News from Guy’s and St Thomas’ Issue 9 | 2013

Winter careHow to keep well this winter

Nursing assistantsleading the way

Spotlight on speech therapy

THIS ISSUE

2 The GiST

Welcome…to the Autumn edition of our magazine.Read on to find out how we plan to invest £1 million in improving our hospitalenvironment for people with dementia, how we are helping people with learningdisabilities to get the care they need, andabout the UK’s first dedicated NHS hair lossclinic for children.

Our main feature looks at the differenttypes of patients who are helped by ourspeech and language therapists. There are2.5 million people in the UK living withspeech and language difficulties, which canbe caused by a wide variety of conditionsincluding stroke, Parkinson’s disease ordementia.

Preparing for winter is a topical issue, soour staff tell us how they ready our hospitaland community services for the coldermonths.

You can also find out how we’re doing inthe new Friends and Family Test.

I hope you enjoy reading this issue.

Ron KerrChief ExecutiveGuy’s and St Thomas’ NHS Foundation Trust

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08 10

Meet the team

Contents

TELL US WHAT

YOU THINK

If you have any commentsabout the magazine orsuggestions for futurearticles, please contact thecommunicationsdepartment, St Thomas’Hospital, WestminsterBridge Road, London SE1 7EH, or email press@gstt.nhs.uk

Visit us online at:www.guysandstthomas.nhs.uk

03 Prime Minister visitsEvelina London David Cameron marks the65th anniversary of the NHSat Evelina London

04 First NHS children’s hair loss clinic Discover how we’re helpingwith hair loss

06 Crossing borders tomake a difference Find out about our work in Zambia

08 e interview We talk to Dr Simon Eccles,consultant physician inemergency medicine

10 Nursing assistant success Leading the way in developingour nursing assistants

12 Winter watchHow we will be helping to keeppatients well this winter

14 Spreading the wordHow our speech and languagetherapists support our patients

Produced by: The communicationsdepartment

Design: AYA-Creative www.aya-creative.co.uk

Print: O’Sullivan Communications

Front cover: Nurses Paula Willmore and Lee Patient.

Pick up your copy: The GiST magazine is for ourpatients, local people, staff,members and other supportersof Guy’s and St Thomas’.

e GiST is published by Guy’s andSt Thomas’ NHS Foundation Trust.

Follow us on Twitter @GSTTnhs

ROUND-UP

www.guysandstthomas.nhs.uk 3

IN THE NEWSA round-up of media activitythat has featured the Trustover the past few months.

BBC, Daily MailDr Ian White, a consultantdermatologist from the St John’s Institute ofDermatology at St Thomas’,was interviewed by BBC’sWatchdog about extremeallergic reactions toparticular ingredients insunscreen. The Daily Mailalso covered the story.

Nursing Times, Nursing Standard

Dementia care commendedHealth Secretary Jeremy Hunt visited St Thomas’ Hospital in July to launch a nationalscheme to improve the care of patients withdementia.

Staff were delighted when he highlighted theOlder Persons’ Unit at St Thomas’ as anexample of best practice.

We will receive almost £1 million of a £50million national fund to create pioneering careenvironments designed to meet the needs ofpeople with dementia.

The funding will enable successful initiativesalready in place on our Older Persons’ Unit tobe rolled out to other high priority areas acrossour hospitals. This includes a speciallydesigned ward environment with colour-coded

bays andsymbols tohelppatientsremembertheir wayback to their bed, blue wristbands so staff can easily identify patients with dementia, and red-topped jugs and meal trays so that staffknow which patients need extra help witheating and drinking.

Chief Nurse Eileen Sills says: “Since thechanges were made to our Older Persons’ Unit, patients have independence and staffreally enjoy working in the pleasantenvironment.”

Prime Minister David Cameron praised EvelinaLondon during a visit to celebrate the 65thanniversary of the NHS in July.

Meeting children, parents and staff withSecretary of State for Health Jeremy Hunt, Mr Cameron said: “My son was treated righthere in this fabulous hospital for much of his life.”

Evelina London, which launched its newname on 1 July to reflect its location at the heartof the capital, also hosted Jeremy Hunt’skeynote address to mark the NHS anniversary.He spoke to an audience of hospital staff, seniorhealth leaders and the media.

Our two special guests spent time chatting toyoung patient Liam Islam, 13, from Lewisham.

Liam said: “I was so pleased to meet DavidCameron and Jeremy Hunt. They were reallydown to earth and took their time to talk to me.They chatted to me about my interests, andsaid they liked my Superman T-shirt!”

Liam’s mum, Ambea, added: “Meeting theVIPs was a great ending to Liam’s stay inhospital. Evelina London is such a special place,all the staff are amazing, we feel like we’re part ofa big family here and I’m glad such influentialpeople had the chance to see this.”

The PM visits Evelina London

National and nursing mediareported on the publicationof the Cavendish Reportinto healthcare assistants.The Nursing Timesmentioned the jointtraining approach at Guy’sand St Thomas’ as anexample of good practice,while the Nursing Standardhighlighted the positivework we are doing at Guy’sand St Thomas’.

BBC, ITV, Evening StandardComfort Momoh wasinterviewed about a newNSPCC helpline for victimsof FGM (female genitalmutilation). Comfort is anFGM and public healthspecialist at St Thomas’and one of the UK’s leadingexperts in FGM.

ROUND-UP

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In line with the nationalaverage, 88% of ourcancer patients rate theircare as excellent or verygood, according to thenational Cancer PatientExperience Survey. Thesurvey reports the views of116,000 cancer patients inall 155 NHS trusts inEngland that providetreatment to patients withcancer.

Guy’s and St Thomas’ isranked in the top 20% ofNHS trusts nationally forseven areas of cancercare, including providinginformation for patientsabout the side effects oftreatment, supportgroups, cancer researchand family support, andfor supporting patients to

look after themselveswhen they return homefrom hospital.

Chief Nurse Eileen Sillssays: “Although themajority of our cancerpatients rate their care asexcellent or very good, we have a number of areas

for improvement.“For example, to ensure

we always communicate adiagnosis sensitively topatients and provide theemotional support thatpatients and their familiesneed.”

Patients recommendtheir care at Guy’s and St Thomas’

Most inpatients and many A&Epatients say that they wouldrecommend our care to their friendsand family.

The national Friends and FamilyTest was introduced in April. It asksadult patients treated on hospitalwards and visiting A&E whether theywould recommend their care. NHStrusts can score between -100 and +100, with 100 being the best.

Guy’s and St Thomas’ has anaverage monthly score of 78 forinpatient services, with some areasscoring more than 90. A&E has anaverage monthly score of 44.

Deputy Chief Nurse Debbie Parkersays: “This is an importantbarometer that tells us very quicklywhat our patients think about theircare. By listening to their responseswe have been able to make simplebut effective improvements.”

For example, a patient on one ofour medical wards highlighted thebenefits of using a carrier for theiroxygen canister because it helpedthem to move around more easily,boosting their recovery and givingthem more independence. The wardsister has now purchased additionalcarriers to help other patients.

From October the Friends andFamily Test is being extended to covermaternity.

First NHS hair loss clinic for childrenSt John’s Institute of Dermatology at St Thomas’ has launched the UK’s first dedicatedNHS hair loss clinic for children.

This national service will treat children with a range of hair loss conditions includingalopecia areata, hair pulling habits, thyroid disorders, hair loss caused by vitamindeficiencies, and hair loss from chemotherapy.

Dr David Fenton, a consultant dermatologist who runs the service,says: “Hair loss can affect anybody at any age, and can have a

devastating effect on people’s lives. “Children and their families deserve special attention

because children have additional needs. We expect to seearound 70 children and young people in the clinic each year.”

Four-year-old Jaiden from Chelmsford started losing herhair nearly two years ago. Her mum Sarah says: “She had

no hair at all at one point. Dr Fenton diagnosed herwith alopecia areata in March this year.

“The condition is normally caused bystress, but we’re not sure what set it off.

Her head is now covered in hair thanks tothe treatment which involved a special

type of shampoo that is only availablethrough the clinic. She started

school in September so it’sbrilliant that her hair came back

before then.”

Patients rate our cancer care

Cancer nurse Lorna Hendry with patient June Marshall

ROUND-UP

www.guysandstthomas.nhs.uk 5

TOP TWEETS@andycarlos: Had to get blood tests

yesterday at St Thomas’hospital. Whole process tookjust 7 minutes. That includedwaiting. Thank you #NHS great job

@DHL66:@GSTTnhs what a most

excellent experience in the#eyea&e today. Thank you foryour kind and prompt attention.Ur Drs & Nurses are the best.

@JohnMcM1: Thank you Guy’s Hospital

@GSTTnhs for looking after mycousin, with a successful kidneytransplant and post-op recovery.#NHS #RichardBright

@ladyyeoman:@GSTTnhs thank you

very much to the team inSurgical Admissions and Daysurgery at St Thomas’ forlooking after me today x

@AnnieMulroy:Thank you

@EvelinaLondon and @GSTTnhs esp Bill in MountainWard for looking after us SOwell. Grateful to live by thisworld class hospital.

Follow @GSTTnhsfor news, service and patientinformation, and jobs.

Breast cancer survivor DianaCrawshaw and local MPSimon Hughes carried out theofficial ‘breaking the ground’ceremony to mark the start ofconstruction work on the new£160 million Cancer Centre atGuy’s Hospital.

Diana chairs the Patient

Our world-famous St John’s Institute of Dermatology at St Thomas’ is celebrating 150 years of medical excellencefocused on improving the lives of people with both commonand more complex and rare skin diseases.

The Institute is home to many of the country’s bestdermatologists, medical equipment and facilities.

Since it opened near Leicester Square in 1863, staff at St John’s have been responsible for many new treatments andmedical discoveries that have transformed the lives of patientsand increased understanding about skin disease.

Dr Sean Whittaker, Clinical Director of the St John’s Institute,says: “Our 150th anniversary is a wonderful moment not only

to reflect on past achievements but also to celebrate progress and think about the future as newtechnologies, genetics and imaging will transform what we do next.

“Our specialists are always pushing the boundaries with pioneering treatments and research,and we are proud to continue the legacy of St John’s.”

Cancer Centre breaks new ground

Reference Group which hasplayed an important role inshaping the new centre. Shesays: “It has been a real privilegeto be involved in thedevelopment of the new CancerCentre. Patients have been fullyconsulted on every importantdecision and we were even

involved in the process ofchoosing the architects.”

Guy’s and St Thomas’ is amajor provider of cancerservices in London but theseare currently located in anumber of different areas onboth hospital sites. When thenew Cancer Centre opens topatients in 2016, it will bringtogether the majority of careand research in a single state-of-the-art building.

Dr Maj Kazmi, ClinicalDirector of cancer services,says: “We want patients to havetheir say in every aspect of theircare, everything from decisionsabout their treatment todesigning the facilities in whichtheir treatment is provided.”

The hospital at 5 Lisle Street,Leicester Square

Free WiFi is now available for patients and visitorsat Guy’s, St Thomas’ and Evelina London. Get connected by using the WiFiSPARK networkthrough a laptop, smartphone or tablet. To register,enter your name and email address, and then acceptthe terms and conditions.

Please note that some internet content will be automatically blocked. WiFi should not be used forviewing TV programmes or making phone calls.

For more information please visit www.wifispark.com or call 0844 848 9555 for technical help.

FreeWiFi

SPOTLIGHT

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Our doctors and nurses travel all over theworld to share their expertise and to learnfrom medical staff in other countries. We have also established formal linkswith two hospitals in Ndola, Zambia –Ndola Central Hospital and ArthurDavison Children’s Hospital. Ourpartnership is part of the growingnumber of international collaborationsacross the NHS which have benefits forstaff and patients in both countries.

Zambia is a large, landlocked countryin southern Africa with many healthproblems including a high incidence ofHIV, low life expectancy and high childand maternal death rates.

Our partnership focuses on improvingchildren’s services, maternal health,patient safety and infection control, aswell as medical equipment maintenanceat both hospitals. The link is not funded

by the NHS, but receives grants fromorganisations such as the Tropical HealthEducation Trust and the World HealthOrganisation (WHO).

In June, a group of five doctors andnurses from Zambia visited Guy’s and St Thomas’ as part of the WHO AfricanPatient Safety Programme. This allowedstaff from both countries to worktogether on ways to improve infectioncontrol and patient safety.

Dr Bill Newsholme, who leads thepatient safety work programme, says:“Working with such enthusiasticcolleagues from Zambia, and having tothink about how to improve patient care insuch a different setting, helps us to thinksmarter about what we do here too.”

The partnership between EvelinaLondon and Arthur Davison Children’sHospital has supported the development

Zambian partnershipbrings shared benefits

of the first chidren’s nursing trainingprogramme which will be delivered inZambia from 2014. This has beendeveloped with Brighton University.Other training and educationprogrammes focus on maternity care,including the use of ultrasound tomonitor the health of unborn babies.

Our joint work also focuses on sickle celldisease, which affects significant numbersof people in south east London, and wehave helped to set up the first clinic forchildren with sickle cell disease in Ndola.

Victoria Cheston, Executive Lead forGlobal Health at Guy’s and St Thomas’says: “Our work with Zambia has been areally positive experience for everyoneinvolved. It’s been great to witness theimprovements in Ndola, and also to seethe benefits for our staff and our workhere in the UK.”

Guy’s and St Thomas’ staff Victoria Cheston (far left) and Dr Bill Newsholme (4th right) with staff at Ndola Central Hospital in Zambia

SPOTLIGHT

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Stop smoking specialist Nirmala Madadi is pictured with William Simmons and his carbon monoxide monitor

89-year-old William Simmonsis an inspiration. In May thisyear he decided it was time togive up smoking after 75 years.

William never considered giving up smokinguntil he began having problems with hisbreathing. Now, thanks to the support fromGuy’s and St Thomas’ stop smoking service, hehas quit smoking and has never looked back.

Last year the team – who run stop smokingclinics at both hospitals and community drop-in workshops at GP surgeries inStreatham and Brixton – helped more than700 patients and staff to take their first stepstowards quitting the habit.

Clients are offered free stop smokingtreatments and expert advice to help themquit. They are also encouraged to find newways of coping with the problems that maytrigger their smoking habit, such as stress ora relationship breakdown.

Stop smoking specialist, Nirmala Madadi,says: “By taking one day at a time we cansupport someone and give them theconfidence to go smoke free for good. IfWilliam can do it, with our help, anyone can.”

At Guy’s and St Thomas’ we are keen to seta positive example to others. We are activelyworking towards becoming a smoke free Trust and, from January 2014, staff will nolonger be permitted to smoke anywhere onTrust property.

When we consulted staff about this, mostsupported our decision.

To help those wanting to give up smoking,

we offer comprehensive supportthrough our stop smoking service aspart of our ‘5 ways to a healthier YOU’staff well-being campaign.

In response to patient feedback we have also removed the smokingshelter outside the main entrance atGuy’s Hospital and replaced it with acycle rack. Smoking is no longerpermitted for staff, patients andvisitors in this area.

• Call the NHS No SmokingHelpline on 0800 022 4332,open Monday – Friday 9am to8pm, and Saturday andSunday 11am to 5pm. This helpline is also available in a number of languages.

• Visit the Department of Health’s ‘Go Smoke Free’websitewww.smokefree.nhs.uk

• Visit www.quit.org.uk or call 0800 002 200

What’sstoppingyou fromgoingsmoke free?

For further informationLambeth: 020 3049 5791Southwark: 020 3049 8550At our hospitals: 020 7188 2847

THE INTERVIEW

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We talk to Dr Simon Eccles, consultant physician inemergency medicine, about exciting plans to improvethe Emergency Department (also known as A&E) andthe emergency care ‘pathways’ at Guy’s and St Thomas’.

Emergency care to get a £19 millionmakeover

Q What does your job involve?

A I joined the Trust in February this year as a consultant in the

Emergency Department after eight yearsas a consultant and then clinical lead in asimilar role at Homerton Hospital inHackney. I have been asked to lead thework transforming the emergency carepathways for patients coming to Guy’sand St Thomas’.

I have also recently been appointed byNHS England as Joint Clinical Director forUrgent and Emergency Care in London toco-ordinate the development of standardsfor emergency care and to help share bestpractice across the capital.

Q How busy is the EmergencyDepartment at St omas’?

A It’s one of the busiest in the NHS. During the heatwave at the

beginning of July we had some of thebusiest days that the department hasever seen, with up to 450 patients a day.

Many patients with long-term andchronic conditions became unwellbecause the heat made their healthworse and some of those patientsneeded to stay in hospital for treatment.

We are used to ‘winter pressures’ butthese were ‘summer pressures’ which isreally unusual.

Q What happens if patients come to the Emergency Department who don’t need

to be here?

A Patients like the convenience of a 24-hour department but there is no

doubt that some patients who come to uswould be better treated elsewhere, forexample in our Urgent Care Centre atGuy’s or by their GP.

We don’t turn away these patients butwe ‘stream’ them to our Urgent CareCentre which is located next to theEmergency Department at St Thomas’where they can be seen and treated byGPs and emergency nurse practitioners.

Q How quickly can patientsexpect to be seen?

A We work hard to see and treat patients as quickly as possible. The

national standard is that 95% of patients

SPOTLIGHT

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are seen, treated and either dischargedor admitted to hospital for furthertreatment within four hours. We met thisstandard in 2012/13, but it is becomingmore difficult as we experience increasesin both the number of patients and how illthey are.

This is why the Trust is investing £19 million to rebuild the EmergencyDepartment at St Thomas’ and redesignthe whole ‘pathway’ of emergency carefor seriously ill patients who need to beadmitted to hospital.

Q What will the redevelopmentmean for patients?

A We are rebuilding the Emergency Department because it is simply

too small – we see an average of 380patients a day and the department in itscurrent form was built to see a maximumof 300 patients a day. So patients shouldsee a real difference in terms of animproved environment for their care.

It will be a major challenge becausethe new department will be built while theexisting department is still very muchopen 24 hours a day. It will be a bit likechanging the wheels on a car withoutstopping!

Q How will the rest of the‘pathway’ of emergency carebe improved?

A Sarah Swift Ward and Victoria Ward, our acute medical wards

which admit most patients from theEmergency Department, are currentlylocated on the 9th and 10th floors of EastWing at St Thomas’ which is far fromideal. They will be moved down to theground floor so they are much closer tothe department.

We will also be working with GPs andcommunity staff to provide betteralternatives. These will include ‘hotclinics’ for specific long-term or chronicconditions, for example breathingproblems or kidney disease, so thesepatients don’t have to come to theEmergency Department every time theircondition worsens.

Hospitals are just part of the healthcaresystem and we all need to work togetherto help patients get the right care in theright place at the right time.

Helping local people with disabilities

Colin Heard (centre) with learning disabilitynurse Michael Ginn (left) and a colleague

Colin Heard, 57, has a learning disability andproblems with his kidneys and eyes. He finds visitingunfamiliar places, like hospitals, frightening.

A Guy’s and St Thomas’ project is helping peoplelike Colin to keep their hospital appointments andhave early discussions about their health. This willprevent up to 6,000 people in Lambeth, Southwarkand Lewisham with learning disabilities fromdeveloping potentially life-threatening conditions.

According to a recent study, people with learningdisabilities sometimes experience delays in diagnosisand treatment because their health needs are notalways picked up by doctors. They are also more likely to die before the age of 50,compared with the general population.

Our community adult learning disability health team includes communitynurses, physiotherapists and speech and language therapists. The teamencourages people with learning disabilities to visit their GP regularly and to seekadvice on issues such as sexual health and diabetes.

Michael Ginn, a learning disability nurse at Guy’s and St Thomas’, attendshospital and GP appointments with Colin. He says: “We have introduced a ‘hospitalpassport’ to help people with learning disabilities so that visits to hospital or ahospital stay are less traumatic.”

The wallet-sized ‘hospital passport’ is a basic summary of known conditions suchas diabetes, epilepsy or mental health problems, as well as more personal information,for example food preferences, behaviour and habits. Patients with learningdisabilities are encouraged to take it with them to every hospital appointment.

Michael adds: “It is important that people like Colin feel able to explain anysymptoms they may be having so that problems can be picked up early andaddressed. By doing this, we can help more people with disabilities to livelonger, fuller and happier lives.”

“By doing this, we can helpmore peoplewith disabilitiesto live longer,fuller andhappier lives.”

INSIDE OUT

10 The GiST

“I love my job, it’s so rewarding.Being able to care for peopleand helping them to feel betterabout themselves makes me feelgood. I get some lovelycomments from patients, I waseven asked to help a patient ona different ward when she heardwhat I can do.”

Nursing assistantStella Barnie with

Blundell Ward patientDavid Chambers

Evelina London nursing assistantsmake the gradeFive nursing assistantsfrom Evelina LondonChildren’s Hospital aresettling into their new roleafter they all passed theirone-year apprenticeshipprogramme in paediatricsupport.

This is the first year of the nursing assistantapprenticeship, which trainsits students to care forchildren on the wards. The nursing assistants willnow ‘buddy’ up with a newapprenticeship group whenthey start in October.

Helen Holloway, jointhead of children’s nursingat Evelina London, says:“We’d like to congratulateall of our nursing assistantson their achievements and hope they have asuccessful career with usat Evelina London.”

INSIDE OUT

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Formerly known as health care assistants(HCAs), our team of more than 550 nursingassistants came together to establish a newidentity which makes it easier for patients tounderstand their role and how vital it is.

Nursing assistants directly care for patients,looking after their nutrition and helping themwith washing and personal care.

Their simple, but effective, name change hasbeen highlighted in the government’s CavendishReview, a report that looked at the role of HCAs.It made a number of recommendations abouthow training and support can help them toprovide care to the highest standard.

Review author Camilla Cavendish praisedGuy’s and St Thomas’ and recommended allhospitals should follow our lead by renamingtheir HCAs as nursing assistants.

She said: “What is important about theadoption of ‘nursing’ in the title is the impliedrecognition by these trusts that HCAs are partof the nursing team, not a separate tribe.”

Deputy head of nursing, Ciara Rooney, says:“We want our nursing assistants to feel valuedand understand the difference they make to apatient’s care.

“Working in any nursing role is a privilege.You take on a position of trust when a person isat their most vulnerable. Our nursingassistants are in this position every day and wewanted to formally acknowledge just howmuch they do for patients.”

One nursing assistant who knows exactlyhow much her role means to those she cares

for is Stella Barnie, who works on BlundellWard at Guy’s Hospital.

She says: “I trained as a beauty therapist so that, in addition to my formal duties, I cangive patients treatments to make them feelbetter about themselves.

“I make sure they are able to have a showerand feel fresh, and then I can do their hair, nails,and feet, anything to help them feel good.”

A change of name is not the only thing ournursing assistants decided when they cametogether at their first ever Trustwide nursingassistants’ conference earlier this year, anevent which now runs as a monthly forum.

They were asked who would be interested intaking steps towards higher education, and70% replied ‘yes’.

Sarah Candy, lead for clinical apprenticeships,says: “We have developed an education planwithin the Trust so that our nursing assistantscan undertake a diploma in health.

“We’ve had a great response and the firstgroup of students have already begun theirdiplomas. They study one day a month in theTrust’s education centre.”

Chief Nurse Eileen Sills says: “TheCavendish Review is a welcome recognition of the vital role that nursing assistants play on our wards. We are proud of our nursingassistants and their initiative to revitalise their role and be the best. I’d like to say welldone to all of them, and thank you to Sarahand Ciara for their hard work with the whole project.”

Our nursing assistants redefined their identity.Now a national review urges the rest of the NHSto follow in their footsteps.

Nursing assistants lead the way

For more information visit:www.guysandstthomas.nhs.uk/nursingassistants

Guy’S AnD STTHoMAS’ nurSinGASSiSTAnTS Top FAcTS

• There are more than 550 nursing assistants in the Trust

• Nursing assistants act as patient advocates

• Nursing assistants bring a wide range ofknowledge to the Trust as they all have differentexperience andeducational backgrounds.

12 The GiST

No one wants to be unwell or in hospitalbut we all want to know that the rightcare is there when we need it. In winter,we usually see more patients with flu,breathing problems, and other healthissues associated with cold weather. So how do our services prepare?

Hospital careOur site nurse practitioners are seniornurses who manage our hospitals day-to-day. They are always on hand tohelp ensure services run smoothly andthat we provide the safe, high quality careour patients expect. They are the eyesand ears of our hospitals, and ensure wecan respond quickly and efficiently to anyemergencies or increases in demand forour services.

Site nurse practitioner Paula Willmoresays: “We monitor bed availability,capacity in operating theatres, waitingtimes, and vital non-clinical issues suchas housekeeping and the delivery ofcrucial supplies – all essential to keep ourhospitals running smoothly and ready forthe unexpected.”

“Working closely with A&E is alwaysimportant, especially if there’s a fluoutbreak or sudden cold weather, as thiscan significantly increase the number ofpeople coming to hospital.”

To prepare for the busier wintermonths, the Trust is recruiting an extra 25 nurses who can be deployed flexiblyand at short notice to wherever they areneeded most. For example, supporting

wards if several staff are off sick orenabling us to open additional beds. We are also extending some services,such as physiotherapy and occupationaltherapy clinics, to open seven-days-a-week so they can provide care wheneverpatients need it.

Help at home During the winter months, ourcommunity teams usually see morepatients with breathing problems orchest infections, and also an increase inolder patients who need extra supportfollowing surgery or a hospital admission.District nurses and other community-based staff can often treat these patientssafely at home.

Launched last January, Home wardand the Enhanced Rapid Responseservice have helped more than 1,200local residents to be treated at homerather than in hospital. The servicessupport people with a range of illnesses,including diabetes, heart disease orsevere breathing problems, who havebeen referred by their GP or hospitalconsultant.

A team of nurses, physiotherapists,support workers, GPs, and social workerswork together to provide patients with thesupport they need. By the end of the year,all GPs in Lambeth and Southwark will beable to refer their patients directly to thisservice.

Ese Umukoro, Home ward matron anda community nurse for 18 years, says:

“These services have been extremelysuccessful because they help patients tobe treated at home which they prefer.Whether it’s assessing if a patient needs astair lift or giving them specialist medicaltreatment, they get the best care possiblein an environment where they are morerelaxed and comfortable.”

choose well If you are unwell it’s good to know whichNHS service is right for you.

“It’s really important that we choose theright service for our needs,” says DrKatherine Henderson, clinical lead for theEmergency Department at St Thomas’.

“The Emergency Department shouldonly be used for emergencies and seriousinjuries. The NHS Choices website is auseful place to get information about whichservices are best to use. Many people don’trealise how much pharmacists can help andthat often there are shorter waits at UrgentCare Centres such as the service at Guy’s.”

Fight fluAnybody can get a flu jab from their GP,high street pharmacists or somesupermarkets.

Flu vaccination is free for certaingroups of people considered at higher riskof health complications, includingchildren, those over the age of 65,pregnant women, or those with underlyingheart or respiratory health conditions. Askat your GP surgery for further details orvisit www.nhs.uk/livewell/winterhealth.

IN FOCUS

Keeping well this winter

Our community and hospital services are gearing up for the colder months. Find out how you can choose the right NHS service this winter.

www.guysandstthomas.nhs.uk 13

IN FOCUS

Top TipS ForkEEpinG WELL

• Get enough sleep

• Look after yourimmune system byeating more fruit andvegetables

• Get a flu jab

• Good lighting helpsavoid slips and trips

• Help elderly neighbourswith their foodshopping or whengetting up the stairs.

“Working closely withA&E is always important,especially if there’s a fluoutbreak or sudden coldweather, as this cansignificantly increase the number of peoplecoming to hospital.”

WHAT’S WronG?

A&E at St Thomas’ Hospital, or call 999

your Gp or dentist, out of hours: call 020 8693 9066

pharmacist

Self care

urgent care centre atGuy’s Hospital 8am- 8pm every day (last arrival at 7pm)

WHAT To Do

choking, chest pain, blackouts, blood loss,

serious injuries

Vomiting, ear pain, painful coughs,toothache, flu-like symptoms,

unwell but unsure

Diarrhoea, runny nose, upset stomach, headache

cuts, bites, sprains

Hangover, sore throat, grazed knee, cough

Site nursepractitioner

Paula Willmore

IN FOCUS

14 The GiST

Speaking from experience

In the UK 2.5 million people are living with speech and language difficulties, ranging from unclear speech or a delay in development to long-term voice loss.

At Guy’s and St Thomas’ we have 31speech and language therapists who helppeople of all ages with speech andlanguage problems to communicatemore easily. They also provide supportfor people who find it difficult to eat, drinkand swallow.

our adult patientsWe see more than 2,000 adult patients ayear. Most of our patients are referred to usby other departments in our hospitals butwe also accept outpatient referrals fromlocal GPs. Our specialists help people afterhead and neck surgery or a stroke, as wellas those who have conditions likeParkinson’s disease, motor neuronedisease or dementia. We also see manypatients with voice disorders.

Strokes are the most common causeof speech loss in the UK, and four in tenpeople who’ve had a stroke will also havetrouble swallowing, so we have twospecialist therapists dedicated tosupporting these patients.

The speech and language therapiststrain our hospital-based doctors, nursesand other therapists so patients on thewards receive support even before aspeech and language therapist seesthem.

There are seven community speech andlanguage therapists who see adult patientsin their own homes in Lambeth andSouthwark. These patients are usuallyreferred by their GP or hospital teams, butpatients can also refer themselves.

caring for childrenOne in ten children have speech,language and communication needs thatrequire long-term support, and 5% ofchildren start school with difficulties withtheir speech and language.

Lindsay McLelland, service managerfor children’s community speech and

language therapy says: “We have 65community therapists helping childrenwho have problems communicating orlanguage difficulties. The service isconvenient and flexible, supportingchildren at local health centres, nurseriesand schools, or at home.”

We also provide hospital-basedservices for children and babies withmore complex medical needs. Theseinclude mild, moderate or severe learningdifficulties, physical disabilities, delayedlanguage skills, specific hearingimpairment, cleft palate, autism, dyslexiaor voice disorders, and children who haveanxiety disorders that may prevent themfrom speaking.

Types of treatment Our therapists assess what the problemis and then decide a plan of treatment.For patients with swallowing difficulties,they may use a fibreoptic endoscope toevaluate how a patient is swallowing andif food goes down the wrong way.

For patients who have had theirvoicebox removed following throatcancer, a silicone valve can be fitted tohelp them breath. Air is pushed throughthe valve, up into the mouth and can bevibrated to produce sounds just like ourvocal cords do. A channel is made by asurgeon and then a speech and languagetherapist fits the valve and shows thepatient how to use and care for it.

After a stroke, confusion, memory lossor tiredness can make followingcomputer instructions or using acomputer mouse too challenging.Adapted keyboards and pointing devicescan help. Therapists teach patients to usea range of communication aids such assigning, symbols, picture boards, orcomputer voice programmes.

Some patients may need relaxation orbreathing exercises to improve their voice.

Silenced singerTyrone Sinclair, 26, is a secondary schoolteacher and sings for church choirs in hisfree time.

Following a sore throat, he lost his voicefor a week and it didn’t recover properly.

In July, Tyrone was assessed in the voiceclinic where he discovered he had a lumpon his vocal cords that needed removing.After treatment, his speech and languagetherapist worked with Tyrone to retrain hisvoice, teaching him how to relax his voicein the classroom and how to releasetension in his throat to avoid a recurrence.

Tyrone says: “Voice therapy hashelped return my voice to normal andeven improved my range, which is greatfor my singing.

“When I had to rest my voice for a weekafter my operation, it showed me howsocially isolating it can be to lose yourvoice or to be unable to use it in the wayyou want to. I now realise what animportant job speech therapists do.”

FAST FAcTS

• Our voice clinic sees around 40 new patients a month

• Inpatients who need urgentsupport are seen within a day

• 15-25% of patients in the voiceclinic are teachers

• 30% of people who have had astroke struggle with speech andlanguage afterwards.

For more information, visitwww.guysandstthomas.nhs.uk/speechtherapy

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Speech and language therapist Christina Iezzi uses a fibreoptic endoscope toevaluate a patient’s swallowing

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16 The GiST

What our values meanEvery day our 13,200 staff strive to provide our patients with exceptional care byfollowing our five values. Our values underpin our new Showing we care strategy inresponse to the lessons learned from the Francis Report into the tragic events atStafford Hospital.

The strategy was developed in consultation and conversation with staff – morethan 2,000 staff took part in our ‘listening exercise’ earlier this year. It translates ourfive values into ‘pledges’ we have made to our patients and staff about the quality andcompassion of the care that patients should receive at Guy’s and St Thomas’ and themutual support and respect that we expect our staff to show for each other.

“I do my best to keep my wardclean. at’s why I’m here, tolook after the patients and keep them free from infection.”

Soledad runasHousekeeper

“I now introduce myself everytime I see a patient. I used to doit just the first time I sawsomeone, but now I do it everytime and I introduce everyonearound the bedside so that mypatients know everyoneinvolved in their care.”

Dr Mark kinironsConsultant in general and geriatric medicine

• you will receive a professionalstandard of care delivered withkindness, dignity and respect

• We will support our staff to listento you

• our staff will ensure that yourcare and treatment is safe

• We will ensure our staff have theright skills and resources toprovide the most effective care

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to our staff and patients

“You have to be your ownmanager and maintain thestandards. It’s important because wherever the patientsare, they deserve the same high standards.”

chris craigPorter

“If you want to be a good doctoryou’ve got to go the extra mile,you can’t just come in at 9 andleave at 5, it just doesn’t worklike that.”

Dr Jelena StojanovicSpecialty trainee in paediatric nephrology

“I know from my personalexperience of having my ownrelatives in hospital that it canbe a difficult time and a prettydaunting experience. By puttingmyself in their shoes andempathising with them, I cantry to understand the needs ofmy patients.”

Gayle campbellPharmacist

• We will always treat you with theutmost kindness and respect

• our staff will treat each other with dignity and respect

• We will ensure your care is basedon clinical evidence and bestpractice, and delivered efficiently

• We will support our staff to deliverthe best possible care 24 hours aday, seven days a week

• We will be open about ourmistakes and work hard to putthem right

• We will listen to our staff andsupport them if they raiseconcerns

We decided to ask our staff, patients and volunteers what our values mean to them – and we turned their insights into a short Showing we care film which wepremiered at our Annual Public Meeting in September. You can watch the film on ourwebsite at www.guysandstthomas.nhs.uk/ourvalues and get a taster of what ourstaff said below.

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18 The GiST

Rolereversal

Clinical specialist nurse in oral health Beverley Banton interviews consultant dentistand senior specialist clinical teacher Barry Quinn

Q What does the St omas’Dental Centre do?

A The Dental Centre provides generaldental treatment for adult patients

by training dental students and postgraduates running specialist dentalclinics. We also hold specialist consultantclinics for patients with sleep apnoea,bleeding disorders, and skin conditionswho require dental intervention whichyour local dentist isn’t always able to help with.

The team also promotes oral healtharound the hospital. We go onto wardsand advise patients on how best to lookafter their teeth or dentures.

Q What is a typical day for you?

A There is no typical day! I’m a consultant dentist, a teacher and

researcher.I usually teach final year dental

students and postgraduate dentists. We have 24 surgeries and patients arereferred to us from the Dental Institute atGuy’s Hospital if they are suitable fordental care and are willing to have theirdental work carried out by students undersupervision of our clinical teachers. We are very lucky to have had more than£3 million spent on refurbishing andupgrading the department which was re-opened by the Chief Dental OfficerBarry Cockcroft in 2011. This has resultedin a better patient experience.

Q What’s the most interestingthing about dentistry?

A The mouth is a mirror to the rest of the body. By looking in someone’s

mouth you can sometimes detectdiseases that have not previously beendiagnosed including diabetes, anaemiaand mouth cancer.

Q What are you most proud of?

A Working at St Thomas’ Dental Centre is a joy due to the

enthusiastic and friendly team. We havewon awards including a commendationfor our Oral Health Promotion Team and I was awarded the King’s College LondonDental Institute Teaching Excellenceaward last year.

“Without greatstaff like you,Beverley, wewouldn’t beable to runour service.”

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Why wefundraise

This summer ‘The Islanders’, JamesPlumley, Alan Morgan, Josh Taylor andGavin Sheehan (pictured above),entered Britain’s toughest rowing race to raise money for Evelina London.

GB Row 2013 is a 2,000 mile non-stopvoyage around the UK’s coast.

Josh’s girlfriend Sarah is a seniorward nurse at Evelina London.

“We were all lucky enough to have ahealthy childhood, but that’s notguaranteed. We wanted the money tohelp children who aren’t so lucky and weknow from Sarah the difference EvelinaLondon staff can make,” says Gavin.

‘The Islanders’ battled winds, tides,busy shipping lanes, and mental andphysical exhaustion to win the race,setting a new Guinness world record.Their time of 26 days 9 hours 9 minutesbeat the previous record by more than 12 hours.

The team has raised almost £10,000so far. You can still sponsor them atbit.ly/Zin9y7.

Q What do you enjoy mostabout your job?

A I have a passion for clinical teaching as I enjoy helping young

people with their careers in dentistry andputting a smile on our patients’ faces.

We have a great team of consultants,teachers, hygiene therapists, dentaltechnicians, and fantastic dental nurseslike you – without great staff like you,Beverley, we wouldn’t be able to run our service.

FAST FAcTS

• Barry and the team teacharound 130 dental students,30 postgraduate dentists, and five medical studentsaiming to become oralmaxillofacial surgeons each year

• The team treats around4,000 patients a year.

To find out how you can fundraise for Guy’s and St Thomas’ visit togetherwecan.org.uk, email supportgstt@togetherwecan.org.ukor call 020 7848 4701.

Beverley and Barry’s toptips for healthy teeth

• Get regular check-ups –at least once every two years.If you’ve had problems withdecay or gum disease thenyou will need to see a dentisttwice a year.

• Look at food labels for theamount of sugar included.Swap sugary foods for fruitand vegetables.

• Limit your sugar intake tobetween two and four timesa day.

• Try to give up smoking.

• Brush your teeth twice a daywith fluoride toothpaste usinga circular motion with a peasized amount of toothpaste.

• Don’t rinse! This washes the protective fluoride offyour teeth.

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Say what?

Aung San Suu Kyi enlists help of Trust’s Buddhist chaplain

Q Growing up, what did you want to be?

A A midwife. My nan was a midwife and used to tell me

wonderful stories.

Q If you could learn onething…?

A I love driving, so stock car rallying or racing.

Q Tell us something aboutyou that we don’t know?

A My Great Great Grandfather was Captain Webb – the first

man to swim the channel unaided.

Q If you could have a superpower, whatwould it be?

A It has to be the power of invisibility.

Q What’s your best advice?

A The longest journey starts with the smallest step.

You can achieve anything if you setyour mind to it.

Q Who is your hero?

A I really admire the unsung heroes who provide care,

whether professionally or thosecaring for friends or family at home.

Q Where is your favouriteplace?

A There is nothing like relaxing in the Cotswolds with a log

fire and a glass of wine.

A Buddhist chaplain at Guy’s and St Thomas’has been asked personally by Aung San SuuKyi, winner of the Nobel Peace Prize, to setup Burma’s first multi-faith spiritual healthteam in two hospitals.

U Uttara, originally from Burma, was the world’s first hospital Buddhist chaplainwhen he joined the department of spiritualcare at Guy’s and St Thomas’ in 2002.

“Having a spiritual health service is vitalto the mental and physical well-being ofmany patients and their families,” he says.

“With the recent political and economicchanges in Burma, public health isincreasingly important, and so the Burmesegovernment welcomed my idea of launchinga service in Rangdoon and Mandalay.”

Burmese opposition party leader AungSan Suu Kyi personally asked U to start work

as soon as possible. He will spend the next 10 months in

Burma training chaplains from differentfaiths, including Buddhist, Muslim, Jewishand Christian.

“Here at Guy’s and St Thomas’ thechaplains are available 24-hours-a-day,seven-days-a-week if a patient or familymember needs someone to talk to –whatever their faith or if they have no faithor religion but would like our support,” he says.

“We listen to concerns, pray withpatients and their families, and supportfamilies after the death of a loved one.

“I hope this is just the start of myoverseas adventure, as my aim is thatevery hospital in Burma will have aservice like the one we have here.”

Buddhist chaplain U Uttara

Dena o’Gorman, IT training manager

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HistoryCornerThe East Wing at St Thomas’ Hospital

Hospital volunteer Elizabeth Watson

Our volunteers provide an extremelyvaluable service which improvespatients’ experience in hospital and complements the work of our full-time staff.

They are involved in assisting withmeals, guiding patients and visitorsaround the hospitals, befriending, giving hand massages, supportingadministrative duties, and providingtrolley services with books andmagazines to patients on the ward.

Amanda Bryan, voluntary servicelead, says: “It is remarkable that thesevolunteers have given up their time forso many years to make a difference topatients. We thank them for their yearsof commitment – it is an outstandingachievement.”

Elizabeth Watson, 82, has volunteeredat the Trust for 15 years. For the lastseven years she has befriended patientsin the Lane Fox Unit, a specialist unit atSt Thomas’ for patients who havesevere breathing conditions, who areoften admitted for long periods.

Elizabeth says: “I enjoy meetingpeople and as a volunteer I have metpeople from all walks of life. Thepatients just want someone to talk towho isn’t a medical professional or afamily member. I enjoy keeping themcompany and I hope to continuevolunteering for as many years as I can.”

Long service awards were recentlypresented to a group of 11 dedicatedvolunteers who between them havegiven 225 years of support to patientsand staff at Guy’s and St Thomas’ –we thank them for their valuablecontribution to the life of the Trust.

ThenIn the early 1960s, land to the east of theoriginal St Thomas’ site was purchasedto extend the hospital. The new buildingaccommodated the casualty departmentand new wards, and was named the East Wing. It was opened in June 1966.

There was one ward on each floor – including a ward for psychiatricpatients, orthopaedics, thoracicsurgery, and the intensive treatmentunit (ITU).

nowCasualty, now known as the EmergencyDepartment, and the Trust’s cardiologyservices, two intensive care units (ICU),and admission wards, as well as offices,teaching facilities and support servicesnow occupy the East Wing.

A major refurbishment is nowunderway to create a building fit forthe next generation.

The proposed design (pictured) willgive a new lease of life to the existingbuilding, and was chosen by patients,staff, and members of the public.

The year-long project will result intwo airy and light glass atria, new lifts,and modern cladding of the exterior to weather-proof the building andimprove energy efficiency.

Celebrating our life-long volunteers11 volunteers, with more than 200 years of volunteering between them, have been praised for their dedicatedservice to the Trust.

•olga ketley, for 40 years’ service

•Bernadette Budge and Doris penman,for 25 years’ service

•Mary Vroom, Margaret Lobband Anthony McEnery, for 20 years’ service

•Beryl Heyden, Doris newnham, Fred Burtenshaw, Sheila pennantJones and Elizabeth Watson, for 15 years’ service.

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What is the rEAcH Domestic abuse service? It is an ‘in-reach’ domestic abuse advisoryservice based in the Emergency Department (A&E) at St Thomas’. Weprovide advice and support to both men andwomen who are being harmed or controlled,and who are afraid of their partner or a familymember. The service is free and confidentialfor all patients, staff and students.

How does the rEAcH team help people?While our clinical staff will be dealingwith the injuries or illness of patients, wework alongside them to provide supportand advice around the patient’s safety,discussing their options when they areready to leave hospital, for example,arranging alternative accommodation if necessary.

“Without the post room service, quitesimply the hospitals would grind to a halt.Without post our staff wouldn’t be able todo their jobs effectively.

“There are two post rooms – one atGuy’s and one at St Thomas’. The teamincludes eight post room operatives,myself and our manager.

“Each morning at 7am, we start to sortthe 15,000 letters and packages that aredelivered to our post rooms by Royal Maileach day.

“In the afternoon we frank – or stamp– the 10,000 letters that staff need us topost out daily.

“We all love our jobs. Two members ofthe team, Mark Tyrell and Nicki Charles,have been here for more than 40 years

between them.“The strangest thing that we’ve had

delivered to the post room by mistakewas a package for television presentersAnt and Dec, in which a fan had sent herunderwear!

“We get a lot of cards delivered forpatients too – an important tip for theirfriends and relatives is to make sure theyput the relevant ward name on theenvelope or it won’t reach the patient.”

For a variety of reasons, some victimsmay not choose to leave the relationshipat this time but REACH will continue tosupport them.

Because we are based in theEmergency Department, we are able torespond at the time of crisis for thosewho have experienced violence. Somepatients may not feel able to say theyhave been assaulted by a loved one so wetrain new staff in how to approach thesubject and how to refer patients to theREACH service.

We also work closely with both ourchild protection and safeguarding adults teams.

How can people get support or advice? If you are a patient, ask your nurse ordoctor to phone us on 020 7188 8161from Monday to Friday, 8am to 6pm. In an emergency please dial 999. If you work in the Trust, or are no longerreceiving treatment, you can self-refer by calling the number above.

From thefrontlineGuy’s post room team leader,Terry reynolds

Ask us: How to gethelp withdomesticabuseWe speak to Laura Stretch,REACH service manager

Terry Reynolds, Mabs Choudhury and Nicki Charles

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What’s On

B C S O L S T I C E F P

M C N S O N K A V K B M

G E O G R O N I C R Y I

N C W E L C I C I V U W

I I B I C R S R S N T G

G H O P N I O N F A G M

D X A A I T L C D G I A

E B R C R W E D T E P R

L D D L D G U R H Z D C

E C I C S N F O N G I T

S I N Y Q W Y X U K S I

E A G N I G D E L S A C

To be in with a chance to win four tickets for the London Eye, simply complete the wordsearch below.

Please send your entry by Friday 9 December to the GiSTcompetition, Communications Department, 4th floor, StaircaseC, South Wing, St Thomas’ Hospital, Westminster Bridge Road,SE1 7EH; or you can email communications@gstt.nhs.uk

The winner will be selected at random and notified withinseven days of the draw. The result will be final and we will notenter into any correspondence regarding the competition ofthe winner. The prize is non-transferable.

Competition

raise money for your hospitalwww.togetherwecan.org.uk

1–31 OctoberBreast cancer Awareness Month Visit www.breastcancercare.org

1–31 OctoberLupus Awareness Month Call 01708 731251 or visitwww.lupusuk.org.uk

1–31 OctoberStoptober (Department of Health stop smoking campaign) Call the Smokefree helpline0800 022 4332 or visitwww.smokefree.nhs.uk

12 OctoberWorld Arthritis Day

23 OctoberJoint Board of Directors and council of Governorsmeeting4 –7.30pm, Robens Suite, Guy’s Hospital

25 OctoberWear it pink (breast cancer campaign)Call 0800 107 3104 or visit www.wearitpink.org

1–30 NovemberMovember (Men’s healthawareness month) Visit http://uk.movember.com

10 Novemberremembrance Day

1 DecemberWorld Aids Day

1–31 DecemberDecembeard (bowel cancer fundraising campaign) Helpline 08450 719301, visitwww.beatingbowelcancer.org

5 DecemberThe Friends of St Thomas’Hospital christmas Market11am –3pm, Central Hall andcorridors, St Thomas’

Every Monday: Free lunchtime concert 1–2pm, Central Hall, St Thomas’

Every Wednesday: Free lunchtime concert 1–2pm, Atrium 3, Guy’s

Arctic

Fuel

Ice

Icicle

Skiing

Sledging

Snowboarding

Solstice

Winter

Guy’s Hospital carries out 1 in 10 of all UK kidneytransplants……but around 400 of ourpatients are still waitingfor a donated kidney.In the UK today more than 7,000 people are on the transplant list, waiting for a heart, kidney, liver or other organ.

Anyone can register to be an organ donor – even if youare over 65, or have a medical condition such as highblood pressure or diabetes.

The gift of lifeA single donor can transform up to nine lives.