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  • pg 1
                                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

                                                                                     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.

                                                                                                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.

                                                                                                   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
 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-
                                                                                      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
    don, who died in her sleep      chemistry by simulating
    in April 2004 after suffering   the metabolism of a fast-
    a suddden and severe epi-       ing body.
    leptic attack.

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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