded for free and passed on to patients<br />
to help them better understand the procedure they may be<br />
undergoing. Many of these are available in different languages and<br />
formats and help patients to give informed consent.<br />
Visit Connect Clinical Systems EIDO PT Leaflets.<br />
For more information, please contact the communications team<br />
on ext.5303 or email swbh.comms@nhs.net<br />
6
Cleaning with Confidence – Confidently<br />
showing everything is clean<br />
COVID-19<br />
I Am Clean stickers will be used to easily identify what items have been sanitised and<br />
when<br />
COVID-19 has once again proven to<br />
us that spotlessly clean wards and<br />
attention to detail isn’t just something<br />
that we aim for but something that we<br />
must see as our standard. Every ward<br />
area should be spotlessly clean, every<br />
colleague should be seen to carefully<br />
wash their hands and, every piece of<br />
equipment should be identifiable as<br />
being clean.<br />
When it comes to equipment on wards,<br />
there has always been a standing rule that<br />
everything must be sanitised after use,<br />
but how do you know when it is clean?<br />
Many of the germs, bacteria and virus are<br />
incredibly small and can be spread without<br />
knowing. This is where our latest change in<br />
practice comes in to play with the rollout of<br />
our ‘I am clean’ stickers.<br />
Colleagues no longer need to assume that<br />
equipment has been cleaned. They can now<br />
look to see if it carries a fresh ‘I am clean’<br />
sign, showing not only that it has been<br />
sanitised but also when it was last sanitised.<br />
As well as being a helpful sign, the new<br />
stickers help build confidence in our practices<br />
and processes. When patients see a blood<br />
pressure monitor or even a commode being<br />
brought to them, they will see that it carries a<br />
sticker that shows it has been cleaned.<br />
To find out more about the new process,<br />
<strong>Heartbeat</strong> caught up Infection Prevention<br />
and Control Nurse, Louise Wilkins. She<br />
said: “COVID-19 has had a considerable<br />
impact on our patients and we have<br />
changed our processes so that we can<br />
be confident that everything is sanitised.<br />
We have always ensured staff sanitise<br />
equipment after use, but we needed a<br />
visual to support our efforts. We know<br />
that sometimes it can be easy to assume<br />
that something is clean if it looks clean,<br />
without a visual sign, how do you know?<br />
This is where the new signs and stickers<br />
help - they remind staff to stop, check<br />
and sanitise if needed.<br />
“We must build responsibility into our<br />
processes and, these stickers are a<br />
reminder to colleagues that although<br />
someone will have taken the time to<br />
sanitise equipment after use, it’s your<br />
responsibility to review the sticker and<br />
assess whether it needs to be sanitised<br />
again before use.<br />
“The stickers are also a very welcome<br />
sign to patients, a lot of work goes into<br />
cleaning, sanitising and preparing every<br />
bed, bay, surface and piece of equipment<br />
in a ward, but the patients often have<br />
to assume this has been done. The new<br />
stickers clearly show that someone has<br />
taken the time to clean and sanitise the<br />
equipment.<br />
“Along with the new stickers, we’re also<br />
encouraging colleagues to complete<br />
the new ‘Cleaning for Confidence’<br />
e-learning package that’s now on offer.<br />
The e-learning programme outlines the<br />
fundamentals of cleaning, intending to<br />
reduce the risks of cross-infection during<br />
the COVID-19 pandemic, and promoting<br />
confidence in our patients and service<br />
users in continuing to access NHS<br />
services. The e-learning session takes<br />
approximately 20 minutes to complete<br />
and, a certificate will be generated on<br />
completion of the e-learning.<br />
Everyone who completes the Cleaning<br />
for Confidence programme will<br />
become a cleaning champion, having<br />
demonstrated their commitment to<br />
keeping colleagues, patients and their<br />
families’ safe every day.”<br />
To find out more about the Infection<br />
Prevention and Control practices and<br />
programmes, contact ext 5900.<br />
7
Not all heroes wear capes but they<br />
do all wear masks<br />
COVID-19<br />
Recently there has been a notable<br />
rise in Coronavirus infections within<br />
healthcare settings and in the<br />
community – and in response, you’ll no<br />
doubt be aware that we have stepped<br />
up our personal protective equipment<br />
(PPE) provisions. But, regardless of our<br />
rules, you can only be safe if everyone<br />
follows them.<br />
We know that if PPE is not worn correctly,<br />
social distancing is not maintained and<br />
cleaning best practices are not followed,<br />
then outbreaks are likely. An outbreak<br />
on top of the current pandemic situation<br />
would be devastating.<br />
Wearing masks can be uncomfortable,<br />
stifling and sore, but they are an absolute<br />
necessity at the current time. And if<br />
you’re a frontline colleague working in a<br />
COVID-19 positive area, masks are your<br />
lifeline, protecting you from inhaling the<br />
particles that are airborne around you.<br />
Some things you need to know:<br />
• The masks filter the air you breathe,<br />
keeping you safe. But in doing so,<br />
they also become host to the infected<br />
particles. So it’s vital you remove them<br />
properly and dispose of them, never<br />
drop them around your neck or pop<br />
them in your pocket to reuse later.<br />
They are a biohazard once worn.<br />
• Masks come in all shapes and sizes,<br />
and they have to be fit tested to you<br />
to be certain they are working.<br />
This means you must not wear<br />
Sandwell and<br />
West Birmingham<br />
NHS Trust<br />
MEDIUM<br />
RISK<br />
Please ensure you wear<br />
the correct PPE in this area.<br />
Lack of adherence to PPE may lead to high risk of cross transmission.<br />
If no direct patient contact wear a fluid resistant surgical face mask<br />
FFP3/silicone<br />
mask for direct<br />
patient care<br />
Disposable gloves<br />
(only required for contact with<br />
patient or immediate environment)<br />
Remove gloves in between<br />
patients and wash your<br />
hands. Do not wear<br />
gloves on nursing stations<br />
or whilst working on<br />
computers.<br />
Hand washing<br />
Eye protection<br />
(sessional use)<br />
Disposable<br />
apron<br />
(for personal care/<br />
examining patient)<br />
Remember to practice hand hygiene on entry to this area and between seeing patients and conducting tasks.<br />
whatever is available; you must<br />
wear what you are fitted for.<br />
Remember the make and model<br />
of your fit, and if you have<br />
forgotten, call infection control to<br />
be reminded.<br />
• Whilst we all breach social distancing<br />
momentarily as we pass by in<br />
corridors or cramped spaces we<br />
work in, this in no way means that<br />
we should become lax in our<br />
distancing. It only takes one person<br />
to have COVID-19 for an infection<br />
to spread.<br />
• Donning and doffing areas should<br />
be marked on wards. These are the<br />
spaces set aside to safely put your<br />
PPE on, and safely remove your PPE.<br />
COVID-19_MEDIUMINFECTION_MS6251<br />
Please ensure you wear the correct PPE in<br />
this area. Within red areas, staff will wear<br />
different PPE depending on the type of<br />
contact they have with patients.<br />
COVID-19 suspected or confirmed or not been screened for symptoms.<br />
FFP3/silicone mask for<br />
direct patient care<br />
Disposable apron (for<br />
personal care/examining<br />
patient)<br />
Hand washing<br />
Eye protection<br />
(sessional use)<br />
Sandwell and<br />
West Birmingham<br />
HIGH<br />
INFECTION<br />
RISK AREA<br />
If no direct patient contact wear a fluid resistant surgical face mask<br />
Disposable gloves (only required<br />
for contact with patient or immediate<br />
environment)<br />
Remove disposable gloves in between patients<br />
and wash your hands. Do not wear gloves<br />
on nursing stations or whilst working on<br />
computers.<br />
Remember to practice hand hygiene on entry to this area and between seeing patients and conducting tasks.<br />
Please pay close attention to the<br />
order in which you put your PPE<br />
on and remove it. Posters are<br />
available for further guidance.<br />
NHS Trust<br />
For close care of COVID-19 patients where rapid deterioration is likely<br />
and for single use AGP wear single use gown with full sleeves. Please<br />
remove the gown after the task is completed.<br />
• If you are in a communal area,<br />
corridor or coffee shop, remember<br />
to wear a fluid-resistant surgical<br />
face mask. These are readily<br />
available in the entrances to each<br />
of our buildings and in most<br />
departments. Please remember to<br />
change your mask for a fresh FRSM<br />
if you are coming from COVID<br />
positive areas.<br />
For more information on the Do’s<br />
and Don’ts of PPE and how to protect<br />
yourself, contact the infection control<br />
team on 0121 507 5900.<br />
COVID-19_HIGHINFECTION_MS6163<br />
8
Midland Met build continues on track<br />
despite COVID-19<br />
CORPORATE AND GENERAL<br />
NEWS<br />
DID YOU KNOW?<br />
Midland Met continues to make positive progress as we head towards our grand<br />
opening in 2022<br />
Whilst COVID-19 and the ensuing<br />
pandemic has brought industries<br />
across the world to a crashing halt, our<br />
flagship hospital continues steadily on<br />
its journey to completion in 2022. As<br />
we finally begin to regain some control<br />
of our lives, we look forward to the<br />
collaborative acute care models we're<br />
set to see in Midland Met.<br />
With multiple trades on-site at any one<br />
time, all vying to play their part and<br />
complete the long-awaited hospital, it has<br />
been no mean feat to keep COVID-19<br />
at the door, and the build continuing its<br />
progression.<br />
Thankfully, when you have an army of<br />
tradestaff on hand who can build you a<br />
world class facility, it doesn’t take much to<br />
create the facilities to help colleagues’ social<br />
distance and sanitise.<br />
We’ve been working on the build now for<br />
several months, and you can start to see the<br />
difference. Slowly but surely, the hospital is<br />
taking shape. Partitions are going in, areas<br />
are getting ready to be signed off on, and<br />
you can envisage what it will look like.<br />
Keeping everything moving has been<br />
at the top of our priorities and, we’re<br />
mindful of COVID-19 too. We have taken<br />
measures to keep the site safe, including<br />
dedicated areas for people to wash their<br />
hands and of course, following social<br />
distancing guidelines. We’ve also given<br />
snoods to Balfour Beatty staff which are<br />
not only warm when working outside but<br />
practical too helping to reduce the risk of<br />
transmission.<br />
Once complete in 2022, our acute hospital<br />
will offer maternity, children and inpatient<br />
adult services to half a million people, and,<br />
as we take small but significant steps towards<br />
opening our new hospital, we will keep you<br />
updated along the way. We'll bring you the<br />
latest news, sneak peeks behind the scenes,<br />
plus lots more so that when the time comes,<br />
you are ready to move to Midland Met.<br />
So what have we achieved in the past<br />
12 months? Since 6 <strong>January</strong> 2020, when<br />
construction began, Balfour Beatty have<br />
worked hard to make our vision a reality.<br />
Spring <strong>2021</strong> is when we expect to see the<br />
power go on, another milestone as we move<br />
closer to our grand opening. This means<br />
we can start to progressively see permanent<br />
lighting be switched on as we head into the<br />
summer months.<br />
In practical terms, we have also made progress<br />
in what will be our clinical areas. Partitioning<br />
in the clinical areas is almost complete, and<br />
ductwork installation to the first zones on<br />
levels two and three are nearing completion.<br />
Rachel Barlow, Director of System<br />
Transformation, commented: “The Midland<br />
Metropolitan University Hospital project is, as<br />
you can imagine, made up of many people,<br />
teams and stakeholders. Once open it will<br />
have a far-reaching impact - not only on those<br />
we care for but also for colleagues and our<br />
community in terms of regeneration, jobs,<br />
housing, our charitable endeavours, transport<br />
and so much more.<br />
“I feel privileged to be a part of this project.<br />
Seeing our hospital being built from the<br />
ground up is an honour, and I am looking<br />
forward to when we can officially welcome<br />
colleagues into their new home. It will<br />
significantly advance what we do and how<br />
we do it. We will have access to the latest<br />
technology, and colleagues can focus on<br />
delivering the best possible clinical outcomes<br />
and an overall enhanced patient experience.”<br />
In 2020 at Midland Met:<br />
• We began working on the<br />
plasterboard wall construction in<br />
the clinical areas<br />
• We made significant progress on<br />
the air system ductwork<br />
installation to the clinical areas<br />
• We had enough deliveries of<br />
construction supplies to create a<br />
13 mile tailback<br />
• Enough vertical plasterboard wall<br />
materials was installed to stretch<br />
from Birmingham to Glasgow –<br />
more than 400km<br />
• We racked up 11,000 hours<br />
moving construction workers and<br />
goods up and down the<br />
building<br />
• Installed 61km of electrical cable<br />
trays and conduit (used to<br />
protect and route electrical wiring<br />
in a building)<br />
• We employed 185 local people<br />
and inducted over 1500 people to<br />
work onsite<br />
• Completed 5,100 quality<br />
workmanship checklists.<br />
This is just the beginning…<br />
#morethanahospital<br />
Balfour Beatty colleagues were gifted<br />
snoods to wear onsite.<br />
9
Shaping the future of<br />
our estate with Engie<br />
CORPORATE AND GENERAL<br />
NEWS<br />
Engie is a leading service, business<br />
energy and regeneration company.<br />
As you may be aware, they are<br />
also our new estates facilities<br />
management provider from the 5<br />
April for our current hospitals and<br />
the Midland Metropolitan University<br />
Hospital.<br />
In early 2019, Engie successfully bid and<br />
secured the contract to become our<br />
exclusive estate management provider<br />
for the next eleven years and will play a<br />
critical role in our move to Midland Met<br />
in 2022. Boasting a workforce of 17,000<br />
people and managing over 25million m²<br />
of space, Engie currently works with 35<br />
other healthcare sites and have 15 local<br />
authority partnerships, so it's safe to say<br />
we'll be working alongside an experienced<br />
service provider, helping to make the<br />
management of our estate activity as it<br />
changes more streamlined and dynamic.<br />
But what will this change mean in reality<br />
for our organisation? Well, for starters you<br />
can expect to see Engie working closely<br />
with SWB, and colleagues in our Trust<br />
to not only look after our estate but to<br />
innovate, collaborate and actively seek<br />
ways to improve our working environment.<br />
From 5 April <strong>2021</strong>, the team will be responsible<br />
for looking after estates facilities management,<br />
reactive maintenance, programmed planned<br />
maintenance, lifecycle works, small works and<br />
some capital works.<br />
Many of our current estates colleagues will be<br />
joining the ENGIE team so we are lucky we will<br />
still be working with staff we know and who<br />
know our estate and services. ENGIE are also<br />
currently working at Midland Met alongside<br />
Balfour Beatty, our construction partners getting<br />
to know the behind the scenes infrastructure<br />
before it is closed behind walls and above<br />
ceilings. This insight is a significant benefit to<br />
managing the new real estate in the future.<br />
So how do Engie ensure that innovation<br />
remains at the heart of their business model?<br />
They keep it simple and keep an eye on<br />
developing new ideas and managing their<br />
impact on the environment.<br />
Engie’s unwavering commitment to the<br />
environment is clear to see - they actively<br />
support organisations to reach a zero carbon<br />
footprint. They will support this ambition by:<br />
• Reducing energy consumption<br />
• Greening supply through investment<br />
in de-carbonised and decentralised<br />
infrastructure<br />
• Enabling progress through innovative<br />
technology, data and partnerships<br />
• Reconciling economic performance<br />
with a positive impact on people and<br />
the planet.<br />
Rachel Barlow, Director of System<br />
Transformation, remarked: “We have been<br />
working closely with Engie to ensure the<br />
transition to using their service is as smooth<br />
as it can be. Over the coming weeks, we<br />
will be working with colleagues, holding<br />
engagement workshops and sharing what<br />
will be changing and how users can access<br />
the services they provide.’’<br />
“We’ve all been working hard behind the<br />
scenes to move to Engie and, one of the<br />
things I am particularly excited about is<br />
their focus on sustainability and innovation.<br />
Being a forward-thinking organisation<br />
looking at how we can operate as carbon<br />
neutral as possible will stand us in good<br />
stead for the future. Plus, Engie works with<br />
over 30 hospitals across the NHS, so they<br />
are sharing that wealth of experience with<br />
us to impact positively on the work we do<br />
onsite and in our communities.”<br />
Richard Samuda, our Chairman,<br />
previously remarked: “This is a key long<br />
term relationship for us, with a shared<br />
commitment to local procurement, local<br />
employment and the living wage.”<br />
Signing up to a better patient<br />
experience<br />
A project to improve signage across all<br />
Trust sites leading to a better patient<br />
experience is now complete.<br />
Led by Victoria Williams from the patient<br />
access team, it ensures signage and<br />
directions in patient letters and texts now<br />
matches what they see when they visit<br />
our sites. The patient access team worked<br />
alongside estates and the improvement<br />
team on the project.<br />
Explaining the need for the improvements,<br />
Victoria said: “We wanted to ensure that<br />
the patient journey was seamless and easy<br />
as possible right from the start. We found<br />
that although we were signposting patients<br />
to particular areas, this didn’t match what<br />
they were seeing when they were on site.<br />
"Patients would complain about being lost,<br />
and this would lead to them being late for<br />
their appointments. Many would have to<br />
stop staff for directions. The point of the<br />
project was to alleviate this and improve the<br />
patient experience from the moment they<br />
arrived on site.”<br />
The 12-month project started with Victoria<br />
alongside colleagues from estates and the<br />
improvement team walking around each<br />
site to check signage and directions to flag<br />
up any initial problems.<br />
Colleagues from across the Trust were<br />
asked to voice any issues they had spotted.<br />
Victoria added: “We had good engagement<br />
from colleagues about areas where signage<br />
needed to be improved.<br />
“We were able to act upon this information<br />
and change signs. It’s undoubtedly had a<br />
positive effect, and we are also hoping that<br />
it will mean that patients are more likely<br />
to attend appointments on time with the<br />
improved information on directions.”<br />
New signage outside BMEC<br />
10
Enabling our partners to<br />
embrace a greener,<br />
more efficient and<br />
increasingly digital world.<br />
ENGIE is committed to making zero carbon happen<br />
for businesses and communities throughout<br />
the UK & Ireland – accelerating the transition<br />
towards a net zero carbon world.<br />
We make this possible by reducing energy consumption and<br />
driving efficiency, greening supply and enabling progress<br />
through innovative technology, data & partnerships.<br />
We are also shaping the future of responsible business<br />
by reconciling economic performance with a positive<br />
impact on people and the planet.<br />
11
Alcoholic mum at the ‘brink of death’<br />
urges people to seek help for addiction<br />
CORPORATE AND GENERAL<br />
NEWS<br />
A recovering alcoholic who was on<br />
the brink of death because of her<br />
addiction has urged people to seek<br />
help if they need it.<br />
Teresa Allen’s life spiralled out of control<br />
after she lost her job, leading her to sink<br />
a litre bottle of whisky a day.<br />
Her problems with alcohol abuse first<br />
began when she found herself drinking<br />
heavily at the weekend to cope with<br />
the pressures of work. Teresa's weight<br />
plummeted from 22 stone to a mere<br />
seven stone, and she lost her job. But<br />
her addiction soon took its toll on her<br />
body and, she began coughing up<br />
blood.<br />
When she was finally admitted to City<br />
Hospital, to seek help for her addiction,<br />
doctors delivered the bad news – her<br />
organs were shutting down and, it was<br />
doubtful that she would survive.<br />
But thanks to the help of our awardwinning<br />
alcohol care team and the<br />
drug and alcohol service, Change Grow<br />
Live (CGL), she is now on the road<br />
to recovery and later this month will<br />
celebrate her first year of going teetotal.<br />
Speaking during Dry <strong>January</strong>, a campaign<br />
to encourage people to stop drinking for<br />
the entire month, Teresa said: “I made<br />
a mistake with my drinking, but I am<br />
grateful that I am here now and able to<br />
tell my story.<br />
“I feel horrible when I think back to the<br />
worst times. I can’t go down the alcohol<br />
aisle in a supermarket as it makes<br />
me feel sick and watching TV adverts<br />
reminds me of the pain and suffering I<br />
went through.<br />
“I still have health problems as a result<br />
of the years of abuse, but I am in an<br />
amazing place now. I am coming up to<br />
my first year anniversary of being dry<br />
and, I want to make sure that I never go<br />
back.”<br />
Teresa’s problems first began when she<br />
would turn to alcohol after a hard day<br />
at work. “It started with a glass or two<br />
of wine or cider,” she recalled. “As<br />
work pressures began building, I began<br />
drinking more at night and at weekends.<br />
“About two years ago, it started getting<br />
out of hand after the breakdown of a<br />
relationship. I was working lots and,<br />
to cope with everything I would drink<br />
a one-litre bottle of whisky over a<br />
Teresa pictured before seeking help<br />
weekend. I realised that I had a problem and,<br />
with the help of my doctor, I managed to stop<br />
for three months.”<br />
But Teresa used a family argument as an<br />
excuse to turn back to the alcohol and, the<br />
row triggered her drinking again.<br />
“I started secretly back on the whisky which<br />
I was drinking during the evening and,<br />
my world fell apart,” she added. “I was<br />
suspended, and when I lost my job, I started<br />
having a bottle of whisky a day.<br />
“People around me could see I was spiralling<br />
out of control. I started vomiting blood and<br />
was admitted to the hospital. I had a feeding<br />
tube inserted as I wasn’t eating enough. I’d<br />
lost so much weight, yet my stomach looked<br />
like I was carrying twins because of the<br />
alcohol.<br />
“I was referred to CGL, and that then led to<br />
me getting on the detox programme with the<br />
alcohol care team at City Hospital.<br />
“On 20 <strong>January</strong> I went into detox, it was then<br />
I realised what sort of state my body was in. I<br />
was on the brink of death - my organs were<br />
shutting down. I was told that I was dying<br />
because of the extent of the cirrhosis.<br />
“As I started on detox and the medication,<br />
as well as eating better, a miracle started to<br />
happen. I was recovering and was discharged<br />
from hospital just over a month later. Since<br />
then, I have had tremendous support from<br />
the alcohol team and CGL. It has continued<br />
Teresa as she looks now<br />
throughout lockdown. Now I believe I am<br />
worth something.”<br />
So what advice does Teresa have for anyone<br />
else who may be going through a similar<br />
experience to her? “If anyone thinks they<br />
have a problem with alcohol should go<br />
to their GP to start the process. I’m not<br />
currently working, but I am building up my<br />
strength to get fit and well, so I can return<br />
to employment. I’m also completing various<br />
online courses to help with this.<br />
“For now I’m enjoying the precious time I<br />
have with my family. They can see how far<br />
I have come and have been so supportive<br />
throughout.”<br />
Roxanne Mahroof, Alcohol Care Team<br />
Nurse, said: “Teresa has done brilliantly.<br />
From the beginning, she was honest<br />
and open about her drinking. She<br />
acknowledged she was becoming physically<br />
unwell and had the courage to make the<br />
necessary changes. It was clear that Teresa<br />
was willing to do whatever was advised by<br />
the professionals to become abstinent and<br />
live her life in healthy sobriety.<br />
“During these uncertain times, people<br />
are struggling. The alcohol care team has<br />
noticed there has been an increase in<br />
drinking amongst people. Her story carries<br />
hope to others struggling with alcohol<br />
misuse; that you can make changes to your<br />
life despite what’s going on in your world.”<br />
12
Alcohol team rise to the challenge to<br />
raise cash for special device<br />
The alcohol team’s fundraising<br />
campaign kicked off in <strong>January</strong> with<br />
members of the service committing to<br />
challenges throughout the month to<br />
raise money for a FibroScan clinic van.<br />
The ultrasound device, which measures<br />
the degree of inflammation in the liver, will<br />
be used by the team during portable clinic<br />
sessions in the community. They will be able<br />
to scan members of the local community,<br />
those attending events, and it will allow<br />
them to visit organisations to offer harm<br />
reduction advice. The FibroScan is a simple,<br />
painless test that uses high-frequency sound<br />
waves.<br />
Challenges to raise the cash to fund the<br />
equipment included taking part in Dry<br />
<strong>January</strong> - a campaign which involves giving<br />
up alcohol for the month, whilst others<br />
committed to walking or running a certain<br />
amount of miles throughout the four<br />
weeks.<br />
Members of the alcohol care team who are<br />
taking part in various challenges to raise<br />
money for a FibroScan clinic van<br />
Sam Morgan, Alcohol Specialist Nurse, said:<br />
“We all wanted to commit to something<br />
challenging so that we can raise these<br />
funds. I’ve started a lifestyle challenge to<br />
benefit my physical and mental health.<br />
“We invited colleagues to join the Dry<br />
<strong>January</strong> challenge and had a lot of interest.<br />
CORPORATE AND GENERAL<br />
NEWS<br />
Throughout the month, we also offered<br />
support sessions to staff who felt they<br />
needed help.”<br />
During <strong>January</strong> Arlene Copland, Lead<br />
Alcohol Nurse and Jo Page, Lead<br />
Administer and Medical Secretary walked<br />
250 miles each, whilst Roxy Mahroof,<br />
Alcohol Nurse and Matt Hinton, Alcohol<br />
Practitioner both ran 5km a day. Carol<br />
Appleyard, Alcohol Specialist Nurse and<br />
Pete Marple, Alcohol Practitioner both<br />
committed to Dry <strong>January</strong> too.<br />
The team are continuing to fundraise<br />
for the van until they hit their target.<br />
To sponsor them head over to Just<br />
Giving and search for Dry <strong>January</strong> 21 @<br />
Sandwell and West Birmingham NHS<br />
Trust.<br />
An Apple (watch) a day keeps the<br />
doctor away!<br />
This month we have an exciting<br />
competition to help get <strong>2021</strong> off to a<br />
more positive start. If you’ve decided to<br />
focus on your health and wellbeing in<br />
<strong>2021</strong>, we have just the thing for you.<br />
We have an Apple watch up for grabs<br />
(courtesy of Personal Group) which could<br />
really help to boost your fitness regime.<br />
It measures all the ways you move, gives<br />
you meaningful health insights, and a<br />
connection to the people and things you<br />
care about most.<br />
To be in with a chance of winning, all you<br />
need to do is answer these six questions<br />
generated from stories featured in this<br />
edition of <strong>Heartbeat</strong> and email your<br />
answers to swbh.comms@nhs.net. The<br />
closing date is Friday, 26 February. Good<br />
luck!<br />
Q1 How many km of conduit was<br />
installed at Midland Met in<br />
2020?<br />
Q2 Sharing his thoughts on the<br />
vaccine, who said: “This is a<br />
massive step forward in the<br />
battle against the<br />
Coronavirus, the Pfizer/<br />
BioNTech COVID-19 vaccine<br />
which we will be<br />
administering has shown to<br />
offer up to 95 per cent<br />
efficacy?”<br />
Q3 How much weight did Heidi<br />
Ferrier-Hixon lose?<br />
Q4 I am X stickers are being<br />
introduced in ward areas. Tell<br />
us the missing word.<br />
Q5 From September 2020, the<br />
infant feeding team received<br />
what percentage of positive<br />
feedback from new mums –<br />
75 per cent, 82 per cent or 100<br />
per cent?<br />
Q6 Name the two community<br />
locations where relaxation<br />
rooms can now be found?<br />
13
Celebrating our<br />
stars of the week<br />
Star of the Week<br />
Jacqueline Clarke and Davinia George, Your Health Partnership<br />
Star of the Week<br />
Jayne Redfern, Service Manager<br />
Congratulations are in order for<br />
Jacqueline Clarke and Davinia George<br />
from Your Health Partnership.<br />
Both Jacqueline and Davinia rapidly set<br />
up the successful delivery of COVID-19<br />
vaccinations for the over 80s within the<br />
local community. They have both worked<br />
incredibly hard, attending work on rest<br />
days to ensure the team were in a position<br />
to administer the vaccines rapidly and<br />
safely. This has been a mammoth effort<br />
undertaken at very short notice and with<br />
constantly changing information. They<br />
considered all aspects of the patient journey,<br />
ensuring patients were cared for holistically.<br />
They worked with the local community<br />
and other services within the Trust<br />
demonstrating and embracing integrated<br />
care and successfully administering over 900<br />
vaccines across just 3.5 days.<br />
In addition to the logistical and clinical work,<br />
they have constantly supported colleagues,<br />
protecting their wellbeing. They have both<br />
gone above and beyond to support the local<br />
community, demonstrating each of the Trust<br />
promises and undertaking work which will<br />
positively impact patients and the wider<br />
community.<br />
Congratulations to Jayne Redfern,<br />
Service Manager.<br />
When her co-worker for running the<br />
medicine rota went on maternity leave,<br />
Jayne stepped in and has been working<br />
hard to ensure as many slots as possible are<br />
filled in the medical rota.<br />
Jayne’s resilience has been nothing but<br />
outstanding. Congratulations Jayne!<br />
Star of the Week<br />
Denise Fitzmaurice,<br />
Community Liaison Nurse<br />
Star of the Week<br />
James Chapman, Porter<br />
Way to go James Chapman, a Porter at<br />
Sandwell.<br />
James was nominated for his work being<br />
“chief swab collector” at Sandwell Hospital.<br />
He always has a smile on his face, greeting<br />
everyone he meets and being really friendly.<br />
In such a difficult time when people<br />
are stressed and generally down, he is<br />
guaranteed to make you feel better if you<br />
pass him in the corridor.<br />
James is an important member of portering<br />
and plays a vital role in boosting the morale<br />
within his team.<br />
Do you know someone in your team that has gone above and beyond<br />
the call of duty? Why not put them forward for Star of the Week by<br />
visiting Connect.<br />
Well done Denise Fitzmaurice,<br />
Community Liaison Nurse.<br />
Denise consistently does excellent work<br />
with patients who have complex social and<br />
health needs. She goes over and above<br />
her duties so that the patients receive the<br />
correct support after discharge. She liaises<br />
with external agencies to ensure a smooth<br />
transition from hospital into the community.<br />
Denise is always happy to help her<br />
colleagues with complex discharges, shares<br />
her expertise and utilises contacts in the<br />
community to achieve the best possible<br />
outcomes for patients. She supports some<br />
of our most vulnerable patients who leave<br />
our hospital sites.<br />
Denise always shows professionalism in her<br />
conduct and always treats her colleagues<br />
and patients with the upmost respect.<br />
14
Shout out has been a regular feature<br />
in <strong>Heartbeat</strong> and it is fantastic to see<br />
colleagues regularly taking the time to<br />
give positive feedback to each other.<br />
We regularly receive positive feedback from<br />
our patients too, and this month we wanted<br />
to share some of those heart-warming<br />
messages which have been sent via our<br />
website and social media platforms.<br />
CORPORATE AND GENERAL<br />
NEWS<br />
To – Bimla Devi<br />
Bimla has helped me out so much since a<br />
colleague left our team. I can't thank you<br />
enough Bimla for all of your hard work and<br />
professionalism, we are so lucky to have<br />
you. Thank you.<br />
From – Lauren Weigh<br />
To – Masood Aga<br />
Fantastic help in tracking down a staff<br />
COVID-19 swab out of hours, and really<br />
supportive in a very stressful moment.<br />
From – Lauren Prior<br />
To – Jocelyn Echaluce<br />
Jocelyn went above and beyond for her<br />
patient on critical care enabling the<br />
neonatal team to create vital and precious<br />
memories for her patient's daughter on<br />
NNU.<br />
From –Rachel Tennant<br />
To – Sister Maureen<br />
Thank you for being the backbone of the<br />
community midwifery service. We would be<br />
well and truly lost without you.<br />
From – Mosheda Begum<br />
To – Lavinia Hines<br />
Lavinia called me after I completed<br />
my online stress assessment. I found it<br />
really helpful to speak with her; she<br />
was supportive, approachable and<br />
understanding and managed to develop<br />
a therapeutic relationship with me even<br />
though we didn't meet face to face. I think<br />
that she and the rest of the wellbeing<br />
team do an amazing job and I would<br />
urge anyone who needs that little bit of<br />
extra support, help or guidance to contact<br />
them. We all have mental health and we<br />
all deserve to achieve and maintain good<br />
mental health. Thank you to Lavinia and<br />
all her colleagues for providing such a<br />
valuable service.<br />
From – Becky Fox<br />
To – AMU A<br />
I would like to thank the team on AMU<br />
A for having me during my third year as<br />
a student nurse. I feel I have grown so<br />
much in confidence as well as expanding<br />
my clinical knowledge and skills. I have<br />
been made to feel part of the team, which<br />
is huge for us student nurses. Working in<br />
such as busy environment felt daunting at<br />
first but the team soon got me through<br />
that, and I quickly began to find myself<br />
enjoying coming to unit. I have had the<br />
pleasure of working with some amazing<br />
nurses whose knowledge astounds me. I<br />
thank you all for your nurturing and help,<br />
as I step into my new role as Band 5.<br />
From – Lauren Melhado-Yeomans<br />
To – Aaron Hyett<br />
Thank you Aaron for saving me from IT<br />
issues on several occasions. Each time fixing<br />
it first time and sorting everything out.<br />
Every time you are so helpful and very<br />
calm with all the issues virtual working is<br />
throwing at us all. Thank you! We would<br />
not be able to provide the care to the<br />
young children we work with without you<br />
and your IT colleagues.<br />
From – Beth Smith<br />
To – Ward Sister Becky and the paediatric<br />
casualty team<br />
I would like to thank the whole team<br />
for looking after my son Zaviyar when<br />
he was poorly. I can’t commend the staff<br />
enough. Every member of staff who came<br />
in contact with him took time out to make<br />
conversation with him.<br />
A& E is traumatic, more so for young<br />
children, especially with everyone wearing<br />
a mask. Thank you.<br />
From – Nazia Aziz<br />
To – Night domestics<br />
I am very proud of the night cleaning staff.<br />
I would highly recommend - you all have<br />
done a fantastic job throughout the night,<br />
especially during the COVID-19 pandemic.<br />
Cleaning very immaculately.<br />
From – Pauline Williams<br />
To – Bereavement Care Volunteers<br />
We would like to say a big thank you to<br />
our lovely volunteers. Val, Jeremy, Rehana<br />
and Victoria for giving their time to the<br />
bereavement service. They have made a<br />
huge difference to families by making<br />
befriending telephone calls and offering<br />
their support during this very difficult time.<br />
You are all truly amazing people and we<br />
are lucky to have you.<br />
From – Angela Jones<br />
To – Theatre reservists<br />
Our theatre staff who are reservists have<br />
risen to the challenge of working in<br />
ITU and supporting our sickest patients,<br />
and they have moved to ITU in a calm<br />
and professional manner. The theatre<br />
triumvirate are immensely proud of them.<br />
Thank you to all of our reservists!<br />
From – Amber Markham<br />
To – Gemma Botfield<br />
Gemma was extremely supportive this<br />
week and gave me some sound advice and<br />
support in my role as a school health nurse.<br />
Thanks for your help and advice Gemma, it<br />
was greatly appreciated.<br />
From – Laura Johnson<br />
To – Laura Johnson<br />
I would like to appreciate my colleagues<br />
on Lyndon 5. You have shown exceptional<br />
resilience despite all the challenges that<br />
came your way. You all worked together<br />
and cared for the most vulnerable since the<br />
ward became a COVID-19 ward. Keep up<br />
the good work.<br />
From – Alice Kimani<br />
To – Kalavatiben Sunnia<br />
A huge thank you to Kal, community<br />
children's dietetic assistant based at<br />
Victoria Health Centre. She is such a hard<br />
worker and nothing is ever too much<br />
trouble for her. Thank you for all that you<br />
do, we really appreciate it<br />
From – Rebecca Anderson<br />
15
COVID-19:<br />
Celebrating the success of vaccination<br />
Alicia Parker - Lead Professional<br />
Development Nurse<br />
Whilst we are not over the worst of the<br />
virus by any stretch of the imagination, we<br />
are finally moving into a position where<br />
we are able to take control. Thanks to the<br />
hard work of the international scientific<br />
community, the task of developing a viable<br />
vaccination has been met in a record time,<br />
giving us the first real opportunity to begin<br />
proactively protecting ourselves.<br />
To date, our guidance has been to social<br />
distance, wash your hands and limit<br />
contact and in the short term, this remains.<br />
But with the roll out of the vaccine, we<br />
now stand a good chance of reaching our<br />
ultimate goal of achieving herd immunity<br />
– a position at which COVID-19 is unable<br />
to infect enough people to become a<br />
problem.<br />
Herd immunity does however mean that<br />
we need everyone, not only colleagues in<br />
clinical settings but those who are working<br />
Lisa Tyler - Nurse<br />
After the chaos and confusion of the last 12 months, with<br />
endless rule changes and lockdowns we are finally seeing<br />
the light at the end of the tunnel with the successful launch<br />
of the vaccination hubs at Sandwell and City Hospitals and<br />
Whiteheath Medical Centre.<br />
in operational roles, those that are isolating<br />
or redeployed to come forward, roll up<br />
their sleeves and join the thousands who<br />
have already received the life saving jab.<br />
Whilst the discomfort of a needle lasts a<br />
moment, the damage that can be done<br />
by COVID-19 once it begins to take over<br />
your lungs is devastating. The effect of<br />
COVID-19 is clear to see, not only through<br />
the stories of broken families that are<br />
often broadcast, but simply by seeing the<br />
numbers of people who are unnecessarily<br />
dying in hospital beds across the country,<br />
isolated from their loved ones and unable<br />
to communicate in their final days.<br />
Whilst we can say the vaccine has been<br />
long awaited, we unfortunately also have<br />
to accept that there has been a lot of<br />
misinformation and misunderstanding<br />
about the vaccine which has led to<br />
colleagues, patients and the public hesitant<br />
to being vaccinated or even declining<br />
the vaccination. Fuelled by mistrust<br />
in pharmaceutical companies and the<br />
incredible speed at which the vaccination<br />
has been developed, tested, trialled<br />
and deployed, rumours have been rife.<br />
However, one fact remains, rarely in history<br />
has the scientific community come together<br />
en-masse with the technology we have<br />
now to work together to develop a cure for<br />
a shared adversary.<br />
Trials which would normally take months<br />
and years have been able to be completed<br />
in lightning speed, not through cutting<br />
corners, but by an international drive<br />
to recruit volunteers to tackle a global<br />
pandemic. Checks and approvals by<br />
regulatory authorities have remained in<br />
place, stringent as ever, ensuring that not<br />
a single vial of vaccine reaches the public<br />
without the right checks in place.<br />
Sharing his thoughts on the vaccine,<br />
Chief Pharmacist, Puneet Sharma said:<br />
“This is a massive step forward in the<br />
battle against the Coronavirus, the Pfizer/<br />
BioNTech COVID-19 vaccine which we will<br />
be administering has shown to offer up to<br />
95 per cent efficacy and has been given<br />
regulatory approval by the Medicines and<br />
Healthcare Regulatory Agency.”<br />
Many people rightly question the safety<br />
of the vaccination; however, the NHS<br />
would not offer any kind of COVID-19<br />
vaccinations to the public until experts<br />
had signed off that it is safe to do so.<br />
The Medicines and Healthcare Regulatory<br />
Agency (MHRA), the official UK regulator,<br />
have said this vaccine is very safe and<br />
highly effective, and we have full<br />
confidence in their expert judgement and<br />
processes. As with any medicine, vaccines<br />
are highly regulated products. There are<br />
checks at every stage in the development<br />
and manufacturing process, and continued<br />
monitoring once it has been authorised and<br />
is being used in the wider population.”<br />
Whilst we were approved for the vaccine<br />
before Christmas, we were able to begin<br />
delivering the first doses to our most<br />
vulnerable patients and over 80yr olds<br />
merely days later, allowing them to ring in<br />
the year knowing they had taken the first<br />
steps to protecting themselves.<br />
Though the process of delivering a<br />
vaccination is simple, completing a checklist<br />
and ensuring the patient understands the
process, there is an incredible amount of<br />
work involved in the logistics of getting<br />
everything in order before the needle<br />
meets skin. Dispensing in the region of<br />
400 vaccinations a day, the tenacious team<br />
of retirees who have returned to battle<br />
COVID, alongside medical students and<br />
overseen by our clinicians plan the delivery<br />
of every single drop of the precious vaccine,<br />
ensuring that those most at need, receive<br />
the protection of the vaccination as soon as<br />
possible.<br />
If you are yet to get your COVID-19<br />
vaccination you can book your by<br />
contacting the booking team on 0121<br />
507 4112 to book into an available slot.<br />
Lucille Hamilton, Senior Imaging Support<br />
Worker with Cath Price, Midwife<br />
Christopher Coleman - Porter<br />
Busting the myths of COVID-19<br />
Now I have had my vaccine do I still<br />
need to follow social distancing<br />
rules?<br />
Yes, you definitely should! Though you<br />
may be protected against the harmful<br />
effects of COVID-19 having had your<br />
vaccine you could still be a carrier and<br />
unknowingly pass it on to a member of<br />
your family, one of your friends or even<br />
a fellow co-worker so with this in mind<br />
please continue to wear a mask.<br />
I suffer with allergies, should I have<br />
the vaccine?<br />
People with history of a severe<br />
(anaphylactoid) allergy to any of the<br />
ingredients within the vaccine should<br />
not be vaccinated currently, nor should<br />
those with severe allergy to multiple<br />
drugs or where there is a history<br />
of anaphylaxis where the cause is<br />
unknown. If you are unsure of your risk,<br />
please contact occupational health for<br />
advice.<br />
Will the cost of the vaccine be<br />
deducted from my salary should I<br />
have it?<br />
No, the COVID-19 vaccination is only<br />
available through the NHS to eligible<br />
groups and it is a free vaccination.<br />
I had my flu jab this season; do I<br />
need to bother with the COVID<br />
vaccination?<br />
The flu vaccine does not protect you<br />
from COVID-19. As you are eligible for<br />
both vaccines you should have them<br />
both but please ensure you separate<br />
each vaccine by at least a week.<br />
I have COVID-19 currently, can I get<br />
the vaccine?<br />
People currently unwell and<br />
experiencing COVID-19 symptoms<br />
should self-isolate and should not<br />
receive the COVID-19 vaccine until they<br />
have recovered. The guidance is that<br />
this should be done 28 days after a<br />
positive PCR swab or from development<br />
of COVID symptoms to avoid mistaking<br />
any COVID related symptoms with<br />
adverse effects of vaccination or vice<br />
versa and to be confident that you are<br />
well enough.<br />
I’m pregnant, should I have the<br />
vaccine?<br />
The MHRA have updated their guidance<br />
to say that pregnant women and those<br />
who are breastfeeding can have the<br />
vaccine but should discuss it with a<br />
clinician to ensure that the benefits<br />
outweigh any potential risks.<br />
I am vegan; can I still have the<br />
vaccine?<br />
There is no material of foetal or animal<br />
origin in either vaccine. All ingredients<br />
are published in healthcare information<br />
on the MHRA’s website.<br />
For the Pfizer/BioNTech vaccine<br />
information is available here:<br />
https://www.gov.uk/government/<br />
publications/regulatory-approval-ofpfizer-biontechvaccine-for-covid-19<br />
For the Oxford/AstraZeneca vaccine<br />
information is available here:<br />
https://www.gov.uk/government/<br />
publications/regulatory-approval-ofcovid-19-vaccine-astrazeneca<br />
The COVID-19 vaccine does not<br />
contain pork<br />
You should not refuse the COVID-19<br />
vaccination due to personal or<br />
religious beliefs associated with pork<br />
as the COVID-19 vaccination does not<br />
contain pork or any porcine products.<br />
Furthermore, the Pfizer BioNTech<br />
COVID-19 vaccine does not contain any<br />
components of animal origin.<br />
Are there lots of side effects of the<br />
vaccine?<br />
For these vaccines, like lots of others,<br />
they have identified that some people<br />
might feel slightly unwell, but they<br />
report that no significant side effects<br />
have been observed in the tens of<br />
thousands of people involved in trials.<br />
All patients will be provided with<br />
information on the vaccine they have<br />
received, how to look out for any side<br />
effects, and what to do if they do occur,<br />
including reporting them to the MHRA.<br />
More information on possible side<br />
effects can be found at https://www.<br />
nhs.uk/conditions/coronavirus-covid-19/<br />
coronavirus-vaccination/coronavirusvaccine/<br />
Is the vaccine actually safe?<br />
Yes. The MHRA, the official UK<br />
regulator authorising licensed use of<br />
medicines and vaccines by healthcare<br />
professionals, has reviewed these<br />
vaccines as safe and highly effective. As<br />
with any medicine, vaccines are highly<br />
regulated products. There are checks at<br />
every stage in the testing, development<br />
and manufacturing process, and<br />
continued monitoring once it has been<br />
authorised and is being used in the<br />
wider population.
The only way is ethics<br />
CORPORATE AND GENERAL<br />
NEWS<br />
As astonishing as it is to say - let<br />
alone write - we are approaching<br />
one year since we in our<br />
organisation (and the wider NHS)<br />
took our first actions in response<br />
to the Coronavirus pandemic. A<br />
situation which dominated 2020 and<br />
seems set to leave an indelible mark<br />
on <strong>2021</strong> as well.<br />
With such a difficult task behind, as<br />
well as in front of us, it is important<br />
that those of us medically trained<br />
maintain our standards for ourselves<br />
as well as the benefits of our patients,<br />
even when we are faced with difficult<br />
decisions. In March 2020, the Clinical<br />
Ethics Committee (CEC) was set up, led<br />
by Dr David Nicholl as chairman. The<br />
committee is there to assist with - but<br />
not replace - clinical decision making.<br />
It’s a sounding board of medical peers<br />
within the Trust if you will.<br />
“We realised at the beginning of the<br />
pandemic that we needed to set up<br />
a clinical ethics committee, which some,<br />
but not all hospitals have. It differs from a<br />
research ethics committee that will look at<br />
research trials. The clinical ethics committee<br />
reviews any controversial areas of clinical<br />
medicine where ethical issues arise, not<br />
just those concerning the pandemic. Areas<br />
that we have looked at recently related to<br />
treatment escalation pathways, resuscitation<br />
decisions and ethical issues about delaying the<br />
second COVID-19 vaccination in light of the<br />
worsening pandemic. We hope that we can<br />
provide support and education for all staff as<br />
ethical issues arise in their work.”<br />
If you wish to submit an ethical issue for<br />
discussion, please complete the ethics<br />
committee referral form which can be found<br />
on Connect. This should then be submitted to<br />
both swbh.clinical-ethics-group@nhs.net as<br />
well as david.nicholl@nhs.net.<br />
For any informal queries colleagues are<br />
welcome to discuss with their concerns with<br />
Dr Nicholl, or any member of the committee.<br />
All discussions will take place in a confidential<br />
manner although a copy of the submission<br />
with the CEC's outcome will subsequently<br />
be included within the patient’s record for<br />
transparency. You will be contacted for<br />
more information if required.<br />
For further information about the UK<br />
Clinical Ethics Committee Network,<br />
please visit http://www.ukcen.net/<br />
Dr David Nicholl<br />
18
School nurse shares th-inspiring story<br />
of 10 stone weightloss<br />
For many of us, the New Year<br />
symbolises change and, for those<br />
of you lacking inspiration, the story<br />
of colleague Heidi Ferrier-Hixon’s<br />
incredible weight loss journey is<br />
enough to spring you into action.<br />
Heidi, who works as a school nurse team<br />
leader for Sandwell school nursing service,<br />
decided to lose a hefty ten stone after<br />
thinking she would die.<br />
“Simple things, like walking from my house<br />
to the car, would leave me gasping for<br />
breath,” explained the 45-year-old, who<br />
weighed 24 stone.<br />
“After climbing up the stairs, I’d be panting.<br />
I honestly thought I was going to die. I’m<br />
just 5ft 3in - I was morbidly obese and<br />
an asthmatic. I didn’t fancy my chances<br />
of having a long and healthy life. I was<br />
depressed.”<br />
Heidi also worried about visiting venues<br />
where she would have to sit down. “I<br />
would always go early to scope out the<br />
chairs to work out if I would be able to fit in<br />
them or if they were strong enough. I had<br />
weight issues all my life, and I guess I was in<br />
denial about my body.<br />
“In the end, something just clicked, and I<br />
realised I wouldn’t live long enough to see<br />
my son grow up. I knew that I had to do<br />
something about it and the only way to do<br />
this was by seeking support via my GP.”<br />
Heidi was referred to a specialist service –<br />
but first had to undergo therapy sessions to<br />
receive more support with her weightloss<br />
journey. “At first I was reluctant because<br />
of my frame of mind,” recalled Heidi. “But<br />
these sessions were what helped me to<br />
change my way of thinking and go on to<br />
lose the weight. I was able to look deeper<br />
at my relationship with food and at why I<br />
would overindulge.<br />
“My portion sizes were off the scale, and<br />
because I was raised to finish everything<br />
on my plate, I would do just that. I would<br />
also secretly binge on fast food in between<br />
my main meals. And I’d think nothing of<br />
heading over to the fridge and grabbing a<br />
snack whenever I arrived home from work.<br />
It was something that I had done from a<br />
young age.<br />
“My dietitian and therapy helped me to see<br />
all of this so clearly, and my journey to a<br />
healthier me began.”<br />
CORPORATE AND GENERAL<br />
NEWS<br />
Heidi reduced her portion sizes, dishing<br />
up her main meals on a side plate.<br />
She also turned vegan, which cut out<br />
processed meat immediately from her<br />
diet.<br />
“By acknowledging all of the above, I<br />
was able to break the cycle. I started<br />
having just three meals a day, with<br />
healthy snacks in between. I scrutinised<br />
food labelling before I brought anything,<br />
so I knew what I was putting in my<br />
body.”<br />
Her dedication paid off, and now Heidi<br />
is a much healthier weight and doesn’t<br />
gasp for breath after walking just a few<br />
yards. “I feel amazing and physically fit.<br />
I go out running, which I wouldn’t have<br />
dreamed of doing before.<br />
“I would encourage anyone who’s<br />
reading this and relates to my<br />
experience, to go and see their GP. Ask<br />
for the help and support because it is<br />
out there. I did, and it’s changed my life<br />
for the better.”<br />
Before and after: These pictures show Heidi’s amazing transformation<br />
19
Neurology referral assessment<br />
service heads online<br />
MEDICINE AND EMERGENCY<br />
CARE<br />
The ongoing pandemic has placed<br />
restrictions on our services like we’ve<br />
never known before; but what it has<br />
brought about is an abundance of<br />
collaboration, new thinking, kindness<br />
and innovation.<br />
One such team that has faced the<br />
difficulties head-on presented by COVID-19<br />
is our neurology team. We caught up<br />
with Andy Wilkinson, Directorate General<br />
Manager – Admitted Care B who told us<br />
more.<br />
“Following the restart of elective neurology<br />
services after the first wave of COVID-19,<br />
the neurology team wanted to use the<br />
opportunity of the service restarting to<br />
simplify and improve patient pathways. The<br />
one thing the pandemic has taught us to do<br />
is think differently.<br />
“The initial implementation of the<br />
neurology referral assessment service was<br />
led by Dr Nicholl, Specialty Lead and I, with<br />
the support of the patient access team.<br />
What this means in a practical sense is<br />
that any neurology outpatient referrals are<br />
Andy Wilkinson, Directorate General<br />
Manager – Admitted Care B<br />
done via a referral form which is available on<br />
Connect. This updated process has been in<br />
place since the start of the pandemic, and<br />
we’ve seen a good uptake among colleagues<br />
using this form.<br />
“This new referral service has drastically<br />
improved the specialties waiting list<br />
management and improved the booking<br />
processes as triage is prompt. For patients,<br />
the pathway is improved too. They are better<br />
supported by their GPs in the community<br />
avoiding unnecessary trips to the hospital.<br />
“Patients also receive a more efficient<br />
pathway when referred to the hospital<br />
as required diagnostics can be identified<br />
and completed before their first<br />
appointment with a consultant. It<br />
means patients have a much greater<br />
chance of receiving treatment earlier<br />
and don’t require long waits for followup<br />
appointments. It also means we can<br />
hopefully empower and support our<br />
primary care colleagues in their clinical<br />
decision making.”<br />
Dr Nicholl added: “The implementation<br />
of the neurology referral assessment<br />
service has drastically improved the<br />
treatment pathways for both patients<br />
and clinicians and has allowed the<br />
service to fully recover after stepping<br />
down services during the first wave of<br />
COVID-19.<br />
“This approach means not only a better<br />
system for ensuring the patient is in<br />
the correct clinic but that we're also<br />
optimising the best and safest manner<br />
for the patient to have an appointment,<br />
e.g. via phone, video or face to face.<br />
As the situation we find ourselves in<br />
continues to evolve, so will we.”<br />
Your Trust Charity has a fantastic<br />
range of toys available for colleagues<br />
to purchase at a discounted rate<br />
Whilst all shops are closed<br />
during lockdown you will be able<br />
to shop and support Your Trust<br />
Charity.<br />
Payments will be online via<br />
PayPal and we can arrange<br />
a collection time from Trinity<br />
House.<br />
To purchase anything<br />
please email amanda.<br />
winwood@nhs.net or<br />
call on 0121 507 4847 for<br />
more information.<br />
20
Making mouth care matter<br />
Research shows that oral care is often<br />
lacking in hospital and community care<br />
settings, especially among patients<br />
who may need support with their<br />
personal care and rely on others for<br />
support; Mouth Care Matters seeks<br />
to address this. Twelve trusts built on<br />
the findings of a study conducted in<br />
2015 at East Surrey Hospital under<br />
the leadership of a special care dental<br />
consultant. From this pioneering work<br />
“Mouth Care Matters” was born.<br />
In early 2020, SWB launched their mouth<br />
care pilot based on the mouth care matters<br />
guidance. It aimed to improve the oral<br />
health of inpatients across four wards<br />
at City and Sandwell hospitals. The trial<br />
involved teams receiving specific training<br />
and equipment to carry out effective<br />
mouth care on patients.<br />
Julie Thompson, Director of Nursing,<br />
Medicine and Emergency Care told us:<br />
“Poor oral health of a hospitalised patient<br />
can lead to an increase in hospital-acquired<br />
infections, namely hospital and ventilator<br />
acquired pneumonia, as well as poorer<br />
nutrition.”<br />
Fast forward to <strong>2021</strong>, and we can now<br />
reveal some of the standout highlights<br />
of the trial and what the team hope to<br />
do next. <strong>Heartbeat</strong> spoke to Ru Hazarika,<br />
Service Planning and Delivery Manager<br />
who told us: “We have seen some<br />
positive results on the back of the trial<br />
we conducted last year. Some of the key<br />
highlights include a 45 per cent reduction<br />
of hospital-acquired pneumonia on our<br />
pilot wards. We’ve also seen a 29 per cent<br />
reduction in antibiotic prescribing and a 34<br />
per cent reduction in Nystatin use.<br />
“Patient and staff feedback has been<br />
positive too. Patients’ mouth conditions<br />
have improved. In turn, it has helped<br />
with being able to eat and drink without<br />
pain and discomfort. Colleagues have<br />
undertaken oral assessments on admission,<br />
and every seven days by rating their oral<br />
health care as red, amber or green. This<br />
insight then informs staff on the necessary<br />
oral care needed based on their oral care<br />
rating. Staff also used specially designed<br />
oral care products and equipment that<br />
assist with effective and simple approaches<br />
to mouth care routines. What makes these<br />
products unique is that the toothpaste,<br />
mouth gel and cleaning swab/brush are all<br />
in one sterile, disposable kit.”<br />
So, how did the pilot continue when<br />
COVID-19 hit? Ru explained: “Fortunately,<br />
we were coming to the end of our trial<br />
at the time so there wasn’t a significant<br />
impact. There was also an upside to the<br />
MEDICINE AND EMERGENCY<br />
CARE<br />
but a few.<br />
“The initiative is part of the weLearn<br />
poster competition, and we are now in<br />
the final ten. We’ve also presented our<br />
findings to the Learning from Deaths<br />
Committee and Pneumonia Taskforce.<br />
In September 2020, Health Education<br />
England asked us to present at the<br />
regional webinar forum for mouth care<br />
matters as an example of good practice<br />
in running a pilot.”<br />
Ru added: “I must say thank you to<br />
everyone involved in this project. It<br />
came about as a result of collaborative<br />
working across different areas including<br />
our GDON of Medicine, Julie Thompson,<br />
Mouth Care Matters display and survey on Janice Nelson, Clinical Procurement<br />
Priory 4<br />
Nurse Specialist, Stryker, our Mouth Care<br />
Matters Fellow from Health Education<br />
use of the products. Evidence shows that the England, Jaffer Ismail and Matrons, Sam<br />
24 hr kits which are designed to use with Walden and Jo Thomas. Colleagues<br />
suction equipment have a significant impact and ward managers on all four sites<br />
on preventing ventilated acquired pneumonia were enthusiastic and passionate about<br />
which is vital in our fight against COVID-19. the pilot, and the results were made<br />
possible all thanks to their willingness<br />
“Initially, we had some challenges<br />
to try something new and implement<br />
implementing the changes so soon after<br />
moving September to Unity. Working 2020, with Health clinical Education change.”<br />
support England asked us to present at the<br />
managers mouth in care IT, we matters are in the process as an of example being of good practice in running a pilot<br />
able to make some small and helpful changes<br />
that will lead to us effectively documenting<br />
September daily Ru oral added: health 2020, care “I<br />
Health<br />
must routines Education<br />
say in the thank future.” England<br />
you<br />
asked<br />
to everyone<br />
us to present<br />
involved<br />
at the regional<br />
in this<br />
webinar<br />
project.<br />
forum<br />
mouth care matters as an example of good practice in running a pilot.”<br />
The<br />
collaborative<br />
team will now be<br />
working<br />
submitting<br />
across<br />
a business<br />
different areas including our GDON of M<br />
case and intend to roll this initiative out<br />
Ru across Nelson, added: our organisation. “I Clinical must say Procurement thank Ru explained: you to “A everyone Nurse involved Specialist, in this project. Stryker, It came our about Mouth as a resu Car<br />
collaborative multidisciplinary working across group different is in place areas to<br />
Education England, Jaffer Ismail and<br />
including<br />
Matrons,<br />
our GDON<br />
Sam<br />
of Medicine,<br />
Walden<br />
Julie<br />
and<br />
Thompson<br />
Jo Nelson, support the Clinical implementation Procurement and Nurse roll out Specialist, once Stryker, our Mouth Care Matters Fellow from H<br />
Education<br />
approved. managers Ensuring<br />
England,<br />
on the all<br />
Jaffer<br />
initiative four<br />
Ismail<br />
sites is sustainable<br />
and<br />
were<br />
Matrons,<br />
enthusiastic<br />
Sam Walden and<br />
and<br />
Jo<br />
passionate<br />
Thomas. Colleagues<br />
about<br />
and<br />
the<br />
w<br />
requires active involvement with our dieticians,<br />
managers made possible on all four sites all thanks were enthusiastic to their and willingness passionate to about try the something pilot, and the new results and w<br />
speech and language therapists and our<br />
made infection possible prevention all thanks and control to their team willingness to name to Staff try something Nurse, Rachel new Paintin and implement change.”<br />
21
Research paves the way for new<br />
anti-fibrotic therapy for glaucoma<br />
SURGICAL SERVICES<br />
Scientists at the University of<br />
Birmingham have shown that a<br />
novel low molecular weight dextransulphate,<br />
ILB ® could play a key role<br />
in treating open angle glaucoma<br />
(OAG), a neurodegenerative disease<br />
that affects over 70 million people<br />
worldwide and causes irreversible<br />
blindness.<br />
The research, reported in npj<br />
Regenerative Medicine, has shown that<br />
that ILB can normalise matrix deposition<br />
inside the eye and lower IOP in a preclinical<br />
model used to mimic these<br />
aspects of human glaucoma, paving the<br />
way for new anti-fibrotic therapies to be<br />
developed for the disease.<br />
OAG is a complex disease and it has<br />
proved difficult to develop effective<br />
therapeutics to target the biochemical<br />
pathways involved. Existing therapies<br />
mainly work by reducing fluid production<br />
in the eye, not the underlying causes, and<br />
even the newer therapies have shown<br />
limited success in the clinic.<br />
Mr Imran Masood<br />
The Birmingham scientists focussed on an<br />
inflammatory pathway that is common to<br />
several diseases, and involves Transforming<br />
Growth Factor β (TGFβ), a signalling<br />
molecule that communicates between cells<br />
and orchestrates both inflammation and<br />
fibrosis. TGFβ's role in OAG is well known,<br />
with patients demonstrating higher levels in<br />
their aqueous humour and laboratory studies<br />
showing that artificially increasing TGFβ<br />
within the eye can lead to fibrosis.<br />
The scientists found that ILB has multimodal<br />
actions across many genes that resolve<br />
inflammatory and fibrotic cellular processes.<br />
When they progressed their work into a<br />
pre-clinical experimental model of glaucoma,<br />
they found that daily subcutaneous injections<br />
of ILB significantly (p
Brexit deal or no deal – and the<br />
challenges for imaging<br />
IMAGING<br />
Jilly Croasdale, Head of Radiopharmacy Services<br />
With much of the Brexit-related talk in<br />
the media being focused on potential<br />
food shortages and whether the fish<br />
are happier as British fish, exit from the<br />
EU had the potential for other more far<br />
reaching implications, particularly in<br />
the absence of a deal.<br />
These included how our healthcare and<br />
medical needs can continue to be best<br />
served in the complex new relationship in<br />
which we find ourselves. In the four years<br />
since the 2016 referendum up to the<br />
announcement that UK and EU leaders<br />
had managed to come to a compromise<br />
meaning we would not have to face a<br />
‘no deal’ scenario, colleagues across our<br />
Trust had been hard at work developing<br />
contingency plans.<br />
One area that was quick to begin work<br />
on scoping out impact was our imaging<br />
team who were acutely aware that the EU<br />
withdrawal would also mean an exit from<br />
the European Atomic Energy Community.<br />
Jilly Croasdale, Head of Radiopharmacy<br />
Services gave <strong>Heartbeat</strong> an insight into<br />
how imaging has been preparing for<br />
Brexit and what the changes mean for our<br />
service. She told us: “The radiopharmacy<br />
community in the UK has been very involved<br />
in the negotiations throughout this process.<br />
When this started, I was Chair of the UK<br />
Radiopharmacy Group and sat on the British<br />
Nuclear Medicine Society (BNMS) Council.<br />
It meant I was involved as one of the NHS<br />
stakeholders in Department of Health and<br />
Social Care (DHSC) meetings to develop<br />
contingency plans. I co-wrote the BNMS<br />
Guidance on how to manage Radiopharmacy<br />
and nuclear medicine services in the event<br />
of a no-deal Brexit with the Royal College<br />
of Radiologists and also liaised with other<br />
radiopharmacies and nuclear medicine<br />
departments across the West Midlands<br />
to assist in the development of their risk<br />
assessments and contingency plans.<br />
“A major impact of a no deal Brexit was the<br />
potential to disrupt how goods, including<br />
medicines, move in and out of the UK. During<br />
the years following the referendum, whilst a<br />
deal was being negotiated, the government<br />
worked closely with stakeholders in the UK to<br />
make contingency plans to limit the impact of<br />
any disruption at borders. These included<br />
the NHS and industry partners.<br />
“For medicines, decisions were made<br />
to stockpile where possible. However,<br />
our area was highlighted as having a<br />
particular problem because of their<br />
time-critical nature. These were the<br />
radioisotopes used in radiopharmacy<br />
and nuclear medicine. Since these<br />
materials are radioactive, and as such,<br />
are decaying away all the time, any<br />
delays have the potential for making<br />
them unusable. It would result in<br />
disruption and subsequent delays to<br />
patient appointments and, subsequently,<br />
diagnosis. Although many nuclear<br />
medicine patients are outpatients, the<br />
majority of them are cancer patients,<br />
or those suffering from cardiovascular<br />
problems. Delays to diagnosis and<br />
treatment can be serious.<br />
“Initially Brexit represented a significant<br />
clinical risk to the radiopharmacy and<br />
nuclear medicine service. A lot of<br />
planning and negotiation followed to<br />
mitigate these risks. It resulted in a move<br />
from road to air freight for all radioactive<br />
shipments into the UK. The reason<br />
for this is that, without a deal, the<br />
channel tunnel and the ‘short straights’<br />
(for example, short channel crossings<br />
via Dover and Calais) could become<br />
congested and the risk of substantial<br />
delays was a real threat. In contrast, air<br />
freight is booked, planned and arranged<br />
in advance - it is a good solution.<br />
However, it has been challenging to<br />
arrange suitable flights. There have<br />
been some delays, it’s not ideal, but is<br />
manageable.”<br />
Thankfully we secured a deal with<br />
the EU, so we asked Jilly how this will<br />
positively impact our service. “Now a<br />
deal is agreed, most deliveries are being<br />
made as expected, albeit with the 24-<br />
hour delay for some things, which does<br />
have a financial impact.<br />
“However, although it has been an<br />
uncertain and worrying few years, it<br />
shows how the NHS, Government and<br />
industry can work together to overcome<br />
potential patient problems. Throughout<br />
this process, the seriousness with which<br />
the DHSC took the impact on our small<br />
specialty could not be faulted. So in the<br />
end, whatever your views on Brexit, this<br />
turned out to be a good news story.”<br />
23
Infant feeding team ‘MBRRACE’<br />
change<br />
WOMEN AND CHILD HEALTH<br />
Breastfeeding – it’s a skill, some<br />
people take naturally to it and<br />
others need a little guidance to<br />
help them get the hang of it. Our<br />
dedicated infant feeding team are on<br />
hand to help each new mum find a<br />
way to breastfeed that feels natural<br />
and comfortable for them should<br />
they wish to do so.<br />
Ensuring that we offer an inclusive<br />
service is something Louise Thompson,<br />
Infant Feeding Coordinator champions<br />
as we serve a diverse community.<br />
Speaking to <strong>Heartbeat</strong>, she explained:<br />
“Last summer we received a complaint<br />
from a mum and her doula, she did<br />
not feel she had been listened to and,<br />
this struck a chord with the team and<br />
I. Usually, we receive a lot of positive<br />
verbal feedback from mums, so this got<br />
us thinking could we have done more<br />
and are we offering effective ways for<br />
people to feedback to us?<br />
“We work to support the choices of the<br />
women we look after and never want<br />
anyone to feel we don’t listen to what<br />
they want. This particular complaint<br />
came from someone with BAME<br />
heritage, so we began looking at what<br />
additional support we could offer and if<br />
women would share any feedback, good<br />
or bad if they didn’t have additional support<br />
to help them do so.<br />
“The MBRRACE report shows we can all<br />
be doing more for women who are black,<br />
Asian or minority ethnic and so we set about<br />
trying to reach out and collect feedback<br />
from all the groups that we see rather than<br />
waiting for people to come to us. We used<br />
the friends and family test and shared it via<br />
Survey Monkey to collect real-time feedback<br />
monthly. We shared the survey with the mum<br />
who made the complaint to let her know<br />
we’d understood and listened to her concerns<br />
and this, in turn, had helped us to shape and<br />
monitor the care we provide.”<br />
So what has the feedback been like we asked<br />
Louise? She explained: “From September<br />
2020, we have received 100 per cent positive<br />
feedback from new mums and we are now<br />
looking at ways we store this more formally.<br />
The Trust is looking at some new software<br />
that will help us collate this feedback more<br />
effectively, plus we’re considering other ways<br />
we can engage with parents and improve our<br />
service<br />
“I’ve also been sharing the feedback across<br />
social media. We wanted to share some<br />
positivity and shine a spotlight on all that is<br />
good about breastfeeding. We have had some<br />
fantastic responses and from across all ethnic<br />
groups, age groups and abilities. It has helped<br />
all of us reflect on the care that we give and<br />
to be more mindful. Next on the agenda is<br />
looking at ways to collect feedback from<br />
mums who do not speak English.<br />
“Overall, I’m pleased that we now have a<br />
mechanism in place that allows mums to<br />
feedback comments in a safe, anonymous<br />
and convenient way. Plus, it’s a boost<br />
for all of us in the team to reflect on the<br />
work we do and see that we do make a<br />
difference. To any expectant mums out<br />
there, I would say we’re here to provide<br />
helpful information on infant feeding. If you<br />
have any feeding worries or concerns, we’re<br />
always here to help.”<br />
Mum’s the word!<br />
Check out this selection of the fabulous<br />
feedback we’ve received since we<br />
implemented our family and friends<br />
survey:<br />
“Very friendly and professional help -<br />
explained everything well and made<br />
me feel at ease.”<br />
“Carmen is a very friendly and warm lady<br />
that makes you feel very comfortable and<br />
is very understanding.”<br />
“Very informative and felt no pressure to<br />
keep breastfeeding baby.”<br />
“The midwife listened to the problem I<br />
was having and watched before giving<br />
advice and trying different methods to<br />
suit my needs.”<br />
“I was really struggling, and Kirsty gave<br />
me the support I needed to not give up.”<br />
Members of the infant feeding team<br />
24
A Christmas moment of hope<br />
from gynaecology<br />
WOMEN AND CHILD HEALTH<br />
Deborah Slater, Regional Fundraising Officer of Black Country Women's Aid, Richard Samuda,<br />
Chairman, Ruth Wilkin, Director of Communications and colleagues from gynaecology<br />
“Oh my goodness, that is amazing!”<br />
For Deborah Slater, Regional Fundraising<br />
Officer of Black Country Women's Aid<br />
(BCWA) the trip to Sandwell Hospital just<br />
before Christmas was particularly exciting.<br />
One filled not with the spectre of COVID<br />
but with hope, kindness and generosity.<br />
A day masterminded by our gynaecology<br />
team.<br />
The BCWA is an independent charity which<br />
supports victims of abuse and violence in<br />
the West Midlands and has done for over<br />
30 years. Offering help and support that<br />
is so sadly needed and it's a cause the<br />
gynaecology team cares passionately about.<br />
Deborah visited the team to collect what<br />
had been collated by them in donations to<br />
help give those who needed it - mothers<br />
and their children especially - a proper<br />
Christmas under these trying circumstances.<br />
Heading in, Deborah had just made eye<br />
contact with one of the most incredible<br />
displays <strong>Heartbeat</strong> had ever seen. The<br />
room was half covered in toys, games,<br />
decorations, clothes, shoes and toiletries<br />
- almost like a miniature version of<br />
Mothercare. The clothes arched around<br />
the room on rails in front of tables with<br />
even more goodies. Only then did Deborah<br />
realise there was more behind her and,<br />
even behind colleagues who had come to<br />
see her. Wherever you looked, there was<br />
something else, something arranged by the<br />
fundraising of the gynae team.<br />
"Oh my goodness, that is amazing!"<br />
Not Deborah this time, but rather Trust<br />
Chairman, Richard Samuda who had also<br />
come along to speak with her. His response,<br />
unwittingly echoing Deborah's not two<br />
minutes before, both in awe at what they<br />
saw.<br />
“It was fantastic to see such dedication and<br />
excitement from the amazing gynaecology<br />
6A team.” Deborah later commented to<br />
<strong>Heartbeat</strong>. “I was overwhelmed to see such<br />
beautiful donations and so many of them,<br />
I know women and children in the refuge<br />
will just love these Christmas gifts, knowing<br />
others care and think about them helps in<br />
their recovery.”<br />
“We want to say a special thank you to<br />
Julie Hill, Tracey Law and Tiffany Jones for<br />
organising everything this year amidst the<br />
strange and stressful times we are all facing. I<br />
have worked with Jules for three years, what<br />
a lady, such passion about our work and drive<br />
to get loads of Christmas presents, clothes,<br />
chocolates, festive food, gift sets, hats scarves,<br />
gloves and baby items knitted with love. A<br />
massive thanks too to all the friends and<br />
family members for helping.”<br />
“It just goes to show what a difference our<br />
organisation can make,” said Richard after an<br />
animated discussion with Deborah where she<br />
Items donated by the gynaecology team<br />
explained some of the stories of people<br />
at the refuges and BCWA's previous<br />
work with the gynaecology team. “Not<br />
just here at the hospital but outside it,<br />
we can all make a real difference with<br />
efforts like these, with Your Trust Charity<br />
and other organisations like BCWA.<br />
This team, everyone in gynaecology,<br />
should be very proud of what they have<br />
achieved.”<br />
And they are, as the aforementioned,<br />
Julie Hill told <strong>Heartbeat</strong> after the<br />
handover.<br />
“We understand domestic abuse can<br />
be such a distressing and isolating<br />
experience for the individual and family.<br />
It may be considered as something of<br />
the past, especially now with women<br />
taking on more equal roles as men.<br />
However, this is far from the truth,<br />
with reports from last year showing 2.3<br />
million adults age 16-74 in England and<br />
Wales had experienced domestic abuse -<br />
the majority of them being women. We<br />
started this campaign back in September<br />
2020 to highlight the importance and<br />
seriousness of domestic abuse.<br />
“In gynaecology 6A with our combined<br />
passion for women's health and safety,<br />
our manager Tiffany Jones, supported us<br />
to carry out fundraising and collections<br />
to assist Black Country Women's Aid.<br />
Supporting this charity for us was<br />
an extension of our everyday role in<br />
supporting women, more so with the<br />
current situation which sees many<br />
women now stuck at home.”<br />
You can find more information about<br />
Black Country Women's Aid at<br />
www.blackcountrywomensaid.co.uk<br />
25
Relaxation rooms are open for<br />
PCCT colleagues<br />
PRIMARY CARE, COMMUNITIES<br />
AND THERAPIES<br />
Community colleagues have been<br />
taking advantage of two wellbeing<br />
rooms based at the Lyng Health<br />
Centre and Rowley Regis Hospital.<br />
Both provide a quiet and a calm, relaxing<br />
environment and a safe space for those<br />
using it - plus support when they need<br />
it most.<br />
Those working within primary care,<br />
communities and therapies (PCCT) can<br />
access the rooms set up by the team<br />
behind the Sanctuary, based at the<br />
Learning Works.<br />
Denise Owen, PCCT Deputy Clinical<br />
Directorate Lead, explained more:<br />
“Following the offer of the Sanctuary,<br />
Denise Owen in the wellbeing room at the Lyng<br />
the iCares directorate wanted to help extend<br />
the wellbeing and kindness offer to benefit<br />
colleagues in local community bases.<br />
“We wanted to make sure it was easily<br />
accessible for them, which is why they are at<br />
Rowley and the Lyng.<br />
“Colleagues can recline and unwind on the<br />
large floor cushions, feel relaxed with the<br />
Himalayan Salt lamps soothing gentle glow<br />
and change the energy levels with the calming<br />
Dermatology wins prestigious<br />
national award<br />
The dermatology department has<br />
been receiving lots of praise after their<br />
award winning poster at the British<br />
Association of Dermatologists Meeting.<br />
The team were given the accolade for Best<br />
Psychodermatology Poster Presentation<br />
Award at the 2020 British Association of<br />
Dermatologists Meeting which is one of the<br />
most highly commendable meetings made<br />
up of authors from across the globe who<br />
submit their work every year.<br />
All the posters are original pieces of<br />
research with the best pieces put forward<br />
by a specialist abstract selection committee<br />
based on the quality of the content.<br />
These pieces are then also later published<br />
in the British Journal of Dermatologists<br />
Supplement.<br />
“We were inspired to create the poster<br />
following inspiration from our patients,”<br />
said Dr Sara Mirhadi, Study Principal<br />
Investigator.<br />
“Our patients have been telling us about<br />
the impact of skin disfigurement on their<br />
psychological wellbeing and how laser<br />
treatment has changed their lives. There<br />
is limited literature on the impact of laser<br />
therapy in psychological burden.<br />
“With this in mind we decided to lead<br />
this study and presented our results at<br />
the British Association of Dermatologists<br />
Meeting to highlight the psychological<br />
burden of skin conditions and the role of<br />
laser therapy in reducing this burden all in a<br />
conscious effort to help better improve the<br />
quality of life of patients.”<br />
In regards to participation, adult patients<br />
with various medical skin conditions,<br />
symptomatic skin lesions and cosmetic<br />
skin lesions took part in the study. These<br />
included red marks, brown marks, scars<br />
and hair removal. Common symptoms may<br />
include pain, discomfort, irritation or impact<br />
on breathing and daily activities including<br />
body movements.<br />
Sara’s study showed that the majority of<br />
patients were suffering from moderate<br />
or high psychological distress with laser<br />
treatment leading to a more than 50 per<br />
cent reduction in at least one of the anxiety<br />
or depression scores. The aim is that the<br />
study can help increase awareness of the<br />
psychological burden of various disfiguring<br />
skin conditions.<br />
Sara and the study investigators could not<br />
have completed this work alone and are<br />
thankful to all that helped them along.<br />
Sara was especially thankful to Dr Anthony<br />
Abdullah, the Study Chief Investigator, for<br />
his continued support in helping design and<br />
conduct of this study and all his guidance<br />
throughout the study.<br />
She added: “I would like to say a huge<br />
thank you to our patients for taking<br />
part in our study and the research and<br />
development team, especially Anne<br />
Rutland.<br />
lavender spray. They are also able to listen<br />
to music from their own devices and take<br />
some time out.”<br />
The rooms have wipeable floor cushions<br />
and pillows and LED candles, whilst those<br />
visiting receive free bottled water, lip balm,<br />
hand cream and soap.<br />
They have been open since October and,<br />
there are plans for them to remain in place<br />
until the end of March. The room at the<br />
Lyng is on the second floor, whilst the<br />
Rowley facility is situated in corridor B.<br />
PCCT colleagues should call 0121 612 3183<br />
to find out if either room is available before<br />
attending. There may be a short waiting<br />
time if you drop in without confirming<br />
availability.<br />
The Lyng room is available Monday<br />
to Friday, between 8am-6pm, whilst<br />
The Rowley wellbeing room is open<br />
Monday to Friday, between 8am-4pm.<br />
Dr Sara Mirhadi<br />
“I would also like to give a special thanks<br />
to the Birmingham Skin Laser Centre team<br />
especially Ann Weaver who went above<br />
and beyond for all her help and extend<br />
my gratitude to our sponsor and Research<br />
Ethics Committee.”<br />
Laser Hair Removal<br />
The laser department is renowned<br />
throughout the UK and the team have the<br />
capacity to treat private patients.<br />
A consultation and test area for laser hair<br />
removal is free of charge to NHS staff.<br />
NHS staff also receive 15 per cent discount<br />
off the price of each treatment session.<br />
For further information, please<br />
contact Ann on 0121 507 6639 or<br />
email: ann.weaver1@nhs.net.<br />
26
Discharge to Assess – a new way of<br />
delivering care<br />
A new model of care delivery known<br />
as Discharge to Assess (D2A) is being<br />
implemented across Sandwell.<br />
D2A has been a model of care used<br />
nationally for over five years. Locally this<br />
was first rolled out in March 2020 for our<br />
patients living in Birmingham and, this<br />
same model is now being used in Sandwell.<br />
“The model of care delivery primarily<br />
focuses on facilitating discharge for<br />
all inpatients on the day that they are<br />
medically optimised therefore reducing<br />
delays for patients who are ready to leave<br />
the hospital. This, in turn, reduces the risk<br />
of hospital-acquired deconditioning and<br />
other risks associated with a prolonged<br />
hospital stay,” said Sarah Oley, Directorate<br />
General Manager for iBeds.<br />
“It’s built around the home first principle,<br />
ensuring that as many people as possible<br />
can return to their own home by asking<br />
two simple but key questions, Why not<br />
home? Why not today?”<br />
“The discharge to assess model focuses on<br />
making sure that only essential assessments<br />
get completed before the person leaves<br />
acute care instead of completing these<br />
assessments in the home environment<br />
or onward community destination.<br />
Assessment in these environments is often<br />
more meaningful for the person and,<br />
allows them to return to a community<br />
setting rather than waiting for those<br />
assessments to take place on the hospital<br />
ward.”<br />
Members of the Discharge to Assess team<br />
COVID-19 has affected many services within<br />
the healthcare sector, and, D2A is no different.<br />
The pandemic has meant that it is now a<br />
nationally mandated model across the NHS as<br />
it helps to maintain patient flow and reduce<br />
the pressure on acute hospital beds. It also<br />
ensures that patients reach their chosen<br />
destination as soon as possible.<br />
The language of D2A centres on ‘pathways’<br />
which will be the language that we will all<br />
need to adopt when discussing hospital<br />
discharge. Those pathways are as follows:<br />
Pathway<br />
number<br />
Definition<br />
0 A simple discharge, no additional support<br />
from health or social care is required<br />
(approximately 50 per cent of discharges)<br />
1 Person can return home, with support from<br />
health or social care (approximately 45 per<br />
cent of discharges)<br />
2 Person requires a temporary move to a<br />
community bed, this may be for rehab or<br />
further assessment (approximately 4 per<br />
cent of discharges)<br />
3 Person requires a permanent move to a 24<br />
hour care environment (approximately 1 per<br />
cent of discharges)<br />
4 Pathways for all people at the end of life<br />
PRIMARY CARE, COMMUNITIES<br />
AND THERAPIES<br />
Other than the obvious benefits to our<br />
patients, there are many benefits of<br />
Discharge to Assess for our colleagues<br />
too.<br />
Sarah added: “Over time the process<br />
of discharging patients has become<br />
complex with multiple funding<br />
arrangements, different agencies<br />
involved and a variety of information<br />
required from the inpatient ward teams.<br />
Discharge to Assess simplifies this for<br />
staff. Their focus should now be on<br />
which pathway a patient needs, no<br />
matter the patient’s home address or GP<br />
details.<br />
“We also now have a team of experts<br />
from the Trust, our local authority and<br />
our CCG working seven days a week.<br />
They are on hand to support and<br />
expediting discharge arrangements for<br />
all patients on pathways one – four<br />
through our integrated discharge hub<br />
and can be contacted for all escalations<br />
or advice regarding discharge.”<br />
For more information or specific<br />
training for your team regarding<br />
Discharge to Assess please contact<br />
saraholey@nhs.net.<br />
To escalate any issues related<br />
to discharge, please contact the<br />
integrated discharge hub on 07815<br />
647936 (open seven days a week,<br />
from 8am to 5pm).<br />
Have you got a<br />
MEDICINE AND EMERGENCY<br />
CARE<br />
We’d love to hear from you if you have…<br />
• An event or special occasion in your department<br />
• If you work with an inspirational colleague<br />
• Does your department do something that makes a<br />
real difference to our patients?<br />
Please get in touch if you’d like to be featured in an<br />
upcoming edition of <strong>Heartbeat</strong>!<br />
story?<br />
Email swbh.comms@nhs.net to submit your story idea.<br />
27
Pulse<br />
News in brief from around our organisation<br />
Children receiving the toys kindly donated to the nursery<br />
Key Construction gives back to<br />
nursery<br />
Christmas may have passed and, <strong>2021</strong><br />
is well underway, but the gifts keep on<br />
coming with the lucky recipients being our<br />
Sandwell nursery.<br />
Key Construction, the contractors building<br />
our GP surgery at Sandwell were kind<br />
enough to donate construction toys for<br />
the children based at our Sandwell nursery.<br />
Founded in 1994, Key Construction, a<br />
Midlands based contractor undertake<br />
a wide range of projects including new<br />
builds and refurbishments. As well as<br />
delivering projects for commercial and<br />
office use, Key Construction also have<br />
extensive experience in providing facilities<br />
for healthcare and education. The<br />
company has worked on many clinical<br />
If you have a story you would like to appear<br />
on the Pulse page, please email a photo and a<br />
short explanation to swbh.comms@nhs.net<br />
IMAGING<br />
build projects in recent years including<br />
Shirley, Netherfield, Brixworth, Great<br />
Barr and Essington Medical Centres and<br />
Khattak Memorial and Woodville Surgeries<br />
to name a handful.<br />
“Key Construction workers on the GP<br />
surgery building first noticed our children<br />
playing in the summer and wanted to gift<br />
something to the nursery,” said Emma<br />
Collier, Day Nursery Manager. “They<br />
decided to give building equipment with<br />
them being a construction company at<br />
heart and felt the toys would be fun for<br />
the children whilst educational too.”<br />
Toni Carr, Deputy Nursery Manager, is<br />
thankful for the toys and said: “I must say<br />
a huge thank you to Key Construction for<br />
going out of their way to give our children<br />
new toys to play with.”<br />
“There are many benefits of these kinds of<br />
toys such as they help our children become<br />
better at problem-solving and learning<br />
cause and effect and, it teaches them how<br />
to play with others through compromise,<br />
conflict resolution and sharing.<br />
“Also, these particular toys will help the<br />
children to nurture their creativity and<br />
imagination as well as discover their<br />
independence and improve their selfesteem<br />
all while having lots of fun and<br />
enjoyment.”<br />
28<br />
Congratulations Sobia – Black<br />
History Month Quiz winner!<br />
During Black History Month 2020,<br />
alongside the awareness campaign, we ran<br />
across at SWB, we also held a Black History<br />
Month Quiz to celebrate the occasion.<br />
The awareness campaign focused<br />
on honouring people of African and<br />
Caribbean descent who have and continue<br />
to shape the history of our country and<br />
that of the NHS. Black people make<br />
a rich contribution and an impact on<br />
our national and cultural life, enriching<br />
communities as business leaders, teachers,<br />
musicians, nurses, doctors and much<br />
more.<br />
Our quiz comprised of 12 questions<br />
and received numerous entries from<br />
colleagues. After successfully answering<br />
all the questions correctly, Sobia Ahmed,<br />
Ward Clerk at City Hospital, was picked<br />
randomly as our winner!<br />
Alongside her £30 of Love2Shop vouchers,<br />
the Black History Month book chosen by<br />
Sobia was White Teeth, written by Zadie<br />
Smith and published by Hamish Hamilton.<br />
The story focuses on the later lives of two<br />
wartime friends - Bangladeshi Samad Iqbal<br />
Sobia Ahmed<br />
and the Englishman Archie Jones and their<br />
families in London. The novel centres on<br />
Britain's relationships with people from<br />
formerly colonised countries in Africa,<br />
Asia, and the Caribbean.<br />
When asked about winning, Sobia said:<br />
“I am so happy to win the book and<br />
vouchers, I don’t win many things, so this<br />
is amazing!”<br />
Sobia is currently shielding due to her<br />
pregnancy and will embark on maternity<br />
leave later this year. Congratulations<br />
Sobia – we hope you enjoy your book and<br />
vouchers!<br />
28
Simon Sheppard<br />
Director of Operational Finance<br />
This month we say a warm welcome<br />
to Simon Sheppard who joins us as our<br />
Director of Operational Finance. We<br />
caught up with Simon to find out all<br />
about his career and how he’ll be shaping<br />
his new role amid a global pandemic.<br />
Speaking to <strong>Heartbeat</strong>, Simon said: “I joined<br />
the NHS over 25 years ago as the NHS<br />
Graduate Trainee within Finance at Queen’s<br />
Medical Centre in Nottingham. I have worked<br />
in the NHS my whole career across mainly<br />
provider organisations including, Nottingham<br />
University Hospitals, Sheffield Teaching<br />
Hospitals and University Hospitals of Leicester.<br />
I was the Director of Finance and Procurement<br />
at The Rotherham NHS Foundation Trust for<br />
six years in my last role.”<br />
So what attracted Simon to join the<br />
organisation we asked? He explained: “The<br />
Trust appealed to me for many reasons,<br />
including the reputation of providing<br />
quality patient services, it’s operational and<br />
financial performance, but most importantly<br />
the chance to support the organisation<br />
in completing the Midland Metropolitan<br />
University Hospital build and then the move<br />
into the new hospital. It is an exciting time for<br />
the organisation, staff and patients.<br />
Simon Sheppard<br />
Simon added: “The welcome I’ve received<br />
from everyone has been so warm and, it does<br />
make you feel like you’re part of a wider work<br />
family.”<br />
Having joined in the middle of a pandemic,<br />
Simon is aware that like other departments,<br />
finance has experienced some challenges but<br />
is impressed by the professionalism of the<br />
team. He remarked: “I think like many other<br />
directorates and departments, the pandemic<br />
has been a challenge for our area. Challenges<br />
have included resolving any barriers to<br />
working from home to the procurement and<br />
logistics team ensuring PPE was available to<br />
frontline colleagues in a timely manner. Since<br />
starting, I have been very impressed by the<br />
morale of the team. The professional manner<br />
they are delivering their services and how<br />
they are supporting frontline colleagues is<br />
admirable. They are a credit to the Trust.”<br />
Simon has wasted no time in getting to know<br />
teams and, looking at ways he can help to<br />
improve the services we provide. He told us:<br />
“One of the areas I am passionate about<br />
is engaging with clinical and operational<br />
colleagues to enable finance to support<br />
improvements in patient care.<br />
“A key aspect of this is the understanding<br />
of the NHS finance regime and removing<br />
any perceived blockers to implementing<br />
improvements. I have always believed if we<br />
work together, great ideas can be taken<br />
forward. Over the next few months, I am<br />
looking to roll out a programme of financial<br />
awareness to key colleagues across the Trust.”<br />
Outside of work, Simon is a family man with a<br />
keen interest in sport. “I’m married to Emma,<br />
a Specialist Paediatric Respiratory Nurse, and<br />
have two children, Ellie (17) and Sam (14). I<br />
am interested in most sports but particularly<br />
football and golf. I lived in the USA for three<br />
years as a child, also have a soft spot for<br />
American football.”<br />
Wave goodbye to…<br />
Bethan Downing<br />
Deputy Director of People and Organisation Development<br />
This month we wave goodbye to one of<br />
our longstanding colleagues as Bethan<br />
Downing moves on to begin a new<br />
chapter in her career.<br />
In December 2011, Bethan began joined<br />
SWB as a directorate-general manager<br />
(DGM) for theatres and anaesthetics and<br />
then became DGM for theatres, urology<br />
and vascular. Bethan has also worked as the<br />
deputy director of operations in medicine<br />
and emergency care and more recently<br />
as our deputy director of people and<br />
organisation development.<br />
Bethan will be returning to Birmingham<br />
Women’s and Children’s Hospital, where<br />
she spent nine years before joining SWB.<br />
She told <strong>Heartbeat</strong>: “I am going back to my<br />
roots, to what is now Birmingham Women’s<br />
and Children’s Hospital. The biggest thing<br />
I will miss from SWB is the people - I know<br />
everyone says that but it is true. I have<br />
had the opportunity to meet and work<br />
alongside so many talented people that I<br />
will be sad to say goodbye.<br />
“I’ve truly enjoyed working here – you are a<br />
fantastic group of people. I am so proud of<br />
all of our shared achievements, all thanks to<br />
the teamwork across the organisation.”<br />
Bethan added: “It would be lovely to stay<br />
in touch with people so remember I’m only<br />
an email away if you ever need any help or<br />
guidance.”<br />
Frieza Mahmood, Director of People and<br />
Organisation Development, commented: “I<br />
have worked with Bethan for several years<br />
and will be sorry to see her go. Whatever<br />
the situation, Bethan always approaches it<br />
with a pragmatic and positive attitude and<br />
never shies away from a challenge. She will<br />
carry these qualities with her to her new<br />
role and will undoubtedly be a success.”<br />
Bethan Downing<br />
29
Letters, of less than 200 words please, can be sent to the Communications Department,<br />
Trust Headquarters, Sandwell Hospital or by email to swb–tr.SWBH–GM–<strong>Heartbeat</strong>@nhs.net<br />
YOUR RIGHT TO BE HEARD<br />
Slipping and sliding into work<br />
Dear <strong>Heartbeat</strong>,<br />
With colder days ahead of us, and<br />
more frosty and icy conditions, I was<br />
wondering if the Trust is going to<br />
start gritting some of the paths and<br />
walkways.<br />
I’ve noticed when I was working during<br />
the festive period that it was very<br />
slippery and icy everywhere I walked.<br />
I understand paths and areas offsite<br />
cannot be gritted, but could we perhaps<br />
look into gritting our own paths? As it<br />
looks like the weather will be getting<br />
colder for the coming weeks, it would<br />
be nice if this could be done across<br />
our sites to ensure staff can stay safe<br />
and minimise risk of serious injury from<br />
falling.<br />
Kind regards<br />
Anon<br />
Dear Colleague,<br />
Thank you for raising this issue,<br />
which is an important one for us<br />
during these cold wintry conditions.<br />
Commencing in November 2020 and<br />
throughout the winter months, the<br />
Trust appointed a winter gritting<br />
contractor to provide a fast response<br />
gritting service.<br />
They monitor the weather conditions<br />
on our behalf and mobilise their<br />
fleet of gritting vehicles to all<br />
of our sites if frost, snow or subzero<br />
temperatures are forecast. In<br />
addition to the roads and car parks<br />
being gritted by their fleet vehicles,<br />
they also manually apply rock salt to<br />
the building entrance and circulation<br />
footpaths around each site.<br />
Should weather conditions become<br />
too harsh, we also have a back-up<br />
gritting team made up of estates<br />
staff who are ready to provide<br />
additional gritting facility if weather<br />
conditions deteriorate.<br />
Yellow rock salt bins are located<br />
around each site to provide the<br />
facility for anyone to apply grit to an<br />
icy or frosty location that has yet to<br />
be reached by the gritting team and<br />
staff are encouraged to utilise these<br />
to assist in minimising icy hazards.<br />
These measures are in place to<br />
ensure colleagues stay safe and<br />
reduce the risk of slips and falls. Should<br />
you require further details of the Trust’s<br />
winter gritting arrangements, please<br />
contact me directly.<br />
Kind regards,<br />
Phil Foley, Deputy Head of Estates<br />
Ext 6088<br />
Has the mask policy changed or<br />
am I missing something here?<br />
Dear <strong>Heartbeat</strong><br />
I recently visited City Hospital; however I<br />
was slightly alarmed when I got there. I<br />
went along the whole main spine and there<br />
were no face coverings available. Has the<br />
mask policy been changed since the launch<br />
of the vaccine?<br />
When I asked at the PPE station they said<br />
they didn’t have any. Have we run out of<br />
stock? What was even more alarming was<br />
the fact people were walking about care<br />
free without masks on. I don’t expect this<br />
on my local high street, never mind in a<br />
hospital when we are currently in lockdown<br />
and things are worse than they have been<br />
before.<br />
To top it off, when I asked a member of<br />
staff where to get one he told me to try<br />
going on one of the wards to get one.<br />
Imagine if I actually followed his advice and<br />
went on a red ward, and either contracted<br />
COVID-19 or even worse, went on a blue<br />
ward and made one of our patients’ ill ?<br />
Kind regards<br />
Anon<br />
Dear colleague,<br />
Thank you for your <strong>Heartbeat</strong> letter.<br />
I am sorry to read that you struggled to<br />
find face masks in the corridors at City<br />
Hospital. To clarify, no, our policy has<br />
not changed. We expect everyone in the<br />
Trust to wear a face mask.<br />
We are routinely reiterating the need<br />
for masks to be worn in the corridors.<br />
We have never had a shortage of masks<br />
and I am disappointed to read that is<br />
the impression you were given. Each<br />
PPE station is left with facemasks on.<br />
When not staffed, sadly however, we<br />
are noting that when hundreds of<br />
masks are left, they seem to vanish<br />
overnight.<br />
Please be assured we have a sufficient<br />
supply of face masks and we have not<br />
changed the rules.<br />
Kind regards,<br />
Helen Bromage<br />
Interim Deputy Chief Nurse<br />
Do I still need to wear PPE now<br />
I’ve had the COVID jab?<br />
Dear <strong>Heartbeat</strong>,<br />
I’ve recently been lucky enough to receive<br />
my COVID vaccination. As I should expect<br />
to receive some level of immunity and<br />
protection in the coming weeks from the<br />
jab, am I now able to stop wearing PPE as<br />
I’m protected? I know we still need to be<br />
sensible, but could I wear less PPE perhaps<br />
if not stop using it altogether so that others<br />
who need it more can use it? Or, would you<br />
recommend I continue to wear it to help<br />
beat the virus?<br />
Thank you,<br />
Anon<br />
Dear colleague,<br />
Thank you for asking this important<br />
and relevant question. We know the<br />
vaccine is protective and vaccinated<br />
colleagues will feel more protected than<br />
before, but, the estimation of the level<br />
of protection offered by vaccination<br />
is difficult to establish at present -<br />
although our knowledge around this is<br />
improving day by day.<br />
This position will evolve. At present,<br />
we are not downgrading the risk<br />
assessments based on having the<br />
vaccine. Staff should strictly continue<br />
to adhere to infection control measures<br />
and workplace adjustments that are in<br />
place.<br />
This also means that shielding staff<br />
should still shield and those who<br />
have arrangements in place due to<br />
a high-risk assessment outcome (e.g.<br />
enhanced PPE) should maintain that<br />
additional protection and everyone<br />
should continue to follow strict social<br />
distancing rules.<br />
Kind regards,<br />
Dr Masood Aga<br />
Consultant and Specialty Lead in<br />
Occupational Medicine<br />
30
David talks about: Improving quality through<br />
adapting to change<br />
Professor David Carruthers, Medical Director and Acting Chief Executive<br />
Toby Lewis is away<br />
DAVID’S LAST WORD<br />
It has been truly fantastic to celebrate<br />
the winners of the annual quality<br />
improvement poster competition<br />
earlier in the month. This annual<br />
contest brings out so many initiatives<br />
that teams are proud to highlight<br />
and all because, at our Trust, we are<br />
committed to learning, improving and<br />
sharing that learning with others.<br />
Despite the pressures on our teams<br />
during this year of all years we still<br />
managed to have a record number<br />
of entries so I want to thank<br />
everyone who committed the time to<br />
summarising their quality improvement<br />
initiatives for this competition. We<br />
have all the entries on display in the<br />
education centre at Sandwell (which<br />
has now become our vaccine hospital<br />
hub) and you can also view each of<br />
them on Connect so they are visible<br />
online from wherever you are. The<br />
winning entries are profiled on the<br />
front cover of this edition of <strong>Heartbeat</strong>.<br />
The individuals and teams behind these<br />
schemes deserve your recognition.<br />
It was a privilege to be one of the<br />
judges this year because it meant<br />
that I had the opportunity to review<br />
each and every one of the shortlisted<br />
entries. It never fails to amaze me<br />
how diligent so many of you are to<br />
making improvements in your area of<br />
work. The improvements ranged from<br />
schemes to make our services more<br />
accessible to patients, recognising the<br />
different needs of individuals, to large<br />
scale service changes, all to either<br />
improve outcomes for patients or<br />
experience for colleagues and partners.<br />
Some of the changes required to<br />
bring about improvement may have<br />
been straightforward to enact but the<br />
majority, I am sure, will have taken<br />
time, energy and resilience. Change<br />
is not easy. It takes courage to speak<br />
up and say that things can be better.<br />
It also takes tenacity to overcome<br />
setbacks and listen to differing views<br />
and opinions on how things should be<br />
done. Engaging with others is often<br />
a marker of success, certainly in how<br />
sustainable our quality improvement<br />
initiatives are. Every shortlisted entrant<br />
and winning project demonstrated that in<br />
spades.<br />
I know that through this year’s process<br />
a number of “COVID learnings” were<br />
highlighted. Although not all of these<br />
were in the shortlisted pile, it is clear that<br />
throughout the challenges that have<br />
faced us this year, the pandemic has<br />
either directly caused, or allowed us to<br />
make changes that previously we would<br />
have found more difficult. We have<br />
had to learn and adapt at pace as our<br />
understanding changed and grew. I know<br />
that the past 12 months has tested many<br />
of us beyond what we thought we could<br />
endure but I have never been more proud<br />
to be part of such a committed and<br />
humble team that has taken all that has<br />
been thrown at us and used it to make<br />
positive change.<br />
We know now that we can use<br />
technology to check in on our patients<br />
who are in the community, and use this<br />
at scale for our outpatient services. Our<br />
rapid changes on infection control and<br />
61 welearn2020<br />
PPE, although at times bewildering<br />
to keep up with, have kept pace<br />
with the changing knowledge about<br />
this virus. We have set up services<br />
in days, not months and years,<br />
such as our vaccination hub. We<br />
have confidence that obstacles can<br />
be overcome, and solutions found<br />
by working together for the same<br />
goals.<br />
Despite the very tough start to <strong>2021</strong>,<br />
I remain confident in the hope of<br />
a brighter year ahead where our<br />
experiences over the past long<br />
months have shaped our response<br />
and our adaptability to whatever<br />
the future brings. Those small or<br />
large scale quality improvements<br />
that have been embedded this year<br />
are evidence of that and I know we<br />
will see more and better changes<br />
in our offering for our patients, our<br />
communities and each other in the<br />
months and years ahead.<br />
Sandwell and<br />
West Birmingham<br />
NHS Trust<br />
Service Improvement – Speech and Language<br />
Therapy Service to Mainstream Schools<br />
Who we are…<br />
The Speech and Language Therapy team sits within the Children's<br />
Therapies Service and we offer support to mainstream schools in<br />
Sandwell so they can then support children with Speech, Language and<br />
Communication Needs (SLCN). SLCN are very common, they impact on<br />
learning, mental health, making friends and can often be undiagnosed.<br />
Developmental Language Disorder is an example of SLCN and is a<br />
new diagnosis that describes children who have difficulties with spoken<br />
language that are likely to be life long.<br />
Our Challenge...<br />
To review the service we offer to mainstream primary schools in Sandwell<br />
and make it as effective and efficient as possible.<br />
Audit<br />
ü We carried out a review of our current service including how often<br />
children are seen and what sort of advice we are offering on a regular basis.<br />
• As a service 63% of our time was spent supporting children<br />
who required assessment and advice for language needs and<br />
only 8% of our time was spent supporting children with<br />
complex communication needs.<br />
• Only 5% of our time was spent supporting children in year<br />
6 before and during their transition to secondary school<br />
which is a significant challenge when you have<br />
communication needs.<br />
ü We reviewed the evidence base including attendance at a national<br />
conference on Developmental Language Disorder (DLD) and contacted<br />
other local Speech and Language Therapy Teams to collect together<br />
best practise.<br />
ü We carried out consultation with service users;<br />
• Each school has a Special Educational Needs Coordinator (SENCo)<br />
and we attended their team meetings<br />
• Held parent drop in sessions<br />
• Sent written information to all families and school management<br />
offering the opportunity for them to contact us<br />
Outcome<br />
The review and consultations highlighted which areas of our service were<br />
having the least impact and highlighted the amount of time we were<br />
spending on these activities.<br />
2020 QIHD Poster Winner<br />
The evidence shows that children with on going SLCN are best supported<br />
by; introducing a tiered approach to the service, ensuring close<br />
collaboration between therapist and school and a combination of<br />
staff training and coaching. There is also evidence that a consultative<br />
model where a SLT service offers ‘reviews’ for children with language<br />
needs in school is not effective at bringing about change for that child.<br />
K. Dunn Speech and Language Therapist<br />
Change<br />
We stopped offering reviews for children with ongoing language needs<br />
and instead we used our time to offer the following:<br />
• Developed training packages to offer free sessions to school<br />
staff and share information on communication and how this can<br />
be supported in school<br />
• This allowed us to offer the information previously discussed in<br />
reviews in more depth<br />
• To date 71/99 primary schools have sent at least 1 member of<br />
staff on a training session<br />
“Lots of practical resources, strategies and games, definitely<br />
found this worthwhile!”<br />
Designed a standardised pathway<br />
for children with SLCN in a<br />
mainstream school based on an<br />
evidence based tiered approach.<br />
We were able to offer intensive<br />
support for children with<br />
more complex or persistent<br />
communication difficulties<br />
which was not previously an option.<br />
Children who have started school with no way of communicating<br />
were prioritised and offered intensive therapy in school.<br />
We are currently planning support for year 6 children with DLD<br />
to attend group therapy to support their transition to secondary<br />
school.<br />
Arranged a joint working party with therapists and school staff to<br />
plan how to support children in Sandwell together.<br />
The working party meets termly and so far we have been<br />
able to;<br />
• Contribute to local legislation<br />
• Review and adapt pathways offered by the SLT service<br />
• Review effectiveness of paperwork<br />
Next steps<br />
• Expand options for intensive therapy packages<br />
Specialist<br />
input<br />
Targeted support<br />
including training<br />
Universal Support<br />
including screening<br />
“Thank you so much for these resources. Excellent!!”<br />
“An excellent starting point from which to develop the<br />
mainstream service further”<br />
• Expand training packages and coaching opportunities for<br />
school staff<br />
LSP<br />
SENCo<br />
Department of Speech and Language Therapy,<br />
Children’s Community Therapies and Nursing<br />
SLT<br />
31
Your Trust Charity looking for your<br />
lockdown-beating fundraising ideas<br />
@SWBHCharity To donate<br />
to the Your Trust Charity text<br />
“SWBH16 £5” to 70070<br />
As the Coronavirus pandemic goes<br />
on, we are all doing what we can for<br />
patients, relatives and of course each<br />
other.<br />
All areas of our local community and the<br />
#SWBfamily need and give the support<br />
they can but, if you want to make a direct<br />
difference even in a pandemic, Your Trust<br />
Charity is still here and wants to hear your<br />
ideas.<br />
Every donation to YTC, no matter how small,<br />
helps people close to our organisation and<br />
makes it a better place for those that use it.<br />
And whilst we may not be able to do bake<br />
sales and things of that nature, there are still<br />
things we can all do to raise money.<br />
Do you paint? Make things, like pottery? Do<br />
you knit or sew? Perhaps you make music<br />
or even DJ. Were you going to raise money<br />
with a sponsored climb or run a marathon?<br />
Well, that can still be done, just from<br />
home. How many times up and down your<br />
staircase do you think it would take to climb<br />
Snowdon? How many laps of the garden<br />
would it take to meet your initial running<br />
target? Maybe you can do a virtual London<br />
YOUR TRUST CHARITY<br />
to Brighton bike ride, or if you're keen<br />
even tackle the equivalent of Land's End<br />
to John O' Groats on your exercise bike.<br />
(Not in one go, obviously.)<br />
If you have the time and what to help<br />
make SWB even better then please get<br />
in touch. Your Trust Charity needs your<br />
help and wants to help you create the<br />
best lockdown beating charity ideas you<br />
can.<br />
Together we can make a difference.<br />
If you are interested in fundraising<br />
you can get in contact at https://<br />
www.swbh.nhs.uk/charity/<br />
fundraising/<br />
How will you get involved? This is just some of the fantastic ways people have supported Your Trust Charity<br />
<strong>January</strong> <strong>2021</strong> staff lottery results<br />
1st £183.25<br />
Michelle O’Connor<br />
2nd £109.95<br />
Hannah Goodwin<br />
3rd £73.30<br />
Andy Watson<br />
Don’t forget that Your Trust Charity lottery costs just £1 a month and anyone<br />
who works for the Trust can join. Payment is deducted from your wages each<br />
month. To take part email amanda.winwood@nhs.net.