July 2024

UHP Awarded IQAS Reaccreditation

The Immunology team at University Hospitals Plymouth NHS Trust (UHP) have been awarded a reaccreditation for Improving Quality in Allergy Services (IQAS)by the Royal College of Physicians.

The Peninsula Clinical Immunology and Allergy service is a specialist tertiary service operating across the whole of Devon and Cornwall. The team made up of just over 30 members of staff, are based in the Eden unit of Derriford Hospital and are one of only nine accredited allergy services in the UK.?

With up to 44% of adults in the UK suffering from an allergy according to Allergy UK, the department continues to see an increase in demand, with the team working tirelessly to give patients in the Peninsula the best care possible.

Christine Symons, Immunology Nurse Consultant, said: “Our service covers a range of allergies, from hay fever which we see a rise of in the summer, to food allergies and venom allergies such as bee and wasp stings.?

“We also do a lot of work around drug allergies – it is common for patients who get reactions to penicillin, such as a rash, to be labelled with a penicillin allergy when it might not be an allergy, so we do a lot of work trying to undo that to better understand the root of the patient’s allergy, which widens the access patients have to appropriate antibiotics.”

The process for the IQAS accreditation has strict and robust standards that the service has to meet in order to receive the accreditation.

Rebecca Wosley, Immunology Quality Manager, praises the hard work of the team who made the reaccreditation possible: “The Eden Unit team is tremendously dedicated and hardworking, they go that extra mile for their patients. The whole team pulled together to provide the information that was required to meet the IQAS standards, and this reaccreditation demonstrates the excellent service they provide. It’s a huge achievement to come through an external inspection without any findings for the team to action, and the team is really proud of this outcome”.

The IQAS report summary states: “The service has provided evidence of a cohesive, flexible, and innovative team working which is led by collaborative leadership. It is evident that providing care to patients at a high standard is at the heart of what the team do, and the excellent patient feedback is testament to this.”

The report also found that the team was well led and cohesive, with members of different professional groups working well together. It praised the flexibility and resilience of the team for managing the “enormous growth” in workload over the last ten years, and the team’s dedication to making patients feel listened to and involved in their treatment. The patients interviewed for the assessment reported being “very well treated by all the staff” and giving examples of their “friendly yet professional approach”.

Although, the hard work has not stopped here for the team. In June, they went through the same process for the Primary Immunodeficiency service with the RCP QPIDS reaccreditation scheme. Feed back was very positive on the day and the Team are now eagerly awaiting the published report.

UHP to help Plymouth residents shape future of health technology in their homes

University Hospitals Plymouth NHS Trust (UHP) are supporting Plymouth Community Homes (PCH) on a ‘digital living lab’ project which will explore the impact of digital health technology within the homes of PCH residents.

Working with the Centre for Health Technology at the University of Plymouth and Livewell Southwest, the project is funded by global IT firm Cisco, through their Country Digital Acceleration initiative, bringing new partners into The Lister Alliance, a healthcare innovation programme.?

The project aims to establish a ‘Plymouth Living Lab’, seeking to address frailty management in the home environment, supported by PCH’s ‘Health and Housing’ partnership with Livewell Southwest. Led by the Centre for Health Technology at the Unviersity of Plymouth and PCH, the ‘Plymouth Living Lab’ is set to be one of the largest in the world, and will be developed by a network of local, national and global partners, which include UHP, Livewell Southwest, Plymouth City Council, NHS Devon and Health Innovation Southwest.

The Lister Alliance’s mission is to embed digital technologies seamlessly across the NHS. They work with NHS Trusts, key partners and academics to create Living Labs, demonstrating new ways to deliver accessible, efficient and personalised healthcare. PCH is a high performing housing business and Plymouth’s largest social housing landlord, with over 16,000 properties providing homes for more than 35,000 people.

The project will focus on older individuals with frailty, and PCH residents will be provided opportunities to help co-design technology, such as sensors in the home and wearable devices. Piloting these various new technologies, that aim to help them remain independent in their own homes, will support the system shift to care delivery away from hospitals to care in peoples’ homes.

This research aims to demonstrate whether and how home-based technologies can both improve the health and well-being of older people with mild to moderate frailty. Wider use of home-based technology supports the management of conditions and care in the community, prevents deterioration and reduces hospital admissions, offering better quality of life for individuals and reducing pressure on the NHS, supporting the local health system and its staff.

At this early stage of the partnership, the investment secured from Cisco will support a PCH based user engagement researcher. This researcher will work with residents, staff, medical professionals, social care staff, and other voluntary organisations to support the co-design, piloting and evaluation of the home-based technologies. Creating a collaborative and safe environment for new technologies to be tested directly with the end users.

Rachael Fox, Partnership Project Manager, said: “The Health and Housing Partnership is all about how we can work together with other organisations to deliver services that support the health and wellbeing of our residents. Enabling them access to test new technology that supports their independence at home is an exciting step forward’’.

“I am proud that PCH is leading the way in bringing housing and health services together. The ‘Plymouth Living Lab’ gives our residents an exciting opportunity to support our local health services, transforming the way they deliver care in the community, and shaping how the system can support people to remain independent in their homes’’.

“I look forward to sharing more with our residents as the project develops.”

Jonathan Cowie, Chief Executive at PCH, said: “We are very proud to be pioneering Plymouth's Living Lab project through our partnership with Livewell Southwest, and it's exciting news this w]ill one of the largest ‘living labs’ in the world.?

"Working with world class organisations including the Centre for Health Technology and CISCO will allow us to form new global partnerships as well as creating positive outcomes for our residents, who will not only play a key part in this exciting research but be able to benefit from brand new technology to help them in their daily lives.?

"Projects like this demonstrate the real, tangible impact partnership working can bring about, for local people as well for innovative technology companies, and I'm delighted PCH is leading the way in demonstrating this."

Professor Sheena Asthana, Director of the Centre for Health Technology, said: “There is an urgent need to shift the balance of care from expensive, reactive hospital treatment to prevention, earlier diagnosis and care within the community (the ‘shift left’ agenda). Digital transformation can support this agenda. To date, however, digital innovations have tended to be introduced in acute as opposed to community settings, supporting hospital discharge rather than hospital avoidance. By providing the necessary conditions to develop home-based technologies that work for end users and support the need to shift left, the Plymouth Living Lab will be leading the way in helping us to visualise what safe, effective and cost-effective health and care could look like in the future."

Liver transplant patients at UHP to receive prehab via an app in UK first

University Hospitals Plymouth NHS Trust (UHP) is working with a telehealth company to deliver digital prehabilitaiton (‘prehab’) services to liver patients across Devon, Cornwall and Somerset.

The year-long trial with the South West Liver Unit at University Hospitals Plymouth NHS Trust will see?50 patients undergoing assessment and listing for liver transplant. If successful, the service may be expanded to patients living with other liver diseases and who currently are not on the list.

Prehab is a relatively new area of healthcare that focuses on improving the general health and activity of patients before surgery and treatment as a way of aiding their recovery.

Each patient will be able to access their individualised programmes via an app. Exercise classes and support sessions will be delivered by a combination of phone, Zoom or Skype calls. Those patients who do not have access to suitable technology will be able to loan equipment from the South West Liver Unit during the trial at no cost to themselves.

Patients who complete a prehab course prior to planned surgery are less likely to be readmitted to hospital, enjoy improved health-related quality of life, return to work earlier and need less involvement with social and primary care providers.

The aim of the trial is to demonstrate two pivotal elements:

• The feasibility of remote delivery of prehab and the benefits in health-related quality of life for patients awaiting liver transplant
• How the time spent waiting for surgery can be utilised in a positive and clinically effective manner, as 50% of patients listed for transplant typically have a wait of six months or more

“We’re very excited to have the opportunity to expand much-needed support to our patients here in the south west,” said Professor Matthew Cramp, Consultant Hepatologist at the South West Liver Unit, UHP.?

“Liver transplant patients face many challenges and to be able to provide a personalised prehab service while they wait for their surgery is something we’ve been keen to offer for some time. Having the consistency of supervision by a prehab specialist we hope will lead to a lower risk of complications post-transplant and improve quality of life both pre and post-operatively.”

The digital programmes and resources run will be specially developed to cater for the clinical and holistic needs of liver patients in collaboration with the hospital team.

The 12-month trial will be evaluated through standardised patient reported outcome measures and physical assessment scores.

Teleheath company QuestPrehab founder Professor Tara Rampalsaid: “Waiting for a liver transplant is an extremely anxious time for all patients. They face the uncertainty of when they will be called up for the transplant whilst also dealing with the consequences of advanced liver disease and the worry that their condition may deteriorate during this time.”

“Patients will receive a highly personalised programme based on four key areas – physical activity, anxiety management, diet advice and lifestyle modifications – with a goal of alleviating their level of anxiety and improving their liver frailty score.”

Infection Prevention at University Hospitals Plymouth NHS Trust celebrated in national awards

The Infection Prevention and Management team at University Hospitals Plymouth NHS Trust were in the spotlight last month, as part of a national campaign to underline the importance of clinical audit and quality improvement in enhancing patient care. They have been announced as a winner of the Influencing Change category of the Clinical Audit Heroes awards hosted by Healthcare Quality Improvement Partnership (HQIP), which are an integral part of Clinical Audit Awareness Week.

Clinical audits review and measure healthcare, often in relation to local and national standards and targets. They are an effective way to determine if services are performing as they should and, if not, identify where changes are needed. They also help healthcare providers and patients alike to understand how their service is performing, and where improvements could be made. As such, the work of clinical audit teams is essential, both as drivers of improvement in their own organisations and in supporting scrutiny of our health system at a national level.

Matron Catherine Ford and Biomedical Specialist Practitioner Annette Koshti-Richman at UHP said: “We are delighted to be recognised in the Clinical Audit Heroes awards. By taking an evidence-informed approach to improvement projects like this we help to target change where it will have the greatest impact.”

Chris Gush, CEO of HQIP, explains: “Without clinical audit, we would lack the necessary insights to understand what is working well and, crucially, what is not. By measuring our healthcare services and tracking the differences that improvement activities make, clinical audits are directly contributing to saving and improving patients’ lives.”

They were recognised for the Biomedical Devices monthly prevalence audit and its part in enabling the Electronic Urinary Catheter Assessment and Monitoring (eUCAM) project which aims to improve urinary catheter care and management.

The judges stated that it is a clearly structured clinical audit with demonstrable changes in practice, including an electronic form and guidance at the point of care. Clear improvement was evidenced, with reduced catheter use and reduced avoidable infections.

New Bigbury Orthopaedic Surgical Suite is now open

University Hospitals Plymouth NHS Trust (UHP) is pleased to announce the opening of the new Bigbury Orthopaedic Surgical?Suite. The new surgical suite is now fully operational and saw its first patients go through the three dedicated elective orthopaedic theatres in June.

Located on level 2 of Derriford Hospital, the theatre facility will support complex and non-complex orthopaedic operations and provide an excellent teaching environment for orthopaedic trainees.

The commencement of the new theatres will substantially increase the number of orthopaedic cases being treated, which will enable UHP to reduce waiting lists and treat patients more quickly.

Mr. Rathan Yarlagadda, Consultant Orthopaedic Surgeon and Clinical lead for Elective Orthopaedic Recovery, said:?"The introduction of the Bigbury Orthopaedic Surgical Suite has greatly enhanced our capacity for orthopaedic surgery, including hip and knee replacements.? This state-of-the-art surgical unit, combined with our improved patient pathways, will allow us to perform a higher volume of procedures each day, thereby reducing waiting times and significantly improving access to essential orthopaedic care for our patients."

Teams at UHP complete first UK Navigational Bronchoscopy with digital fluoroscopic navigation

Teams from University Hospitals Plymouth NHS Trust (UHP) performed the first Electromagnetic Navigational Bronchoscopy (ENB) biopsy case in Devon and Cornwall, and the first case in the UK which incorporated digital fluoroscopic navigation.

The Thoracic Surgery and Respiratory Medicine teams at UHP came together last week to perform an ENB procedure for first the time in Devon and Cornwall.?UHP was able to undertake this new procedure, thanks to NHS England Funding, which provided the necessary equipment last year to help with diagnosing lung cancers more accurately.

ENB is a day case procedure performed under general anaesthesia to biopsy lung lesions by inserting a telescope in the patient's windpipe and using a "GPS" system (based on the patient’s CT scan) to navigate to where the lung tumour is to accurately biopsy the lesion. What makes the procedure at UHP even more unique is that digital fluoroscopic navigation was also used to increase the accuracy of the biopsy by calibrating the “GPS” in real-time.

Currently CT-guided lung biopsy remains the preferred method to biopsy lesions on the periphery of the lung. However, lesions deep in the lung are notoriously difficult to biopsy and traditional bronchoscopy methods only yield a success rate of 40-50% meaning many patients may not get a conclusive diagnosis before surgery or other treatments. ENB takes this success rate to over 60% and ENB with digital fluoroscopy takes this to in excess of 75%.?

Other thoracic centres in the UK, although utilising ENB, have not yet adopted concurrent digital fluoroscopy, making UHP the first in the UK to deliver the full recommended procedure.

Lung cancer has the highest mortality of all cancers in the UK and the world. By diagnosing lung cancers early, patients are more likely to be able to be cured, rather than requiring palliative treatment.

Talking about the procedure, Mr Priyad Ariyaratnam, Consultant Thoracic Surgeon at UHP, said: "We are delighted to have brought Electromagnetic Navigational Bronchoscopy (ENB) to UHP as a collaboration between the respiratory medicine and thoracic surgery departments.”

“The cutting-edge day-case biopsy procedure will allow us to diagnose early-stage lung cancers more accurately to improve survival whilst also allowing us to label lesions as benign with more confidence. The procedure complements the minimally invasive thoracic surgery ethos that we have proudly cultured here at UHP over the last decade.

“Although early days, ENB will help put UHP at the forefront of delivering on national targets in lung cancer.”

In the UK, lung cancer screening has been introduced to help pick up lung tumours early. However, once these tumours are located, they will still need to be biopsied to inform what treatment the patient requires.

ENB, especially when assisted with digital fluoroscopy, will enable UHP to provide patients with more accurate biopsies and the most appropriate treatment plans.

For more information on the Thoracic Surgery and Respiratory Medicine services at UHP, visit our website.