Inside Story - University College London Hospitals

Inside Story
Focus on QEP – pages 4 & 5
AND
Meet the new chief nurse – page 6
PLUS
Clinical breakthrough for vCJD – page 7
Inside Story is the UCLH staff magazine

news
Top young artists brighten Cancer Centre
Fifteen of London’s top young artists are
to brighten UCLH’s new Macmillan
Cancer Centre with their work.
The original art, on the theme of
wellbeing, will decorate patient areas
when the £100m new centre opens in
2012.
Copies of the eye-catching collection
have already gone on display outside the
construction site in Huntley Street where
they will remain for the next 12 months.
A third edition will be auctioned at a
London gallery in March next year with
all proceeds to the centre.
UCLH Arts curator, Guy Noble said:
“They are fantastic original art works
created by some of London’s best up
and coming young talent.
“They are humorous, distracting, thought
provoking and uplifting and this fits with
our commitment to provide the best
possible environment for patients when
they are receiving treatment from us.”
He added: “Displaying the eye-catching
designs outside the centre will help raise
public awareness of the development
and being able to auction copies next
year will raise valuable funds for the
centre. We are very grateful to the artists
for their support.”
For further information or to request
images please contact the arts curator,
Guy Noble.
Dedicated healthcare assistants win awards
Three staff have won praise for the
contribution they make to patients and
healthcare across the Trust. They were
presented with awards in memory of
Christine Harcourt-Smith, a former UCH
nurse who died unexpectedly at the age
of just 26.
Contact Us
If you have any information you would like included in Inside Story, or on the Trust intranet
site Insight, contact: Communications Unit, 2nd Floor Central, 250 Euston Road, London
NW1 2PG. Email: communications@uclh.nhs.uk, Tel: ext 9897, Fax: ext 9401.
2
Annette, Margarita and Dexter show off their certificates,
alongside Barbara Baer, President of the UCH Nurses’ League
Carlos ‘Dexter’ Regarde has made a big
impact in a short time since joining
UCLH last March. He was named
Healthcare Assistant of the Year for his
'exceptional ability to communicate, his
welcoming and caring manner and his
enthusiasm and commitment to
learning’.
Margarita Petrus Camps
won an award to recognise
her achievements whilst
training to be a registered
nurse. Margarita
approached the course with
‘commitment and maturity’
and her academic
development led to her
achieving the BSc in
Nursing Studies.
Annette Sylvester was
presented with the award
for Registered Nurse
Mentor. Nominated by staff nurse Faye
Stemp and senior nurse Alison Finch,
Annette was commended for her
'friendly, calm and considered approach'
in mentoring paediatric nursing students
and for the way she provides them with
a rich learning experience’.
The awards were established as a
lasting memorial to Christine Harcourt-
Smith (pictured left) who qualified in
1971 and became a staff nurse on the
metabolic ward. In 1976 – just six weeks
after becoming engaged to be married –
she died suddenly of a brain tumour. Her
mother Irene donated money to the
Nurses’ League to establish an annual
award in her name.
Sheila Adam, head of nursing specialist
hospitals board, said: “Health care
assistants are a vital part of our nursing
team, and contribute hugely to the
quality of care our patients receive.”
Front cover: Darren Barnes, charge nurse,
Sophia Mavrommatis, physiotherapy
practitioner and Fares Haddad, consultant
orthopaedic surgeon. (Story on page 3)

news
Midwifery award for our pioneering staff
All the RCM winners with Cathy
Warwick, second from left; Yana
Richens, third from left; Sarah
Creighton, fifth from left; and
Natasha Kaplinsky, fifth from right
Two consultants have won one of the
UK’s top midwifery prizes for their
innovative work to help women whose
lives are scarred by genital mutilation.
Yana Richens OBE, consultant
midwife and Sarah Creighton,
consultant gynaecologist were
presented with the award by the
Royal College of Midwives for their
educational DVD which gives clinical
advice on how to repair the damage
caused by female genital mutilation
(FGM).
The procedure is offered at the Trust’s
African Women’s Clinic which also
gives advice to women who suffer
problems related to FGM.
Cathy Warwick, RCM general
secretary, praised their ‘important,
innovative and pioneering work’.
Yana said: "I feel passionately about
highlighting the issue of health
inequalities for non-English speaking
women and those from ethnic
minorities. Female genital mutilation
ruins many women's lives and can
cause severe gynaecological and
obstetric problems.
“I have been fortunate to be able to
work in an environment where I have
the resources, support and freedom
to develop professionally”
Sarah added: “Patients with FGM are
at much greater risk during childbirth
if they are not assessed and
managed appropriately. This DVD
provides immediate and practical
instruction to doctors and midwives”.
The DVD has received national and
international recognition from the
Royal College of Obstetricians, Royal
College of Midwives and WHO. It
educates midwives, doctors and
traditional birth attendants, as well as
people in local communities.
ER – just what the doctor ordered
Imagine being admitted to hospital
and knowing what to expect at each
stage, from the moment you come in
until you go home. Imagine waking up
after surgery and feeling well enough
to talk, eat and drink and be
comfortable enough to be back on
your feet soon afterwards.
Orthopaedic patients at UCLH are the
latest to benefit from the enhanced
recovery (ER) programme to make
their hospital stay less daunting,
boost recovery and reduce length of
stay. It offers patients advice and
practical support before, during and
after their knee or hip replacement.
New education groups have been
set up to give people the
opportunity to meet other patients
and members of the nursing,
occupational therapy and
physiotherapy teams before
admission. They can seek
reassurance, find out the full facts,
practice exercises, and try out stairs
and equipment to help walking and
dressing.
Pre-assessment, same day
admission and excellent surgical
and anaesthetic management are
also key elements of the
programme. The ER pathways have
already been established in the
Trust’s colorectal,
bariatric and
cardiothoracic
services.
Sophia
Mavrommatis,
physiotherapy
practitioner, said:
“The group
sessions have been very popular and
patients say it offers them
reassurance. We are also planning to
produce a DVD for patients, updated
patient information booklets and an e-
learning package for new staff which
will explain the ethos behind the
enhanced recovery pathway.”
The North Central London Enhanced
Recovery Partnership is part of a
national initiative supported by
the Department of Health.
ER – linked to reduced
length of stay – is part of the
Quality, Efficiency and Productivity
programme. See centre pages for
the latest update on QEP.
3

quality, efficiency and productivity
QEP: one year on
A series of special events are on the horizon to mark the first
anniversary of the Trust’s Quality, Efficiency and Productivity (QEP)
programme.
Staff are invited to activities and workshops to showcase and share
the impressive work that is underway across the Trust. National NHS
efficiency lead Jim Easton returns as guest speaker.
In this edition of Inside Story, we are looking at the achievements of the
past year – ways we have improved quality of care, treated more patients
and saved money. Plus, we’ll be looking at the important challenges that lie
ahead.
For more information on QEP week, which is
beginning on 28 February, click the QEP button on
the front page of Insight.
Improving the way we care for the elderly
The elderly care team has redesigned the way it cares for patients to help them
recover quickly. As well as proving popular with patients, 1,542 bed days have
been saved. This is helping us treat more people needing care.
How did they do it?
Elderly patients are now assessed by a
specialist consultant soon after arriving on the
Acute Medical Unit, rather than when
transferred to a ward. Care is coordinated from
the outset and often requires a complex
package of health and social care assessment.
Once on the ward, nursing staff regularly visit the bedside to reassure and support
the elderly patients.
The team has achieved the highest pre-11am discharge
in the trust with 40% of patients leaving hospital
promptly in the mornings.
Regular outpatient clinics with specialist consultants help
minimise re-admissions.
Success stories
QEP champions
among those who
Trust's Improvem
provides practical
to help them del
projects in the
We are on target to save £32m this financial year
Streamlining surgery
Clinical teams at the NHNN have worked hard to
reduce the length of time non-elective patients stay in
hospital before and after their operation. For
example, where patients have been transferred from
other hospitals for specialist brain and spinal surgery,
the average stay is down from 16 to 13 days.
How has this been achieved?
Surgery times are booked as soon as a patient is
accepted for treatment and admissions planned more
thoroughly. Improved communication means patients
on urgent standby are fully ready for their operation at
short notice.
Post surgery, length of stay was shortened by more
efficient assessments after the operation; improved
protocols and a new discharge lounge has
streamlined transfers to another hospital or home.
Developing strong relationships and high levels of
trust with teams in partner hospitals has been vital.
The number of agency staff has been halved,
saving around £12m. But the aim is to have no
agency staff, (achieved by maternity, paediatrics,
medical specialities and infection division last
month)
We are treating more patients than ever before
We have reduced waiting times (eg IVF clinic);
reduced length of stay following surgery (eg The
Heart Hospital and care of the elderly); increased
outpatient care; increased theatre use at UCH by
10%; increased pre-11am discharge across all
areas
Quality indicators are performing well, with
mortality rates now among the best in the
country, and recently at a record low for the
Trust
4

quality, efficiency and productivity
: These staff are
've signed up to the
ent Network, which
support and training
iver QEP inspired
ir departments.
Reduced delays sweeten the pill
With the help of the pharmacy team, T6 nursing staff are being
trained to dispense painkillers and other simple medications directly
to patients – a move to help end frustrating delays and ensure the
discharge process runs as smoothly as possible.
How will it work?
The pre-packaged medicine will be stored safely on the short stay
surgical ward and dispensed against a pre-formatted discharge
prescription. WebRx, the Trust’s eDischarge system, is also being
modified so that doctors can prescribe specific and pre-agreed
combinations of medicines with a single click.
To next year – and beyond!
Ward sister Naimh Gavaghan said: “Patients and staff can find it
really frustrating to wait for the prescription to be prepared and the
medicine to be dispensed, particularly if it is for a straightforward
analgesic, laxative or antibiotic.
“This will be much simpler and means patients can go home as soon
as they are ready. It will help ward staff to run the whole discharge
process more effectively. “
Building on last year’s success, its now time to look ahead. The Executive Board has recently agreed the Trust strategy
for the next five years, outlined in ‘Thriving through the Downturn’. You can read a summary of the strategy (during QEP
week), or the full document, on the QEP pages of Insight.
With £175m savings to be made by 2015, there are obviously challenges ahead – both in reducing costs and retaining
high quality care. The support of staff will be vital in helping achieve this goal.
Sir Robert Naylor, chief executive, said: “We will need the energy, commitment and ideas of all staff. Everyone needs to
be involved to help us significantly change the way we work to meet this challenge whilst protecting the quality of care we
provide to patients.” More details about the five year plan will be available during QEP week.
Online QEP facts – just a click away.
Visit the QEP pages on Insight
for summaries of important
national QEP publications,
PowerPoint presentations,
news updates and success
stories.
Please keep your comments
and suggestions rolling in –
email us at QEP@uclh.nhs.uk.
Stop press:
Jim Easton, national
director for
improvement and
efficiency, is returning
to give the keynote
address at the QEP
Trust-wide event next
week. Jim is pictured
here with chief executive Sir Robert Naylor and Tara
Donnelly, the Trust’s QEP project director, at the QEP
launch event in January 2010.
5

interview
Meet our new chief nurse
Katherine Fenton talks to Elke Tullett
New chief nurse Katherine Fenton
vividly remembers her first shift as a
staff nurse. It was in the late 1970s in
a Leeds hospital and she felt, like
most other relative rookies, a sense
of bewilderment. It was the ward
sister – a calm, confident, firm leader
– who saved the day.
“It was a gynae ward and there was
a patient with a threatened
miscarriage and I thought ‘what
makes me think I have what it takes
to help her?’ I was petrified. Luckily,
the ward sister was fantastic. She
was supportive, strict, had high
standards and she ruled the ward.
I’m not sure how I would have
“I’m not a pen pusher. I
want to get out there”
survived the first day without her!”
And that memory continues to shape
her views.
“We must continue to invest in our
ward sisters, to make sure we have
the best we possibly can. Their
influence is so important and they set
the standard for everyone else.”
Nursing and midwifery care based on
the ‘basics of what really matters to
patients’ – are one of her priorities.
“Whether patients are fed and watered
properly, low infection rates,
preventing falls and pressure ulcers –
all the things that lead to first class
care and reduce the risk of harm to
patients.”
Reducing harm to patients is always
uppermost in her mind: she led the
development of the NHS Institute for
Innovation and Improvement national
nursing and midwifery high impact
actions aimed at reducing the risk of
harm.
“I want us to be among the best in the
world for fundamental nursing care.
UCLH is already so successful – the
challenge is to take it to the next level.”
Sitting behind a
desk is not the
answer. A highenergy
person
like Katherine
(who enjoys
running, skiing
and sailing), will
be pacing the
corridors and
wards of UCLH
each week.
“I’m not a pen
pusher. I want to
get out there, talk
to as many
nurses and
midwives as I can – I hope to create
the ambition among our staff, to
make them see that we can be
world class in all we do and that it is
within their reach. They are the
ones who can really make it
happen, my job as chief nurse is to
ensure they have the right facilities,
the right training and the
opportunities to help them achieve
it.”
Creating a more structured training
and career pathway is on her
agenda to encourage more nurses
and midwives to become nurse
consultants. So too, is
strengthening nurse and midwifeled
research.
She acknowledges the ‘tremendous’
legacy left by her predecessor
Louise Boden “fantastic…there
were no holes… no ‘oh God! Look
at the mess I’ve got to sort out.’ She
really was on top of everything.”
Like Louise, Katherine shares a real
love of grass roots nursing and
midwifery – a feeling that grows
stronger as the years go by.
She spent many years in intensive
neonatal care: “It’s intense, technical,
caring – so many things. A patient will
come in with a big belly – and leave
with a baby in her arms. It is magic!
“Trying to make sure every patient
receives brilliant care is what drives
me on, they deserve the same care as
you would want for your own father,
mother, and child. I may look friendly, I
am friendly - but I can crack the whip if
I see standards slipping.”
CV
Previously director of clinical
standards and workforce/chief
nurse at South Central Strategic
Health Authority
Career spans 30 years including
posts at St James’s is University
Hospital, University Hospital
Birmingham, director of nursing
and patient services at
Southampton University
Hospitals NHS Trust and at Barts
and the London NHS Trust.
6

Breakthrough discovery in blood test for vCJD
The world’s first accurate
blood test for variant
Creutzfeldt-Jakob
disease (vCJD) has been
developed by the Medical
Research Council (MRC),
with help from staff at the
National Hospital for
Neurology and
Neurosurgery (NHNN).
The results could
transform the diagnosis
and screening of the
brain disease.
A widely available,
accurate blood test would
enable people to be
diagnosed earlier and
could also help identify
carriers of the disease.
This would help measure how
widespread the prion infection is in the
general population and identify those
who are at risk of passing it on to
others.
The research team tested 190 blood
samples, including 21 from individuals
known to have vCJD. The blood test
was able to detect blood spiked with a
dilution of vCJD to within one part per
Dr Simon Mead, clinical lead, and Prof John Collinge, director, of the National
Prion Clinic
ten billion – 100,000 times more
sensitive than any other method
developed so far.
Variant CJD, the human form of BSE
(or mad cow disease) first emerged in
1995. The disease, which affects the
brain, is believed to have passed from
cattle to humans through infected food.
It causes personality change, loss of
body function, and eventually death.
our trust
Professor John Collinge,
director of the Prion Unit
based at the NHNN, said:
“One of the reasons that
vCJD is such a dreaded
disease and has caused
such disruption and
expense to health services
is the lack of knowledge of
who is and who is not a
carrier of this infection.
Longer term studies will be
needed to assess what
proportion of individuals
who test positive for prion
infection will then go on to
develop the disease later in
life.
“It will be crucial for
clinicians to be able to offer
treatment before extensive irreversible
damage to the brain has occurred. At
the moment, a firm diagnosis of vCJD
can usually be made only once serious
symptoms of the disease have
developed which indicate extensive
damage to the brain.”
For more information visit the National
Prion Clinic pages on the UCLH
website.
New cancer technology – a UK first
Cancer patients at UCLH will be
among the first in the country to benefit
from exciting new technology which
treats patients with greater precision
and twice as quickly as conventional
methods.
The new TrueBeam® linear
accelerator delivers precise
radiotherapy and radiosurgery
alongside real-time imaging and is
particularly effective for lung, liver,
pancreas and other mobile tumours.
More than
100,000 data
points are
measured every
ten seconds
during treatment
to ensure the
tumour is
targeted with the
utmost accuracy.
It will also offer
well targeted
radiotherapy for
some of the
children treated
at UCLH, which
has the largest
paediatric
radiotherapy practice in the UK.
Derek D’Souza, head of radiotherapy
physics at UCLH, said: “TrueBeam®
will offer patients new treatments using
small, high-intensity fields of radiation
to treat the tumour.It provides greater
efficiency in the steps needed for
imaging, positioning and treating
patients and offers unparalleled
precision.”
The project is a partnership between
HCA NHS Ventures and Fight for Life,
a UCLH charity which has been raising
funds to help fight children’s cancer for
the past 14 years.
Julia Solano, radiotherapy services
manager, said the upgraded facilities
and technical radiotherapy were a ‘UK
first’. “It will be truly innovative,” she
added.
The UK’s first machine is expected to
be up-and-running in the UCH
radiotherapy department by the
summer.
7

the back page
Secret lives
By day, Taj Fregene gently eases
people into the deepest of sleeps, at
night he rouses them wide awake.
Instead of mixing oxygen, anaesthesia
and nitrous oxide, he mixes music. The
controlled calm of the operating theatre
may be replaced by the raucous
revelry of a rock venue, but there are
similarities too.
Taj, a specialist registrar, said: “It can
feel strange dealing with an emergency
in the hybrid theatre in the afternoon
and then a couple of hours later doing
a sound check at a gig. Anaesthesia
can be stressful and you have to make
sure you have planned for every
eventuality. That philosophy helps me
on stage too. You must plan well - then
if things start to go wrong
unexpectedly, you can quickly put them
right.”
The five-piece band call themselves
“Alchemy” -an upbeat fusion of hip
hop, indie and pop with influences from
90s Britpop and 70s
Mowtown. They are busy
making a name for
themselves in clubs and
pubs across north London.
“I write about love and
about the realities of
life…songs about when it’s
grey, rainy, you feel rubbish
and you can’t be bothered
to get out of bed. The lyrics
are thought-provoking but
the sing-along melody and
catchy rhythms make
people want to dance.”
Taj, who lives in Tufnell Park, has been
making music since he was a young
lad.
My mum liked glam rock and my dad
preferred the Mowtown greats and I
think they influenced my love of music.
They’re my biggest fans!”
As for fame and fortune, Taj is realistic.
“As long as I can carry on writing
songs and playing music I’ll be happy.
Fame – if it happens, it happens…but
I’m not banking on it. Besides, I like
being an anaesthetist!”
* You can see Alchemy perform at 229
The Venue, 229 Great Portland Street
on Sunday March 27th.
www.ThisIsAlchemy.co.uk
Archives
Miss Godiva Thorold was the matron and Lady
Superintendent of Nurses at The Middlesex Hospital.
She trained at University College Hospital and was
appointed to The Middlesex in 1870. Her working day
was long, rising early and not going to bed before
2.30am, after completing her correspondence. She was
considered to be an authoritarian but improved
conditions for nurses, by creating a pension which
helped attract nurses to remain in charitable institutions
rather than go in to private nursing, which paid more.
She was very
particular on
uniforms, and had
designed a dress
for Lady
Probationers
(women who paid
to train as nurses).
It had a small train
that covered their
ankles so that
when they needed
to stretch across a
patient or over a
bed their ankles
could not be seen
by the medical
students.She
retired in 1905.
Ward of the week
T7
T14
Ward of the week is a QEP initiative that
focuses on efficient patient discharge and
celebrates hard working and successful
teams. Here are some of our recent winners.
Grant Mann, charge nurse on T14 south, said: “We were
thrilled to achieve the Ward of the Week for Pre-11am
discharge. It was the culmination of much hard work”.
8