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www.stgeorges.nhs.uk/gpindex gp news For GPs and practice managers in SW London Issue 59 w May/June 2006 BRIDGING THE GAP PREMIER SAVER Medical Director Dr Chris Streather The Trust is forecasting an in-year on why the Trust wants to repair its deficit of £12m for 2005/06 relationship with local GPs. after saving £18m. Opinion - page 3 Full story - page 2 g ALSO INSIDE! UNVEILED: THE NEW w Endoscopy unit ‘excels’, say inspectors PATIENT GOWN w New ketogenic service for epileptic children SGH NAMED HEART ATTACK CENTRE FOR SW LONDONN THE TRUST has been named the of- the quality and speed of its clinical ficial heart attack centre for South care. West London by paramedics. “While we have had unofficial A bulletin sent to London Ambu- heart attack centre status for several lance staff on 22 March named St months now, everyone in the team is George’s as one of nine heart attack delighted that we have been award- centres in the capital. ed official recognition for the emer- Other heart attack centres include gency care we offer.” King’s College Hospital, Hammer- The teaching hospital treats smith Hospital and St Thomas’ Hos- around 1,500 heart attack patients pital. every year, and in 2005 became The hospital’s Director of Cardiac the fourth hospital in the capital Catheterisation, Dr Stephen Brecker, to launch a 24-hour primary angi- SUITS YOU: The welcomed the Trust’s new status: oplasty service. new gown is ‘com- ” St George’s is the main provider Around 250 primary angioplasties fortable, practical of cardiothoracic services in the re- are expected to be performed this and dignified’, say gion and has a strong reputation for year. patients and nurses A HOSPITAL gown that actually fastens at the back can make pa- HIGH-RES MRI SCANNER TO protects patients’ modesty? Hard to believe but, yes, from now on tients feel unnecessarily uncom- fortable and vulnerable. BOOST SCANNING CAPACITY the Trust’s patients will be spared “The old gowns worn by patients the embarrassment of accidentally were never attractive or dignified,” THE TRUST is to take de- our scanning capacity, which at baring their bodies to others as a she adds, “and our aim was to de- livery of a state-of-the- times has been hindered by the new gown – designed by nurses sign a gown that was comfortable art MRI scanner in June. age and maintenance needs of our and described as ‘practical, com- and dignified as well as practical The £750k machine, made by current machine.” fortable and dignified’ – hits the and functional for medical care. GE Healthcare and paid for by The new scanner will take three wards. In association with Sunlight the Department of Health, will months to install. Patients needing The new garment, dubbed a Healthcare Service Group, a com- replace one of the hospital’s two an MRI scan during this period will ‘dignity’ gown, is similar in style to pany that provides and launders MRI scanners that is 13 years be re-directed to a mobile unit in a Japanese kimono. It is wider and gowns for several hospitals across old. one of the hospital’s car parks. longer than its predecessor and the country, a team of nurses de- The new machine - a Signa fastens together at the front rather signed a new gown which patients 1.5 T HDMR - will produce scans than at the back. would find more comfortable and of a higher resolution than its The design of the gown allows dignified to wear. predecessor which will lead to doctors and nurses easy access to Jayne Quigley continues: “The the more accurate diagnosis a patient’s arm or neck to place in- fabric of the new gown looks and of diseases and health prob- travenous drips without the need feels so much better and is practi- lems. to ever remove the garment. cal, comfortable and dignified. The scanner is expected The gown was piloted by 40 pa- “The cornflower blue colour to perform around 4500 tients at St George’s Hospital ear- suits all skin tones and makes eve- scans every year. lier last year. ryone look better. We’ve provided Medical Director and “Being a patient in hospital can access at the neck for patients who Radiologist Dr Derek be a stressful time,” says Jayne need drips and drains, and sleeves Dundas, says: Quigley, a senior nurse from St have been given poppers so that “The new scanner George’s Hospital and one of the they can be opened for patients will improve the qual- new gown’s designers, “and the with large arms.” ity of our images and indignity of wearing a gown which Endoscopy unit ‘exc THE ENDOSCOPY unit at St George’s Surgeons, Radiologists and GPs, praised Hospital is set to become a screening the centre for being ‘an exemplary unit LOOKING TO THE FUTURE: Dr Murray Bain and ward receptionist June centre for bowel cancer after reviews by deserving of its national and interna- Goodrich welcome the new WIFI technology the Government and a group represent- tional reputation.’ ing four Royal Colleges described it as an “The staff are motivated and have an ‘outstanding’ centre for patient care and , excellent team spirit” notes the report KIDS WARDS GO WIFI medical training. The reviews, which were held in No- vember 2005 by the Department of by JAG and adds that the unit ‘demon- strates a culture of service improvement and clearly puts patients first.’ WIRELESS technology on the Trust’s clinician for paediatric medicine and Health and the Joint Advisory Group The unit scored ‘straight As’ in a sepa- paediatric wards is allowing doctors one of the architects of the project, (JAG) on GI Endoscopy which acts on be- rate review of its services by inspectors to view test results at the bedsides the WI-FI technology has improved half of the Royal Colleges of Physicians, from the Department of Health who of their patients and complete im- the efficiency of the ward round and portant discharge paperwork more simplified the bureaucratic way of TRUST SHOUL quickly. discharging patients: The hospital’s four paediatric “This project is a good example of wards have been equipped with how technology can improve clinical wireless-fidelity (or WI-FI) transmit- efficiency and reduce unnecessary ters that allow doctors armed with paperwork,” says Murray. WITH DEFICIT laptop computers to access test re- “The ward round was continually sults and complete discharge forms being disrupted by doctors having online. to go and find a vacant computer Before the wireless revolution last terminal for the most recent results. summer, the discharge process for “By filling out one hand-written doctors was a lengthy, drawn-out form at the point of discharge and affair. then typing up another, more formal, THE TRUST is expected to report an in- “However, there will be many staff Doctors would have to complete record several weeks later, we were year deficit of £12m for 2005/06 follow- and patients who will be sorry to see an initial discharge form by hand. in effect doubling our workload and ing the eleventh hour sale of the Atkin- the Trust lose such an important part of Copies of that form would then be making everyone wait for very im- son Morley Hospital in Wimbledon at its heritage. given to the patient, their GP and portant information, especially the the end of March. “The old hospital had a wonderful the hospital’s team of clinical coders. patient and their GP. The hospital, which was home to the sense of community and it will be re- Weeks later, a formal discharge sum- “Now, with the aid of WI-FI tech- neurosciences unit until 2003 when membered with great affection by eve- mary would be typed up. nology, without disrupting the ward services transferred to the Atkinson ryone who worked there.” The electronic paper record (EPR) round we can access the most up to Morley Wing at St George’s Hospital, St George’s was asked by the South could only be accessed from the date results and the amount of pa- was sold to a private developer on Fri- West London Strategic Health Author- nearest unused computer terminal perwork our team has to deal with day 31 March - only a few hours before ity to hit a target deficit of £12.5m by if results were required on the ward can be substantially reduced while the end of the financial year. March 2006. round. our clinical coding is now far more The hospital, which fetched £15.1m, To reach the target, the hospital has Now, with the aid of an online form accurate. will now be turned into a private medi- had to make savings of around £18m from a system called ‘Merlin’, doctors “Patients now leave the hospital cal facility. through a combination of measures can complete the formal summary with a formal and legible record of Around £11.5m will be given to the which included the closure of around at the bedside before their patients discharge while their GPs receive a South West London Strategic Health 100 beds and the removal of 300 posts leave the ward. copy of that form a few days - rather Authority to repay a loan which helped from the organisation - 230 of which According to Dr Murray Bain, lead than a few weeks - later.” fund construction of the Atkinson Mor- were vacancies. ley Wing while the remaining £3.3m The Trust has also cut back on the use will be kept by the Trust to improve its of expensive agency and bank staff. financial position. However, the number of patients SERVICE NEWS: ANTI-D PROPHYLAXIS FOR The completion of the sale means the treated by the hospital has risen by RHESUS NEGATIVE PREGNANT WOMEN Trust is expected to end 2005/06 with an in-year deficit of £12m, as the Trust’s 5,000 this year while the average length of stay across the hospital has fallen - THE TRUST’S maternity unit Please contact Pauline Curran, Chief Executive, Peter Homa, explains: from seven to six days. will be offering routine an- antenatal screening co-ordinator “The sale of AMH will improve our fi- MRSA bacteraemia infections have tenatal anti-D prophylaxis on 020 8725 0948 for more infor- nancial position and we are more than also remained low with 63 cases re- to rhesus negative women mation. likely to report a deficit of £12m for last ported in the last 12 months - the same booking from 1st April 2006. year. number of cases as the previous year. 2 GP news May/June 2006 TEAM SPIRIT: Mr Roger Leicester, Director of Endoscopy, (centre) flanked by members of his team. opinion The Trust has neglected its relationship with local GPs in recent years. But the relationship is worth salvaging, says Dr Chris Streather, and this time the Trust is determined to heal the rift between primary and secondary care. cels’, say inspectors “AT SOME point in nearly every re- lationship, one person will turn to the other and say,“We never talk any better itself both clinically and fi- nancially. While our clinical care is regarded as second to none, some of examined the quality and safety of care the staff who work there. more.” the systems that support the de liv- given to patients. Waiting times for an endoscopy have Communication, or rather the lack ery of that care need to be improved, The strong performance in both re- been halved since the unit moved to of it, has led to more break-ups, bust- such as the way we receive and proc- views means that the unit can become a state-of-the-art accommodation in No- ups and heartache than we might ess your referrals. We are not blind to screening centre for bowel cancer once vember 2004. care to think about.Yet it’s the oxygen the problems we have. Nor are we the colorectal screening programme is The maximum wait for a routine en- of any relationship and something unwilling to act. launched nationwide later this year. doscopy has fallen from 12 to six weeks, which if missing breeds distrust and Take the organisation of our out- Welcoming the reports, the Trust’s Di- while urgent procedures are now car- misunderstanding. Communication patient clinics. Several months ago, rector of Endoscopy Mr Roger Leicester, ried out within a fortnight rather than a really does keep a relationship alive. work began on a project to redesign said: “The reviews are glowing and the month. Somewhere along the way, we our outpatient services, centralising praise they heap on the unit is testament The average wait for a routine endos- have lost touch with one of our most our clinics to offer patients and GPs really to the hard work and dedication of copy in the UK is six months. important stakeholder groups - the a high-quality experience whichever 700 GPs who practice in South West clinic they attend. Some of our clinics London. work extremely well; others do not. LD END YEAR Now we’ve taken the first step to- Our amibition is to provide well-run wards mending that relationship. In clinics across the entire hospital. T OF £12M “We are not blind to the problems we have. Nor are we unwilling to act.” Dr Chris Streather, Medical Director Next year, the Trust must reduce its “We have achieved a great deal this deficit and attempt to pay off the ac- year - both financially and clinically. March, an open letter was sent to all Outsourcing the typing of our cumulated deficit of around £34m from “Achieving and exceeding the target GP practices in the region by myself clinical letters is another initiative, the previous financial years 2005/06 deficit set by the SHA was a huge chal- and the Trust’s two other medical di- which has improved the speed of and 2004/05. lenge but we have done it. rectors, Mr Mike Bailey and Dr Derek consultant-to-GP letters. Important The combination of these financial “But there is a long way to go before Dundas. It was a letter that promised letters now reach practices in days challenges makes next year look partic- we achieve financial balance and next action and was in response to some rather than weeks, and we are in the ularly tough, according to Peter Homa: year will be an even greater challenge.” research we carried out with a repre- process of procuring a trust-wide sentative group of GPs that flagged contract for such a service that will up a wide range of issues that frus- be used by all specialities rather than SOLD: Money from the £15.1m sale of the trate you. the handful which use it at the mo- Atkinson Morley Hospital in Wimbledon will “While we are working to deal ment. help the Trust improve its financial position. with the issues our interviews high- Finally, there is our clinical lighted,” says the letter, “we want to services strategy, which charts do more and go further to improve the development of our serv- both clinical relationships, and good ices over the next five to ten years. communications with you and your The creation of this strategy is some- patients” . thing that we need you to be a part We know it will take more than of. The clinical pathways that bridge a single letter to resolve the differ- primary, secondary and tertiary care ences that exist between the Trust offer a more streamlined and joined- and local GPs. Trust takes time to re- up approach to patient care across build and you will quite rightly want the various sectors. In the last issue to see some evidence of our resolve of GP news, we asked you to shape to make things better and easier for these pathways and help us translate you. these words on the page into a prac- This is not some idle promise. The tical reality. sentiment expressed in that letter is There is still an opportunity for backed up by a real commitment to you to be involved in this work and make this relationship work. we really urge you to be a part of it. “ The hospital is on a voyage to May/June 2006 GP news 3 AN EYE FOR DETAIL: Techni- UP CLOSE: FACIAL PROSTHETICS cians from the facial prosthet- NO, this isn’t the gruesome handi- acrylic materials for patients suf- ics lab fabricate work of a Hollywood special ef- fering from severe trauma or a ma- replacement fects workshop but a collection lignant diseases such as cancer. facial objects for cancer and of prosthetic facial parts made by The fabricated objects can be trauma victims. technicians from the Trust’s max- attached to the face using an ad- illo-facial laboratory. hesive or inserted underneath the The laboratory, which opened skin. before Christmas after a million- Technicians also make titanium pound relocation from Queen plates for victims of road traffic ac- Mary’s Hospital, Roehampton, fab- cidents who have lost part of their ricates ears, eyes, teeth and other skull. facial objects out of silicon and KETOGENIC SERVICE TO About GP News HELP EPILEPTIC CHILDREN GP NEWS is a bulletin for GPs and practice staff working in South West London. CHILDREN suffering from Lee-Anne McHarry, (pic- It brings you all the latest news a drug-resistant form of tured) is the first ketogenic epilepsy will have access dietitian to be funded by from St George’s Healthcare NHS to a special diet that can the charity. Trust including new develop- control their seizures fol- “The ketogenic diet has ments and service updates. lowing a campaign by a been around since the GP News is produced and de- Wimbledon charity to raise 1920s but is rarely used,” signed by the Trust’s Communi- thousands of pounds for a says 28-year-old Lee-Anne. cations Office and is distributed specialist dietitian at the “The diet can can have a electronically to all practices in hospital. dramatic effect on the be- Wandsworth, Sutton and Merton. The Daisy Garland char- haviour and development Want to comment on a story? ity has raised £48,000 for of a child who has medica- E-mail communications@ a paediatric ketogenic di- tion-resistant epilepsy.” stgeorges.nhs.uk or write to: The etitian who will prescribe “We can now help chil- Editor, GP News, special high-fat meals that dren who suffer from this Communica- prompt the body to pro- rare condition to have a tions, St duce a seizure-inhibiting better quality of life.” George’s substance called a ketone q The ketogenic diet was Hospital, when fat is burned for fuel. developed in the 1920s at Blackshaw The charity was founded John Hopkins University Road, Toot- last year by the parents of Hospital, Baltimore. Math- ing, London Daisy Garland, a five-year- ematically calculated, SW17 0QT. old girl from West Wimble- the diet alters the body’s Ketogenic don, who died in her sleep chemistry by simulating dietitian in April 2004 after suffering the metabolism of a fast- Lee-Anne a suddden and severe epi- ing body. McHarry leptic attack. PATIENT TRANSPORT SERVICE IN NEW HANDS FROM MAY 1 A COMPANY that built the new dering process. been designed specifically for this enthusiastic and geared towards the headquarters for GCHQ, the Gov- The company will take over the contract and at the same we will needs of their customers. ernment’s code-breaking agency, running of the transport service be introducing some new systems “GSL are a company with a repu- has won a five-year contract to run a from Parkwood Healthcare on May which should make the issue of pa- tation for providing a good service non-emergency transport service for 1, 2006. tient transport much less of a head- to patients of other hospitals, and the Trust’s patients. Mick Smith, National Operations ache for patients and hospital staff.” we are delighted to award them the GSL, a company that already pro- Manager for GSL, said: The hospital’s Director of Estates, transport contract, which is now a vides transport to several hospitals in “This is our fourth non-emergency Neal Deans, said: much tougher agreement that in- London, including Epsom and St Hel- patient services contract with the “We want to provide our patients cludes penalties for poor perform- ier University Hospital and Barking, NHS and we are looking forward with a safe, comfortable, reliable and ance.” Havering & Redbridge NHS Hospitals to working in partnership with St punctual service. The company is expected to trans- Trust, was awarded the contract in George’s to provide a first-class trans- “The ending of our previous con- port around 100,000 patients every February after an extensive re-ten- port service for its patients. tract has given us the opportunity year. “We will be bringing in a new fleet to review the service, set out our re- All tenders for the transport con- of around 30 ambulances that have quirements in a revised specification tract were evaluated by a panel of and find a company that is dynamic, staff whose members included two matrons and a sister from the hospi- tal’s geriatric outpatients unit.
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