TRUST SPRING ISSUE TALKMAGAZINE. Recruitment.

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1 TRUST TALKMAGAZINE Cumbria Partnership NHS Foundation Trust & North Cumbria University Hospitals NHS Trust SPRING ISSUE Good Stuff Amazing people NHS 70 STAFF AND PATIENT STORIES CHRIS POINTON S VISIT TO CUMBRIA CELEBRATING NHS TURNING 70 Recruitment IS THIS YOU?

2 STEPHEN S Welcome Trust Talk SPRING 2018 In my role across both Trusts I ve continued to meet with staff, patients and stakeholders to gather feedback which has been used to shape our priorities. Over the coming months we ll be focusing on partnership working to deliver sustainable services for the future, working with our communities, balancing the books and continuing to improve the quality of care we provide. In this edition you can read lots of examples of where this work is already underway. We are working more closely with other health and care organisations and using patient feedback to improve care. I believe that being open and honest is central to delivering high quality care and building sustainable services. With this in mind, you can read about how our Freedom to Speak Up Guardians are working to create a more transparent culture. Since the last edition, we have had the results of the latest CQC inspection at Cumbria Partnership NHS Foundation Trust (CPFT) and while the overall rating remained at Requires Improvement all services assessed were rated as good or outstanding for caring which says a lot about our fantastic staff and while we still have work to do, improvements are well underway. Maternity services at North Cumbria University Hospitals NHS Trust (NCUH) have also performed above the national average with several improvements highlighted in the latest CQC survey. We are now awaiting results from the CQC system wide review of health and social care services and we are expecting the next CQC inspection at NCUH shortly. I would like to extend my sincere thanks to staff for your continued professionalism throughout the CQC visits. You can read more about our recruitment efforts which have continued both locally and internationally with successful efforts to recruit more health professionals to the area. We recruited staff on a recent trip to Poland with the North West Ambulance Service and had a great turn out at our local nursing careers fair. You can also find out more about our plans to celebrate 70 years of the NHS. As part of the celebrations, we are looking for photos and stories from those whose lives have been touched by services in Cumbria, no matter how big or small please get in touch with our communications team. Finally I would like to say thank you to all our staff and local communities who came together during the recent severe weather to ensure our patients were safe. The team work and sense of community in Cumbria really is second to none! Stephen Eames Chief Executive Get in touch CHIEF EXECUTIVE Communications team for Trust Talk enquiries: communications.helpdesk@cumbria.nhs.uk For any questions, comments or concerns about our services contact the Patient Experience Team: CPFT: pet@cumbria.nhs.uk NCUH: Cumberland Infirmary West Cumberland Hospital Your CPFT Governors represent the views of people like you and always want to hear your thoughts on local healthcare AskYourGovernor@cumbria.nhs.uk 2 Become a member to have your say: as a Foundation Trust CPFT has members and governors local people that input into how we shape our services. Anyone who lives in Cumbria, is over the age of 14 and has an interest in their local health services can become a member. It is free to join simply fill in the form on our website.

3 Trust Talk SPRING 2018 Staff recognised for compassionate care International health campaigner Chris Pointon recently visited Cumbria to raise awareness of the little things that make a big difference to patients, meet staff who have been recognised for the compassionate care they provide and kick start our NHS 70 celebrations. Chris is the co-founder of the #hellomynameis campaign and husband of the late Dr Kate Granger MBE. During a hospital stay, when Kate was terminally ill with cancer and experiencing the NHS through the eyes of a patient, she noticed that some staff didn t introduce themselves and the negative impact this had on her care. They decided to do something about it and launched the campaign to remind staff about the importance of introductions. This campaign quickly grew and Chris has continued to spread the word since Kate s death in He met with teams from Penrith and Whitehaven to raise awareness and talk about the values Kate held close, including the firm belief everyone can make a difference, even if it s in a small way. In 2014 NHS England introduced the Kate Granger Award for compassionate care to recognise healthcare staff who go the extra mile. Chris met with Lydia Jackson, community health care assistant within the Penrith District Nursing Team, who won the award in 2015 and Sarah Linnard, speech and language therapist from Carlisle, who was shortlisted in Lydia said: It was really emotional to meet Chris and talk about the legacy that Kate has left behind. I was lucky enough to talk to Kate before she died and I think she would be really impressed to see the impact that #hellomynameis continues to have. Chris also met with Rachel Tang, former Keswick School student, who was one of the first people to be awarded the University of Central Lancashire and North Cumbria Kate Granger medical scholarship. She is now training as a medic in Preston. Helen Ray, executive managing director of operations at NCUH and north community services at CPFT, said: It was fantastic to welcome Chris back to West Cumberland Hospital after he visited with Kate in We were pleased to introduce him to staff both past and present and we all agreed that no matter how long you have been a healthcare professional, it is always important to reflect on the little things that make a big difference to patients. Chris then joined more than a hundred members of DH Runners and NHS staff on a run in Carlisle to celebrate the NHS in its 70th year. One NHS 70 initiative is encouraging everyone to gift 1000 miles to the NHS and improve their health by moving more. Chris said: "It was brilliant to see so many NHS staff running on a cold Wednesday night and hear about their plans for a special NHS parkrun later this year to celebrate 70 years of such a remarkable organisation that touches all of us." 3

4 Trust Talk SPRING 2018 Preventing delirium An innovative new service is helping patients who are at risk of becoming confused during their hospital stay. Delirium is a common, serious but often treatable condition that starts suddenly in someone who is unwell. It causes them to become easily distracted and confused and can be very distressing for the person and their family. It can be caused by a number of things including infections, dehydration and pain, but with the right support it can be managed or even avoided. The Memory and Later Life service has introduced Reach-Out to do just that in north Cumbria. This service is the first of its kind in the UK and has been co-produced by mental health specialists and clinicians, with input from patients and carers. Health professionals work with patients at the Cumberland Infirmary and West Cumberland Hospital who are at risk of developing delirium to prevent unnecessary distress and help them get home sooner. David Storm, senior clinical service manager, explains: The service will check for anyone admitted to hospital who is at risk of developing delirium. These patients will then be screened daily to try to prevent them developing delirium but also ensuring quick treatment if they do. There will be twice daily social and mental stimulation to those at high risk and support for hospital staff, families and carers. Renal dialysis unit expansion Work is underway to expand the Renal Dialysis Unit at West Cumberland Hospital (WCH) to meet growing demand. Nationally, demand for dialysis services is growing at six per cent each year. The unit will be expanded in a phased way from seven treatment spaces to 11 and the extra spaces will allow a further 16 people to receive their dialysis treatment in WCH. It will also provide a training room to build on self-care dialysis work which is ongoing within the unit. The Home Therapies team plan to expand the service to allow patients the additional option of home treatment where suitable, avoiding regular trips to hospital, and freeing up capacity for those who require their dialysis in hospital. Dr Andrew Bow, clinical director for renal services, said: The expansion means more people can be treated locally, avoiding frequent trips to Carlisle. We are committed to offering our patients as much choice and flexibility as possible which these developments will allow.

5 Trust Talk SPRING 2018 Celebrating 70 years of the NHS The NHS is turning 70 on 5th July and plans are underway to celebrate both locally and nationally. The wide range of opportunities being created by advances in science and technology will be showcased and we ll be thanking the extraordinary NHS staff the everyday heroes who are always there to greet, advise and care for us. SHARING STORIES We ll be sharing stories from Cumbrian people whose lives have been touched by the NHS and Cumbria County Council s archive centre is planning a series of exhibitions on the NHS locally. LET US KNOW if you have a great story to tell about how your life has been touched by the NHS you could be a staff member, volunteer, or member of the public. GETTING ACTIVE All over the country people are logging their miles walking, running, swimming, horse riding, buggy pushing (anything counts!) over the year and trying to reach 1000 miles as a gift to the NHS. The more active we are, the healthier we get - and that s great news for the NHS! You can get involved on social media or by joining the Strava group. Members of Carlisle parkrun are also planning a dedicated NHS 70 run to inspire more people to get active and improve their health and wellbeing. THE FUTURE OF THE NHS Children and young people make up around one fifth of the UK s population. Improving their health and wellbeing is an investment in future generations and the sustainability of the NHS. NHS England are encouraging young people to get involved and will be providing more details on their website. GET INVOLVED If you want to show your support, why not hold your own celebration? Let us know what you are planning to do and we can add it to our website. To get in touch please communications.helpdesk@cumbria.nhs.uk or call Find out more about national plans at 5

6 Latest from the CQC Maternity units perform above national average Results from a national Care Quality Commission (CQC) maternity survey show maternity departments in north Cumbria have performed better than expected. North Cumbria s three maternity units are performing above the national average in 12 areas and have made significant improvements in: Asking about emotional wellbeing of women during pregnancy. Ensuring staff stay with women as much as possible in times of worry during labour. Ensuring new mothers are given information needed following the birth. Alison Atkinson-Budd, new associate director of midwifery at NCUH, said: I m really pleased to be coming into a team that gives excellent support to women at one of the most exciting yet vulnerable times of their life. These results are incredibly promising. Staff praised for kindness and compassion Following the CQC inspection of CPFT services in Autumn 2017, the Trust s overall rating remains as Requires improvement. The kindness and compassion of staff was praised and every service inspected was rated Good for Caring, with the exception of the Dental Service and Memory and Later Life Inpatient services which were rated Outstanding. The report highlighted a positive and open culture, a visible senior management team and significant improvements in wards for people with learning disabilities and within community health services for children and young people. Stephen Eames said: I m not at all surprised that the report highlights how caring and dedicated staff are and I m pleased that the CQC noted how good the culture within the organisation is and how open and honest we are. The report clearly identified areas where significant improvements are required and work is underway to address this. The report highlights a series of improvements that the Trust must make, including: Ensuring all patient records are up to date, care plans are fully completed and consent recorded. Improving waiting times in some areas, particularly dentistry. Ensuring the Trust s risk registers at board level are aligned with the service risk registers. Ensuring young people are fully involved in developing their care plans. Health and care review The CQC has carried out a Local System Review of Health and Social Care in Cumbria as one of 20 targeted reviews across the country. It looked at how people move between health and social care, with a particular focus on people over 65. The CQC spoke to NHS staff, Adult Social Care, third sector organisations, people who use the services and their families. The outcome of this review will be available soon. 6

7 Staff encouraged to speak up Trust Talk SPRING 2018 We promote an open and transparent culture by ensuring that staff feel able to raise any concerns they have. Staff are encouraged to raise any issues through their line manager but if this isn t possible, they can talk in confidence to their Freedom to Speak up Guardian who will offer advice and support and escalate concerns where necessary. The introduction of Freedom to Speak up Guardians has given staff, volunteers and students an extra way to ask for support. Catherine Bird, freedom to speak up guardian, explained: We all want to have a culture that is free from bullying or harassment and where we feel confident and supported to raise concerns. Richard and I are here for all staff who have concerns about any behaviour that isn t in line with our values. Richard Heaton The role was developed nationally to allow staff to confidently raise concerns they have about patient or staff safety. CPFT staff can contact Catherine at FTSU@cumbria.nhs.uk and staff at NCUH can contact their Freedom to Speak up Guardian, Richard Heaton, at speakup@ncuh.nhs.uk #honestaboutmoney Catherine Bird We have large financial savings to achieve and have been looking at how these can be made, while maintaining high quality care. For the first 10 months of this financial year, we have met these savings targets across both Trusts. This means rethinking things like postage, travel, printing and stock management as well as finding opportunities to reuse and recycle equipment and making sure we re getting the best deals. We have achieved a lot thanks to staff suggestions but we need to do more. Clare Parker, director of quality & nursing at CPFT, said: I m impressed by the savings that have been made so far. We have some challenging targets to meet but by being open and honest we can continue to make savings and ensure our money is being spent on what it should be. One thing all staff can do is think about the meetings they attend; could you car-share, hold meetings over the phone or via video conference? Also, let s question whether the meeting is needed at all. By doing so, it s not just saving fuel costs but also staff time and the impact on the environment. SOME OF OUR SUCCESSES: NCUH has switched some clinical products, saving over 250,000 in six months and by using a different dressing on the orthopaedics ward, a saving of 37,000 a year is expected. Reusing, recycling or selling redundant equipment has saved 18,000 and generated 11,000 since April The print in black and white campaign has saved over 65,000 at CPFT and is now being rolled out across NCUH. If you re a member of staff and have any suggestions on how we can save, honestaboutmoney@cumbria.nhs.uk Bank of NHS in Cumbria Bank of NHS in Cumbria NHS in Cumbria Bank of NHS in Cumbria 7

8 News in brief Trust Talk SPRING 2018 Some big changes are underway in Cumbria s health and care services, here s a quick look at what s happening. WORKING TOGETHER CPFT and NCUH are continuing to work more closely together to reduce duplication and ensure we can make the best use of skills and resources across both Trusts. Recent highlights include: From April, CPFT and NCUH board meetings will be held together and the boards have now appointed their first joint non-executive director, Dr Louise Nelson. Occupational Health services provided in-house at NCUH will also cover CPFT staff, so there is no longer a need for an external provider. Stephen Prince has been appointed as joint associate director of estates and facilities. These are all important steps in integrating our services and will continue; next steps include the integration of more support services and expanding the Governor s Council (GC) across both Trusts. CUMBRIA WIDE SERVICES Health services in Cumbria are currently delivered across two integrated health and care systems one covering north Cumbria, and one covering south Cumbria and north Lancashire. As some of CPFT s services are provided across Cumbria, discussions are underway about how these services can effectively be delivered into two different systems. For example, diabetes services provided by CPFT countywide will transfer to NCUH in the north and University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) in the south. The diabetes services already work very closely with services at both acute trusts, so this move which has been backed by staff, will strengthen these partnerships. Stephen Eames said I ve met with staff to discuss the future of countywide services. Where it s best for patients, we ll aim to deliver services locally in the two health and care systems. Where this isn t possible, we ll use our partnerships to ensure the services are sustainable and deliver high quality patient care. COMMUNITY SERVICES IN SOUTH CUMBRIA Community services in south Cumbria will be transferring from CPFT to UHMBT on 1st April This follows consultation with staff from both Trusts and continues the closer working across the health and care system in the Morecambe Bay area. Dee Houghton, associate director of operations for community south, said: I d like to thank all staff involved for their continued hard work and professionalism during this uncertain time. The move will allow closer working between community and hospital teams as we provide more care closer to people s homes. There s already lots of innovative work underway and working as one team will allow us to develop this further.

9 COMMUNITY HOSPITALS Trust Talk SPRING 2018 The Alliances in Alston, Maryport and Wigton have developed exciting plans for future provision of health and care services for the towns and surrounding areas. They include delivering more services locally to reduce the number of times people have to travel, working with young people to help them understand how to look after their health, and all health and care partners working together to ensure that services are high quality and efficient. Following the Healthcare for the Future consultation, the decision was made to close hospital beds in Alston, Wigton and Maryport and adjust the number of beds in other community hospitals to make them more robust. This will be done in a phased way when alternative plans have been agreed by NHS North Cumbria Clinical Commissioining Group s governing body in April. MATERNITY SERVICES Following the Healthcare for the Future public consultation, it was agreed that consultant-led maternity care would continue at West Cumberland Hospital, while an Independent Steering Group looked at the challenges faced by the service over a 12 month period which will begin on 1st April The community, third sector, frontline health and care staff, as well as system leaders, have been working together to support efforts to sustain the service through co-production and will continue to do so over the coming year. WEST CUMBERLAND HOSPITAL REDEVELOPMENT Plans to develop a health campus at West Cumberland Hospital are underway with the aim of providing fully integrated health and care that improves the health of local people. Following NHS England s announcement in July 2017 regarding funding, the Trust has been working with partners on how that will look, with opportunities for the community to get involved. The key objectives for the next phase of the redevelopment include: demolishing the old buildings; providing high quality care for older people with integrated social care services; improving antenatal care and experience and creating an academic campus in partnership with the University of Central Lancashire (UCLan). A plan is being developed and will be submitted in the summer for approval. Work is currently being carried out to prepare for demolition of the old buildings at the front of the hospital which will make a big impression on the appearance. Work is also underway to developing a new permanent suite for breast screening, cardiology and vascular services in the old children s ward. CANCER SERVICES TRANSFORMING IN CUMBRIA Plans to transform cancer services in north Cumbria see NCUH working in partnership with Newcastle Upon Tyne Hospitals NHS Foundation Trust as part of a Cancer Alliance, bringing together clinical and local health leaders to improve services. NCUH is one of 15 trusts across the UK to benefit from NHS England s investment as part of a national modernisation programme for cancer. The first stage of this investment has seen the latest technology in radiotherapy treatment at the Cumberland Infirmary with a new LINAC (linear accelerator) machine now installed.

10 Recruitment Trust Talk SPRING 2018 We re working together with health and care organisations and local communities to recruit health professionals to Cumbria. By joining forces we ve been able to strengthen our recruitment efforts and show off what makes the area unique. Amanda Dunkley, project manager for attraction, said: We ve had to think outside of the box to address our recruitment challenges and it is really starting to pay off. We have some very innovative roles that aren t available elsewhere in the country and the development opportunities that we can offer make Cumbria a really strong choice. Here s a selection of the work we ve been doing to help Cumbria stand out as a great place to work and live. New recruitment look sthisyou? we are recruiting We have developed a new look for recruitment across the two Trusts which is different to anything we ve done before to help us stand out to job seekers. It describes the kind of people we re looking for in a bold and fun way. We re looking for innovators, experts, adventurers, thrill seekers, explorers, team players the list goes on. We want to show that we have something for everyone. The campaign uses images from local people following an appeal for photos that show what they love about living and working here. We had almost 200 entries which will be used throughout the campaign. Local recruitment Recent nursing careers fairs and partnerships with local education providers are helping to showcase the range of opportunities available in Cumbria. We re encouraging new graduates to stay in the area and developing local talent for the workforce of the future. Our recent nursing careers fair attracted 55 nurses and successful interviews took place on the day. 10

11 National recruitment Trust Talk SPRING 2018 Our recruitment team have a full schedule of careers fairs across the country to encourage people to choose a career in Cumbria. We ll be promoting these widely through social media over the coming months. We re always looking for chances to promote careers in Cumbria and recently showcased the unique medical training programmes we offer on 21st century healthcare, a programme produced by ITN Productions in partnership with The Royal Society of Medicine. International recruitment Staff from both Trusts joined North West Ambulance Service NHS Trust (NWAS) on a recent trip to Poland to recruit health professionals to Cumbria. This follows successful recruitment by NWAS in 2016 and by working together we have been able to use their experience to recruit. Interviews took place in Poland and 17 job offers were made across the three Trusts. Another trip has been planned which will also include Cumbria County Council to recruit social care professionals too. As staff shortages in the UK grow, international recruitment is a key element of developing our future workforce in Cumbria. These trips have proved to be a cost effective and highly successful method of recruiting health and care staff. New medicine course in west Cumbria A new medicine programme has started at the University of Central Lancashire (UCLan) in partnership with NCUH. The two-year Hospitalist Medicine programme follows the Royal College of Physicians curriculum to equip clinical professionals from a non-medical background with the competencies to work at registrar level in acute medicine. The role forms a key part of the Trust s Composite Workforce Model at West Cumberland Hospital which is made up of clinicians from a variety of backgrounds rather than the traditional medical model which is hard to recruit to. The model won a national Healthcare People Management Association (HPMA) Excellence Award in June Five advanced clinical practitioners, who are all nurses by background, have recently joined the pilot programme. Upon successful completion and progression through a recruitment/selection process, these professionals will become senior advanced clinical practitioners and join the middle grade (senior decision maker) composite rota, alongside conventionally trained medical registrars. Professor Gershan Davis, professor of cardiology at UCLan and NCUH, said: We believe this to be a definitive first in the UK and it is an example of how the collaboration between NCUH and UCLan is helping to lead the way in innovative practice by looking at new models of health care delivery to maintain the health and well-being of our population. 11

12 Trust Talk SPRING 2018 Support for parents Lisa Brown, a mother of two from Carlisle, has spoken about her mental health to encourage others to get help. Lisa contacted First Step, an NHS talking therapies service, after reaching her lowest point while pregnant. I think I ve always suffered with depression, but I didn t realise that s what it was. If something didn t go right I d panic and I would convince myself that the worst would happen. Things started to get worse when I was pregnant. Everything just felt really overwhelming, not being here anymore seemed like the best option, although I would never have acted on those thoughts. I was terrified that someone would take my child away from me, that they would think I was a bad mother. It s hard to admit you re struggling when that thought is hanging over you. The turning point for Lisa came when her GP suggested First Step. First Step made me see that lots of people experience the same thoughts and feelings. It wasn t intrusive I just talked and talked and as I did I started answering my own questions. I walked away feeling lighter, and I really looked forward to going back. Now I try not to worry so much. There are still some hard days but I know that it s okay to feel that way. I m about to start a Cognitive Behavioural Therapy course to help me even more. The midwives and health visitors were fantastic - however, they only have so much time. When you are asked how you are feeling, it s easier to say I m fine. My advice to anyone who feels this way is to tell somebody there is help available and you are not alone. Dr Richard Thwaites, clinical director for First Step, commented: It s not uncommon for both mums and dads to struggle following a new baby. We provide evidence-based talking therapy to people during this crucial time, a time when they can be more vulnerable to common mental health problems such as depression, panic or obsessional thoughts. Leanne Huntley, First Step s perinatal lead, added: Between 10 and 20% of women develop a mental illness during pregnancy or in the first year after birth. Around half of these cases of depression and anxiety go undetected, and many women don t receive the right help. First Step is working with midwives and health visitors to increase awareness of perinatal mental illness in both women and men, and improve access to therapy in Cumbria. 12 FIRST STEP provides free, talking therapies to adults (18+) in Cumbria for a range of common mental health problems including mild to moderate depression, anxiety disorders, anger and sleep problems. Speak to your GP for more information.

13 Trust Talk SPRING 2018 Breastfeeding support Breastfeeding rates in the UK are among the lowest in the world at 74.3% and even lower in Cumbria at 64.9%. Breastfeeding reduces a baby s risk of health problems such as obesity, diabetes and allergies and the mother s chances of contracting breast and ovarian cancer. Diane Clark and Fiona Sim, specialist breast feeding health visitors, have been working with families to increase rates in Cumbria. Jo Hayward, mum to six month old twin boys Lars and Linus from Orton, has shared her story to highlight support available. Our breastfeeding journey didn t have the best start. Linus was in a Special Care Baby Unit and I was on a separate floor recovering from a C-section. Neither baby was able to latch to feed after birth, so I began the cycle of expressing milk, trying the babies at the breast, bottle feeding my milk and topping up with formula. When I first met Fiona we were in this 3-hourly cycle and I wondered if we would ever be able to exclusively breastfeed. Fiona has such a wealth of knowledge but was careful not to overwhelm a new, sleepdeprived mum. Starting with the basics, we concentrated on latch, the feeding cycle and positioning. We started to find our groove and when the boys were six weeks old, achieved our goal of exclusively breastfeeding. Fiona s support, made this possible. She is so passionate about the special relationship breastfeeding brings and the benefits to baby and mum, encouraging in the most gentle way. Despite being very busy, she always makes time to visit us or to speak on the phone. The first three months were especially hard but the relationship that I have developed with Lars and Linus as a result is wonderful. Fiona also runs our local breastfeeding support group. When the boys were just a few weeks old I went along with my husband Richard. Seeing the boys next to older babies reinforced just how tiny and vulnerable they were and how ginormous our responsibility was to nurture and protect them. For anyone wanting to breastfeed, I suggest as much preparation as possible. Go along to a support group before the birth and include your partner; they are crucial to success. Richard has always been very welcome at the group and is there for me day and night. Include parents and in-laws too; let them know exactly how they can help. And finally, believe in yourself; you were made to do this and you can. The Facebook group Breastfeeding Twins and Triplets UK & Ireland has been a great forum for advice, laughs and letting off steam. I wish I had joined before I had the boys to prepare me for growth spurts, developmental leaps and for constant feeding some days. We decided to move to Cumbria from London and I m so glad we did. Orton is a warm and welcoming community, surrounded by stunning countryside and fresh, clean air. I can t imagine navigating a double buggy on the Underground! 13

14 Trust Talk SPRING 2018 Listening to mums Afterthoughts is a postnatal listening service which supports women who have given birth. The service, which is run by midwives, enables those who have gone through a difficult labour or birth, or who would just like clarification on what happened during their birth, to discuss their feelings with professionals. Due to the nature of giving birth, many women do not remember or understand what happened during the experience and can have unanswered questions. The team s role is to answer these in a way patients understand to reduce any worry or anxiety. Only a handful of Trusts in the country provide a postnatal listening service. Denise Evans, midwife at Cumberland Infirmary, said: Quite often women are told by friends and family that as long as the baby is fine that is all that matters. We listen and validate how the woman feels and how important her feelings are. The service can also identify women who may need referral to more specialised practitioners, such as physiotherapists, who may not have been identified had they not come to the Afterthoughts appointment. I m very proud of the service and the help it gives so many mothers and fathers, the team has worked tirelessly outside their normal working hours to ensure it s a service that works well. One mum who used the service said: This is a fantastic service and I would definitely recommend it. It helped me understand and come to terms with everything that happened during my labour. Also I could ask questions that I didn t think to ask at the time and they were answered honestly and as accurately as possible. If you think Afterthoughts could benefit you, contact The child health app - NHS advice Parents and carers can now find NHS advice at their fingertips to help them look after their children s health. The Child Health App gives easy to understand guidance on childhood illnesses, recognising when your child is unwell, and advice on when and where to seek further treatment. The app contains advice on everything from oral health, upset tummies and diarrhoea to advice on bumps and bruises. Download the app now, available on Google Play and the App Store by searching for 'NHS child health'.

15 Trust Talk SPRING 2018 Reducing and avoiding hospital stays Staying in hospital longer than necessary is likely to reduce patients independence and muscle strength and increase their risk of developing an infection, and research has shown that people often recover quicker at home. Health and care services across Cumbria are working together along with third sector organisations, patients and their families to ensure patients are in the best place for their needs. Here are just some of examples of work that s underway. SUPPORTING PATIENTS CHOICES Community services in south Cumbria are working closely with health and care partners to help patients avoid long hospital stays. People who are medically fit well enough to leave hospital can be delayed for a number of reasons but the roll out of a new joint policy to support patients choices is helping to address this. Becca Carter, community manager, explained: Planning for leaving hospital now starts as soon as the patient is admitted into an acute or community inpatient unit. This has improved communication with patients and families which helps their planning and allows them to make more informed decisions. Staff discuss what is going to happen, when the patient is likely to leave hospital, and where they will go next. Most patients return to their own home when they leave hospital but those with significant health and care needs may require further support. Staff work closely with these patients and their families and/or carers to help them understand their options and support the decisions they make. ASSESSING ONGOING NEEDS AT HOME Another approach that has been introduced across south Cumbria is the Discharge to Assess model. This sees people leaving hospital when it s medically safe to do so and then have their ongoing needs assessed at home. This not only reduces the length of stay in hospital, as patients don t have to stay to wait for assessments, but also allows health and care staff to assess patients in a more appropriate setting. When the patient s immediate and longer term needs are assessed in their own home, support can be more easily tailored to their individual circumstances. AVOIDING HOSPITAL STAYS A new service based in West Cumberland Hospital s A&E department is working to help people avoid hospital stays altogether. Home First sees physiotherapists and occupational therapists based in A&E to assess older patients when they arrive to see if they can remain at home, with some extra support. Gwyn Lishman, clinical lead occupational therapist, explained: We see between five and fifteen patients a week and on average 40% of these avoid a hospital stay. These people are able to return to their own homes, reducing stress for them and their families and ensuring hospital beds are available for those who really need them. We have really good relationships with wider health and care teams which help us to quickly arrange the right support to keep patients out of hospital. 15

16 Diabetic eye screening reaching more people Trust Talk SPRING 2018 People with diabetes have an increased risk of developing problems with their eyes that can lead to sight loss if not treated. The best way to prevent this is regular eye screening which can detect changes early. In Cumbria, anyone with diabetes is automatically referred to the diabetic eye screening service through their GP. However the number of people who attend their screening is lower than expected in some areas. The diabetic eye screening team has been working to identify what s stopping people, break down barriers and increase screening rates. Steve Quirk, Cumbria diabetic eye screening programme manager, explained: Everyone with diabetes aged over 12 should attend regular eye screening - it has been shown to reduce the risk of developing sight problems. We noticed that certain groups, such as young people, people from traveller communities and those with learning difficulties, had a lower attendance rate and were therefore at higher risk of developing problems. The team looked at why these groups were less likely to attend retinal eye screening and what they could do to help them: People with learning disabilities are now offered trial appointments to get to know the service, longer time slots and health passports documents with key information about their needs - to ensure they are fully involved in their care. This work has been recognised and featured in the Public Health England Screening Blog as good practice and shared with Trusts across the country. The team worked with Cumbria County Council and used their connections to build relationships within traveller communities. They held focus groups to identify issues and have since held drop in sessions within these communities to raise awareness. The team also noticed that young people, or those from areas of high social deprivation, were less likely to attend because of issues such as lack of awareness, child care or transport. In these areas, screening is now being held within GP surgeries to make it more accessible. By tailoring the service to the needs of different groups of people the team has significantly increased attendance rates for screening across Cumbria seeing almost 1000 more people between October and December 2017 than the same period in Steve added: We appreciate there may be barriers for patients to attend screening but by thinking creatively to break these down, we ve seen some great results. I d encourage anyone with diabetes to attend their screening. It s quick, easy and can significantly reduce the risk of sight loss. If you have any concerns about screening contact: retinalscreeningbooking@nhs.net

17 Hospitals go smoke free Trust Talk SPRING 2018 Smoking contributes towards approximately 2,800 deaths in Cumbria each year in people aged 35+. In Cumbria, 64,000 people over the age of 16 smoke, that s 15.5% of the population. The estimated annual cost of smoking to Cumbria s economy is 6.7 million. 14 March was No Smoking Day and to mark the occasion, NCUH s two sites reaffirmed their commitment to go smoke free. Leaflets are available about the support on offer and staff can access training to support their patients to stop smoking. The Trust also took the opportunity to remind people that there is no smoking on hospital grounds including the car park areas. Dr John Atkinson, clinical director for respiratory at NCUH, said: We re trying to make sure that every patient we see gets the help and support they need to quit and will no longer feel the need to stand outside and smoke. People who smoke have longer recovery times and much higher risks during hospital procedures. We know the vast majority of patients and visitors want to see an end to people smoking on site and we re asking for everyone s support to make our hospitals smoke free. We have taken the difficult decision to allow people to vape outdoors on site. While vaping is not risk free, it is far less damaging to peoples health and there are no known effects from second hand vaping. CPFT sites are also increasing efforts to reduce smoking and encouraging all patients to get support to quit. Local services and pharmacies provide free, expert support. People who quit with the support of a stop smoking service adviser are four times more likely to stop for good. Members of the public can contact Cumbria s stop smoking service on or Act F.A.S.T. - signs of a stroke The national Act F.A.S.T campaign has been relaunched to help people understand the signs of a stroke and what to do if you think someone is having one. This simple test identifies stroke symptoms: FACE has their face fallen on one side? Can they smile? ARMS can they raise both arms and keep them there? SPEECH is their speech slurred? TIME to call 999 if you see any one of these signs. You don t need all three to suspect a stroke. A stroke is a medical emergency and the faster you act the greater the chances of recovery. There are over 100,000 strokes a year in the UK, causing over 40,000 deaths. It is a medical emergency that requires immediate attention as every minute is vital. That is why calling 999 is so crucial. An ambulance can give stroke patients those extra precious minutes, through faster and more specialist treatment, via their knowledge of the nearest appropriate Hyper Acute Stroke Unit. 17

18 Dealing with stress Trust Talk SPRING 2018 Staff from both Trusts recently completed a health and wellbeing survey to identify areas where they would like extra support. We re looking at the top areas staff highlighted, including stress. Professor John Howarth, deputy chief executive and GP, said: Staff told us they would like more support to help them deal with stress and the challenges of daily life. We have a range of support available and encourage everyone to access the help they need. These stress busting tips have been adapted from NHS Choices the UK s biggest health website offering trusted advice from health professionals. GET ACTIVE: Exercise can improve your mood, sleep quality, energy and how you feel about yourself, as well as reduce stress and help to clear your thoughts. TAKE CONTROL: Try to identify the cause of your stress so you can do something about it. Taking control is empowering and will help you find a solution. CONNECT WITH PEOPLE: A good support network of colleagues, friends and family can help you see things differently. 10 stress busters WORK SMARTER, NOT HARDER: Prioritise your workload and don t be afraid to ask for help if you re struggling. TRY TO BE POSITIVE: Look for the positives each day this might be things you re grateful for or things that have gone well. ACCEPT THE THINGS YOU CAN T CHANGE: Changing a difficult situation isn t always possible but try to concentrate on the things you do have control over. HAVE SOME ME TIME : Prioritise the activities you really enjoy, and set some time aside for them every week. CHALLENGE YOURSELF: Setting goals, such as learning a new language or qualification, helps to build confidence and in turn increases your resilience. AVOID UNHEALTHY HABITS: Habits such as alcohol, caffeine or smoking might provide temporary relief but won t solve your problems and could lead to more issues. HELP OTHER PEOPLE: Helping others can build resilience, put problems into perspective and make you feel happier. Support for staff Support is available for staff who are struggling to cope with stress. Firstly, talk to your line manager who will be able to offer advice. Both Trusts have Health & Wellbeing advocates, trained staff who can help with more information. Further details are available on the intranet.

19 A DAY IN THE LIFE OF... MATT SIBBALD Hospital Porter West Cumberland Hospital, Whitehaven Trust Talk SPRING 2018 WHAT DOES A TYPICAL DAY AT WORK LOOK LIKE? My typical working day involves facing a lot of different challenges. I am based on the Emergency floor, so I cover both Accident & Emergency (A&E) and the Emergency Assessment Unit (EAU). These two areas contact me for things like assisting with patient transfers to and from wards, taking patients to x-ray and for other scans as well as tasks like getting more oxygen or delivering specialist mattresses. TELL US MORE ABOUT THE UNUSUAL PARTS OF YOUR JOB. Every day is different. People come to A&E for lots of different reasons, some with interesting stories as to how they have ended up in West Cumberland Hospital. When you work in an A&E department you learn that nothing is that unusual, you see it all! WHAT S YOUR FAVOURITE PART OF THE JOB? It is a busy area so I m usually non-stop. My favourite part of the job is getting to meet new people each day and being asked to assist the public in what can be a troubling time for them. I meet a lot of different people throughout a typical shift: patients, their relatives, visitors and staff from different departments. The types of patients we see vary considerably. I can be helping an elderly patient to x-ray and 10 minutes later taking a poorly child to Children s Ward. Family often accompany loved ones who are in the department so I end up speaking to a lot of people every day. HOW DO YOU SUPPORT PATIENTS? I need to be ready and available at all times should urgent jobs come up, as well as being in and around the department to provide non-urgent support like checking the gas cylinders are full or finding wheelchairs. The support I give to patients helps the department to run smoothly and efficiently! The portering service is vital in delivering a safe and secure environment for patients, visitors and staff, not just in A&E and EAU but to the wider departments and hospital in general. WHAT S THE BIGGEST CHALLENGE YOU FACE IN YOUR WORK? The biggest challenge I face during my shift is not knowing what challenges the day might bring as no two shifts are the same. Sometimes it can be quite upsetting working in the emergency departments. WHY DID YOU CHOOSE A CAREER AS A PORTER? I chose a career as a porter as the NHS offers secure, long-term prospects and a good pension. I was interested in applying for the role as soon as the opportunity came up. 19

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