Autumn/Winter 2012 - East Lancashire Hospitals NHS Trust

ISSUE 2
GP
e-brief...
autumn/
winter
2012
welcome
Welcome to another edition and suggestions are welcomed!
of our GP newsletter through
which we aim to communicate
issues that we think will be of
interest to our primary care
colleagues.
We continue to develop our Care Closer
to Home strategy with models such as
the Virtual Ward now rolled out into 4
localities. Other services that are now
being developed to better interface
with primary care include diabetes and
respiratory services. Please continue to
give us feedback on your experience of
accessing these services. All comments
A major piece of work for us currently,
is to prepare all services to cope
throughout the winter period and to
ensure that we can meet the needs of
all of our patients, but in particular
our most vulnerable patients, over the
coming months.
We are working closely across the whole
organisation to ensure that we keep
people within a community setting
when at all appropriate and possible. In
particular we are working closely with
the ED department at Royal Blackburn
Hospital on a service improvement
programme looking at a community
response service and ambulatory care.
We are also preparing all services to be
as flexible as possible to ensure that we
can meet the needs of any ‘hotspots’
that may need additional support.
Best wishes,
Catriona Logan,
Community Division,
General Manager
Telephone: 01282 731105 or
catriona.logan@elht.nhs.uk or
alan.crowther@nhs.net
Alan Crowther,
Community Division,
Director
- In this issue... click on the following links to read more -
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Community Division Senior
Management Team
Clinical Educational Seminars
Palliative Care Consultants
National Falls Awareness
Week
Be a Governor – Your Trust
Needs You
The Reablement Service
Continence Service
Trust Service Wins Award
Assistant Practitioner Role...
Lower Limb Vascular Service
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Safety Express – Pressure
Ulcer Work-Stream
Macmillan Inaugural
Professional Excellence
Awards
NHS North West Diabetes
Foot Care Network Launch
East Lancashire Prostate
Cancer Support Group
Care ‘Commended’ status
Low Back Pain Drop-In Clinic
NHSLA Level 3 Success
Partnership in Speech and
Language Therapy Renewed
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Pennine Lancashire Integrated
Diabetes Service Locality
Services Communication
Acute Oncology Services to be
Strengthened at Trust
p10 Combined Medical Antenatal
Clinic for Pregnant Women
with Diabetes
p10 Local MSK Physiotherapy Pilot
study of the Euroqol Patient
Rated Outcome Measure
(PROM)

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Community Division
Senior Management Team
Please note from June 2012 Kenyon Road transferred onto the IPT Cisco phone system. Please see
new telephone numbers below. The main switchboard at Kenyon Road has changed to:
Tel: 01282 731111 Fax: 01282 731103
Alan Crowther
Divisional Director
PA Tina Rushton
01282 731105
Belinda Taylor,
Governance Lead
PA Tina Rushton
01282 731105
Waheeda Patel
Assistant HR Business
Partner
01282 731128
Chris Payne
Business Manager
PA/Admin –
Carole Spencer
01282 731106
Janet Stott
Divisional Accountant
Admin – Rachel Loftus
01282 731107
Catriona Logan
Divisional General
Manager
PA Tina Rushton
01282 731105
Val Sibson
Head of Business Planning,
Contracts and Performance
Admin – Rachel Loftus
01282 731107
Suzanne Whelan
Head of Adult
Community Services
Admin – Rachel Loftus
01282 731107
Jane Tancock
Business Manager
PA/Admin –
Carole Spencer
01282 731106
Sherolyn Collins
Head of Clinical Flow
01254 732398
Clinical Educational Seminars
Our Consultants at the Trust
are happy to attend GP
surgeries to run educational
seminars on a range of topics,
for example:
• EVAR – endovascular aneurysm
repair
• The respiratory assessment
centre
• Alternatives to hysterectomy
• Outpatient IV antibiotics (OPAT)
The clinical education seminars are
designed and delivered specifically
for Primary Care Practitioners
Consultants.
Depending on the subject, the sessions
can count towards CPD. Sessions
include a range of subjects and learning
styles so your practice can select the
clinical area and delivery method that
would suit your needs.
The Consultant can attend the surgery
at a convenient date/time for you or if
you prefer, the session can be held at
the Trust and incorporate a tour of the
facilities.
For more information, please contact
communications@elht.nhs.uk
Palliative Care
Consultants
The Community Division has
successfully recruited 2 palliative
care consultants. Dr Marion
Leith and Dr Anna Macpherson.
They will be based across
Royal Blackburn Hospital and
Pendleside Hospice.
They will be working cross
divisionally with the existing
palliative care consultants, Dr Alison
Thorpe, Dr Mark Kitchen and the
wider team. This is an exciting
development within the division
which can drive the palliative care
agenda forward.
2 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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National Falls
Awareness Week
18-22 June 2012 - Our Falls Team response
East Lancs Community Falls
team held five ‘Boost your
Bones’ events at Accrington and
Clitheroe Markets, in Burnley
town Centre, Rawtenstall and
Colne ASDA stores.
The team spoke with over 600 local
people ‘on their own patch’ to
encourage and smooth the way for them
to take further steps to help prevent falls
and keep their bones strong.
The National campaign run by Age
UK, highlighted the importance of
exercise alongside a balanced diet, rich
in calcium, whilst also getting enough
Vitamin D through sunshine, in order
to build and maintain healthy bones,
therefore helping to prevent falls and
fractures in later life.
Although the week had its challenges,
one of which was having all four seasons
in one day – we had a really productive
week. Some immediate outcomes
included; over 600 people received face
to face advice, new bookings for STEADY
On! talks, new exercise referrals, 24
BMI and BP checks, 18 home fire safety
checks, checked 67 and changed 58 worn
rubber ferrules.
East Lancs Community Podiatry and
Musculoskeletal services, Clitheroe
Hospital Outreach and RDU and Catering
Department, Healthy Living Pharmacies
and Anchor all supported the campaign.
The people we met at the events
received information on services
available to them; how to refer to
medicines management , where they
can do t’ai chi, activity classes, how to
access therapy services, Healthy Living
Pharmacies, CEDA centre services,
balance and safety, care and repair,
recycling unwanted equipment and
much more. In addition to answering
many falls related questions it became
apparent that a lot of people had a
range of questions on how to access
other of health, social care and universal
services. It was beneficial working with
partners; Healthy Lifestyles, Age UK
Lancs, Lancs Fire and Rescue and Help
Direct at the events so that we could to
provide a full range of answers to people
there and then.
It is with thanks to our wonderful
Community Member volunteers Dorothy,
Geoffrey, Eileen and Les that we were
able to hold events in each locality whilst
also keeping our falls service running.
For further information contact Yvonne
Skellern-Foster (01200) 420678.
Pictured above from top: Clitheroe
Community Hospital catering team; and
Yvonne and Maureen from Age UK; and
Community member volunteers.
Be a Governor – Your Trust Needs You
The Trust is looking for 15 members
of the public to be part of the
Council of Governors who will
oversee decision making when we
are authorised as a Foundation Trust
in 2013.
To be eligible to stand for election as a
governor you must be a member of the
Trust.
The public governors are made up from
people living in the following areas:
Blackburn with Darwen (3); Burnley
(2); Pendle (3); Rossendale (2); Ribble
Valley (2); Hyndburn (2); Rest of England
(1). The public governors will form
the Council of Governors with eight
elected staff governors and a further
six stakeholder governors made up
of commissioners, local authorities
and third sector organisations. All
of the Trust’s public members will be
responsible for electing governors in
their area.
As a governor you will:
• Be invited to attend a minimum of
four Council of Governor meetings per
year
• Be consulted on how the Trust
develops its services and its strategic
priorities
• Represent the interests of the Trust’s
members and regularly feed back
information about the Trust, its vision
and its performance
• Be prepared to meet with and speak
to members informally
• Attend induction and regular training
sessions to keep up to date with the
work of the Trust
Notice of elections will be given in
February.
To become a member, visit
www.elht.nhs.uk and fill in a
membership form online.
For more information on standing as a
governor, please contact
ftenquiries@elht.nhs.uk or
01254 732110.
3 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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The Reablement Service
The Reablement Service is a
key element of our approach to
preventing hospital and care home
admissions and supporting people to
regain their independence following
an illness or injury.
The service will be re-launched on 17
September 2012 with capacity increasing
to almost four times the current level
across the county over the following
couple of months as well as an improved
service model.
What is Reablement?
The purpose of the Reablement Service is
to help people re-learn valuable life skills
that may have been lost due to a period
of illness or incapacity. Service users are
Reablement Case Study - Stanley
Stanley is a 66 year old man who
lives with his wife Mary. They have
been married for 40 years and
Stanley has just retired from his job
as a postman.
He and Mary were looking forward to
spending more time with their hobbies
of bowling, ballroom dancing and
drives in the country with their pet
Labrador
Whilst on holiday in Devon Stanley was
taken ill and rushed to hospital where
it was identified he had experienced
a haemorrhage and subsequently
experienced a stroke, affecting him both
physically and cognitively. After 3 weeks
was transferred to Blackburn Infirmary
and following a further two weeks was
then discharged to LCCG Care Services
Reablement service with therapy.
gradually encouraged to do more and
more for themselves, with the ultimate
goal of becoming as independent
as possible, thereby minimising the
requirement for longer term care.
Who is it for?
Anyone aged 18 or over can be referred
to the service where the person’s
presenting needs indicate that they have
the potential to benefit from Reablement
with the exception of:
• People who need end of life care.
• People whose needs are likely to be
best met in a care home.
• People who need specialist
therapeutic intervention e.g. specialist
rehabilitation, acquired brain injury
rehab etc.
Following assessment the Reablement
Service provided three calls per day,
all approximately one hour. Initially two
members of staff supported Stanley
with all activities of daily living, as well
as support from his wife Mary and
health input, including physiotherapy
intervention.
Several Support Assistants were
identified to work with Stanley to
ensure continuity in order to support his
recovery following his brain injury. Staff
worked with Stanley to begin to relearn
skills, regain confidence and identify
techniques which would compensate for
his short term memory difficulties.
The Reablement assistants continued
to support Stanley to achieve his
aspirations and increase his confidence
in undertaking tasks with minimal
assistance.
• People whose needs could be met by
the provision of equipment or multi
vouchers only.
How do I refer?
Referrals can be made via staff within
Care Connect and the REACT team. If you
want to make a referral you can do so by
referring to Care Connect staff on
0845 0053 0009 or via the REACT on
07584 218 725.
Dawn Butterfield,
Head of Commissioning (North),
Adult & Community Services,
Lancashire County Council,
County Hall, Fishergate,
Preston PR1 0LD
Tel: 01772 530439
Mobile: 07500 976708
CASE
STUDY
During this time Stanley also
continued to receive physiotherapy
intervention, which has enabled him
to progress from using a wheelchair
to mobilising independently with
the use of one stick, which was his
aspiration and is one of his greatest
achievements.
Stanley has remained determined
throughout his illness, and has made
significant improvements, including
getting back behind the wheel which
is enabling him to get out and resume
one of his favourite pastimes, a drive
out with Mary to a country pub.
Stanley and Mary are now able to get
out and about again and spend time
socialising with old friends, Stanley
did not require any on-going support.
Continence Service
The Continence Service recently
held a Patient Support Event
for service users who perform
intermittent self catheterisation.
The Event was held at the Acorn Primary
Health Care Centre in Accrington. The
aim of the event was to provide ongoing
support to our existing service users and
to encourage new service users to take
their first steps in contacting us in an
informal environment. The event was
publicised in all GP surgeries within East
Lancashire and Blackburn with Darwen
and was for anyone of any age who
perform intermittent self catheterisation
to attend. Via the use of Infection
Control’s light box, we were able to
demonstrate the importance of hand
hygiene and many service users were
surprised at their results! Alongside this
we offered information relating not only
to intermittent self catheterisation, but
also provided healthy bladder and bowel
advice.
We are happy to report that the day was
a success with both familiar and new
faces attending!
Pictured: (L-R) Polly Harris (Nurse Manager/
Specialist Nurse), Jacqueline (Jay) Barker
(Continence Nurse Advisor), Joanne Tunney
(Paediatric Continence Nurse Advisor),
Melanie Mark (Staff Nurse)
4 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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The Community Lower Limb
Vascular Service Wins Award
Staff at the Trust were
celebrating after scooping
a national award for their
service treating patients with
lower limb vascular problems.
The Trust’s Community Lower Limb
Vascular Service won Cardiovascular
Clinical Team of the Year at the GP
Practice Awards. The team received
their award from Dr Phil Hammond at
the award ceremony which recognised
the achievements of healthcare workers
across the UK.
The team are based at the Acorn Primary
Health Care Centre in Accrington but
treat people from across the whole of
East Lancashire. The overall aim of the
service is improve the quality of life for
people living with lower limb problems.
In addition to the normal clinic sessions,
the team also run leg cafes where
patients can drop into community
settings such as church halls and meet
other people in similar situations and
get help and advice on other related
lifestyle issues such as stopping smoking,
improving their walking distance and
maintaining a healthy lifestyle.
Marcia Haworth, Team Leader, said:
“This is an incredible and fantastic
achievement and a well-deserved
honour for the team. This exemplifies
what can be achieved through effective
relationships with our patients,
consultant vascular surgeons and
commissioners. As we move forward
we are keen to work with the Locality
Clinical Commissioning Group to support
the patient pathway”
Pictured: the Lower Limb Vascular Service team
with Dr Phil Hammond (far right).
Assistant Practitioner Role...
Lower Limb Vascular Service
Working as Assistant
Practitioners in the lower
limb vascular service, is a very
rewarding role.
Our main duties involve supporting the
lower limb vascular staff in providing
a comprehensive lower limb service
to patients, carers and health care
professionals within the community
setting, with the aim of maintaining
patients in their own homes, preventing
hospital admissions and enabling
patients to enjoy maximum dependence
and optimum quality of life.
We work alongside a senior nurse based
in the Acorn Centre assessing patients’
vascular status, assessing wounds and
carrying out the appropriate treatment.
We are competent in using the
diagnostic equipment which is used in
the assessment of vascular conditions.
We also asses and treat patients
with chronic leg ulcers, applying the
appropriate dressing and compression
bandaging for best management.
We work in the leg cafes, which are
in different areas within East Lancs
assessing and monitoring patients.
We work without direct supervision but
we are always responsible to a registered
nurse implementing and reporting back
on delegated tasks.
In the leg cafes we provide compression
hosiery to patients after performing
a holistic assessment together with
the readings found following a pulse
oximetry test. We feel we are valued
members of the lower limb vascular team
and enjoy our role within the service.
Pictured: Advanced Practitioners Christine
Coyne (left) and Jane Butterworth.
5 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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Safety Express – Pressure Ulcer
Work-Stream
Feedback Summary
As part of Energise for Excellence (E4E)
Week of Action the Safety Express –
Pressure Ulcer Prevention Work-Stream
developed and delivered a Pressure Ulcer
Prevention Study Day in the auditorium
at Royal Blackburn Hospital. The 85
delegates reported an average 20%
increase in knowledge. 95% of delegates
rated the study day ‘good’ or ‘excellent’.
Sessions most enjoyed
Pressure Ulcer Prevention Study Day
80
70
60
50
40
30
20
10
0
Causes/grading of
pressure ulcers
All about heels
Selection of Comments:
Patient’s story
• Loved the patient’s story, gave a good
insight into patient experience. Very
interesting to learn about mattresses
and to be able to provide information
to patients. Knowledge of grading
and causes of pressure ulcers very, very
useful.
• Very well delivered learning
experience.
• Very interesting day and learnt a lot
about ulcers.
• Enjoyed the day immensely – well done
to the team!
• I couldn’t fault any of the course,
especially enjoyed the patient’s story.
Patient’s story extremely moving.
• The patient story made me realise
what an impact nursing has on a
patient’s life.
• I enjoyed all sessions but learning the
patient’s story was fantastic.
• Dietitian was most interesting and
unknown factor to me on care of
pressure ulcers.
• Very practical, sensible advice on
management.
• Good to be in a group of mixed skills,
job knowledge levels.
• As a Podiatrist bed mattresses are not
of great importance.
• Not very relevant to Podiatry
• Good to have risk management
information delivered from senior
management.
We thanked John for presenting on the
Pressure Ulcer Prevention Study Day and
from the course evaluation it was clear
that the best part of the day was “the
patient story”!
This feedback has highlighted how
valuable John’s presentation was in
contributing to the day’s success. Listening
to patients helps our care teams review
what we do and improve our delivery of
care and staff education.
We would also like to thank all the
speakers including Pete Weller, Associate
Director of Patient Safety & Governance
who started the day off with a corporate
overview of risk management.
We hope to make this an annual event
during Pressure Ulcer Week by bringing
experts and teams involved in eliminating
pressure ulcers during an Energise for
Excellence Week of Action.
Pictured (L - R): Liz White – Tissue Viability
Lead Nurse; Heather Todd – Wound Care
Dietitian; Marcia Haworth – Operational &
Clinical Lead; Maureen Heys – Tissue Viability
Nurse; John Clack – Our Patient; Janet Creswell
– Senior Physiotherapist; Jill Lomax – Specialist
Podiatrist and Amanda Cook – Occupational
Therapist.
Macmillan Inaugural Professional Excellence Awards
The community
division are
delighted to
announce Erin
Bolton, Macmillan
End of Life
Lead, has been
awarded one of
only four awards
for innovation
excellence.
Erin was nominated by her line manager,
Alison James in recognition of the
excellent and innovative work in the
development of a play “Was Your
Death as Good as Mine”. This play
promotes the use of the end of life tools
and emphasises the benefit of having
discussions with love ones and forward
planning.
Following the success of the play, a
DVD was produced in partnership with
Macmillan Cancer Support; this was
launched nationally at the End of Life
Facilitators Conference in November
2011.
This highly innovative tool shares serious,
sensitive and important messages which
have a powerful impact for the audience.
Erin was supported in producing and
performing the play and the DVD by
her Macmillan colleague Catherine
Hargreaves.
Erin, Catherine and Alison attended
the award reception on Thursday 8th
November to celebrate the outstanding
work of the successful nominees.
Pictured Erin Bolton.
6 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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NHS North West Diabetes
Foot Care Network Launch
On 10 July 2012 at the Thistle
Hotel Haydock, representatives
from East Lancashire Hospitals
Trust Medical Division and
Community Services Division
attended the inaugural meeting
for the launch of the NHS NW
Diabetes Foot Care Network
alongside other Trusts across the
North West.
Dr Geraint Jones, Consultant Physician
was one of the guest speakers at the
event highlighting the importance of
diabetes foot care in the national health
economy.
Marion Kerr, Health Economist
presented her paper “Foot Care for
People with Diabetes: The Economic
Case for Change” which highlighted
the hidden costs for care in the primary
and community settings. Early access to
preventative lower limb services include
benefits to patients such as reduction
in amputation rates, improved wound
healing rates and decreased mortality
and morbidity rates. Benefits to the
organisation include reduced hospital
admissions, reduced length of hospital
stays and reduction in costs from
reduced number of amputations. It was
clearly established that multidisciplinary
integrated services working within
primary, secondary and community
services could generate qualitative
clinical practice improvements and
significant financial savings.
The event discussed priorities for the
North West and the way forward in
improving diabetes foot services as
this network has been established to
ensure that national guidelines are
incorporated into clinical evidence based
practice at a local and regional level.
The network will also work to improve
healthcare professional competencies
in primary care and through improved
education, ensure patients better
understand their heightened risk
of developing foot and lower limb
problems.
Following on from this event, further
work will be taking place including the
launch of the East Lancashire Diabetes
Lower Limb Management Network on
26th July 2012 at which representatives
from the East Lancashire Health
Economy including NHS Commissioners
will attend.
Jenny Smith
Podiatry Service and Professional
Development Lead
East Lancashire
Prostate Cancer
Support Group
On the 5 July 2012 Polly Harris, Service
Manager/Specialist Nurse, had the
opportunity to speak to the East
Lancashire Prostate Cancer Support
Group who hold monthly meetings in
the region.
The group asked for information
regarding incontinence following
surgery, radiotherapy or other
treatments for prostate cancer. Over
forty men attended the event and it
was clear that incontinence for these
patients is a significant factor affecting
their quality of life.The group always
welcomes new members and can be
contacted at www.elpcsg.org.uk
Care ‘Commended’ status
Staff from Altham Care Home,
in Clayton-le-Moors, have won a
national award recognising their
high quality of care for people
nearing the end of life.
The home received ‘Commended’
status, as part of the Gold Standards
Framework (GSF), in the Care Homes
Quality Hallmark Awards.
What is the GSF in Care Homes
(GSCH) Programme?
‘It Is about living well until you die’.
The GSFCH Training Programme is one
of the biggest, most comprehensive
programmes ever undertaken to
enhance end of life care in care homes.
It has been running for almost five
years, with nearly 1,000 homes having
undertaken the training across the
country and up to 100 homes a year
being accredited. It is endorsed by all
four major care homes organisations
(ECCA, RNHA, NCA and NCF), and
supported by Help the Aged.
GSF in Care Homes aims to improve
patient outcomes and cost effectiveness
by:
1. Improving the quality of care
for people nearing the end
of life
2. Improving collaboration
between care homes and GPs,
primary care teams, specialists
and others
3. Reducing hospitalisation
in the last stages of life,
enabling more to die in care
homes.
7 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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Low Back Pain Drop-In Clinic
Patients with lower back pain
are reaping the benefits of
early treatment, thanks to the
innovative and time-saving
service.
Patients access the spinal drop-in
service, available at 13 clinics across East
Lancashire, at their own convenience,
either following a GP visit, or as selfreferrers.
The service has proved incredibly
successful and resulted in a host of
beneficial outcomes including reduced
waiting times, gains in productivity
and reduced diagnostic requirements.
Most importantly the project has also
led to more patients being successfully
managed.
The service is run by experienced
physiotherapists who offer patients early
assessment, advice and reassurance.
Patients who attend following GP
visits are given invitation slips by the
GP, giving clinic locations and times,
and they can then ‘drop in’ without an
appointment, when it suits them.
Referrals are required for complex cases,
patients who don’t speak English and
require a translator or have learning
difficulties.
As soon as a GP passes on the invite, the
patient can receive a targeted treatment
that prioritises them as urgent or routine
- rather than being placed on a waiting
list.’ At the clinics, patients receive a
subjective 20 minute assessment in which
they are screened for red and yellow
flags, before being directed along the
most suitable pathway of care.
The team can then order diagnostics or,
if necessary, immediately refer patients
on to other specialists. The emphasis on
early assessment expedites the entire
pathway of care explains Gillian Rose,
Acting General Manager for Diagnostic
and Clinical Support at East Lancashire
Hospitals NHS Trust.
‘The spinal drop-in service allows
patients with low back pain to be
seen quickly, without an appointment,
by specialist physiotherapy staff in
community settings. This reduces
pressure and cost for GP and hospital
services, speeds recovery, and
allows safe fast tracking of serious
pathology.’
For more information regarding referrals
and invitation slips, please contact
Lesley Harper, Extended Scope Spinal
Practitioner on 01282 803 294.
Partnership in Speech and
Language Therapy Renewed
The adult Speech and Language
Therapy team has had a close
working relationship with The
University of Manchester over
recent years building a unique
academic-clinical partnership.
This has led to the creation of
a Specialist Aphasia Clinic, a
series of research collaborations,
developments in clinical services and
continuing professional development
opportunities. The team is delighted
that honorary contracts have now
been renewed for Professor Matthew
Lambon Ralph, Associate Vice-
President (Research) & Director of the
Neuroscience and Aphasia Research
Unit (NARU) and Dr Karen Sage, Senior
Clinical Lecturer in Speech & Language
Therapy (both pictured above).
The innovative Specialist Aphasia Clinic
provides guidance and advice to the
speech and language therapists in the
assessment and treatment of individual
cases of people with acquired language
difficulties. Additionally people with
aphasia who wish to participate in
research can be directed to appropriate
research projects within The
University of Manchester. It provides
crucial opportunities for clinic-to-basic
and basic-to-bedside translations of
clinical questions and research findings,
and for trialling and embracing evolving
SLT practice and new service needs.
The principles underlying the Clinic
are that it is locally based and driven
by the needs of people with aphasia.
Additionally, the Clinic fosters an open
and supportive environment to enable
both newly qualified practitioners
and specialist clinicians to develop
their knowledge and skills. For many
specialist and experienced clinicians,
opportunities for CPD in the field of
advanced aphasia practice are limited
and so the peer support and academic
liaison offered provides a rare forum for
learning through partnership.
NHSLA Level 3
Success
As you will be aware from the briefing
last month we were assessed by the
NHS Litigation Authority (NHSLA) on the
15th and 16th November 2012:
We are delighted to be able to inform
you that following the rigorous two
day assessment we maintained NHSLA
Level 3 and achieved the new standards.
We are still one of only a small number
of Trusts in the country to have been
awarded Level 3 status.
We were assessed against five standards
each containing ten criteria giving a
total possible score of 50. In order to be
successful Trusts must achieve a score of
at least 40. We scored 49 out of 50. We
were aware of the area where we were
not awarded compliance and had self
declared this prior to the assessment and
have taken action to address it.
All staff are to be congratulated on this
excellent achievement in particular, a big
thank you goes Pete Weller and his team
in the Governance Unit, the leads for
each criterion and the Divisional teams
who made the success possible. It is the
culmination of a significant amount of
work embedded organisation-wide over
a number of years and reflects the hard
work and dedication of our staff.
8 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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Pennine Lancashire Integrated Diabetes
Service Locality Services Communication
In March we informed you
of planned developments
in specialist diabetes care in
line with the commissioned
integrated diabetes service
model to provide quality
evidence-based diabetes
care in a greater range
of localities and increase
access to care closer to
home for people with
diabetes.
Consultant led locality diabetes teams
have now been established, and locality
services will see further development
during 2012/13.
The Consultant led teams will deliver
enhanced multidisciplinary diabetes
services in community localities and will
also work in closer collaboration with
GP practices, which will include patients’
care being reviewed jointly with their
own GP/practice nurse at their GP’s
surgery.
To improve access and communication
the key members of the locality
consultant led services are named below.
Note from October 1st all choose and
book referrals for diabetes and advice
and guidance will be triaged on a daily
(Mon – Friday) basis by clinical members
of specialist diabetes team for immediate
action, care will be delivered in localities
when appropriate.
The team leads for locality diabetes
specialist services are:
Blackburn with Darwen
(as part of the current community
diabetes service)
- Consultant Dr John Dean (01254
282708)
- GPwSI Dr Bhojani (01254 282708)
- Diabetes Specialist Nurse Nicky
Nuttall (01254 282708)
- Specialist Dietitian Helen
Loughnane (01254 734576)
- Clinical Specialist Podiatrist Jane
Musgrove (01254 734576)
Burnley
- Consultant Dr Manoj Mishra (01254
734051)
- Diabetes Specialist Nurse Christine
McLaughlin (01282 804795 Mob
07943822714)
- Specialist Dietitian Faith Taylor
(01282 602452)
- Clinical Specialist Podiatrist Joanne
Sinclair (01282 644184)
Hyndburn
- Consultant Dr Geraint Jones (01254
282404)
- Diabetes Specialist Nurse Janet
Sarsfield (01254 282404)
- Specialist Dietitian Anil Joshi
(01254 282404)
- Clinical Specialist Podiatrist Lesley
Baron (01254 282370)
- Clinical Specialist Podiatrist Sue
Hudson (01254 282404)
Pendle
- Consultant Dr Malcolm Littley
(01254 732562)
- Diabetes Specialist Nurse Helen
Cockett (01282 804813 Mob
07943822733)
- Dietetics Faith Taylor (01254
602452)
- Clinical Specialist Podiatrist Wendy
Mayo (01282 657623)
Ribble Valley
- Consultant Dr Robert Wilkinson
(01254 282404)
- Diabetes Specialist Nurse Susan
Starkie (01282 804457/01254
731031 Mob 07943822712)
- Specialist Dietitian Helen
Loughnane (01254 734576)
- Clinical Specialist Podiatrist Laura
Kaye - in post Jan 2013 (01200
413500)
Rossendale
- Consultant Dr Robert Wilkinson
(01254 252404)
- Diabetes Specialist Nurse Susan
Starkie (01282 804457/01254
731031 Mob 07943822712)
- Specialist Dietitian Anil Joshi
(01254 282404)
- Clinical Specialist Podiatrist Becky
Brown (01706 253345)
Acute Oncology Services to be Strengthened at Trust
The Trust is in the process of
enhancing the treatment and
delivery of cancer services, this will
improve the quality and experience
of care specifically for those patients
who present as an emergency
admission.
The Trust appointed Liz Schofield as the
first Acute Oncology CNS in May 2012 to
launch the Acute Oncology Service for
ELHT. We are looking forward to Tony
Eaton commencing in post in January
2013, as an additional Macmillan Acute
Oncology CNS.
We are also in the process of recruiting
Medical Oncologists who will play a key
role in assessing patients who attend
with an acute oncology presentation.
Following appointment of the Medical
Oncology Consultant posts it is envisaged
that all acute oncology admissions will
be triaged by the Acute Oncology CNS
team and also benefit from a Senior
Medical Oncology review if appropriate.
The two Clinical Nurse Specialists are
the point of contact for liaison between
primary care and the Trust for advice
on Acute Oncology emergencies. E.g.
neutropenic sepsis and malignant
metastatic spinal cord compression.
Pictured: Liz Schofield.
9 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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Combined Medical Antenatal Clinic
for Pregnant Women with Diabetes
We ask that GPs refer pregnant
women with diabetes early
to the combined medical and
obstetric antenatal clinics here at
the Trust where preconception
care is also provided.
Clinics are run at both Royal Blackburn
Hospital and Burnley General Hospital.
A recent audit showed that in spite of
national guidance:
• 26% of patients with diabetes
were not immediately referred
to the hospital medical antenatal
clinic by their midwife or GP
• 29% did not have their first
appointment by 9 weeks
• 24% were not booked by 10
weeks gestation
Women can be referred to:
- Diabetes Unit at Royal Blackburn
Hospital by fax: 01254 736032
- Diabetes Specialist Nurses Office, BGH
fax: 01282 804696 or by telephone
direct to the Diabetes Specialist
Midwife on 0780 836 4509.
NICE Clinical Guideline 63,
Diabetes in Pregnancy, 2008,
recommends that women should
be informed about the benefits
of preconception glycaemic
control at each contact with
health care professionals from
adolescence and that the
intentions regarding pregnancy
and contraceptive use should
also be documented. It is also
recommended that women
planning to become pregnant
should be offered preconception
care and advice before
discontinuing contraception.
The recommended dose of folic acid for
women with diabetes who are planning
pregnancy is 5 mg daily. This should
be commenced before conception and
continued through to 12 weeks of
pregnancy. Folic acid tablets purchased
over the counter contain only 400 mcg
folic acid which is not adequate for this
purpose. Folic acid 5 mg daily must be
prescribed and cannot be obtained over
the counter.
Diabetes UK Care Recommendation
2011, highlights that women planning
a pregnancy should have a medical,
dietetic, educational, drug, obstetric and
gynaecological history taken.
If the woman is taking any medication
that is not recommended in pregnancy
– e.g. ACE inhibitors, statins, diuretics or
beta-blockers – steps should be taken to
remedy this before conception.
Local MSK Physiotherapy Pilot study of the
EuroQol Patient Rated Outcome Measure (PROM)
All Trust MSK Physiotherapy
departments are to pilot a robust
PROMS system that meets NHS
contracts with local commissioning
teams. The pilot will run from
December 2012 to March 2013.
Service compliance and patient
focused health status will be
demonstrated.
The EuroQol (EQ-5D-5L) is a standardised
measure of health status, applicable to
a wide range of health conditions and
treatments and has widespread currency
outside the Physiotherapy profession.
It is one of the key measures chosen by
the Department of Health in England
in the current PROM programme. It
is supported by NICE and the Scottish
Health Department MSK expert group
for measuring change in health related
quantity of life.
PROM data will inform the CCGs so they
can:
• Measure & benchmarking the
performance of Trust Physiotherapy
services
• Enable Physiotherapists to monitor
and improve health care practices
• Regulate for safety and quality
Patients complete the Euroqul at the
start and end of treatment which
comprises five dimensions of health:
• Mobility
• Ability to self-care
• Ability to undertake usual activities
• Pain and discomfort
• Anxiety and depression
It is hoped that this data can be used in
conjunction with NHS East Lancashire to
use social marketing techniques in order
to reach those people who suffer the
greatest disadvantages.
For more information, please contact
Suzanne Folley, Extended Scope
Physiotherapy Practitioner, East
Lancashire Hospitals NHS Trust on
01282 804115
10 | GP e-brief | autumn/winter 2012 East Lancashire Hospitals NHS Trust
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