The Trust

celebrates one

year with no

hospital acquired

MRSA infections!

Ashford and St Peter’s Trust

has now gone a record 357 days

(as of 20th July 2011) without a

hospital acquired MRSA

bacteraemia, as defined by a

positive blood culture taken

more than 48 hours after

admission into the Trust.

Between April and July 2010 we

had 5 such cases. However, 3

were likely to be false positives as

the patients responded to

antibiotics that would not treat

MRSA.

We introduced drastic measures

to reduce the risk of further

contaminated samples. At the end

of August 2010 we introduced a

phlebotomy-led blood culture

taking system. There was training

and competency testing for other

staff, as a result of which the

numbers of likely skin

contaminants

in blood

cultures has

fallen by

80%.

We have also maintained our

focus on other potential sources of

MRSA bacteraemias such as good

insertion and care of intravenous

lines and urinary catheters.

All of which means we have had

no further infections since July

2010. We have had the longest

period without a post-48 hour

case of all our neighbouring

hospitals.

For further information on our

infections control services please

contact: Dr Angela Shaw,

Consultant Microbiologist, 01932

723423 or Linda Fairhead,

Consultant Nurse infection control,

01932 722128

August 2011

Our aim is to transfer patient care

from Dr Kadiwal to Dr Anis (For

further details, see page 3) with

minimal delay, disruption and

confusion to your patients. It may

be that in order to achieve this

some care may be transferred to

Dr King, Dr Block, or myself.

Please let me know if there are

any particular difficulties with this

process, and I'll do my utmost to

resolve them.

Pain management clinics are

currently run at St Peter's

Hospital, Staines and Woking

leisure centres. In order to

improve patient access we plan to

run Pain Management Programme

courses in Ashford Hospital in the

near future, details will follow. We

are also looking to expand our

range of satellite clinics to include

Hounslow.

Surrey PCT guidelines for

interventional pain procedures

have recently come into force. The

impact of these should be minimal

to your patients as our clinicians

are already working to the highest

standards based on the best

available clinical evidence.

We would be delighted to visit

your practice to meet with you. We

can also offer discussions or

lectures on Pain Management at

your practice or locality meeting. If

you would like us to do so, please

contact our secretary on 01932

722579.

Dr Ian Hart FRCA FFPMRCA

Pain Specialty Lead

Ian.Hart@asph.nhs.uk

01932 722579

Pain Management Service

You may have heard that Dr

Kadiwal is taking well

deserved retirement after many

years work in the Pain Clinic at

Ashford Hospital. We wish him

a long and happy retirement.

We also want to assure you

that we continue to offer a

multidisciplinary pain

management service

acknowledging the

biopsychosocial nature of

pain. We know that single

dimensional treatment rarely

brings about long term

benefits to patients.

Rheumatology Services

at Ashford Hospitals

• Arthritis and

musculoskeletal conditions

affect 1 in 5 of the UK

population

• At Ashford Hospital the

average waiting time from

GP referral is 40 days (less

than 6 weeks), well below

the 18 week target.

• To support the consultant

led clinics there are also 5

specialist nurse led

outpatient clinics.

• Both the consultant and

specialist nurse led clinics

run at Ashford Hospital on

Tues – Fri am, with 2 clinics

running simultaneously on

Thursday mornings.

• In addition, the

rheumatology service

supports two helpline

numbers. The advice line

number for patients who

are experiencing a disease

flare up is 01932 722703.

• The GP enquiry line for

general enquires and

results is 01932 722396.

Osteoporosis

assessment –

bridging the gap

Fragility fractures are defined

by a fracture of any site

following a fall from standing

height. The NHS treats 300,000

fragility fractures annually,

including 76,000 hip fractures at

a cost to the NHS of £2.3 billion

per year. Once a patient has

experienced one fragility

fracture they are twice as likely

to experience further fragility

fractures if not treated

appropriately.

NICE issued updated guidelines

for the secondary prevention of

osteoporotic fractures in post-

menopausal women (TA161) in

Jan 2011. Comprehensive

implementation of these guidelines

will help to prevent half of all future

hip fractures.

There is currently no established

local system whereby patients

presenting with non hip fractures

are assessed for osteoporosis. A

small number of elderly patients

who are discharged from fracture

clinic or A&E will be assessed by

the GP providing it is clear from

the clinic letter that a fragility

fracture had occurred.

To address the issue, a trial was

undertaken April – July 2010 to

improve the assessment rate for

patients over the age of 50

presenting to A&E or fracture clinic

with a fragility fracture. For these

patients a letter was sent to their

GP requesting osteoporosis

assessment (with guidance for

that assessment). The patient also

received a letter requesting they

make a non-urgent appointment

with their GP for this assessment.

At the end of the trial 45% of

patients had been assessed as

per the guidelines. This represents

an improvement in the percentage

of patients assessed compared

with the “National Audit of Falls

and Bone Health in Older

People” (May 2011). Empowering

patients appears to improve the

chance of a patient being

assessed or treated for

osteoporosis but the majority of

patients remain at risk.

One of the key messages from the

National Audit is that a Fracture

Liaison Service (FLS) is essential

to close the management gap for

secondary prevention of

osteoporosis.

The FLS was first introduced in

Glasgow in 1999 and is a nurse

led osteoporosis clinic which offers

a comprehensive mechanism for

the treatment and assessment of

patients who have had a

osteoporotic fracture. They can

now demonstrate a 97 – 99 %

assessment rate for their patients.

This has lead to a 7.3% reduction

in hip fractures compared to a 2%

year on year increase elsewhere

in England and Wales.

ASPH is currently exploring the

option of establishing a FLS. This

service would ensure that all

fracture patients over the age of

50 would receive the appropriate

investigations and assessments at

the point of contact. Until this

becomes operational it is essential

we remain vigilant in identifying

patients with fragility fractures and

offering them assessments and/or

treatments as required.

For further information on the trial

or the osteoporosis assessment

guidelines please contact:

Dr Keefai Yeong Consultant

Geriatrician

Keefai.yeong@asph.nhs.uk

01784 884246

New Appointments – Enquiries or Changes: 0208 296 2887 or 0208 296 2283

Follow Up Appointments – Enquiries or Changes: 01784 884351

(Secretary @ St Peters Tel: 01932 722306 Fax: 01932 723575)

Renal department

Contact Details

Physiotherapy Survey: Have you completed yours? Closing date: 31st August 2011 http://www.surveymonkey.com/s/CNRTM79

Mr Tahir Ali, MBChB MS (Lon)

MRCS (Eng) FRCS (Gen). Mr Ali

is a substantive General and

Vascular Consultant Surgeon at

both Ashford and St Peter’s

Hospitals NHS Foundation Trust

and Epsom General Hospital.

Tahir graduated from Leicester

University Medical School and

completed his postgraduate

general surgical training in

London.

He is a fellow of the Royal College

of Surgeons of England and has

been awarded a Master of Surgery

degree from the University of

London for his research into

improving outcomes following

venous thrombosis. Following

completion of his training, Mr Ali

was awarded a

national

fellowship at

Guys and St

Thomas’

Hospital to undertake further

specialisation in interventional

radiology and endovascular

surgery.

Mr Ali has published and

presented both nationally and

internationally. His main clinical

interests include endovascular

surgery, lower limb

revascularisation, diabetic limb

salvage, abdominal and thoracic

aneurysmal disease, venous

ulceration, minimally invasive laser

therapy of varicose veins, varicose

vein surgery, sclerotherapy for

venous anomalies, lymphoedema,

key hole surgery for hyperhidrosis,

thoracic outlet syndrome and

carotid artery surgery for

prevention of stroke. In addition,

Mr Ali also undertakes a range of

general surgical procedures

including open and laparoscopic

hernia surgery, day case surgery

and laparoscopic

cholecystectomy.

How to Contact Dr Ali: tahir.ali@asph.nhs.uk, sec: 01932 722232 or

mobile 07779271851 .

How to Refer: For Choose and Book Mr Ali’s clinics can be found

under general surgery and vascular surgery. Mr Ali is also available

as a named consultant.

Welcome To Dr Ali

Sexually Transmitted Infections Foundation Course (STIF)

Monday 19th

September—STIF Foundation £150 ,

Tuesday 20TH

September 2011 - STIF Plus £150

Or £250 for Both Days

at Waverley Abbey, Farnham

The aim of the course is to equip participants with the basic knowledge, skills and attitudes

for the effective management of STIs. The course is designed for both doctors and nurses working in general practice.

For further information or to book please contact: Shirley Cumming 01932 723645 or use

the link: http://nww.asph.nhs.uk/docs/stif_form_2011.pdf

Pain Clinic

Welcomes Dr Anis

Dr Saad Anis is the new

consultant in pain management.

He is a graduate of the

University of Liverpool and

completed his post graduate

education in London.

Dr Anis trained in anaesthesia at

Barts and the Royal London

Hospital before choosing to

specialise in chronic pain

management. Saad’s pain

management training was

undertaken at Basildon University

Hospital, and his Advanced Pain

Training at the Heart of England

Trust. He is a

Fellow of the

College of

Anaesthetists of

Ireland and has

a BSc (Hons) in

Human Biology.

Dr Anis is an extremely dynamic

consultant with a keen interest in

the biopsychosocial model of pain

management. He has been

published in peer review journals

and presented at both national

and international meetings.

He has a keen interest in medical

education and is completing a post

graduate certificate in medical

education from Staffordshire

University.

How to Contact Dr Anis: Saad.Anis@asph.nhs.uk

How to Refer to Pain Management:

Paper or fax referral to named consultant Dr S. Anis or his col-

leagues Dr R. Block, Dr A. King or Dr I. Hart. Fax: 01784 884291

For Choose and Book clinics can be found under : Service: General

Pain Management and Clinic: Pain Management

Price Increase for Private Blood Group

Testing

Due to an increase in costs, prices will

increase from 1st August 2011

Private tests taken at the GP surgery will

be £30, tests taken at the trust will be £40

Cheques should be made payable to:

Ashford and St Peter’s Hospitals NHS

Foundation Trust

Contacts

“The Contemporary

Approach to AF

Management”

presented by

Dr. Riyaz Kaba

Wednesday 21st September 2011

6.30-8.30pm.

The Lightbox, Chobham Road,

Woking, Surrey, GU21 4AA

Hot buffet will be served from

6.30pm with the presentation

beginning at 7.15pm.

Limited places available, to reserve

your place,

please contact Caroline Simpson on

01932 723581 or email

caroline.simpson@asph.nhs.uk

This seminar is kindly sponsored by AGA

Medical Ltd

Dates For Your Diary

ASHFORD HOSPITAL GENERAL PRACTITIONER LUNCHEON

CLUB AUTUMN TERM 2011

Ashford Education Centre 1pm to 2:45pm, sandwich lunch from 12:30

To register please contact Gladys Essien

gladys.essien@asph.nhs.uk 01932 723987

Thursday 8th

September

Investigating Bowel Problems –direct to test colonoscopy; barium enema, CT colonoscopy

Speaker TBC

Coeliac Disease Dr Sohail Butt GP Ashford

Wednesday

5th October

Programme TBC

Thursday 10th

November

Spotting the sick child - managing acute respiratory infections.

Dr Bhatti Paediatric Consultant ASPH

Safeguarding Children Dr Tara Jones PCT lead GP for Safeguarding Children

Wednesday 7th

December

Dementia - Legal Issues, Consent and Capacity

Dr Rejin Dayandanan Consultant Psychogeriatrician

End of Life care in the

community

Dr Fiona Bailey Consultant in Palliative Care ASPH

Prescribing Update PCT Pharmacists

Using Antipyretics PCT Phamacists

Prescribing in Dementia PCT Pharmacists

and Dr Dayandanan

ST PETER’S GENERAL PRACTITIONER LUNCHEON CLUB

AUTUMN TERM 2011

TUESDAYS 12:15pm – Lunch, 1-2 pm – Meeting

Post Graduate Education Centre, St Peter’s Hospital. Details will be

circulated when available.

Save The Date:

20th October 2011

GP Spotlight Seminar at

Foxhills. 6:30 - 9:30pm

Paediatric Allergy Service

Survey

http://www.surveymonkey.com/s/

R582KMZ

Please complete before 31st

August 2011

If you have any feedback on this

publication or the Trust in

general, require any further

information about the Trust or

require this document

electronically please contact:

Sue Robertson,

01932 722420

Sue.Robertson@asph.nhs.uk

Debbie Beesley,

CAB Manager and Assistant GP

Liaison Manager,

01932 723511,

Debbie.beesley@asph.nhs.uk