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October 2017

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The virtual clinic team
Trust Introduces New Virtual Fracture Clinic
Ashford and St Peter's Hospitals NHS Foundation Trust has introduced an innovative new Virtual Fracture Clinic (VFC) in a bid to reduce outpatient appointments.

The new clinic which comprises a Consultant Orthopaedic Surgeon, Virtual Fracture Clinic Nurse and Administrative Support will significantly help cut the number of times patients have to attend a traditional fracture clinic.

Under the new approach, hospital patients with acute injuries will initially be seen in A&E and advised they will be assessed in the Virtual Fracture Clinic within a couple of days. Each case is then assessed by a 'Consultant of the Week' and the patient's care pathway is developed from there.

Patients will then receive telephone advice from the VFC team who offer guidance on the next steps for recovery. Follow-up advice on care management is sent to each patient via email or post. Additional patient advice and guidance videos will also be available on the Surrey iMSK website

Cathy Parsons, Director of Clinical Services, Trauma and Orthopaedics said: "Since its launch, up to 50% of our patients have been discharged directly after assessment in the Virtual Fracture Clinic and up to 20% have been seen at a later date for follow up care. This is simply fantastic news for patients, many of whom will now have reduced or no further visits to hospital following their initial A&E attendance.

"The service is a further boost to our ongoing efforts at ASPH to continually improve the patient experience and will also help the Trust realise some financial benefits."

Jeremy Hunt MP with staff
Secretary of State for Health, Jeremy Hunt MP, visits Ashford and St Peter's Hospitals
Secretary of State for Health, Jeremy Hunt MP and his Senior Clinical Advisor, Professor Sir Norman Williams visited Ashford and St. Peter's Hospitals on Friday 15th September to discuss patient safety with around 40 members of staff.

The event kicked off with a presentation from Trust Medical Director, Dr David Fluck, who described the patient safety journey taken by the Trust. He said: "Since introducing our '4 Ps' - Patients First, Personal Responsibility, Passion for Excellence and Pride in our Team - around eight years ago we've been on a journey to improve patient safety. Key to that is enabling the right culture at our hospitals - one of openness, transparency and mutual support - where colleagues feel able to raise concerns, report incidents and share learning from mistakes.

We've made some great progress with this and I was pleased to share some examples with Jeremy - including our work to improve the early identification and treatment of sepsis and to reduce the number of hospital-acquired pressure ulcers. However, we are not complacent and know there is always more to do."

Jeremy Hunt went on to share his own journey, experiences and reflections on patient safety. He described the stories of some patients and their families which had really struck a chord, leading him to make patient safety one of his biggest priorities.

Jeremy said: "It was a pleasure to meet staff at Ashford and St. Peter's Hospitals and hear about their patient safety initiatives and drive to embed transparency at the heart of the Trust. I was impressed by their work to create a culture of openness where staff are supported to speak up, helping to achieve our ambition of making the NHS the safest healthcare system in the world."

Chief Executive, Suzanne Rankin, said: "We were really pleased to welcome Jeremy and Professor Williams to the Trust and for the opportunity to share our patient safety journey and achievements with them. That journey continues and it was good to hear Jeremy talk about the national context and a desire to share learning more quickly and more widely across the healthcare sector."

Child and a member of our play team
Hospitals shortlisted for prestigious national award
Ashford and St. Peter's Hospitals has been shortlisted in the 'staff engagement' category of the 2017 HSJ Awards. The awards are one of the largest celebrations of healthcare excellence in the world, recognizing and promoting the finest achievements in the NHS.

Director of Workforce Transformation, Louise McKenzie, said: "We are delighted to be shortlisted for this award, in recognition of our 'Be the Change' and '#Rightculture' programmes. We began these back in 2014 whilst reflecting on lessons learnt from the Francis report; we wanted to transform our culture and improve the feel of the Trust for colleagues."

"'Be the Change' was introduced by a group of junior doctors, as a way of enabling any member of staff to put forward suggestions for change and improvement. We created something that broke through traditional hierarchies and empowered people to put their ideas forward. Since then, it's become an integral part of our approach to quality improvement and we've worked hard to equip staff with the knowledge, skills and capability they need to make positive changes."

The winners will be announced at an awards ceremony on 22nd November at the Intercontinental O2 in London.

At the display stand
Trust pledges to #EndPJParalysis
Older patients at Ashford and St Peter's Hospitals NHS Foundation Trust were encouraged to 'get up, get dressed and get moving' last week as part of the Trust's week-long series of events to highlight its commitment to ending pyjama paralysis.

In support of the campaign, more commonly known as #EndPJParalysis, staff across the Trust dressed up in pyjamas, held pyjama ward parties and joined scores of colleagues, patients and visitors to the hospital as they pledged to help #EndPJparalysis.

The campaign is the brainchild of world renowned Professor Brian Dolan, Director of Health Service 360 and the originator of #Last1000days and builds on evidence that suggests that older people mobilise less when in pyjamas and more when fully dressed, which ultimately helps reduce deconditioning.

Consultant Orthogeriatrican, Dr. Keefai Yeong said: "We had an excellent response to the launch of our campaign with staff and visitor pledges reaching an impressive 350. It was great to see so many patients embrace the theme and importantly seeing the real-time benefits they derived from getting up, getting dressed and moving.

"A big thank you to everyone who helped make the week the success it was. We must now build on the good work we've started and help empower our patients by getting them up and moving.

We are privileged to be hosting a visit from Professor Brian Dolan next month where we hope to learn more about this fascinating topic."

Members of the Orthopaedic team
We are in the top rank for safe care of hip fracture patients
The latest report by the National Hip Fracture Database, detailing outcomes for patients admitted to 177 hospitals in England with a hip fracture in 2016, shows that Ashford & St. Peter's (ASPH) was in the top 10% for the first time for achieving best practice in treatment and care, low mortality and shorter length of stay.

Recording the lowest-ever 30 day mortality of 4.4% (national average 6.7%) confirms that ASPH is one of the safest hospital trusts for hip fracture patients.

Patients with hip fracture spend a significant amount of time in hospital, recuperating after the operation and undergoing rehabilitation. Their care consumes a lot of resources, increases the risk of institutionalisation and may lead to hospital-related harm.

There is also significant continuing ill-health associated with hip fractures, with only 50% of patients returning to their previous level of mobility and 10-20% of patients being discharged to a residential or nursing care placement.

Elderly patients with hip fractures have complex medical, surgical and rehabilitation needs so a well-coordinated multidisciplinary team approach is essential. Over the years, the Ashford and St Peter's team has shown significant improvements, successfully achieving best care for their hip fracture patients and reducing mortality significantly.

In 2016, the Trust's Best Practice score was 83.2% (national average 59.2%). This measures a range of criteria including operations within 36 hours of admission, a multi-disciplinary approach (doctors, nurses and therapist working together), assessment and aftercare.

The Trust's average length of stay is also falling steadily - which is better for patients - from 21.3 days in 2013 (average 19.8 days) to 15 days in 2016 (average 21.6 days).

Lead Consultant Orthogeriatrican at the Trust, Dr. Radcliffe Lisk said: "We are delighted that all the thought and hard work the Trust has put in over the last few years to improving outcomes for our older and vulnerable patients has been recognised.

Consultant Orthogeriatrican, Dr. Keefai Yeong said "We have transformed the way we care for our patients with hip fractures. There is greater collaboration and teamwork across the board and this has resulted in excellent results we have seen"

Map of the redevelopment site
Planning Application Submitted for Redevelopment of part of St Peter's Healthcare Campus, Chertsey
Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey and Borders Partnership NHS Foundation Trust and Optivo have submitted a planning application to Runnymede Borough Council for the redevelopment of surplus land at St Peter's Healthcare campus in Chertsey, Surrey. The application includes plans for affordable housing for NHS staff; open-market housing; a multi-storey car park; and an extension to St Peter's main reception to provide an improved customer café and retail offering.

The plans largely focus on surplus land on the western part of the campus. The intention is to secure permission for the redevelopment of the land for housing and sell it to directly fund improved local healthcare facilities and enable improvements to staff accommodation which will help the hospital attract and retain staff.

The money raised would:
  • Provide a new Accident & Emergency unit within an extended Prince Edward Wing at St Peter's Hospital
  • Provide significant funding towards refurbishing and redeveloping mental health hospital and community services which serve people in north west, mid and east Surrey.
  • The new housing will also provide much-needed homes in a borough which has a significant shortage of affordable housing and housing land.
The planning application is a 'hybrid' application, comprising applications for both outline and full planning permission. The outline application is for:
  • 328 open-market homes, consisting of a retirement village and a mix of apartments and houses, on the west site
  • 144 new and redeveloped affordable homes, primarily for NHS staff, 72 of which would be on the west site, and 72 on the eastern part of the campus
  • Two new, separate access roads for the west site from Holloway Hill and Stoneleigh Road to the north west.
The full application is for:
  • The new multi-storey car park - this will improve patient access to the main entrance and replace spaces lost through the redevelopment of the west site
  • The extension to the main hospital reception area which will link to the new car park and will improve the entrance and waiting areas for patients and visitors.
Local Plan policies designate St Peter's Healthcare Campus as a 'major developed site' in the green belt. National and local planning policy demand that very special circumstances justify development in the green belt. The Trusts consider that these very special circumstances exist and include the overwhelming need for investment in St Peter's Hospital to accommodate population growth in north west Surrey and the need to provide on-site housing for staff.

Valerie Bartlett, Deputy Chief Executive at Ashford and St Peter's NHS Foundation Trust, said: ""We are very pleased about this latest stage in proceedings. This opportunity signals our commitment to improve the facilities in which we provide care to our local population. The resources will be used to improve a number of important facilities in our hospital, particularly for those people who arrive here in an emergency. We are also particularly pleased that this development will enable us to offer better quality staff accommodation, which is vital for recruitment and retention. The redevelopment will also provide much needed new homes in Runnymede, an area with a housing shortage."

Jo Young, Chief Nursing Officer at Surrey and Borders Partnership NHS Foundation Trust said: We want people to experience our services in surroundings that are modern, safe and accessible. The capital we raise from the St Peter's development will go straight back into providing welcoming environments to those living in Runnymede and the other boroughs that we serve.

"We know that access to suitable accommodation is key to people's mental wellbeing, so we are really pleased that the development includes affordable housing. It will give those local people who might otherwise be left feeling isolated an opportunity to connect with their local community."