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This Month's News

Urology Update

A New Innovation - Bipolar TURP

Improving Communication for Patients

Contacting the Orthopaedic Service

Introducing the EQUIP Team

Under pressure but well supported

Revised guidelines when dealing with pathology samples

Forthcoming Events

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February 2011

Urology Update

The Urology Department at Ashford & St Peter's provides a wide range of urological services to North West Surrey including outpatient outreach clinics in Woking, Weybridge, Cobham and Shepperton.

They are a dedicated and active surgical unit and over the years the department has continued to develop and grow. It now consists of a team of 5 consultants, 6 middle grade registrars, 4 further junior doctors and 4 urology nurse practitioners supported by 3 secretaries.

On 27th January 2011 a Urology Spotlight Seminar was held at Foxhills Golf & Country Club.

The event was attended by local GPs and feedback has been positive. All the consultants as well as Alison Roodhouse, urology nurse specialist, were available to answer questions from GPs before and after the event.

Among the subjects covered were: Bladder Cancer; Haematuria and the management of urological cancers in our Trust; Laparoscopic urology in our Trust -an evolution in pelvic laparoscopy and robotics; Improving patient communication in the 21st century and overall service provision; Stone service and an outline of pelvic oncological services.

The highlight of the evening was a video on robotic surgery produced by Mr Krishna Patil and Mr Bill Dunsmuir and presented by Mr Krishna Patil which was enjoyed by everyone present. Seminars are held throughout the year at various locations. Please contact our GP Liaison Manager on 01932 723716 for more information. Referrals can be made through all usual pathways, including Choose and Book.

A New Innovation - Bipolar TURP

On the 2nd of February two patients underwent the Trust's first bipolar transurethral resection of the prostate (TURP) for benign prostatic enlargement. There is increasing evidence of the increased safety from bipolar TURP for benign prostatic enlargement. It has been shown to result in less blood loss and prevent TUR syndrome. There are currently 5 centres in the country offering bipolar TURP as a day-case procedure, and we aim to become the 6th.

Both patients had successful operations and were discharged home catheter free within 23 hours of their operations. Normally patients that have a standard TURP stay in hospital for an average of 2.5 days.

Said Justin Collins, "Bipolar TURPs are an important part of our strategy to get more patients successfully treated as day-cases or with overnight stay and home the next morning. To achieve this we are utilising the latest technology available."

Improving Communication for Patients

Outpatient Matron Di Lashbrook demonstrates the new communications system

Outpatient Matron Di Lashbrook demonstrates the new communications system

Our outpatient department at St Peter.s has recently opened a Communications Resource room, to help patients with specific communication needs.

The room offers a private and quiet place for individual consultations and is set up with specific communication equipment to give patients extra support.

The room has a built in hearing loop system for patients who use a hearing aid, and also offers access - via an online service - to sign language interpreting. This works by using a webcam to film the patient, who in turn can view a sign language interpreter via the computer screen. The doctor or nurse would communicate with the interpreter via the telephone. The service can also offer sign language in a variety of other languages as well as a range of printed patient information.

The room is also equipped with a dedicated Language Line telephone, which is a double handset allowing both the patient and the member of staff to speak directly, via their individual handsets, to an interpreter at the other end. Language Line offers a 24/7 telephone translation service in a large number of foreign languages.

Outpatient Matron Di Lashbrook comments; "The resource room is making a real difference for our patients with additional communication needs. Having a dedicated and relaxed space, with all the relevant equipment in one place, makes this kind of communication much easier both for patients and for staff."

Referral Guidelines

If you are referring a patient who has communication needs of any kind, please make this clear on the referral letter so that suitable arrangements can be made to assist the patient.

Please also be sure to include a daytime contact telephone number for all patients.

Further information on referral guidelines and the Referral To Treatment (RTT) pathway which has replaced the 18 week guidelines is available in the 2011 Service Directory which is currently being distributed or by contacting the GP Liaison Manager on 01932 723716.

Contacting the Orthopaedic Service

Our Trauma and Orthopaedics Division welcomes dialogue and direct rapid communication between GP practices and the consultant surgeons.

There is a Hotline number 01932 722394 manned from 08:00 - 18:00 weekdays which can be used to make urgent referrals, request a consultant call back or for general enquiries. The individual consultants can be contacted by e-mail or direct by mobile phone and will be happy to take calls or receive texts from GPs (see contact list included with this mailing).

We look forward to working more closely with our GP colleagues and welcome any feedback and communication.

Introducing the EQUIP Team

The team

The EQUIP team is led by Chris Matthews, Head of Service Improvement and consists of Holly Hamilton, Amber Lane, Philippa May and Grehan Murphy.

Our teams brainstorming ideas during some of our recent projects.

Our teams brainstorming ideas during some of our recent projects.

The story so far

The Efficiency, Quality, Improvement and Productivity (EQUIP) team is Ashford & St Peter's Hospitals NHS Foundation Trusts service improvement team, established in September 2009 to run a programme of service improvement based on Lean methodology.

The EQUIP team is working alongside a company called SimplerŪ who are experts in applying Lean techniques in different environments, from aerospace to healthcare. The idea behind the programme is that staff are equipped with the ownership, knowledge and skills to improve productivity and efficiency in their own areas. So far the team have supported projects focusing on the medical discharge pathway, day surgery, hip replacements and A&E.

What is Lean?

Lean methodology is not a new concept. It originates from the car manufacturers Toyota and the principles have been applied successfully across many industries, including healthcare, worldwide. Lean looks at all work as a process (or more commonly referred to in healthcare as a "pathway.).

It focuses on finding and getting rid of the wasteful parts of the pathway. As a consequence, pathways can become more efficient and improve the experience for both patients and staff. Lean is not just a toolbox of improvement techniques, it is a culture and philosophy based on respect and involvement of people.

Womack, James., & Jones, Daniel T. (1990) The Machine that changed the world. Simon & Schuster Ltd.

How To Get involved

We would like your help to get more primary care clinicians involved with EQUIP. In the coming months, planned pathways include:
  • Emergency admission avoidance;
  • Urogynaecology;
  • Endoscopy;
  • Discharge.
The last event was enhanced by having a local GP present for part of the time.

If you would like to contribute, or have any questions please contact;

Chris Matthews
Head of Service Improvement and EQUIP Programme Manager
Ashford & St. Peter's Hospitals
Foundation NHS Trust
01784 884891
07827 955799

Under pressure but well supported

Over the past two months, this Trust has experienced extreme pressure across many of our services, due to a combination of bad weather, expected increases in winter related illnesses and the flu outbreak. Staff have worked hard to make sure we have been able to continue providing emergency and life saving treatment, and to manage the additional demand.

Unfortunately, we have had to cancel a number of planned operations in order to manage this situation, but every cancellation was assessed on an individual basis to make sure a delay would not cause any clinical harm to the patient. No confirmed or suspected cancer patients had operations cancelled. We are now rebooking any cancelled patients for their surgery as soon as possible.

We would like to pass on our thanks to GP and community colleagues for your help and support in managing patients during this time, which has seen us all under pressure.

The arrangement of alternative referral and care pathways by GPs after discussion with the on call teams was a great help in managing patient flows, and it would be good to think that this level of communication and co-operation between GPs and the Trust can continue throughout the year.

The on call team can be contacted via the hospital switchboard on 01932 872000.

Revised guidelines for GP surgeries and outreach clinics when dealing with pathology samples

Attached as an insert are the updated guidelines for GP surgeries to follow when dealing with pathology samples.

These guidelines also apply to outreach clinics on any site.

There is also an updated sample list to be completed and included with each transport box. This can be photocopied. The Pathology Services Handbook can be accessed via the Trust.s main web page:

Forthcoming Events


(including Locums and Sessional Doctors)
Lunch from 12:30

Who? What? When? Where?
Mr Kafil-Hussain
Consultant Ophthalmologist
GP Tutor Ashford and St Peter.s
Update on antibiotic resistance, C. diff, ESBL and MRSA
Dr Clive Grundy Consultant Microbiologist
3:15pm: onwards

Optional informal session on collecting information for appraisal and revalidation, including difficulties for non-principal doctors

To register please contact Gladys Essien on 01932 723987 or email me at

There will be opportunities for discussion with all topics. For more information or to submit questions in advance please contact Dr Coward