p>Year 10 pupils from Bordesley Green Girls School have discovered what life as a doctor or nurse is really like thanks to an innovative new scheme run with Good Hope Hospital’s Hollier Simulation Centre.
A group of 15 year olds from the school spent a day in the Simulation Centre – an advanced training centre where medical scenarios are simulated. Clinical areas such as wards are mocked up to provide a realistic, ‘live’ Hospital experience with high fidelity mannequins that respond to treatment. During the session, pupils were guided through medical scenarios and worked alongside Good Hope nurse, Tracey Starkey-Moore, to provide the appropriate care and treatment for the patient.
Sara Wood, Good Hope faculty access and placement unit manager, said: “All the pupils who attended the day are studying for a Society, Health and Development diploma; so this was a fantastic way for them to learn about the healthcare environment.
“The visit was the first event of its kind in the area and falls in with Good Hope’s plans to engage with the local community. The day’s success means we are keen to repeat similar sessions with local schools in the near future.”
Sue Hughes, assistant head teacher at Bordesley Green Girls School, said: “The Diploma for 14 to 19 year olds is a new qualification aimed at offering practical experience as well as traditional class work, so the visit to Good Hope Hospital was a great way for our pupils to gain genuine insight into life as a medical professional.
“All the pupils thought the experience was extremely worthwhile, and they picked up some excellent transferable skills.”
The Hollier Simulation Centre is a state-of-the-art medical training facility for training doctors, nurses, allied health professionals and multi-professional teams. The centre was created using a £1.8 million legacy left to Good Hope Hospital by Mr and Mrs Harry Hollier.
An important study using the latest DNA technology, conducted at Heartlands Hospital, paves the way to drive down MRSA infections in the NHS.
Led by researchers at the Heart of England NHS Foundation Trust, the University of Birmingham, Health Protection Agency Birmingham regional laboratory and the University of Warwick, the study was able to detect patients carrying MRSA on admission.
By finding patients carrying MRSA within hours of admission and giving them treatment to kill the MRSA, the chance of those patients passing on MRSA was reduced by 50 per cent.
On leading the study, Professor Peter Hawkey, said: “The NHS sponsored study consisted of two eight month cross-over periods in which 12,000 patients were tested on admission, and every four days thereafter until discharged, by either the rapid DNA method or the traditional slow method. It was a challenging test of the rapid versus slower culture based methods for MRSA screening, but we can conclude that using the rapid test can significantly reduce MRSA transmission.”
Professor Hawkey, along with BD who produces the rapid test, presented the findings at the Reducing HCAIs ’10 – quality, innovation and care conference, on the 18 February 2010, at Church House, Westminster.
Over a year ago Dr Mark Goldman, Chief Executive of Heart of England NHS Foundation Trust informed the Board that, as he was in his 59th year, he would be retiring from his post as chief executive before the end of 2010. This would enable the new Chair the opportunity of appointing a new chief executive. This also coincides with a general election and, whoever wins, a new administration.
Dr Goldman has formally informed the Trust Board that he will leave following his six month notice period in August 2010. He has indicated that if it is in the interest of the Trust he would be prepared, following discussions and a formal agreement, to extend this period to allow the Chair to settle into post.
Chairman, Clive Wilkinson said:
“Mark has been an outstanding chief executive with a national reputation which is why he was appointed to the National Leadership Council and leads nationally on clinical leadership.
“He will be sorely missed by the Trust but as we have come to expect has again put the interests of the Trust before those of his own. The forthcoming general election, new priorities for the NHS and a new chair will require the Trust to continue to look to the long term future and develop its priorities and services based on a new agenda.
“Mark and I have worked together for nine years and he is highly regarded by all staff and partners who work with the Trust. He has been a tower of strength to me as chairman and whomever he chooses to work with in the future they will be fortunate to have someone of his calibre.
“We wish him every success in whatever he does in the future. He will be a big loss to the Trust and a hard act to follow.”
Andrew Mitchell, MP for Sutton Coldfield, said “I have worked closely with Mark Goldman and he has been very helpful in assisting with my constituents’ concerns. He has taken a personal interest in developing Good Hope Hospital and has been committed to developing the Hospital to deliver local services for local people. I wish him well for the future”
Prior to taking up the role of chief executive, Mark spent seven years as medical director and 17 longstanding years as a consultant surgeon. At the point of leaving Heart of England Mark will have been a member of staff at the Trust for over 26 years and have served in the NHS for 34 years.
The Trust Board will commence the process for appointing a new chief executive so that an appointment can be made as close to the date when Mark retires as possible.
Recently, we’ve been asked a lot of questions about the changes to Solihull maternity. Below are a list of the frequently asked questions for February 2010, which should hopefully answer some questions you may have about the changes.
If there are any questions you have which still have not been answered, please contact firstname.lastname@example.org and we will do our best to get an answer for you.
Frequently Asked Questions – February 2010
Q1. What maternity services does the Trust currently have?
Since 1995 babies have been delivered through an obstetrician led service at Solihull without on-site paediatric/neonatal support. This was because of the withdrawal of the paediatric service when the Deanery judged the paediatric throughput at the hospital was too low to meet the needs of trainees. The Solihull obstetric-led maternity service without on-site paediatric cover is believed to be a unique model of care.
The current models of obstetric provision across the three sites vary with Solihull being a low-risk obstetric unit with no onsite 24/7 paediatric cover and no special care baby unit facility. On booking, all mothers are risk-assessed and only those presenting as routine are booked for delivery at Solihull. Good Hope has a Level 1 (special care facilities) neonatal unit with 40-hour labour ward cover and Heartlands is a Level 3 unit (neonatal intensive care), again with 40-hour obstetric cover.
Q2. How many births happen at the different Hospitals?
Just over 11,000 births took place within the Trust in 2008. of these, there were 4,921 births at Heartlands, 3,601;at Good Hope, and 2,792.at Solihull
Q3. What has been done to increase maternity staffing and support at Solihull Hospital?
In 2008 the Trust had 26 midwives with the additional voluntary qualification of Advanced Resuscitation of the New Borns (ARNBs) in Solihull. They were concerned about maintaining their advanced practical skills as very few babies born in Solihull need this level of support (roughly 1in 1,600 babies require this, which is about one baby every six months at Solihull).
The Trust explored a number of ways of supporting this service, including additional specialist nursing and medical staffing, approaching the Royal College of Paediatricians to see if it would be acceptable for training if trainees could rotate through Solihull to be available to support neonatal resuscitation. Despite Three attempts to recruit additional paediatricians, no suitable applications were received and the adverts for additional nurses only generated eight applicants for more than 17 vacancies. The College remained unable to accept Solihull as a training location because of the very low volume of paediatric clinical throughput.
At the same time, a national workforce survey suggested a shortfall of some 3,000 specialist paediatricians.
Q4. What changes have been made to meet these new safety requirements?
In 1995 following an accreditation inspection by the British Paediatric Association (fore-runner of RCPCH) the volume of in-patient activity at Solihull Hospital was found to be below required levels for training and accreditation was withdrawn. This meant that the Hospital could no-longer employ paediatric doctors in training or attract paediatric specialists.
In order to continue obstetric services in Solihull, some midwives in 1996 agreed voluntarily to supplement their skills to be able to undertake immediate advanced newborn resuscitation and maintain this for up to 40 minutes while specialist help came from Heartlands Hospital.
This role is unique within the UK and although it has been in place now for many years, has not been taken up by other units faced with similar issues.
A policy of accepting only low risk bookings at Solihull was put in place, with all other bookings being referred to Heartlands Hospital.
In 2005, new resuscitation standards were introduced by Resuscitation Council. This included the expectation that adrenaline should be given by intravenous or intraosseous route as the endotracheal route was thought to be less effective. This gave rise to a new skill requirement in umbilical vein catheterisation.
In 2007 minimum standards were agreed by the joint colleges of obstetricians, midwives, anaesthetists and paediatricians. These stated that there must be 24-hour availability in obstetric units of senior paediatric colleagues who have advanced skills for immediate advice and urgent attendance, who will attend within 10 minutes.
There must also be 24-hour availability in obstetric units within 30 minutes of a consultant paediatrician (or equivalent SAS grade) trained and assessed as competent in neonatal advanced life support. All of these requirements are for medical attendance; where advanced neonatal nurse practitionners are involved, this is only envisaged within Level 2 and Level 3 units.
An audit undertaken in 2007 showed no difference in neonatal outcomes between Heartlands and Solihull. The audit concluded “current booking, in utero transfers, neonatal resuscitation and retrieval transfer practices at Solihull appear overall to give the same outcome as if the baby had been born at Heartlands. On the basis of this audit … there is no difference in the effectiveness of neonatal support and outcomes between births in Heartlands and Solihull maternity units”.
Heartlands neonatologists expressed concerns particularly about the maintenance of midwives’ advanced resuscitation competences given the infrequent use of their intubation and advanced support skills. An estimated 1;1,600 babies require advanced skills such as umbilical catheterisation = 1 baby every 6 months at Solihull leading to an infrequent use of skills.
Repeated efforts have been made by the Trust to provide appropriate clinical support for this service (see Q3 above)
A great deal of work has been carried out by the Trust to make the service as safe as possible but despite this, the full requirements still cannot be met all the time and those ‘fixes’ that are in place are not sustainable. They include:
January 2009 – A revised protocol for the ‘fast car’ service was agreed. This does not guarantee medical assistance for an emergency call in under 40 minutes (from call to arrival at Solihull) and could at certain times be longer.
February 2009 ongoing – To enable us to meet changed European resuscitation guidelines, midwives offering Advanced Resuscitation of the New Borns (ARNBs) were offered additional training to insert umbilical vein catheters for the administration of emergency resuscitation drugs. As midwives successfully went through the training we were able to offer improved care in an emergency.
April 2009 – The Trust started to allocate a Neonatal Intensive Care Nurse (ENB 405) each shift to Solihull to assist ARNBs with resuscitation, keep the specialised equipment checked and to further assist when an emergency team arrives from Heartlands Hospital. They also act as transport nurse if necessary. While recruitment continued, these nurses were initially on-site from 07:30 – 21:00 daily.
June 2009 ongoing – Consultant paediatrians and advanced neonatal nurse practitioner (ANNP)s, agreed to do resident shifts at Solihull to provide second level resuscitation support in an emergency. In the first two months of the rota it was possible to cover around half of nights.
July 2009 – ENB 405 Nurse cover becomes 24/7.
August 2009 – Paediatric cover improved to 80% coverage of nights.
THE CURRENT POSITION
Q1. Why can’t we continue as we are?
Over the last few years, the Department of Health and medical Royal Colleges have produced a series of policy documents seeking to improve both safety of mothers and children and mothers’ experience of maternity care.
There are two specific standards where Solihull Hospital’s current maternity service does not consistently meet best practice:
• Access to advanced paediatric resuscitation within 10 minutes
• Paediatric Medical consultation available to baby within 30 minutes
Q2. When will the consultation process take place?
The consultation will be led by the commissioners of the service (Solihull Care Trust and NHS Birmingham East and North PCT ). The Commissioners will confirm the exact timeline once the date of the election is known. It is likely to take place after the election to ensure that a full and open dialogue can take place with the residents of Solihull and Birmingham. HEFT will support this consultation to the fullest extent.
Q3. Why is this not sustainable until the outcome of the consultation is known?
A lot of work is necessary to prepare for the full public consultation, which is led by the PCTs. This is currently in progress, and the date when this will commence is not yet known. As the Trust cannot sustain the present safety levels beyond April 2010 some safe solution must be put in place in the meanwhile to prevent the service closing completely.
Q4. Why are we making these changes if there have been no issues or incidents with regards to the safety of the service?
The current safety support mechanisms cannot be sustained beyond April, so from that date, the service will have to change.
Q5. Is this a cost-saving measure by the Trust?
No. This is all about safety. A series of independent, professional reviews have raised concerns about the sustainability of the present service and the Trust would not undertake a change unless it was absolutely unable to meet the necessary standards.
WHAT HAPPENS NEXT?
Q1. Will we be closing the maternity service at Solihull Hospital?
A table top planning has enabled clinical staff to review the overall model, consider potential risks and mitigations and ensure as far as possible that all implications of the proposal have been considered.
It is anticipated that the necessary changes should be in place to accommodate additional births at Heartlands and Good Hope Hospitals by April. Once these are operational, all deliveries would temporarily cease at Solihull for a short period of some weeks (possibly up to twelve weeks) to ensure that the new model can be fully tested and all staff fully orientated to the new model. This includes providing staff with additional experience in an established birthing unit. Once this has been completed and the clinical teams are confident that the service is as safe as possible Solihull Hospital will open a midwifery-led unit and this will stay in place until the outcome of the consultation is known.
Q2. What are the temporary changes?
Solihull Hospital will continue to provide midwifery services for low risk births as a midwifery-led birthing unit. While Solihull has had criteria to select appropriate, lower risk deliveries for many years, suitable deliveries for the birthing unit will be similar to those suitable for home delivery. More complicated births will be transferred to Heartlands Hospital, Good Hope Hospital or another nearby Hospital.
Women will have the following choices Solihull – Low risk birthing unit; Full obstetric outpatients
• Good Hope – Low, medium and high risk births; Full obstetric outpatients and ambulatory care unit; Access to Level 1 neonatal unit
• Heartlands – Low, medium and high risk births; Full obstetric outpatients and ambulatory care unit; Access to Level 3 neonatal unit
In order to ensure there is adequate space for additional deliveries in Heartlands, the present gynaecology ward is being made available. Most elective gynaecology cases will be done using the ward vacated by obstetric patients in Solihull with a small number of appropriately chosen, higher risk elective cases being undertaken at Good Hope.
This model offers the following benefits
• Risk Reduction
• Cost-effectiveness, particularly mindful of the contingency nature of this proposal
• Use of available specialised resources
Q3. What maternity services will still be available in Solihull?
From the spring antenatal and postnatal clinics will continue as normal. There will be a short period when no deliveries at all can be dealt with at Solihull, but once the birthing unit is open, women whose pregnancy and maternity history would qualify for a home-birth will be able to choose to deliver in Solihull if they prefer.
These arrangements will continue until the people of Solihull have had the opportunity to discuss the various longer-term choices for the service, through a formal consultation process that will start in a few months’ time.
Q4. Why will the maternity unit at Solihull have to close to births for a short period of time?
we need to be confident that the new model has been fully tested and all staff fully orientated to the new practices. This includes providing staff with additional experience in an established birthing unit. Once this has been completed and the clinical teams are confident that the service is as safe as possible, Solihull Hospital will open the new unit and this will stay in place until the outcome of the consultation is known.
Q5. What is a midwife-led unit?
A birthing unit is a small, maternity unit that is staffed and run by midwives. They offer a comfortable, low-tech environment, where birth is treated as a normal event, in a personal, unhurried and informal environment.
Q6. How will the other two hospitals, Heartlands and Good Hope accommodate the additional deliveries?
The temporary changes include:
• Developing a midwife-led unit at Heartlands immediately beside the obstetric-led unit.
• Using the ward vacated at Solihull by the obstetric service to refocus most elective gynaecology at Solihull, except for more complex cases requiring higher levels of care that would fit well within the capabilities and capacity at Good Hope
• Exchanging operating theatres between ophthalmology and gynaecology at Solihull, offering advantages to both patients and the services
• Centring emergency gynaecology at Heartlands, to include the assessment and management of the small number of cases normally dealt with in Solihull (less than one patient a day)
Q7. When will these temporary changes be made?
We are currently in the planning phase and the aim is to have the plans complete and have some of the changes in place in the spring of 2010. The exact dates of all of the changes will be available as soon as possible
Q8. What building works will be carried out to support these temporary changes?
• These include On the Heartlands site work to accommodate additional births, including additional induction and delivery facilities, patient assessment area and creation of a midwife-led unit
• Internal changes at Solihull ward 12 to accommodate gynaecology elective changes
• Solihull theatre changes necessary to accommodate the gynae elective patients (entails swapping ophthalmology and obstetric theatres)
• Internal changes at Good Hope necessitating the conversion of two doctor on-call rooms to delivery rooms to accommodate additional deliveries
• Creation of birthing unit at Solihull including changes to the birthing pool arrangements (with the provision of an additional birthing pool), alterations to existing rooms to provide en-suite facilities and a new patient assessment area
Q1. Will any staff be made redundant or lose their jobs as part of these temporary changes?
No staff will lose their jobs or be made redundant as part of these changes.
MOTHERS TO BE
Q1. When the maternity service opens as a birthing unit how many local women will be able to choose to have their baby at Solihull Hospital?
Providing the criteria are met, the unit will be able to accommodate approximately 300 births a year.
Q2. What will happen to those women who have already booked in to have their baby when the Solihull maternity unit is scheduled to be closed briefly?
All of these women are being contacted by midwives from the community and/or hospital to explain the options available. All women will automatically be offered the choice of either Heartlands or Good Hope Hospital. They may also choose another unit.
Q3. Will women still be able to have their antenatal care at Solihull Hospital?
There will be no changes to antenatal care. All women choosing to have their antenatal care at Solihull Hospital will be able to have this.
Q4. What choices do women have if they are not able to have their baby at Solihull Hospital?
Ante-natal care is still being offered at Solihull Hospital. If a woman is not able to have her baby at Solihull Hospital she will be offered a number of choices including Heartlands and Good Hope Hospitals. Some women may choose to look at alternative hospitals and all options will be discussed in full with the mother by community based midwives.
Q5. What is being done for those women who choose to be transferred to Heartlands or Solihull Hospital?
All women and partners will be offered the opportunity to visit the hospitals while they are thinking about their choices.
Q6. What happens to a woman turning up at Solihull Hospital in labour during the time the maternity unit is closed to births?
As with any other emergency that cannot be dealt with by the team and facilities at Solihull, the woman would be transferred directly to Heartlands Hospital.
Q7. What happens to a woman who has complications during labour who is in the Solihull birthing unit?
If there is a concern at any time with mother and/or baby arrangements will be made to transfer the patient to the appropriate maternity unit. The ambulance service will treat any requests of this sort by Solihull hospital as true, blue light, emergencies.
Q8. How fast will an ambulance get to a woman in labour at Solihull Hospital?
The ambulance service will treat any request by the Hospital to transfer a woman in labour or a woman and her newly born baby as an emergency, within eight minutes of the call. This will mean that an ambulance will arrive and will transfer the women under blue light ensuring this is as fast as possible.
Q9. What are the main factors which will mean a woman cannot choose Solihull Hospital to deliver her baby?
The unit, once reopened, will only be able to take low risk women similar to those women who are able to have a home birth. Any women with a medical condition or complications will not be able to chose Solihull Hospital to deliver their baby.
Q1. What will happen if the consultation outcome says that Solihull Hospital should have something different?
The Trust is keen to support the consultation process and will honour the outcome.
A new initiative has been launched at Heartlands Hospital which will help tackle one of the most common cancers in females in the region.
The pilot programme, which runs until May 2010, aims to ensure all women receive the results of their cervical screening test within 14 days, meaning patients will receive their test results much sooner and begin treatment earlier if needed.
Karen Tomlinson, cervical screening coordinator at the Hospital said: “This really is an exciting development which will help us in our fight against cervical cancer, the second most common cancer in the Midlands for women under 35.
“Being screened regularly means that any abnormal changes in the cervix can be identified early on and, if necessary, treated to stop cancer developing. It is estimated that early detection and treatment can prevent up to 75 per cent of cervical cancers from developing.”
The cytology department at Heartlands, including the Heart of England Trust’s other two Hospitals Good Hope and Solihull, was nominated by the West Midlands Strategic Health Authority to run the pilot, which is designed to drive improvements in the way services are delivered and to support clinical teams make significant improvements for patients.
- Bob Gessey with Mary Hayward
Patients, staff and visitors to Good Hope Hospital’s stroke unit enjoyed a free music concert last week, thanks to the charity Music in Hospitals.
Attendees sang, danced and joined in as singer and guitarist, Bob Gessey, performed a range of hits from the 40s, 50s and 60s as well as requests including Amazing Grace and Paper Moon.
Good Hope patient, Mary Hayward, said: “It’s really great to have something a bit different on the ward. Recovering from a stroke can be really boring, we have television and visitors come to see us, but having something like this has cheered us all up. Every one of us enjoyed it.”
Blanche Benouakhil, sister on the stroke unit, said: “Having Bob here really lifts everybody’s spirits. The patients really respond to music – we have a stereo, but it’s nothing like having someone here to sing live. It really was wonderful to watch patients, who sometimes find it hard to talk, singing along.”
The arts team is looking for volunteers who are passionate about music and could give up some of their time to perform for the patients at Good Hope Hospital. Even if you are not able to play a musical instrument, the Hospital is keen to hear from people who could help host the events. If you are interested in becoming a music volunteer, please contact Esther Jackson, music co-ordinator, on 0121 424 0113.
Minister of State for Health, Mike O’Brien, visited Sutton Coldfield last week to take a tour of Good Hope Hospital.
The visit provided an opportunity for the Minister to see, first hand, the services and facilities the Hospital provides for its community. The tour included a visit to Good Hope’s Simulation Centre, an innovative medical facility provided to train doctors, nurses, allied health professionals and multi-disciplinary teams across the West Midlands.
Good Hope staff also provided the Minister with a progress update and tour of the new ward block being built at the Hospital. At an investment of more than £16.5m, and the first part of a larger site strategy plan, the block will accommodate four new and modern wards near to A&E. This will mean the expansion of the clinical decisions unit based in the emergency department, as well as accommodating a critical care facility, coronary care unit and cardiology ward, and a 28-bed short stay elderly care ward.
Hospital Trust Chairman, Clive Wilkinson, said: “We are proud to have Mike O’Brien visit the Hospital to give us the opportunity to show him the moves we are making to provide the highest quality patient care, and to be the local provider of choice.
“The Simulation Centre is a facility that most visitors to Good Hope do not get to see. With animated dummies for patients and clinical areas like wards, laboratories and operating theatres mocked up, medical scenarios are run from a control room. It is an extraordinary sight to see and provides essential training for clinical staff.
“The new ward block at Good Hope is expected to be completed in January 2011 and will mean a large investment in services for the Hospital, bringing significant benefits to patients, staff and visitors alike.”
Health Minister, Mike O’Brien, said: “I wanted to visit Good Hope Hospital to look at some of the issues they confront, and see what steps they are taking to improve quality of care.
“I look forward to hearing how the new facilities will make a difference to patients by meeting the needs of the local community.”
- Good Hope’s Fortel donation
Good Hope Hospital has received a generous donation to help sick babies breathe more easily.
Fortel, the construction company working on the new ward block at the Hospital, donated £500 to the children’s ward to buy a new piece of equipment used to treat babies on the ward who need assisted ventilation before being moved into intensive care.
The high flow oxygen meter will help with the care of many more children and babies needing treatment for chest infections, especially during the winter months when breathing difficulties due to chest infections brought on by the cold weather are common.
Andrew Murphy, contracts manager for Fortel, said: “I chose the Harvey ward at Good Hope for the donation, because two of my children were born at the Hospital and I was impressed with the quality of care given.
“Our company does a lot of charity work in the UK and India focusing on the homeless, hungry and those in need of medical attention as well as sponsorship of local schools and football teams. After working closely with the Hospital on their new ward development, we wanted to extend our support.”
Locals suffering from chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) can now receive community testing for oxygen support, thanks to a new initiative at Solihull Hospital.
The community testing service, developed alongside Solihull NHS Care Trust, will benefit patients with GPs in the Solihull area by giving them the opportunity to have their oxygen level tested at the nearest community clinic, rather than travelling to Solihull Hospital. Patients referred to this service can be seen by specialist community nurses and only need to visit the Hospital clinic if additional assessment or treatment is required.
Dr Salman Ghani, Solihull Hospital respiratory consultant, said: “We aim to provide the best possible care for our patients and if that means assessments can be performed within the community safely, we don’t see any reason why it shouldn’t. Community testing not only improves the efficiency of the service, but is also more convenient for the patient.”
Sandy Walmsley, lead respiratory nurse specialist, said: “Needing oxygen support can often be seen by those suffering respiratory problems as embarrassing or a sign of weakness; but it is important for people to remember needing support for breathing is not a negative thing. In fact many people who use oxygen support say it has given them their life back and has helped improve their quality of life by allowing them to participate in more of life’s activities.”
The oxygen assessment service in the community is available to suit the needs of patients alongside the weekly oxygen assessment clinic at Solihull Hospital; helping support patients who require ambulatory oxygen and long term oxygen therapy support.
If you would like more information about the new assessment service, please contact lead respiratory nurse specialist, Sandy Walmsley by email on email@example.com or call (07813) 022368.