April 2023
University Hospitals Plymouth NHS Trust
Providing outstanding integrated care and making a difference to people's lives #1BigTeam
Patients waiting for heart bypass operations at Derriford Hospital will now have the opportunity to access a specialised prehabilitation programme offering advice and support on lifestyle management to be at their best for surgery and aid recovery.
Funding from the South West Clinical Network has enabled the appointment of a Cardiac Rehabilitation Nurse who will deliver group sessions on smoking cessation, diet and exercise programmes. Chloe Hutchinson will sit within the Community Cardiac Team run by Cardiac and Respiratory Teams Manager Kirsty Settle, one of the first patient services to come under the Integrated Care Partnership which began in 2021.
“The incentives for patients to be as fit as possible can significantly improve their outcomes for surgery and their post-surgical recovery,” said Kirsty. “Chloe will focus on delivering this pilot programme to around 50 patients currently on the bypass waiting list, and ensure they are receiving and enacting upon as much information as they can before going for surgery.”
The idea of a prehabilitation pilot project was first suggested at the Cardiac Steering Group – a selection of UHP, Livewell Southwest and primary care colleagues brought together through the Integrated Care Partnership as one of the first patient services to be brought under the ICP umbrella.
“Whilst the ICP as a whole can be complex, as we work through the initial years of the partnership, this prehab project is an exemplar of how bringing the specialist services in the city together provide greater services for our population,” said Integration Manager, Kathryn Taylor. “The group have been able to really strip back and focus on how our joined-up approach from UHP, Livewell and Plymouth City Council will make improvements to the patients in our region. Hence, this prehab project was seen as a quite simple solution, that we hope will have some really positive effects on those waiting for heart bypass surgery and therefore provide greater health outcomes for them.”
From the moment patients are identified by their consultant as appropriate for surgery, they will be immediately available to Chloe, who will invite them into the prehab pilot. Once their surgery is complete, they will continue on to the current cardiac patient pathway and join the rehabilitation programme delivered by the Cardiac Community team.
Consultant Cardiothoracic Surgeon at UHP Mr Adrian Marchbank, said: “I am very excited about the prospect of patients having cardiac surgery being offered this service, which has been shown to be very effective for patients having other types of surgery.
“It is good to see clinical staff in hospitals and the community are working together, as it has been my impression we have common goals but can approach these in different ways, so it is pleasing that we can start to demonstrate shared learning across organisations within the NHS and in social care.”
The Peninsular Cardiac Network has already had an impact in the delivery of cardiac services for patients in the ICP, supporting other key initiatives such as the MyHeart app which is available to patients on the rehabilitation programme.?
About the Plymouth’s Integrated Care Partnership
The Integrated Care Partnership is part of a longer journey towards integrated care, which began in 2014 with a vision set out by the Plymouth Health and Wellbeing Board. It also builds on the way partners have come together to respond to the COVID pandemic. For example, the large vaccination centres at Home Park and Derriford Hospital’s Centre for Wellbeing have been jointly run. Staff from UHP, LSW, NHS Devon, Plymouth City Council and the voluntary sector have worked together to engage with people to encourage them to take up the COVID-19 vaccine. This is just one of many examples of closer working. The Partnership will continue to work collaboratively with primary care, the voluntary sector and communities and patients and carers to develop and improve services.
Neonatal Intensive Care Unit shortlisted for Neonatal Nurses Association Awards 2023
Cassie Rogers and Bex Clarke, from the Neonatal Intensive Care Unit (NICU) at University Hospitals Plymouth NHS Trust (UHP), were recently shortlisted for the Neonatal Nurses Association (NNA) Team of the Year award.
The Plymouth NICU cares for babies born in Plymouth and other hospitals in the south west region who are born much earlier than expected (preterm) or who require intensive care if they are very poorly when born at full term.
The NNA award acknowledges a neonatal team and their incredible efforts, even during incredibly challenging times, to improve the neonatal experience for colleagues, babies, and families.
Róisín McKeon-Carter, Chair of the Neonatal Nurses Association, said: “The Neonatal Nurses Association searches nationally across all the neonatal units in the UK for the best work and contributions that neonatal nurses deliver in their roles. Each year we celebrate and reward these neonatal champions by awarding them with national recognised awards.
“Cassie and Bex were shortlisted for this award for their innovative working with other specialties, wider teams within the Trust, collaborative parallel planning, and showing commitment and determination to providing optimal neonatal care for babies and their families.”
Last year, UHP officially opened its newly transformed Intensive Care Unit (ICU) Secret Garden, the first of its kind in the south of England. The bespoke outdoor rehabilitation space now enables ICU ventilated patients to breathe fresh air in the company of their families, loved ones and carers. The NICU team have been keen to make sure that babies from the unit are also able to benefit from the garden.
Kate Tantam, ICU Specialist Sister, adds: “The Critical Care team were thrilled to be able to support the NICU team in their aspiration for providing fresh air care for their babies.?The Secret Garden is a space for everyone who needs it and we can't wait to support even more babies and families to enjoy the space wherever they are on their journey at UHP.”
The NICU team at UHP are keen regulars at the NNA awards. Last year, Jo Bennett, a Neonatal Nurse at UHP, won the Neonatal Nurse of the Year award. She said: “I wanted to put the award money to best use for families and, with the current cost of living crisis, help alleviate some of the pressures whilst they have a baby on the neonatal unit.
“I purchased a good stock of ￡40 Tesco vouchers to be given to parents to help with food, nappies, baby clothes etc. I also made up some emergency toiletry packs. These are for parents who might be staying in the parent accommodation but do not have access to their own toiletries.”
The NICU provides 14 intensive high dependency and six special care cots. They also host the regional retinopathy of prematurity (ROP) treatment centre for the Peninsula within the NICU footprint in a specially configured treatment / intensive care room.
To find out more about Plymouth NICU please visit:?https://www.plymouthhospitals.nhs.uk/nicu
You can also find out more about other initiatives led by the NICU team, such as the ‘Cuddle Bundle’ initiative to encourage more parents to have skin-to-skin contact with their babies during their stay in hospital, here:?https://www.plymouthhospitals.nhs.uk/latest-news/initiative-to-encourage-more-cuddles-for-poorly-babies-in-the-nicu-5635
Discharge Lounge team breaking records to support patient flow
The issue of how we keep patients flowing through the hospital, freeing up beds and creating space for new admissions is one that is wrestled with daily. For Kellyann Whalley, the Senior Sister in charge of our Discharge Lounge, it’s a question that she spends a lot of time thinking about.
“We are fundamental to the function of the of the hospital,” she explains. “There is always a lot of focus on the front doors.?I like to think of us as the back doors.”?
Since opening in December 2019, Kellyann and her team have rapidly expanded the Discharge Lounge from five days a week, to running across the weekend. Recent weeks have seen them breaking their own records, discharging 58 patients over a 12 hour period, with over 2700 patients passing through the lounge this year, 461 more than the same time period last year.?
You can find the Discharge Lounge on level 3 where its location gives direct access to outside making transferring patients to transport simple.?The lounge has 20 chairs, 2 of which are suitable for bariatric patients and space for 2 stretchers.?
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It is an ideal location for patients awaiting medication or discharge, letters for example, to wait as they can move from the ward and stay in a comfortable space while still being cared for by a nursing team until they are able to leave hospital. This, in turn, frees their hospital bed on the ward to be cleaned and made ready for the next patient.??
The aim is to for patients to spend a maximum of 2 hours in the unit before leaving. Coming from the ward dressed and ready to home further speeds up the process.?
The three nurses and additional three HCAs who work in the mornings can wash patients, apply dressings, and administer IVs.?“One of the great things about my role is that I can get involved and still have hands-on contact with patients,” says Kellyann, “I would really miss that if I didn’t get to do clinical.”
There are also two regular volunteers, who do vital legwork like tracking down medications from wards and reuniting it with patients, all of which can be a major barrier to patients leaving promptly.?
For many of the older patients the discharge process can be complex and need careful planning.?Some go into care settings and need transport pre booked, any delays have a knock-on effect meaning they spend longer in hospital.?“We are the key to patients getting home and I get great satisfaction from knowing that we have looked after and successfully discharged them.”
Kellyann has ambitions to grow the service further. “I’d love to have a bigger nursing establishment and to have more treatments rooms where we could ECGs and scans for example.?I have a fantastic team here already and it would be great for us to be able to offer more things to patients to help make their discharge run more smoothly.?Our volunteers do so much but we always have capacity for more.”?
If there is one message that Kellyann would like everyone to know it is that there are very few patients the Discharge Lounge can’t take. “A lot of time we see on Salus that a patient is not suitable for us when it isn’t always the case”, she explains.?“We can take all your patients and I’m always happy to discuss them moving to us.?Call me, talk to us, don’t assume we can’t help because we almost certainly can.”??
Second wellbeing room opens for staff at Derriford
A second wellbeing room for staff at University Hospitals Plymouth’s Derriford Hospital has opened. Following the success of the first wellbeing room, an additional space has been opened for staff to have a place to relax and take a break.
Sarah Hamley, Site Services Administrator and Sylvia Piper, Space Utilisation Manager designed the room. Reflecting on the success of the first wellbeing room, Sarah said “The space was so well used, and we got so much positive feedback from staff, we realised how important these spaces are for staff to have five minutes away from their wards and breathe”.
The pair designed the space to be beach themed, with a beach hut mural and skylight. Sarah said, “Ever since we worked on the first wellbeing room we’ve been itching to create a costal themed room, the beach is my favourite place to be as a Plymothian”. Sylvia added: “We wanted to bring the theme of our costal city into the hospital and create a brief escape from the clinical environment”.?
The room offers tea and coffee making facilities, with microwaves and comfortable seating. Ann James, Chief Executive, praised the space as a place for staff be able to “Sit and take a moment to be able to decompress”. She praised the team and Mental Health Champions’ hard work to create such a “beautiful and tranquil” space.
The space was also designed to be a breakout room for departments such as Hotel Services who do not have a designated break space. Sarah said, “We went for lots of dining tables and comfortable seating to make a practical space for staff to take a break”. Sylvia said: “We designed this space to be more of a social environment, that way the wellbeing room on level 5 could remain a quiet space for staff to enjoy”.
You can find the level 6 wellbeing room to the right of Warrens on the main concourse, the entrance is next to the Hotel Services Operational Office.
Breast screening bus hits the roads of Plymouth
Thanks to funding from NHS England, The Primrose Foundation and the West Devon and East Cornwall Breast Screening Programme, a signwritten bus will be making its way around Plymouth reminding people of the importance of breast screening.
Each year over 25,000 people attend their breast screening appointments, with 400-600 breast cancers being diagnosed and treated. However, there has been a dramatic drop in the number of people attending their breast screening appointments both nationally and locally.
It is hoped that this new eye-catching double-decker bus will transport the important message of breast screening across the city and help to promote the Primrose Breast Care Unit at University Hospitals Plymouth NHS Trust (UHP) while encouraging people who are eligible to attend their appointments.
Dr Karen Paisley, Director of Breast Screening at UHP, said: “This is a great initiative to try and improve uptake for breast screening. We know that the impact of screening in saving lives from breast cancer is greater the more women that attend for their screening mammogram.
“Screening saves about 1 life from breast cancer for every 200 women screened, as cancers are diagnosed and treated earlier than they would have been without screening.?Unfortunately, there has been a drop in uptake recently and overall uptake in our local programme was only 72.5% in 2021/22, a drop of nearly 8% in the last 10 years (78.5% in 2010/11) and is as low as 54% in some areas of Plymouth.
“While this compares favourably with national uptake (62.3% in 2021/22, a drop of 15% since 2010/11), we are working hard locally to explore the reasons for non-attendance and to try and address these, ensure equity of access and improve uptake and, consequently, the mortality benefit of breast screening.”
The bus has also been partly funded for by money raised by a group of nine local women who are part of a group called 'Dare 2'. Each member had received a breast cancer diagnosis and subsequent treatment at the Primrose Breast Care Centre at UHP and wanted to do something to raise awareness about the importance of attending breast screening appointments when invited. Through a charity dance last autumn, the group raised almost ￡12,000 which went towards the bus campaign.?
The Plymouth Citybus owned double-decker features the slogan, 'Breast screening saves lives – Always attend your free screening appointment’ as well as pink, yellow and grey colours which represent The Primrose Foundation, a charity which helps fund and support the Primrose Breast Care Unit. It will be on the roads of Plymouth for 12 months from April 2023 and will be used on routes across the city, primarily targeting areas where breast screening uptake is known to be particularly low.
How to check your breasts
As well as attending breast screenings when invited, it is important that all women regularly check their breasts and discuss any changes with their doctors immediately.
The?NHS Breast Screening Programme ?has produced a 5-point plan for being breast aware:
Look at your breasts and feel each breast and armpit, and up to your collarbone. You may find it easiest to do this in the shower or bath, by running a soapy hand over each breast and up under each armpit.
You can also look at your breasts in the mirror. Look with your arms by your side and also with them raised.