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This Month's News

New Developments in Accident and Emergency

Reducing Falls in Care Homes

Ophthalmology Service

Welcome to Dr Barry Quinn

Welcome to Mr Shaheen Khazali

Welcome to Mr Manish Kothari

Dates for your Diary

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January / February 2012


New Developments in Accident and Emergency

Over the last two months there have been a number of changes in the Accident and Emergency Department aimed at both improving the patient experience and also the flow of patients through the unit.



The newly opened Clinical Decisions Unit


To facilitate the changes there have been some changes to the management structure of the department.

Marcus Wootton is the Emergency Department (ED)Lead Nurse, while Deb Sutton and Caroline Farrar have been appointed as Divisional General Manager, Acute Medicine and Emergency Services and Divisional General Manager, Unplanned Care respectively. Steven Crouch takes over as the Manager for A&E. All of these appointments are currently on an interim basis.

Over the next few months the Trust will also welcome two new consultants in A&E. Mr Jacob Addoo (previously a Registrar in the department) will take up his post in February 2012 and will lead on Ambulatory Care pathways. Mr Suresh David has also been appointed and a start date is to be confirmed.



The STaRT area - waiting to treat patients as they arrive


In the week commencing 12th December 2011 a Clinical Decision Unit (CDU) opened with the aim of providing a better environment for patients who need to be observed, tested or treated for a more extended period of care than 4 hours, but who do not need to be admitted to a ward. The CDU has 6 spaces which are single-sex compliant plus a side room which can be allocated as required. This unit has greatly improved the patient experience and the flow of patients through A&E.

In addition to the CDU, the Trust has introduced a STaRT service. Standing for Simple Triage and Rapid Treatment, the service is aimed at all patients coming in by ambulance and aims to provide joint nurse and doctor assessment at the point of entry to the department. Doctors providing this triage are of registrar grade or above and this service enables value-added decision making as well as improving ambulance turn-around times.



Reducing Falls in Care Homes

On 16th November 2011 a year-long project was launched with the aim of clarifying whether the provision of a ‘falls and fracture reduction package’ to care homes can reduce the incidence of falls and fractures, as currently 40% of hospital admissions from care homes follow a fall.

The project takes in five care homes around the locality and is being run by Ashford and St. Peter’s NHS Foundation Trust in collaboration with Surrey Community Health, NHS Surrey and the pharmaceutical company Servier.

The project will focus on developing a close working relationship with the homes and to empower the carers within the home to take personal responsibility for falls prevention. It was launched with an educational event directed at raising awareness of the topic which was attended by care home managers and falls champions elected within the homes.

The project is designed to enhance contact with the Community Falls team and the geriatricians from the Acute Trust. Effective fall prevention programmes within care homes require a culture of proactive management of fallers and the Falls Team is ideally placed to facilitate this. The Falls Team will assist in training of staff and reviewing residents who are at risk of falls. They will also be in a position to assess environmental risks that can contribute to falls and help staff identify and reduce these.

The project will also be supported by the Orthogeriatricians from the Trust. Part of their role will be to ensure that all homes have the necessary policies in place and to help design falls prevention tools tailored to the individual homes in accordance to national guidelines. They will also be responsible for liaising with the GPs regarding high risk patients requiring further input and provide secondary care support for the project.

The medication reviews will be carried out by NHS Surrey primary care pharmacists. Care home patients will be identified at the GP Practices responsible for the patients and a medication review will occur using the patient’s computer record. This will include identifying medications that increases the risk of falls for instance antipsychotics and hypnotics.

Medications that are associated with osteoporosis e.g glucocorticoids and anticonvulsants will also be identified. The Pharmacist will then visit the care home to identify any issues with medications, on an individual basis, with care home staff and to address compliance issues.

A multidisciplinary meeting will then occur with the GP, pharmacist and consultant orthogeriatrician to optimise medications for the patient, ensuring local and national guidelines are followed. The GP Practice computer system will also be updated with relevant read codes e.g. patient has history of falls, previous fracture, allergies, intolerances and any other useful information not previously captured.

Full engagement of the care home staff is essential for the success of this project and initial feedback from care home staff following the event was very encouraging. If successful, the project will be rolled out across more homes. Results from the project should be available at the end of the year.




Ophthalmology Service

Change of Fax Number for Emergency Referrals

The fax number for emergency ophthalmology referrals has changed to:

01784 884350


Please see the separate letter included for further information



Welcome to Dr Barry Quinn
New Consultant Nurse Lead for Acute Oncology


Dr Barry Quinn joined our oncology team late last year as Consultant Lead Cancer Nurse, and will also be the Trust’s Acute Oncology Service Lead, helping to offer more targeted care to emergency cancer patients.

Barry has an interesting background with wide experience working in cancer and palliative care. He first studied to be a Priest in Ireland and volunteered in a Dublin hospice for three years, his first experience working with patients with cancer and palliative care needs. Deciding to change career Barry chose nursing and, once trained, began to work in oncology at University College Hospitals, London.



Dr Barry Quinn


Barry’s career includes time at The Royal Marsden as a lecturer practitioner before completing first an MSc in healthcare, focusing on how nurses support patients who are trying to make sense of their illness and the effect this has on them, and continuing through his doctoral studies. Barry continues to lecture and write on this subject both here and abroad.

Before coming to Ashford and St Peter’s, Barry worked at St George’s and became their senior oncology nurse and lead chemotherapy nurse for the cancer network in SW London. He writes and reviews for many European cancer journals, and sits on the Board of the European Journal of Oncology. Barry chairs a national group developing guidance on oral care in cancer and palliative care and is part of a group addressing pain guidelines in cancer care for the European Oncology Nursing Society.

Part of Barry’s role will be to continue raising the profile of cancer within Ashford and St Peter’s, helping to train staff in non specialist areas and to support the senior cancer team. The new Acute Oncology Service will help support staff in areas such as A&E and MAU, and on the wards, to treat cancer patients (particularly those coming in as emergencies or with suspected cancers) urgently and appropriately speeding up access to the correct investigations and care.

Barry adds: “I am passionate about nursing, particularly about supporting patients with cancer, and their families. As our new acute service develops I will be working hard to ensure good staff engagement across the Trust – patients coming into hospital with cancer are not just the responsibility of the oncology team, they are everyone’s responsibility. I also intend to set up a patient user group so we can get a better understanding of what our patients want from the service”.

Barry is currently Chair of the Trust’s End of Life Group working to ensure that all patients at the end of life get the best care possible.



Welcome to Mr Shaheen Khazali

Mr. Shaheen Khazali MRCOG MScConsultant Obstetrician and Gynaecologist

Shaheen is our new appointment to the Department of Obstetrics and Gynaecology, replacing Professor Jeremy Wright who has now retired. He has a special interest in advanced Laparoscopic and Hysteroscopic surgery as well as gynaecological ultrasound scanning. He holds a Masters degree in Advanced Gynaecological Endoscopy from the University of Surrey.

Shaheen has a keen interest in pelvic pain and endometriosis.

Shaheen started his specialty training at John Radcliff Hospital, Oxford, having spent his basic training in London and Cambridge. He then moved to the south coast and worked in Poole, Winchester and Southampton hospitals where he completed his training.



Mr Shaheen Khazali


He has led a number of innovative projects, including an online pain diary for chronic pelvic pain patients, development of a new laparoscopic instrument to improve safety and speed of surgery and also has devised a scoring system for assessing laparoscopic surgical skills of trainees.

He was a board member of British Society of Gynaecological Endoscopy (BSGE) for 3 years and now is the editor of BSGE’s video library and forum, which he has set up. He has published in various journals, contributed to a number of book chapters in the field and presented at national and international meetings.

He has recently moved into the locality with his wife Tina, who is a GP, and their two young children.


Clinical interests:
  • Advanced Laparoscopic and Hysteroscopic surgery (particularly in relation to fibroids, abnormal uterine bleeding and endometriosis)
  • Pelvic pain and Endometriosis
  • Menstrual disorders
  • Gynaecological Ultrasound

How to Refer:

Referrals can be made by forwarding a letter to the Appointments Centre and we hope to have the clinics available for booking via Choose and Book in the near future.



Welcome to Mr Manish Kothari

We are pleased to welcome Consultant Oncoplastic and Reconstructive Breast surgeon Mr Manish Kothari to the Trust.

Mr Kothari did his basic surgical training in Mumbai, India. He arrived in the UK in 1997 to pursue specialist higher surgical training in the treatment of breast cancer. Mr Kothari was awarded his MD thesis by the University of London for his research on ‘purification and culture of breast cancer cells’ performed at Hammersmith hospital, London. This work was presented and published both nationally and internationally.



Mr Manish Kothari


He went on to undergo higher surgical training in the North West Thames deanery and received Oncoplastic and Reconstructive breast surgery training at The Royal Marsden, Charing Cross and St. Mary's hospitals in London. Mr Kothari lays great emphasis on delivering high quality and efficient care to his patients through a skilled multidisciplinary team of doctors, nurses and other staff.


Some of the procedures offered are:
  • Sentinel lymph node biopsy
  • Oncoplastic Breast reshaping at the time of breast conservation cancer surgery
  • Mastopexy and Therapeutic mammaplasty
  • Immediate and delayed breast reconstruction using implants and/or flaps after mastectomy
  • Nipple reconstruction
  • Breast reduction/augmentation
  • Lipomodelling



Dates for your Diary

GP Lunchtime Meetings — Spring term 2012:


ASHFORD HOSPITAL EDUCATION CENTRE 1pm (lunch from 12 45pm)

THURSDAY 9th FEBRUARY DERMATOLOGY UPDATE
Scalp problems and hair loss
Logical use of local treatments for acne
Dr Richard Moore GPwSI Dermatology
and the Dermatology Department ASPH
WEDNESDAY 14th MARCH DIZZINESS - ENT or not? Miss Harriet Patmore
Consultant Surgeon ENT ASPH
TIA and STROKE – diagnosis and secondary prevention Dr Bhaskar Mandal
Consultant in Stroke Medicine and Care of the Elderly ASPH



ST PETER’S HOSPITAL POST GRADUATE CENTRE 1 pm (lunch from 12 45pm)

TUESDAY 7th FEBRUARY Latest Developments in the Management of Women with Urinary Urgency and Urge Incontinence. Mr Wolf Gelman
Consultant Gynaecologist ASPH

Ms Linda Tranter
Physiotherapist
TUESDAY 6th MARCH PARKINSON’S DISEASE
– non motor symptoms
Case presentations
Meet the PD nurse team
Dr Zahid Dhakim
Consultant Physician Care of the Elderly ASPH




Contacts

You have any feedback or require any further information about the Ashford and St Peter’s NHS Hospitals Foundation Trust or require this document electronically please contact:

Sue Robertson,
Marketing Manager
01932 722420
Sue.Robertson@asph.nhs.uk

Debbie Beesley,
CAB Manager
01932 723511
Debbie.beesley@asph.nhs.uk