Contents. NBT monthly for primary care. July 2017

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NBT monthly for primary care supporting GP practices with service updates and news July 2017 NBT values your feedback. The GP liaison manager is always happy to come and visit your practice at your convenience. Contact details are given at the end of the newsletter. Contents Contacting services in Medicine Medical photography and illustration direct GP direct access to plain imaging referrals Endoscopy referral pathway 2 Week Wait colorectal pathway New phone numbers for Cossham Birthsuite Quality Trauma Discharge Short news

Contacting services in Medicine For all outpatient referrals and all outpatient appointment enquiries, please use the Outpatient appointments number 0117 414 9400. For all other clinical correspondence, please use the specialty specific fax numbers below. Service Fax number Outpatient Appointments 0117 414 9400 Cardiac Cath Labs and Diagnostic Queries 0117 414 9416 Cardiology 0117 414 9377 Care of the Elderly 0117 414 9431 Diabetes and Endocrinology 0117 414 9402 Gastroenterology and Hepatology 0117 414 9435 Immunology and Allergy 0117 414 9386 Infectious Diseases 0117 414 9443 Medical Virology (HIV) 0117 414 9442 Respiratory 0117 414 9496 Medical Photography & Illustration Department Commercial video services include: clinical video Commercial photographic services include: clinical photography

patient information films online submissions for digital magazines patient interviews demonstration of equipment and techniques public relations and promotional material recording of lectures and presentations. public relations photography staff board photographs enhancement and adaptation of images. We also provide a bureau poster printing service. Please email posters@nbt.nhs.uk. For more information about our services and our prices please visit our web page: https://www.nbt.nhs.uk/our-services/a-z-services/medical-photography-illustration General enquiries: 0117 4146500/501 or email photography@nbt.nhs.uk GP direct access to plain imaging referrals GP X-Ray services: Clevedon Hospital, Old Street, Clevedon, Bristol, BS21 6BS Monday to Friday 0900-1600 hours (Closed for lunch 1300-1400hours) Cossham Hospital, Lodge Road, Kingswood, Bristol, BS15 1LF Monday to Friday 0815-1630 hours Gate 18, Brunel Building, Southmead Hospital, Bristol, BS10 5NB Monday to Friday 0815-1630 hours Yate West Gate Centre, 21 West Walk, Yate, BS37 4AX Monday to Thursday 0800-1930 and Friday 0830-1630 hours

The community X-Ray services at Yate Health Centre, Cossham and Clevedon hospitals are able to provide X-Ray imaging for walk in patients with the exception of the following patient types: patients presenting with a high clinical suspicion relating to hip/pelvic or spinal fracture transport patients (except Chest X-Ray and extremity imaging) patients with limited mobility that require manual handling and hoisting (without prior arrangement with the X-ray department) Any patients in these categories should only be directed to Southmead Hospital Bristol, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB Endoscopy referral pathway 2 Week Wait all referrals to be made via ICE only. Non 2 week wait all referrals to be made to the relevant gastroenterology / upper GI surgery / colorectal / respiratory service (via E-referral where available). Upon receipt the receiving clinician will triage and request the procedure via ICE and arrange any other tests or outpatient appointments as appropriate. Please note - all 2 week wait referrals to be made via ICE only. The endoscopy service cannot accept paper, email or fax referrals directly to them.

2 week wait colorectal pathway Why Use the ICE 2WW referral system? Allows GPs to book straight to test Takes away the need for a structured referral form and internal triage to test Has reduced the time to colorectal cancer diagnosis from 28 to 11 days Improved 62 day cancer performance Good feedback from GPs and patients For all the information (including criteria) you may need regarding this pathway, please visit our web page. The ICE referral system is set up for patients who fulfil one of the NICE criteria. If your patient does not fulfil the criteria you will not be able to book them direct to test. However, these patients can be referred under the 2 week wait if you suspect that they may have cancer. Please refer these patients to a 2 week wait clinic via NHS ereferral. If you have any questions or concerns about the pathway, please contact any member of the colorectal or endoscopy team: Colorectal cancer nurse specialists 0117 4140557 Colorectal secretaries 0117 4140828, 0117 4140838, 0117 4140835 Endoscopy 0117 4145070

New phone numbers for Cossham birthsuite Please be aware that the numbers for Cossham birthsuite have changed. Please see the table below for the changes. The old numbers will continue to work until November but please update your contact details now. Cossham Birthsuite 0117 41 45150 Cossham Community Midwife 0117 41 45160 Community Midwife 0117 41 45159 Quality trauma discharge UK Major Trauma Networks were launched in 2012 and have reported significantly reduced mortality in the first years of operation. Whilst mortality has reduced, post discharge and rehabilitation concerns remain the most common issues identified at annual national peer review visits and through patient feedback. The current discharge process is focused on the patient leaving hospital rather than exploiting an opportunity to educate and facilitate enhanced recovery. Quality Trauma Discharge (QTD) is a group of simple interventions which aim to do this: The after hospital care plan is an online patient controlled record which reflects the individual needs of the patient. It forms the basis of a structured discharge consultation delivered by a specialist Major Trauma Practitioner and Pharmacist. The electronic portal also contains the mandated rehabilitation prescription which can be used as a detailed referral document outlining the HPC and ongoing needs. A telephone follow-up call to the patient which occurs two weeks following discharge is used to reinforce the information provided and to troubleshoot identified problems.

In the first year of QTD, key outcome measures were very positive: Significant reduction (51% vs 71%, p=0.0037) in unscheduled GP attendances following discharge Increased level of patient activation (PAM) to manage individual healthcare needs Significant improvement in hospital rating score (9.1 vs 8.2, p<0.0001) Components of QTD QTD has improved our ability to deliver safe, individualised care which is responsive to the needs of our patients and empowers them to self-manage beyond the point of discharge. The electronic format has also allowed seamless information-sharing between clinicians in a regional service. QTD is now an integral part of the service that the major trauma team provides to our patients and their families. We have demonstrated that it improves the quality of care we deliver to our patients whilst reducing demand upon primary care services. As we embed QTD into our routine practice we are continuing to refine and evaluate each component to ensure we deliver the most effective and efficient intervention. Concurrently, with support from the Health Foundation and Patients know best we are working to spread QTD within the local and National Trauma Networks and also to other patient groups within our hospital. This is an extremely simple intervention which makes a significant difference and has huge potential.

Short news Dr Greenslade (Pain Centre) has retired from the Trust. NBT is now out of special measures. You can see our annual report here. Macmillan Wellbeing Centre has launched a new bra-fitting service for women undergoing mastectomy surgery and breast reconstructions. For more information visit their web page here. Dr Carmen Arnáiz GP Liaison Manager Headquarters North Bristol NHS Trust Southmead Road, Bristol BS10 5NB Direct Line: 0117 4143937 Email: carmen.arnaiz@nbt.nhs.uk Secure email: carmen.arnaiz@nhs.net