Issue Number 2Summer 2009

GP

Following publication of the Darzi report last year, patient safety has rightlybecome the major area of focus in attempts to improve clinical quality. TheTrust is totally committed to this issue and has embarked on a series of

initiatives to ensure that patients are safe in our hands. Every year we will focus onspecific areas of risk and commit further resources toimproving patient care in those areas.

During 2009/10 we are targeting medication prescribingerrors and hospital acquired infections. Medication errorsaccount for nearly half of all serious adverse events inhospitals and are a major source of patient harm. We aim toreduce our error rate by 50 per cent within the next year.

Last year saw a drop of over 50 per cent in our MRSA andC difficile rates at NNUH, making us one of the best performing Trusts in the Eastof England. As well as further reducing these infection rates, we are committed toachieving similar reductions in central line and surgical site infections.

In April the Trust appointed Dr Debbie Browne, consultant anaesthetist, asDirector for Patient Safety and she will chair a new Patient Safety Committee madeup largely of experienced clinicians. This committee will monitor all aspects ofpatient mortality and safety and produce regular reports for staff and the public.

We would appreciate any information or ideas you may haveto help us provide our patients with totally safe care.

Krishna Sethia, Medical Director, Norfolk and Norwich University Hospitals

NHS Foundation Trust

Stroke services are changing FAST NNUH IS working in partnership with

Norfolk Community Health and Care to

develop a seamless approach to specialist

stroke care in central Norfolk. With the help

of the ambulance trust, social services and

the voluntary sector, the aim is to achieve

improvements along the entire patient

pathway.

Coinciding with the Government’s TV

advertising campaign to help people

recognise stroke symptoms and seek help

FAST (the intials stand for Facial weakness,Arm and leg weakness, Speech problems,Time to call 999), NNUH now provides clot-

busting thrombolysis 24 hours a day, 7 days

a week. Additional medical, nursing and

therapeutic staff have been recruited to

ensure rapid assessment of patients

(including CT scanning) and hyperacute

care immediately following stroke.

Specialist rehabilitation will be provided

in a dedicated 24-bed unit which is currently

being built at the Norwich Community

Hospital, in the same complex as another ~

24-bed rehabilitation ward.

An early supported discharge team is

being established with the recruitment of

30 staff including nurses, therapists, social

workers and rehabilitation assistants. The

team will provide specialist stroke care in

patients’ own homes and will be a model

that we hope to replicate across central

Norfolk. For the first time there will also be a

clinical psychologist employed in the stroke

service to help patients and their families

come to terms with the life changes brought

about by having a stroke.

Stroke is the third largest cause of death in

England and is the single largest cause of

adult disability. These new developments

commissioned by NHS Norfolk will have a

significant impact on stroke services,

ensuring patients and their families receive

high quality specialist stroke care to enable

best possible recovery.

Infection ratesat record low

NEWS FROM

UpdateINFECTION RATES at the Norfolk and

Norwich University Hospitals NHS

Foundation Trust have fallen to a record

low. In the financial year 2008/09, there

were 15 cases of MRSA infection (down

from 33 the year before) and 139 of C

difficile (down from 326 the year before).

Five of the MRSA patients had acquired

the infection in the community before

being admitted to hospital.

The Trust has now expanded its

current MRSA screening programme for

all patients having elective surgery. Those

colonised by MRSA are offered a special

antibacterial skin wash and cream for the

nostrils which helps to clear the bacteria

prior to hospital admission.

The reduction in C diff infection has

been achieved with the help of changes

to antibiotic prescribing, the use of

isolation rooms, and deep cleaning of

infected areas, as well as scrupulous hand

hygiene.

REFERRAL BETWEEN CONSULTANTS We are aware that consultant-to-consultant referral can be confusing. Therules currently are: if another opinionrelating to the same condition is neededthen internal referral is appropriate. Thiswould include, for example, a referralfrom rheumatology to orthopaedics for ajoint problem, or a cardiological oranaesthetic assessment prior to surgery.If, however, the patient raises anothercomplaint then the consultant is obligedto refer back to the GP who can decide ifanother referral is necessary.

DO YOUR GPS HAVE QUESTIONS FOR DIFFERENT SPECIALITIES?When the Medical Director, KrishnaSethia and I visit practices some of thequestions often refer to differentspecialities within the hospital. If yourpractice would like a visit from aConsultant from a specific hospital areaplease contact me and I will arrange at amutually convenient time.

ROADSHOWS WILL GO ONThe second GP IT Roadshow took placeon the 26 March and was well attended.

It is my intention for us to continue withthe roadshows as feedback has indicatedthat they are very worthwhile, allowinginformation to be exchanged andinformation shared. Let me know if you have any thoughts on topics for anautumn roadshow.

HELP PATIENTS TO BE PREPAREDPlease ensure that all patients who reportto us for blood tests arrive with a validrequest form (preferably computerised).as we cannot print or raise forms in ourphlebotomy department.

Glucose Tolerance Tests (GIT) are byappointment only and unfortunately wecannot accommodate people who havefasted but turn up without a pre-bookedappointment.

GP UPDATE SUMMER 2009KEY CONTACTS

New vascular theatre opens

GP UPDATEGP Update is edited by RebeccaPerry and produced by the NNUHCommunications team If you haveany questions, comments orcontributions please contactRebecca on 01603 289989 or byemail: rebecca.perry@nnuh.nhs.uk

Norfolk and Norwich UniversityHospitalColney Lane Norfolk NR4 7UYWebsite: www.nnuh.nhs.uk

On-call: For emergencies tel: 01603 286286 andask to be transferred to the on-call SpR.(bleep 0080). There is also an on-callgeneral (GI) and vascular consultantavailable via the switchboard.

Norwich Community HospitalBowthorpe RoadNorwichNR2 3TUTel: 01603 776776(Also Breast Screening, Pain Management)

Norwich Central Family Planning ClinicGrove RoadNorwichNR1 3RHTel: 01603 287345

PharmacyMedicines information line: 01603 287139

Pathology

Clinical Biochemistry and Haematology 01603 286929 / 286932 / 286959

Microbiology01603 288587 / 288588

Knowledge Norfolk website:

http://nww.eastern.nhs.uk/scripts/index.as

p?pid=73450&id=95975

NEWS IN BRIEF

NNUH IS expanding its theatre

capacity with the opening of a £1.5

million theatre designed for specialist

vascular surgery. It will be the focus

for complex aneurysm repairs, as

well as more routine operations.

New techniques make use of X-ray

guidance to insert stents into the

affected arteries without the need for

open surgery.

At NNUH more than 170

aneurysm repairs were carried out

last year, of which 53 involved the

stenting procedure. The Department of

Health published data that showed the Trust

had the best mortality rates nationally for

emergency AAA (abdominal aorta

aneurysm) repair.

The new theatre has been built within the

main theatre complex, bringing the total

number of theatres at NNUH to 29. It is the

first to be fully equipped with audio visual

links to beam live images to the education

centre for training purposes.

TV sports presenter Kevin Piper officially

opened the new theatre in March. He

commented: “It’s great to see the people of

Norfolk being offered such cutting edge

treatment and facilities and I’m delighted to

be involved in the opening of this new

theatre.”

SUMMARY FORMS REDESIGNEDFrom your feedback on the content andlayout of our Electronic DischargeSummaries we are keen to have asummary which better reflects the needsof GP practices.

We have now set up a group to reviewand redesign the summary with the helpof a representative from primary care. We are grateful for all your commentsand we look forward to workingtogether to improve the form. We willkeep you informed of our progress laterin the year