Four bits of news

The Royal Surrey Maternity Unit undertook UNICEF’s rigorous assessment in the spring and was awarded Gold in June. The Department has also maintained its Baby Friendly accreditation for twenty years and is one of only a few organisations in the county to be awarded the UNICEF’s Baby Friendly Gold Award.

According to latest statistics the Royal Surrey has the lowest death rate for cardiac arrest than any other hospital.

The latest national figures show that the Royal Surrey has 21% less deaths than would be expected given its case mix and is in the top 5 hospitals in the country.

Ever since the Maternity Department opened at the Royal Surrey in 1991there has been only one Obstetric Theatre and the Anaesthetic Room has been used as a back-up theatre for emergency caesarean sections when the existing theatre was in use. This has resulted in cramped working conditions for staff and potential safety issues for patients, neither of which is desirable for a unit that was graded as 'Outstanding' following last year's CQC inspection. All of this is about to change with the building of a new second Obstetric Theatre adjacent to the existing one, which will necessitate moving the existing Special Care Baby Unit to a new location. This will provide the opportunity to build a brand new unit which will offer more family-focused care by allowing new mum's to sleep alongside their poorly babies, even when those babies are requiring high dependency care. This will bring a degree of comfort and reassurance to parents at a very difficult time for them and is a new model of care which is not offered at any other Trust in the locality.

More awards for the Royal Surrey.

In an earlier blog (14 February) I reported that the Pregnancy Advice Line developed at the Royal Surrey and used across Surrey Heartlands had received a prestigious award. Well it has just received another. It scooped the Innovation in Practice award at the British Journal of Midwifery Practice Annual Awards.in Leeds

And there has been more success for the Royal Surrey. The Acute Frailty Pathway and the Emergency Laparotomy Collaborative have been shortlisted for the prestigious BMJ Awards 2019. The Acute Frailty Pathway is one of six projects to have been shortlisted for the Care of the Older Person Team award. And the Emergency Laparotomy Collaborative is a finalist in the Innovation in Quality Improvement Team category, also facing competition from six other entries.

Well done the Royal Surrey

Car Parking at the Royal Surrey

Car Parking has been a problem for years at the Royal Surrey. It was about to get much worse. Hospital staff have access to about 388 parking spaces on a plot of land near the hospital but Guildford Borough have now withdrawn permission to use it and it will be sold. Potentially that could be disastrous for staff – the hospital has enough problems recruiting and retaining staff !!! However it has been announced that monies have been included in capital allocations for a second floor over an existing area of car park probably to the rear of the hospital. It is expected to provide 400 spaces i.e. sufficient to restore the status quo. If planning proceeds smoothly it could be in operation by June next year.

But is there anything in the offing to actually relieve parking problems? It appears yes.

Firstly there are steps being taken to increase staff parking spaces which will allow more spaces on the hospital site for patients and visitors

·         Talks are well on the way to allow hospital staff to use some of the spaces at the nearby Park and Ride. With so many spaces empty that is just good common sense.

·         Talks are also underway to pay for some further staff parking spaces at another nearby area.

Secondly there are steps to reduce car traffic by improving public transport links.

·         Most significantly park and ride buses will soon stop at the hospital main entrance. The cost of Park and Ride is very much less than hospital parking charges and it will be much easier to find a space there than driving endlessly around the hospital site

·         Finally there is the new railway station proposed for Westborough with a pedestrian link to the hospital. Some way ahead I know but it has at last been approved.

Pregnancy Advice Line.    

The highly successful and popular Pregnancy Advice Line which was developed in the Royal Surrey and is used across Surrey Heartlands (approximates to West Surrey), continues to win wide acclaim. On 5 February it won the National Maternity and Midwifery Festival Innovation Award. The awards recognise the outstanding achievements and commitment by midwifery and maternity staff across the UK. It is among the shortlisted nominations for Innovation in Practice at the British Journal of Midwifery Practice Annual Awards in Leeds. Since it opened in April 2018, the service has been accessed by 10,000 women and is estimated to have freed up hundreds of hours of staff time which would previously have been taken up with phone calls. According to Jacqui Tingle, Deputy Director of Midwifery and Divisional Head of Nursing for Women and Children. ‘It’s a great example of forward thinking which has freed up our staff and hugely increased contact time in the Maternity Unit”.

Maternity team in the running for national award Royal Surrey’s maternity team and their colleagues in the Surrey Heartlands Trust have been shortlisted for the British Journal of Midwifery (BJM) Awards for ‘Innovation in Practice’.

The ‘Pregnancy Advice Line’ which was launched by Royal Surrey’s maternity team in April has been accessed by 10,000 women. Since its launch it has saved hundreds of hours of maternity staff time. Winners will be announced at the annual BJM awards in Leeds on 13 February – let’s hope they are rewarded

Latest on Stroke Services

In September 2017 a review of stroke services in Surrey recommended that the Royal Surrey lose its Hyperacute Stroke Unit (HASU) – a decision I opposed.  As reported in previous blogs, I on behalf of Royal Surrey Governors sought to persuade authorities to at least preserve Royal Surrey’s Acute Stroke Unit. That would allow those people living in Guildford and Waverley who experience a stroke and are taken to HASUs either at Frimley or St Peters, to continue acute care in the Royal Surrey close to family, friends and carers. The Royal Surrey Executive was in favour and as a result Frimley and the Royal Surrey came to an arrangement to allow this to happen and consequently Royal Surrey now has an ASU with a stroke consultant who shares her time with Frimley.

However no similar agreement proved possible with St Peters and, as reported in other blogs. I continue to pursue the matter particularly since it is people from Guildford who are most likely to be taken to St Peters and I am an elected Governor for Guildford.

In August last year I met with Claire Fuller who heads up the Surrey Heartlands Healthcare Partnership. She was sympathetic to the problem and told me several activities were underway which might have an impact and we agreed to meet again when matters were clearer. Thus on 2 January I met again with Claire Fuller who was joined by Mathew Tait who is the Chair of the Stroke Oversight Group for the Surrey Clinical Commissioning Groups (CCGs).

They were both very sympathetic to governors’ concerns but pointed out that

1.    An NHS England review was underway of stroke services in Surrey, Kent and Sussex. That will report later this year and might impact on HASU/ASU provision in Surrey but whatever the result any impact would be a long way off. Whether it would affect St Peters’ HASU and thus relationship with Royal Surrey is unknown.

2.    The number of stroke patients arriving at St Peters is significantly below the predictions of the modelling undertaken in the original CCGs review. Discussions with SECAMB had increased numbers slightly but this shortfall is of obvious concern. An audit is underway of stroke patients who have been taken to St Peters to get a clearer view of their pathways. This will report soon.

In the Guildford and Waverly CCG risk management report of 24 July 2018 the following was in the top 10 risks

“(Surrey Heartlands CCGs) if the flows from Guildford to ASPH for stroke patients are not achieved as modelled there is a risk that the clinical benefits and critical mass will not be realised and patient outcomes will not improve; workforce challenges and recruitment deteriorates; financial sustainability of the HASU/ASU at ASPH”

This has consequences for the likelihood of an agreement for patients from Guildford to be able to go to the Royal Surrey ASU after care in St Peters’ HASU.  Such an agreement would damage the fragile financial viability of St Peters stoke services – a consequence which would be unacceptable in that it would put at risk all the patients who they treat from other areas.

An audit of St Peters stroke patient pathways is underway. Mathew Tait said he would request that figures for patients originating in the Guildford area be analysed. It could be that ambulances are in fact taking ”Guildford” patients to Frimley hence the numbers problem at St Peters. If so the number of “Guildford” patients could be small thus diminishing the problem and, ifnumbers are small, perhaps they could transfer without much financial consequence.

Secondly stroke patients are likely to be away from home for the longest period when in a community rehabilitation facility and perhaps it is here that patients will most want visitors. Maybe it is at this stage that “Guildford” patients could transfer to a community rehabilitation closer to home rather than to Woking which is the default at the moment. Claire and Mathew said they would look in to this together with the results of the audit.

It was agreed that another meeting would take place as soon as the audit analysis had been completed – probably in 3 or 4 months. I will report.

New Chief Nursing Officer

I reported in an earlier blog that Louise Stead the Royal Surrey's Chief Nursing Officer (CNO) had been promoted to Chief Executive leaving a vacancy. That vacancy has just been filled by Jo Embleton who was Louise's deputy. The CNO is a key person in any hospital and we are lucky to have Jo stepping in to that post. I know her well and she is extremely competent, efficient and well liked.

Christmas decorations

I and fellow Governors had the pleasure of judging the hospital’s Christmas decorations. I always look forward to it. All wards participate and the effort which staff put in to it in their own time is wonderful. The winner is always announced on Christmas day and this year the winner was Eashing Ward which looks after the frail elderly and those with dementia. I mention it because of its theme. Apparently dementia patients tend to lose their will to eat because they lose their sense of taste. The last sense of taste to go is that of sweetness and so that was the theme chosen. Each bed bay was decorated with a different aspect of sweetness – donuts, fairy cakes, sweets, hockey-stick rocks – all beautifully hand made much with recycled materials. The other wards were also great but Eashing stood out. We are fortunate to have such dedicated staff at the Royal Surrey.