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GP Round Up Issue 67 | April 2016 Dear GPs and practice managers This month I am delighted to let you know that our 2 week pathway for urgent skin referrals is seeing patients on time again. The dermatology department has worked closely with the CGG and wider cancer network to improve performance. Consultant Dermatologist Helena Malhomme has led her team through the changes and together they have successfully streamlined the referral process for tele-dermatology, revised the 2ww referral form and made plans for a GP education programme. In this issue we also have other good news to share with you about new orthopaedic services, national recognition of our excellent end of life care and the success of Whitley Day Unit for heart failure patients one year on. Dr Lindsey Barker Medical Director ---------------------------------------------------------------------------------------------------------------- Dermatology good news We are delighted to report that patients who meet our 2ww referral criteria for skin are being seen on time again. We are now taking steps to ensure that we continue to see all patients in a timely manner. We have appointed a full-time locum from May for 6 months, a “see and treat” service at Townlands commences in May and a GP VTS will be working with us from August. 1 We will also be encouraging GPs to attend our Friday “see and treat” clinics at RBH and WBCH to gain experience and confidence in diagnosing skin lesions (more detailed information will be circulated by the CCG) If you have any queries please get in touch with Dr Helena Malhomme Clinical Lead Dermatology Email: helena.malhomme@royalberks hire.nhs.uk GP Round Up Issue 67 | April 2016 New T&O “Hip Knee Elbow Shoulder & Paediatric” clinics The Orthopaedic department recently welcomed two new Consultants to their team. Giuseppe Sforza specialises in shoulder & elbow surgery and Ed Tayton specialises in hip & knee surgery. Ed Tayton (pictured left) qualified from The Royal Free (UCL) in 2002 and is nearing the end of his Higher Surgical Training with the Wessex Deanery. He took time out of the programme from 2010 to 2012 to undertake a PhD with the Bone and Joint Research Group at the University of Southampton as a MRC Research Fellow. Giuseppe Sforza studied medicine at the University of Bari, Italy and in 1999 he was appointed shoulder surgery fellow at the Reading Shoulder Unit. In 2000 after completion of his fellowship, he returned to Italy and was appointed Consultant Orthopaedic Surgeon. In 2004 he joined the Reading Shoulder Unit. In 2007, he was appointed Consultant Orthopaedic Surgeon in Redditch, Worchester Acute NHS Trust. Short waiting times! Hip or knee appointment in 1 week followed by surgery within 1-2 weeks. Shoulder appointment in 3-4 weeks and a further 4 week wait for shoulder surgery. Hip & knee RBH WBCH Bracknell &Townlands Ed Tayton: weekly clinics, alternating between RBH and Bracknell. All-day fracture clinic @ Newbury (WBCH) each Tuesday Richard Dodds: knee clinic on the 1st and 3rd Thursdays of the month at Townlands Hospital Bryan Riemer (in post from May): weekly hip & knee clinic from 17th May T&O Paediatrics Townlands Richard Dodds holds a general paediatric clinic on the 2nd and 4th Thursdays of the month. Shoulder and Elbow RBH & WBCH Giuseppe Sforza holds twice weekly clinics at RBH (accompanied by a Clinical Fellow and a Physiotherapist). On the 3rd Thursday of the month, the shoulder clinic is held at WBCH. We are keen to receive more orthopaedic referrals and wish to work with primary care to ensure that the services we provide meet the needs of our local community. Please email [email protected] Surgical Directorate Manager or call 0118 322 6660 if you have any questions. 2 Follow the Trust on Twitter @RBNHSFT GP Round Up Issue 67 | April 2016 Dying Matters to us In a recent audit led by the Royal College of Physicians “End of Life Care – dying in hospital” , the Trust achieved scores between 82% and 96% compared to the national average of 56% to 84% across 5 indicators. Mindful that every patient is someone’s loved one, the Trust has invested in end of life care training across clinical and support staff. There is a close relationship with local community health and social care providers (including GP and district nursing, palliative care teams and hospice care providers), to give patients who do want to die at home, the chance to do so. Susi Lund is the Trust’s End of Life Care lead. She puts the Trust’s performance in this emotive area down to our staff’s focus on delivering excellent quality of end of life care. Susi explains “Ultimately, when you lose someone close to you, you remember the people around you in hospital at that time and it is important to those who work at the Trust that we are remembered for our compassion, and our care, for the patient and for the families. “Our End of Life Governance Group includes clinical, pastoral and support staff. The group focussed on what we thought was important at the end of a person’s life and the care we would want to see given. That is the standard we set ourselves: what care would we want for ourselves or our family.” It should also be noted that the Trust has good Hospital Standardised Mortality Ratios (HSMR) which means that fewer people die at the hospital than would be expected according to the last reported annual data for 2015/15. We are delighted to be identified as a national leader in delivering end of life care in Next day RACOP appointments for the elderly Please consider referring elderly patients to the Rapid Access Clinic for Older People (RACOP) whenever possible, rather than sending them to A&E. This clinic is suitable for those with anaemia (Hb 74); unexplained breathlessness that may be idiopathic pulmonary fibrosis; heart failure with hyponatraemia (normally about 130, had fallen to 126); 3 month history of worsening cognition and falls (with several unsuitable medications). Referrals can be made by telephone conversation with the registrar or consultant covering RACOP from 8.30-16.30 via switchboard (0118 322 5111) and then asking for bleep 510. In this way patients can be seen on the next working day if necessary. 3 Follow RBFT on Twitter @RBNHSFT GP Round Up Issue 67 | April 2016 New Unit improves patient experience and saves 1000 hospital bed days The Whitley Day Unit at the Royal Berkshire Hospital has saved 1000 bed days in the year that it has been open. The innovative service was set up to improve the care of patients with heart failure, a chronic illness caused by the inability of the heart to pump properly. Patients with this condition typically experience breathlessness and, as the condition worsens, often accumulate fluid in their legs and lungs making day to day life difficult or impossible. Jon Swinburn, Consultant Cardiologist said: “In the past, when the condition reached the point that tablet medication was failing to control their symptoms, these patients had no option but to spend days, and often weeks, in hospital receiving intravenous treatment. “Since opening the new ‘Furosemide Lounge’, patients have been able to attend on a daily basis to receive intravenous furosemide to clear the fluid. They are assessed by a nurse and have blood tests performed in a visit that might last from one to four hours. “This results in a huge quality of life benefit for the patients, who, although they have to travel to hospital daily, still spend the rest of the day at home with their families. It is also more efficient and since starting the new service has saved the equivalent of almost three hospital beds. 80 year old Walter Clark from Newbury travels with wife Janet to the Royal Berkshire Hospital every morning, seven days a week, to receive his treatment and said: “I can’t praise the staff and the service highly enough,” “Everyone is so considerate, helpful and professional. Being able to have my infusion and then carry on my day in the comfort of my own home with my family is fantastic. If this service wasn’t available I would have to stay in hospital for the duration of my treatment - so far that’s been two weeks and it’s not finished yet." As well as receiving excellent praise from patients, the service has received endorsement from the British Heart Foundation, and hosted visits from other Trusts across the country and healthcare commissioners who have been interested to find out more about how the service was set up and operates. Consultant joiners and leavers Recently we welcomed Ed Tayton and Giuseppe Sforza to T&O. Dana Brooks has been appointed to a substantive post in Gastroenterology. We bid farewell to Margaret Myszor Gastroenterology Consultant at the end of March. 4 Follow RBFT on Twitter @RBNHSFT GP Round Up Issue 67 | April 2016 GP pages on Trust website The Trust website http://www.royalberkshire.nhs.uk/ has a new layout and resources for GPs are all in one place under the blue “GP” tab http://www.royalberkshire.nhs.uk/gps.htm at the top of the main page. The following links may be found in the GP section: Directory of outpatient services http://www.royalberkshire.nhs.uk/directory-ofservices.htm GP secure online resources http://www.royalberkshire.nhs.uk/gp-secure-onlineresources.htm Clinical and referral guidelines http://www.royalberkshire.nhs.uk/gp-referralinformation.htm Consultant directory http://www.royalberkshire.nhs.uk/consultant-directory.htm GP Newsletter http://www.royalberkshire.nhs.uk/gp-newsletter.htm Choose & Book http://www.royalberkshire.nhs.uk/choose-and-book.htm Continuing professional development for GPs http://www.royalberkshire.nhs.uk/continuing-professional-development.htm Patient information leaflets http://www.royalberkshire.nhs.uk/patient-informationleaflets/ Infection control information http://www.royalberkshire.nhs.uk/infection-controlinformation.htm How to raise a query or concern http://www.royalberkshire.nhs.uk/how-to-raise-aquery-or-concern.htm How to Raise a Query or Concern We welcome feedback from GPs and Practice Managers, so please let us know if you experience any problems with our services by sending a secure email to [email protected]. Alternatively you can telephone Caroline Hillman GP Liaison Manager on 0118 322 5313. We will acknowledge your concern within 3 working days. If a GP wishes to raise a formal complaint, this should be made in writing (by letter or email) to Lindsey Barker Medical Director. Alternatively, if the complaint is of a sensitive nature, the GP may prefer to telephone or speak to Lindsey in person. Our Patient Advice and Liaison Team (PALS) focus on providing support and on the spot help to patients, relatives and carers and can be contacted via [email protected] The PALS Team also investigate serious patient complaints. 5 Follow RBFT on Twitter @RBNHSFT