the

Issue 18, June 2011

FuTureFor our Members - from the Governors

One of the many ways in which the hospital consults with its members, patients and visitors is by the hospital governors who, with a lot of support from the hospital Non Executive Directors, carry out Listening Exercises around the Trust

at least once a year. The purpose of these governor-led Listening Exercises is to give patients and visitors to the hospital and its satellite clinics the opportunity to tell them anything they want about the hospital. All of the responses are collated and then analysed with the aim of ensuring that appropriate action is taken. For example, complaints are passed onto PALS; concerns are looked into with the departments concerned; compliments are sent to the appropriate department; and questions are answered after referral to the department which may be able to take action. Every patient or visitor who raises an issue, and who provides us with their contact details, is contacted at a later date with a full response from the hospital.

The last completed Listening Exercise was at Urology Outpatients and the Gynaecology Clinic in the hospital; Tyrells Centre, Thundersley; Canvey Outpatients Clinic; Urology & Ear Nose and Throat at Brentwood Community Hospital; and the Eye Clinic, Orsett Hospital. It produced a total of 177 reports from the patients and visitors who approached the governors and Non Executive Directors. 10 were suggestions; 80 were concerns; and 87 were compliments.

Previous Listening Exercises regularly highlighted car parking and phlebotomy (blood tests) as major issues.

These and other factors resulted in the construction of the Multi Storey Car Park and the planned relocation of phlebotomy services to a much improved section of the recently refurbished Main Outpatients Department and into community locations.

A further series of Listening Exercises were carried out during May 2011 in the hospital's Accident & Emergency Department. They took place during one weekend and at two consecutive evenings and the results will be published in an edition of FuTure.

YOUR GOVERNORS ARE LISTENING TO YOU...

Governor Ron Kennedy in A & E

2 A day in the life of...

Pathology and its team of biomedical scientists..........They say that an iceberg only shows the top third of its height and width on the surface of the ocean – the other two-thirds remain unseen. The same analogy applies to the Pathology department – as although its work is largely unseen it is a vital if not critical part of the war against illness and disease. You may not realise that statistically 70 to 80% of diagnosis and treatment is determined by your path lab results! From urine infections to heart attacks, from anaemia to leukaemia, from infection to cancerous tissue – and more - all are either diagnosed, excluded or confirmed by the laboratory results. In fact, the services our Pathology Laboratories give are so varied and diverse that it is not possible to cover everything in just one article!

Pathology performs a 24 hour service to Southend hospital and the wider community. Each day sees 3,000 plus requests for its services and it accounts for approximately 3% of the hospital budget. Some samples come from within the hospital environment itself, the phlebotomy clinics, ward rounds, surgery etc., some from your local GP surgery. As you probably know there are clinics outside the hospital in the local community which also take blood samples so you do not have to travel to hospital for this simple procedure – it saves our patients time, travelling costs and car parking. This helps us too as it reduces pressure on car park spaces for out patient appointments etc. Accident and Emergency have a fast track via a chute directly into the pathology laboratories. Pathology also perform a valuable role in health prevention through cervical smear and clamydia screening for example.

92% of the results of blood tests for A&E are available to the doctor within the hour and 99% within two hours. GP results are normally available on the

computerised system (ICE) on the day of receipt with the exception of those investigations which take longer such as bacterial infections where it takes time for the cell cultures to grow or samples referred to specialist laboratories

Tony Guinness, Governor for Rochford, and myself were privileged to visit Pathology and were fascinated by the substantial variety of procedures carried out. Pathology is split into four areas - Biochemistry, Cellular Pathology, Microbiology and Haematology & Transfusion. In this edition of The FuTure we will look at the unique work of Biochemistry and Cell Pathology. Each department has its own expert team specialising in their chosen discipline.

BIOCHEMISTRY On arrival at Reception each sample is identified by a personal unique number and is additionally bar coded. Throughout the processes great care is taken and all identifiers constantly checked ensuring they match and no sample or patient is mismatched. Biochemistry relies heavily on instrumentation to perform the analysis – the bar code determines what analytes are measured and up to 30 different substances can be measured on the same sample. All results are validated and when an

Blood samples enter the centrifugal machine

Fully automated blood testingBlood testing general area

A day in the life of... 3abnormal result is found which is serious enough to be acted on immediately then the results are telephoned through straight away either to the hospital doctor or GP. The BMS loads all samples into a centrifuge to separate the components before loading a machine which removes the tops (this saves enormous technical time and prevents repetitive strain injury) before going into the

analyser. From here on the screening process is then fully automated to completion.

In Biochemistry the other tests range from abnormal proteins which may indicate cancers of the bone marrow to providing a drug abuse service for Grays, Basildon and Southend. In the case of suspected drug abuse samples are screened for the full range of illicit substances such as heroin, cocaine and cannabis. A positive screening result will then be confirmed and positively identified by analysis on a complex specialist instrument.

CELLULAR PATHOLOGYIn one section of the Cellular Pathology department (Histology) – samples are received as tissue specimens and can come from theatre, GP’s, etc. Samples are colour coded to determine their urgency – for urgent diagnoses it is possible to analyse samples sent from the theatre and the result is sent back to the surgeons while the patient is still undergoing surgery. In the case of other specimens which require a more detailed investigation, samples are set into a wax block, then once set, thinly shaved and placed onto glass slides. The tissue is then stained – and is studied by

Pathologists. Again at every part of the process samples are checked against their identifiers so that there is no error between patient and result. This particular department also looks at semen - checking for presence of sperm at post vasectomy as well as assisting in the diagnosis of infertility.

In another section of the department (Cytology) cervical samples are received in liquid form and processed and screened for abnormalities by specifically trained staff, who may also analyse cell samples from other sites in the body.

We hope you have enjoyed this brief insight into

the comprehensive and varied work of two areas of Pathology and Tony and I would like to say a huge thank you to the staff who helped us on our visit and shared their day with us. It was a real privilege.

Patient Governor - Rochford

Samples set in wax are sliced

Microscopic examination of a specimen

State-of-the-art blood analyser

Valerie Powell

Open for business It’s out with the old and in with the new this month. After four months of round-the-clock construction, we have opened the revolving doors to our newly-refurbished outpatients department.

The project, undertaken by Colchester-based contractors, The Brennan Group, has seen a dramatic overhaul of the main entrance and ground floor waiting area, with 60 revamped clinical treatment rooms and a new blood-testing unit set to be unveiled in June.

Associate director of estates development, Jan China, said: “I’m delighted that this first phase of the

project has been completed. The waiting area looks

fantastic. I’m sure that staff, patients and visitors will be pleased with the transformation.”

“This is generally the first department that patients visit when they come to the hospital, and first impressions are important. The fresh and modern environment reflects our commitment to ensuring our patients have the

best possible experience, from the moment they walk through the door.”

Over the coming weeks a brand new reception area and volunteer information desk will be installed, as well as

state-of-the-art self check in kiosks.

“The kiosks are really simple to use and are designed with all of our service users in mind,” explains outpatient general manager, Melanie Solieri. “They are fully accessible to wheelchair users; we have settings for those who are partially sighted and also for those whose first language is not English. Once patients

are checked in, the system will ensure that we know exactly where they are at all times so we

can track them

throughout their appointment.”

She added: “We’re thrilled with the progress so far. Once work to the clinical areas is complete and the

finishing touches have been applied it will be wonderful, and I’m sure our patients will be impressed with the new waiting areas and treatment rooms.”

Out-Patients clinics 1-5 will remain in their current locations for the time being, and will transfer back to main outpatients over a period of two weekends in June.

4 Outpatients

Checking-in kiosks

5

Future Members' MeetingsDetails of Members' Meetings are now available on our web site at:http://www.southend.nhs.uk/Membership/Member+Meetings/

Date Venue Doors Open

21st June 2011 Community Hall, Westwood Primary School, Beresford Close, Hadleigh SS7 2SU 7 pm Speakers: Dr Ray Wong, Clinical presentation on arthritis Malcolm McFrederick (Director of Operations)13th July 2011 Balmoral Community Centre, Salisbury Avenue, Westcliff-on-Sea SS0 7AU 7 pm Speakers: Dr Gary Bray, Gastroenterology Services

Jacqueline Totterdell (Chief Executive)26th July 2011 Lake View Hall (Winter Gardens Primary School), Hilton Road, Canvey SS8 9QA 1 pm Speakers: Dr David Gatland (FRCS Consultant ENT Surgeon) - Hearing Loss

Jacqueline Totterdell (Chief Executive)8th September 2011 Swans Green Community Hall, The Rundels, Hart Road, Thundersley SS7 3PE 1 pm Speakers: Mr Sam Prasad (Consultant Orthopaedic Spinal Surgeon) Jacqueline Totterdell (Chief Executive)22nd September 2011 Clements Hall Leisure Complex, Clements Hall Way, Hawkwell SS5 4LN 1 pm Speakers: Matron Emma Dowling - Infection Control in the hospital Jacqueline Totterdell (Chief Executive)

All welcome but please confirm attendance so we can cater for refreshments on arrival

Telephone: Freephone 0800 0185202 email: foundation.members@southend.nhs.uk

Members' InformationSeveral years ago the Trust took the decision to create a website in order to improve access to infor-mation for patients, carers, the public, GPs, potential new mem-bers of staff, and anyone else with an interest in our hospital. This has worked very well, and achieved lots of positive feedback over time,

but now the website infrastructure, functionality and also the 'look and feel of the website' has become in-creasingly dated, particularly as you consider the increas-ing number of people that now use the internet as a key source for information.

Southend Hospital is looking to its members to help develop an 'online/electronic strategy', and also to help implement this strategy which will include a new web-site. For example, this may include: • A new website for patients, carers and visitors• Additional website functionality for members and

governors• A GP information website• A new staff website The ultimate aim of this project is to improve the patients', carers ' and visitors' experience by providing the information required effectively and efficiently. We need to find the right balance of the information we

need to provide, but also ensure the site is reduced in size as large sites are often very difficult to find your way round or the information you need quickly.

In order to fund this new website, the hospital will con-tinue to be responsible for maintenance, development and content, and it is currently working with IT suppliers to minimise or neutralise other costs.

We want to involve Members in the creation of an on-line/electronic strategy. Let us know what you feel is crucial information we ought to have on our site.

How would you want the website to 'look and feel'?

Are there any other websites or hospital websites that you feel set a good standard that we ought to be looking to match?

If you do want to get involved, we will be looking to set up discussion groups and opportunities for individual feedback.

If you have an interest in developing websites, particu-larly for hard to reach groups, or for patients, carers and visitors that may find it difficult to access certain informa-tion, and have suggestions as to how we can utilise the website to improve patient information and interaction with patient support groups, then please do get in con-tact.

Further information and updates will be provided in this newsletter, or alternatively please contact the following email address: communications@southend.nhs.uk

6 Patient Experience

In Issue 13 of the FuTure (December 2009) we outlined work being done by the Trust to understand the patient experience while at the hospital. The information is gathered from a selection of about 20 wards and allows the Trust to capture a large sample of patients’ views quickly and accurately. The data is shared with staff for action where required. It is collected from patients by volunteers who are independent of the Trust.

The Patient Experience Tracker (PET) collects the data electronically and has five questions that can

be changed periodically. We would like to take this opportunity to update you with the latest results. The chart below shows the results of the five questions asked between January and April 2011. The target scores, when compared with the national inpatient survey results are based on the mid score of the 2009 results. The data is from 951 patients who responded to the survey and shows the results at the beginning and end of the survey.

On a positive note, for patients recommending the hospital to other people, our scores have improved.

Target Jan AprilSatisfaction with cleanliness of hospital room or ward 92% 89% 92%Do you feel you were treated with kindness? 90% 94% 95%Do clinical staff answer your questions in a way you can understand? 85% 84% 88%Do staff introduce themselves to you? 90% 86% 85%Would you recommend this hospital to a relative or friend? 90% 88% 93%

Patient Experience Tracker (Real time feedback)

Congratulations to:

Hilary Seago - Public Governor, SouthendGeraldine Alward - Public Governor, RochfordAshley Jayaweera - Public Governor, Castle PointColin Pavitt - Public Governor, Castle PointSam James - Worker GovernorSharon Wallace - Worker Governor

Welcome back to re-elected Governors:

Ted Lewin - Public Governor, SouthendNora Goodman - Patient Governor, SouthendBob Bradbrook - Volunteers Worker Governor

And finally, enormous thanks to departing Governors:

David Maslen-Jones – Worker Governor

The following departing Governors have been support-ing and shaping the work of governors and the hospital from the beginning of our journey as a Foundation Trust and we are particularly grateful for their wisdom, time and energy in the six years they have served as well as time when were in shadow form: Della Cain - Worker GovernorLes Catley - Public Governor, RochfordCarolin Dodds - Public Governor, Castle PointStephanie Stamp - Public Governor, Southend

John BruceChairman

Welcome to new Governors

I’m a registered dietitian (RD) and work at Southend University Hospital. RDs are uniquely qualified to translate scientific information about food into practical dietary advice. As well as providing impartial advice about nutrition and health, dietitians also advise about food related problems and treat disease and ill health. 50% of my role is dedicated to the Acute Stroke Unit and the other 50% is general work where I provide a service to a number of wards across the hospital and an outpatient clinic. In my day to day role I deal mostly with patients who are acutely unwell. Malnourishment is a major problem for hospitals and the impact on patients is multifaceted.

Healthy Eating is simple. No? There are currently so many messages from different media, many people I speak to find it hard to decipher fact from fiction. This confusion can lead to apathy with regard to diet. Before talking about healthy eating I think it’s important to understand three key points.

Firstly, that nutrition is a relatively new and emerging science, therefore messages will change and this is a natural part of progression, we once thought the earth was flat after all.

Secondly, how to read and understand a scientific journal is a skill acquired during our training. A single line taken out of context and included in a magazine article can be very misleading. Newspapers and magazines are not written by scientists and basic healthy eating messages often don’t make exciting reading or public grabbing headlines. So take these with a pinch of salt!

Thirdly everyone’s an expert. Well actually, I am! The general healthy eating message is simple and is backed up by global health authorities. More and more evidence suggests that eating a diet high in fruit and vegetables is good for you. They help to maintain a healthy weight, keep blood pressure and blood cholesterol low and prevent some cancers. But how do they fit into the rest of our diet and in what

proportion?

Well, basic healthy eating messages are represented by the eatwell plate. A pictorial representation of the types and proportions of foods we should eat for a healthy, well balanced diet. Published and produced by the Food Standards Agency alongside 8 key tips to guide you in following these

proportions in the right way:

1. Base your meals on starchy food.2. Eat lots of fruit and veg3. Eat more fish – including a portion of oily fish each

week4. Cut down on saturated fat and sugar5. Try to eat less salt – no more than 6g a day for

adults6. Get active and try to be a healthy weight7. Drink plenty of water8. Don’t skip breakfast

And, last but not least, enjoy your food!

7From Our Expert...

Josephine Robinson

Newsletter eMail AppealThe present economic situation means that the Hospital needs to reduce costs in all areas. The FuTure editorial team faces a choice of reducing the number of issues per annum from 4 to 3 or reducing the cost of postage and printing. If we could significantly increase the number of copies sent by e-mail we can continue to issue quarterly.

You can help us by sending your e-mail address to newsletteremailappeal@southend.nhs.uk. Each quarter we will send you an e-mail with a direct link to the latest issue enabling us to save on printing and postage.

Eatwell Plate

Governors8

Contact Southend Hospita

l Governor via:

The Foundation Trust Se

cretary

Trust Corporate Office

Southend University Hosp

ital NHS Foun-

dation Trust

FREEPOST ANG1863

Prittlewell Chase

Westcliff-on-Sea

Essex SS0 0RY

Freephone 0800 0185 20

2

Hospital switchboard01702 435555then add extension if known

Editorial Team:

Valerie Powell

Tony Guinness

Heather Glynn

John Bruce

David Fairweather

EEd

H

Member Meeting 6 January 2011

Question for Dr James Ahlquist (Diabetic Consultant)

Q If after having been referred to the clinic from the GP, how long should it be before you get an appointment?

A You should have your appointment within a month. If you don't you should call the hospital.

Q Could you tell me the benefits of injections over tablets?

A Tablets cost less but injections are better.

Question for John Gilham (CEO)Q What health improvements have there been in

the population?A Annual report shows how health care is changing.

There have been changes in the way strokes are dealt with - the number of deaths has reduced. We now have early detection methods which are used in stroke clinics. We also have new methods of treatment for cancer.

Member Meeting 3 Feb 2011

Question for Patrick Lusty

Q Have you noticed any difference between cultures for recovery times?

A There are racial differences in terms of anatomy but not cultural differences in terms of recovery.

Member Meeting 15 March 2011

Question for Jacqueline Totterdell

Q How do you improve the relationship between staff and patients by ensuring that you have friendly staff?

A Our Patient Experience Programme is designed to ensure that we improve in this area and also continue to respect our patients.

Member Meeting 14 April 2011

Question for John Day

Q Are Healthcare workers immunised against Tuberculosis?

A Yes. The only effective immunisation against TB is the BCG vaccination. This is most useful for young children and young people but its effectiveness fades with time.

Question for Jacqueline Totterdell

Q People who stand around the entrances to the hospital smoking need covered designated areas.

A I agree and confirm that there is a group who are investigating this.

Q Is there still an 18 week treatment deadline?A Yes

A few Q & A's from our Member Meetings