August 2016

3 / Introducing our new CEO4/5 Safety steps: ward walk round7 / Our super slimmers

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Reducing the amount of antibiotics we prescribe unnecessarily at UCLH is a priority following global concerns about the rise in drug-resistant bacteria.

Lead antimicrobial pharmacist Preet Panesar (pictured front cover) is working with medical director Charles House, chair of the antimicrobial CQUIN delivery project, and colleagues throughout UCLH to cut antibiotic use over the coming year, as part of a CQUIN target.

“Imagine a world without effective antibiotics – it is a frightening thought,” said Preet. “A recent report (Tackling drug resistant infections globally) warns that, without policies to stop the spread of antibiotic resistance, deaths could rise to 10 million every year. That is more than the current death toll from cancer.”

The following should be considered whenever prescribing antibiotics:

Only start antibiotics if there is evidence of bacterial infection. Follow the antibiotic guidelines on the Micro Guide app. Carbapenems, such as meropenem, should only be used as a last resort and all prescriptions must be approved by microbiology before use.

All antibiotic prescriptions must be reviewed within 72 hours and details of the review recorded in patient medical notes. STOP antibiotics/IV to ORAL switch/CHANGE antibiotic/CONTINUE and review again in 48 hours or refer patient to OPAT.

Medical director Charles House said: “Every front-line member of staff – whether they work in theatres, radiology, pharmacy, A&E or inpatient wards – needs to be willing to challenge or question decisions relating to antibiotic use if they feel a course of action is no longer appropriate. We all have a responsibility to do all we can to tackle this global risk.”

News

Meet the teamProduced and designed by: The communications department

Front cover photo: Pharmacist Preet Panesar is part of a UCLH-wide project team working to cut antibiotic use over the coming year.

Inside Story magazine is published by UCLH (University College London Hospitals NHS Foundation Trust) for our staff

Contact us If you have any information you would like included in Inside Story or on Insight, contact: Communications department, 2nd Floor Central, 250 Euston Road, London NW1 2PG. Email: communications@uclh.nhs.uk Tel: ext 79746 Fax: ext 79401. Visit us online at www.uclh.nhs.uk

Tackling antibiotic resistance

Flu and you: survey resultsThe flu vaccination season will be arriving soon – start talking to your colleagues about the flu jab and how it can protect you.In a survey we asked UCLH staff why they had the flu jab last year. This is what you said:

Didn’t have the vaccine? What might persuade you?

35% to protect myself

25% protect my patients

9% I get the vaccine every year

7% I felt obliged

4% other

20% protect my family

13% Other

33% Clinical data about vaccine effectiveness

27%nothing will persuade me

10% Time to leave the ward/department

9% Better access to the vaccine

7% More communications about where/when vaccine is available

1% More encouragement from senior management/clinicians

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Professor Marcel Levi to join UCLH as chief executive

Word on the Tweet...

Follow us: @uclh@DrJoanneFarrow Thanks to @uclh @MDT_Diabetes and @NightscoutProj - my T1 son had clinic today & his HbA1c was 5.2% or 33!

@Matineegirl A MASSIVE #ff @uclh to the BRILLIANT team on T10S for your brilliant care after my hip op. You guys were absolutely AMAZING!! @NHSMillion

@henryfrench_ICR I love the #NHS. Fabulous service at A&E today @uclh Thank you. (I have a fractured rib.)

@PrisEyiah I would like to thank staff @uclh EGA for a splendid prenatal and delivery. Excellence from admin to midwives. #grateful

@joeflatman wonderful, friendly and efficient physio service @uclh this morning. True professionals at the top of their game #LongLivetheNHS

UCLH is pleased to announce the appointment of Professor Marcel Levi as its new chief executive. He is due to take up his post on 3 January 2017, succeeding UCLH’s current chief executive, Sir Robert Naylor.

Welcoming the announcement, UCLH chairman Richard Murley, said: “I am delighted to welcome Marcel to London from The Netherlands. We conducted an extensive international search for our new chief executive and in Marcel we have found an exceptional leader with a strong track record in medicine, management, education and research. I am confident that he will inspire colleagues across UCLH to continue to be the best that we can be.”

Marcel said: “It is a great privilege to become chief executive at a Trust with UCLH’s reputation and history. I am fortunate to have been part of an excellent team at the Academic Medical Center in Amsterdam for more than 25 years and I look forward to working with UCLH patients and staff to deliver top-quality patient care, excellent education and world class research.”

Sir Robert Naylor will retire from UCLH on 30 September 2016. Neil Griffiths, deputy chief executive, will become interim chief executive until 3 January 2017.

UCLH’s Council of Governors has agreed to extend Richard Murley’s term as chairman for a further six months until the end of 2017 to support the transition to the new chief executive.

Dr Mike Loosemore, consultant in sport and exercise medicine at the UCLH Institute of Sport, Exercise and Health and lead sports physician for the English Institute of Sport, is pictured here setting off for Rio to join the Olympic Games as deputy chief medical officer for the Great Britain (GB) Olympic team, primarily looking after the boxing team.

Dr Loosemore has been involved with five Olympic Games and five Commonwealth Games. His priority while in Rio will be to

look after the physical and mental wellbeing of the GB teams.

“Athletes are not like the rest of us,” said Dr Loosemore. “Whatever health problems they might have, they will want to play their sport even if they are unwell. As doctors, we need to have intimate knowledge of how our athletes tick and be involved in every aspect of their routine. It’s the greatest show on earth and we want to make it as joyful and successful as possible for them all.”

The medicine behind the medals

Fact file: Consultant physician, specialising in haemostasis and thrombosis, and leads an active research programme

Chairman of the executive board, Academic Medical Center, University of Amsterdam

Former chairman, Department of Medicine and Division of Medical Specialisms, University of Amsterdam

News

10% Time to leave the ward/department

9% Better access to the vaccine

7% More communications about where/when vaccine is available

1% More encouragement from senior management/clinicians

In the know

Spotlight

Improving our care

With a checklist in hand, matrons, nurses, volunteers, governors, environmental monitoring officers, visit the wards throughout University College Hospital keeping their eyes and ears open.

“It’s about getting a different perspective, new eyes to see afresh any safety issues that may be unnoticed by the regular staff,” said Sarah Jordan, a ward sister on T14 North.

Improving care rounds were introduced in 2013 following the CQC pilot inspection and have continued since then. Sarah Jordan, accompanied by Quality and Safety manager Maria Adiseshiah, pulls at a drug cupboard and finds that it’s not as secure as it should be. It is quickly remedied.

But, on the whole, there’s a positive mood.Sarah added: “It shows what needs to be done, what

improvements need to be made and that’s helpful to ward sisters like myself. There is lots of good practice too and many of the checks are 100 per cent.”

Afterwards, the UCLH participants meet to discuss their findings including things that need action: unlabelled sharps bins, an out-of-order check-in kiosk.

The elderly medicine ward on T10 North receives praise. “The bed boards were 100 per cent up-to-date, oxygen had been prescribed, and dispensers were full of alcohol gel,” said Diana Scarrott, lead governor for UCLH, who was on this particular round.

The team visited all the inpatient wards except Acute Medical Unit at University College Hospital, including the Elizabeth Garrett Anderson Wing. On this occasion they focused on safety checks and the environment. Others focus on issues such as ward culture, staff or patient experience, training and safeguarding. Their findings are relayed to the divisional managers, who then liaise with their ward teams.

Maria Adiseshiah said the improving care rounds aim to help colleagues make and sustain improvements which in turn impact on patient safety and the experience of both patients and staff. Their findings feed back into divisional action plans.

Maria said: “By bringing in the ‘fresh eyes’ of staff and volunteers from different disciplines we often identify concerns that staff may be struggling to resolve which can then be highlighted with the divisional management team.

“Also, we encourage staff to showcase what they are proud of and when they have overcome challenges.”

The methodology is based on what the CQC expect to see in a hospital rated as ‘good’. This was the first time UCLH volunteers joined the walk round and they bring a valuable perspective.

The improving care rounds will continue fortnightly from next month. Would you like to join the walk round teams? If so, please contact victoria.sloggett@uclh.nhs.uk.

Bed boards fully updated in one ward, clutter-free corridors in another, a calm atmosphere in the third: just some of the observations made by a UCLH team during their recent improving care walk round.

6 In the know

Nursing in surgery is fast paced, evolving and demanding. A combination of pressurised targets and specialist nursing requirements for anaesthetic, scrub and recovery has meant that it has been difficult to attract nurses to this critical and rewarding clinical area. That changed this month when, after an 18-month long initiative coordinated by Oscar Fernandez-Saborit, senior matron, the vacancy rates for scrub and recovery nurses have been reduced from 40 per cent to 0 per cent and for anaesthetic nurses from 50 per cent to 30 per cent.

Oscar said: “It’s unprecedented. We have shifted from having a high reliance on temporary staff to recruiting and training staff to our own standards, so much so that some student nurses have told us that they’re desperate to work in theatre. This is unusual for us to hear.”

Lorraine Szeremeta, deputy chief nurse, added: “This shows the results that can be achieved when we work in partnership, especially

with our recruitment and bank colleagues. Thank you to everyone who contributed to this valuable initiative.”

Armela Magtangob is lead theatres practitioner and helps to support the new recruits. She said: “We are a very busy department in a very busy hospital trust, so the recruitment of more theatre nurses will have a good impact for both our patients and staff.”

A recruitment challenge remains in the anaesthetics team but this is an issue that affects trusts not only in London but also across the country. The 20 per cent reduction so far in the team’s vacancy rate is encouragement to build on that initial success.

Oscar said: “Even when we had high vacancy rates we still managed not to cancel operating theatre lists. We want to continue achieving reductions. All in all, it’s been an extremely positive experience.”

New recruitment drive boosts surgery department

Great team work, great team results.

Actor Dominic created the Joy Through Art foundation to bring interaction and entertainment to older people. UCLH Voluntary Services invited him to share his experience of how his work has enriched the lives of older people.

What does Joy Through Art offer and why do you do it?We’re a US charity that enables professional artists to bring music and theatre to residents in their nursing homes, becoming part of each other’s extended family.You’re also a musician and play rhythm guitar. What is your favourite music?There’s only two types of music – good and bad! My taste is eclectic but you’ve got to have a good rhythm and a changing tempo.You’ve acted in some high profile series, including The Sopranos and The Godfather Part II. What roles would you still like to play?I’d love to play Fagin again in Oliver Twist and also Don Quixote.What piece of advice would your older self, give to your younger self?Definitely to listen more – listening is the best thing anyone can do for someone else.You’re an accomplished tenor. Who would you most like to sing with?My favourite is four-part harmony and I love to sing a cappella.What greater support could be given for older people?The most important thing is to feel loved, to have intimacy and to dispel loneliness. As an older person myself now, we need what we’ve always needed – love.Apart from the Joy Through Art foundation, what is your passion in life?Writing songs and lyrics. Improving your craft is a big thing for me.

60 seconds with... Dominic Chianese

Before

Before

Before

Before

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Josie Turgill-Clarke, radiographer, University College Hospital

Lost: 1 stone 7lbs“I was born chubby,” laughed Josie whose ultimate aim is

to lose five stone. “This diet suits me, I can still have a treat and haven’t lost my social life. What I’d love is to feel happy in my own skin and buy something without panicking about

how it’ll look. The results are already showing.”Out: take-out pizza on night shift

In: a uniform that’s already one size smaller

In the know

We’ve lost weight, gained vitalityOne hundred members of staff signed up to the healthy eating plan. So far 84 have completed a free 12-week introductory membership organised by UCLH and Slimming World. The course, organised and promoted by our occupational health team, supports the Five Year Forward View to promote health and wellbeing in the NHS workforce. It was supported by UCLH Charity.

Since stepping on the scales just three months ago, our slimming recruits have shed more than 40 stone (585 Ibs) between them – that’s a mountainous 265 bags of sugar!

After

Caroline Thould, radiographer, University College HospitalLost 1 stone 13Ibs (her target weight)

“I’m back into my normal scrubs at work. I can climb two steps at a time without getting out of breath and it has given me more confidence. It is not a diet – it is a healthy eating plan and helps you change bad habits in the longer term. It’s brilliant!”

Out: cheese on toast, processed ready meals, sweet treats in the staff room

IN: steamed salmon and vegetables and home-cooked mealsBefore

After

Maree Bodycomb, senior nurse, RNTNEHLost: 2 stone 7lbs

“This eating plan really works and everyone has been so encouraging,” said Maree who put on weight after a cycle accident and knee injury. At her heaviest she weighed 17 stone and her joints were feeling the strain. “Losing weight is already making my life easier – my mobility is getting much better.”

Out: chips, pasties and TV snacksIn: a balanced diet and distracting myself! AfterBefo

re

Matthew Fenty, claims department, 250 Euston Road.Lost: 1 stone 2 IbsMy aunty who also works for UCLH saw this photo (left) from Get Active for Work Week last October and let me know I had put on weight. Having to step on the scales each week is a great motivator. For me it’s been more about adding food like veg to my diet, rather than cutting out food.”Out: counting caloriesIn: masses of vegetables to boost metabolism and more

gym AfterBefore

Before

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An inter-hospital swimming competition at John Astor House, the nurses’ home for The Middlesex Hospital. The home, which opened in 1931, was built with a swimming pool in the basement and a tennis court at the back so that the nurses had areas where they could exercise regularly. Both the swimming and inter-hospital tennis competitions were hotly contested by the nurses.

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Inside out

Nice neat little marigolds, manicured lawns, fragrant roses and ornate bird baths: the quintessential English country garden. “Ugh!” says Clive Pankhurst, UCLH lead for volunteer services, bee-keeper and grower of all things scary.

Carnivorous plants that trigger-trap their prey before slowly suffocating it and digesting them with deadly enzymes; two foot high blood-red Sarracenia that drug their insect victims with dopamine before dissolving them slowly or Sundew, its delicate tentacles droplet-laden with glue.

But by far the most toxic is Ricinus, which has seeds a thousand times more deadly than powerful poisons. Why Clive, why?

“I have always been passionate about exotic plants, ones that make you feel as if you’re in a jungle,” explains Clive, who studied botany at university. “I like undulating paths, wild and self-seeding plants with big leaves or unusual characteristics. At the end of the working day I like to walk around the garden, it is calming, an escape.”

His love of Venus fly traps stems from an experience as a young lad. “My parents bought one at a garden centre on holiday and I had the plant on my lap on the car journey back from Cornwall. I had a lot of time to look at it. It was an amazing, clever thing and I was fascinated by the science behind it.”

The team from BBC’s Gardeners’ World admired his botanical garden in one of their episodes, as do the hundreds of people who visit his Camberwell oasis each year as part of the National Garden Scheme open day. Last year Clive raised £1,500 for charity, including the cancer charity Macmillan.

But like Dr Livingstone, any explorers will stumble across the most amazing discovery at the heart of his urban jungle: hidden behind a banana tree are two hives and around

100,000 bees producing 200 jars of honey each year. Although he’s been stung “many many times”, been caught in a “swirling swarm-like cyclone”, Clive is happy. “It’s my corner of paradise,” he said.

*You can visit Clive’s garden in Camberwell on Sunday 4 September. Visit the National Gardens Scheme website and look for Grove Park for more details.

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