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Top Performing Trust for Hip Fractures

Are you using ICE for Your Pathology Requests?

Urological Surgeon Awarded Scholarship to Top Californian Hospital

Spotlight on ... the Vascular Surgery Department

Introducing Mr Marcus Cleanthis

New Appointment Confirmation Service for Patients

Dates for your Diary

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September 2011

Ashford and St Peter’s Top Performing Trust for Hip Fractures

Recent data published in the National Hip Fracture Database Report for 2011 shows Ashford and St Peter's Hospitals NHS Foundation Trust as one of the top performing Trusts in the country for the care and treatment of patients with hip fractures.

The team from L-R. Back row: Hazel Watters, Orthopaedic Trauma Nurse, Sister Christine Linley, Rachel Simpson, Senior Physiotherapist;

Front row: Mitesh Pancha, Physiotherapist and Consultant Orthogeriatrician Dr Keefai Yeong, with patient Joan Blackmore (centre) from Shepperton.

Consultant Orthogeriatrician at the Trust, Radcliffe Lisk, explains more:

"Hip fracture is a common, serious injury in older people that can bring loss of mobility and independence and, for some patients, even the loss of their home if they are no longer able to look after themselves.

We know that the quicker we operate on a fractured hip, and the quicker we get a patient back on their feet after the operation, the better a patient's chance of recovery. Here at the Trust we have put a lot of work into improving the care and treatment we give to this important group of patients which has been borne out by the results published in this latest report."

The national database is a way for all Trusts across the country to record data on how they are performing - for example how quickly patients go to surgery, access to specialist staff and treatment, how long patients spend in hospital and so on - which is then compared at a national level so hospitals can measure and improve their performance, providing an even better service for patients.

The latest report was published last week and is based on data collected from over 53,000 cases across the country.

The report demonstrates an excellent performance by Ashford and St Peter's compared to other Trusts across the country which includes: Being within the top 20% of Trusts nationally (and first within the South East Coast region) for getting patients to surgery quickly - since November 2010, the Trust has been operating on over 80% of patients within 36 hours, which is a national measure, and over 60% of patients within 24 hours. One of the top 15% of Trusts getting their patients to a specialist ward within 4 hours. 1st nationally (with 9 other Trusts) for assessing patients before their discharge on bone health and risk of falling . we do this for 100% of our hip fracture patients. 1st across the South East Coast region for assessment by a specialist geriatrician within 72 hours of being admitted to hospital. Expanding the physiotherapy service to 7 days a week means that the Trust is now able to mobilise 74% of patients within 24 hours of surgery.

Ashford and St Peter's is also the 5th best Trust nationally for achieving the enhanced payments (known as the Best Practice Tariff) for hip fracture treatment, based on a set of nationally agreed standards of care which reflect the elements recorded in the National Hip Fracture Database.

73% of hip fracture patients at the Trust meet these high standards of care, compared to the national average of only 28%.

Consultant Orthogeriatrician Dr Keefai Yeong continues: "We are delighted with the results published in this latest report, which demonstrate the significant progress and investment the Trust has made in treating this vulnerable patient group.

The experience of our patients has hugely improved over the last few years and this is due to the dedication of our whole team - including doctors, nurses, therapists, porters, healthcare assistants, everyone - it's a real team effort."

Are you using ICE for Your Pathology Requests?

There are many benefits of the new Pathology ICE GP Electronic Ordering and Reporting System.

Some of the main improvements are highlighted below.

Reduction in tests ordered: analysis shows that GPs who have been using the system for more than 3 months have seen an average 11% reduction in the number of blood tests ordered, compared with the same period last year. Reductions in microbiology and cytology tests are not likely to be as great.

Benefits to the quality of patient care come because GPs can now see all Pathology reports, including those ordered for a patient while under the care of Ashford and St. Peter's Hospitals. This has led to a reduction in duplication of tests which has obvious benefits to patients.

Improving the process - the sample bottles needed for each blood test are indicated on the form, assisting the phlebotomist in making the correct choices and reducing rejected samples.

Saving time - use of the system has improved data quality and saves time: legible requests, provision of mandatory information, receipt of complete and accurate information means fewer enquiries and telephone calls needed between practices and the laboratories.

NHS numbers and the correct locations and requestor codes are supplied electronically and the request is automatically copied to the practice computer management system.

Quality and Information governance is further enhanced by readily available audit trails.

How to find out more about using ICE


If you would like training for your practice on use of the ICE system, please call: Sue Saunders on: 01932 72 3413 or email:

Technical support

For IT support:
Call James Tew Deputy Pathology IT Manager on:
01932 72 3414

Urological Surgeon Awarded Scholarship to Top Californian Hospital

Justin Collins, a Consultant Urologist at Ashford and St Peter's Hospitals with an interest in minimally invasive surgery, has been successful in winning a scholarship to study robotic surgery in California.

USC University Hospital

USC University Hospital

The scholarship also includes time at Guy's and Thomas' Hospitals with Professor Prokar Dasgupta who is the first Professor of Robotic surgery in the UK.

"I am delighted to have the chance to learn from the experience of the robotic surgeons at Guy's and Thomas' and at USC University Hospital in California" said Justin Collins. "Robotic surgery is really starting to take off in the UK, but it is still more established in the USA where over 80% of patients who require surgery for prostate cancer undergo a robotic assisted radical prostatectomy.

There is increasing evidence that this results in better cancer clearance and better outcomes in terms of continence and erectile dysfunction compared to other surgical treatments.

Guy's is undoubtedly one of the centres of excellence in the UK and Professor Indibar Gill at USC has been pioneering new minimally invasive techniques in Urology for over a decade.

At USC they are doing amazing work with radical cystectomies and creating new bladders out of the bowel (neobladders).

They are also using a new technique for partial nephrectomies that results in minimal trauma to the remaining kidney tissue called "zero ischaemia technique".

Mr Collins aims to learn from their experience and bring those skills and new approaches back, so that patients in Surrey can benefit from them.

"Our patients deserve the best care that is available and because robotic surgery is a minimally invasive technique that results in shorter length of stay in hospital and decreased post-operative complications, it doesn't have to be a more expensive option.

Spotlight on ... the Vascular Surgery Department

Consultants Tahir Ali and Kieran Dawson (standing either side of patient Mr Gerald Taylor), with some of the team.

Ashford and St. Peter's provides a comprehensive range of emergency and planned vascular surgery - collaborating with others in the Surrey Vascular Network, which now extends to Epsom. Part of an integrated service, and supported by 24/7 interventional radiology at St Peter's Hospital, the vascular department works closely with the stroke physicians to provide an emergency carotid endarterectomy service.

Telemedicine links support stroke services throughout the Surrey network. The vascular department together with the diabetic service supports a multidisciplinary approach to the management of diabetic foot disease.

New Techniques in Vascular Surgery: Improving Patient Care

The endovascular (minimally invasive) aneurysm service at St Peter's is now able to provide a 24/7 emergency endovascular service for ruptured aneurysms.

Last month, consultant surgeon, Mr Tahir Ali, performed the Trust.s first emergency endovascular aneurysm repair. The patient had been rushed to St Peter's Hospital with a life threatening, leaking abdominal aortic aneurysm.

Normally this requires .open. surgery with a large cut in the abdomen and a prolonged recovery time. Using endovascular surgery, a small incision is made in the groin, guide wires passed through the artery to locate the aneurysm and a stent graft deployed to complete the repair.

X-ray images are used to guide the surgeon. The small cut in the groin is repaired using dissolvable stitches.

Because of the minimally invasive nature of the surgery, the patient was up and about the next day and able to leave hospital within 48 hours of his surgery.

Introducing Mr Marcus Cleanthis

We are pleased to welcome Consultant Vascular Surgeon, Mr. Marcus Cleanthis (see profile below), increasing the strength of department to four dedicated consultant vascular surgeons, as Marcus joins colleagues Mr. Kieran Dawson, Mr. Neil Browning and Mr. Tahir Ali.

Mr. Marcus Cleanthis

After graduating from Guy's and St. Thomas' Medical School, Marcus started his surgical training at the John Radcliffe hospital in Oxford.

He completed higher surgical training in General and Vascular Surgery in Newcastle upon Tyne. In 2006 he was awarded a higher degree (MD) for his research into patients with peripheral arterial disease.

In 2009 he moved to Canada to complete a 12 month post CCT fellowship in complex open and endovascular surgery at the University of Toronto.

Marcus returned to the UK in 2010 to work as a locum consultant at St Mary.s Hospital, London. He has published numerous papers, presented at national and international meetings and contributed to postgraduate vascular textbooks.

Clinical interests

Full range of vascular services, including arterial and venous clinics; open and endovascular treatment of aneurysmal disease; management of carotid disease; lower limb arterial disease; cardiovascular risk factor management; diabetic foot disease; endovascular and surgical management of venous disease; Chronic leg ulcers, management of hyperhydrosis and thoracic outlet syndrome.

General day case surgical procedures including laparoscopic and open hernia repair.

How to refer

Via Choose and Book or by letter.

Clinics at both hospitals

Tuesday (Ashford)
Thursday (St. Peter's) with surgery at both sites

Contact details

Secretary: 01932 72 3576

New Appointment Confirmation Service for Patients

On 15th August 2011, a new Appointment Confirmation Service was launched which involves making an advance telephone call to our patients to remind them of their upcoming outpatient appointments.

Our aim is to ensure as many patients as possible receive the care they require. Every year, thousands of appointments are wasted when patients fail to attend.

By providing a reminder, we can help those patients who may have forgotten their appointment and make it easier for patients who wish to cancel or rearrange their appointment to do so.

Reminders will be made using a combination of automated telephone calls (an "Interactive Voice Response" call) and calls made by call centre staff. Please note that calls may be recorded for quality and training purposes.

When the patient receives the call, they will be asked to follow the recorded instructions, which will ask them to confirm who they are before giving the appointment details.

The patient can then press the appropriate button on the telephone to confirm, cancel or rearrange the appointment.

Patients will not be charged for the call.

The Department of Health puts the average cost of a DNA at £100 per DNA. This means that missed appointments are costing the NHS millions of pounds every year.

Last year, Ashford & St Peter's Hospitals NHS Foundation Trust had 44,000 DNAs between April 2010 and March 2011, at an approximate cost of £4m.

The cost of the reminders is insignificant compared to the amount of money wasted by missed appointments, and we expect the new service to save us at least £1m between now and the end of March 2012, and even more in the coming years, when we are able to reduce DNA.s much further.

The service will commence in Trauma & Orthopaedics during September.

We have not yet set a date to start this for our Children & Young Persons. Department, but will let you know when this has been agreed.

The patient will receive the reminder call at least 7 days before their appointment.

We will try to ring them at least 3 times, at various times of the day and early evening, in order to obtain confirmation of their attendance.

We hope patients will welcome this service; however, if they tell you that they do not wish to receive a reminder, they can let the Appointments Centre know.

This can be done by calling them on:

For appointments at St Peter's: 01932 72 3831
For appointments at Ashford: 01784 88 4351

If you would like any further information about this, or have any questions, please do not hesitate to contact Hannah Donoghue on: 01932 72 3133

Dates for your Diary


Ashford Education Centre 1pm to 2:45pm,
Sandwich lunch from 12:30

To register please contact Gladys Essien 01932 723987
Thursday 8th September Investigating Bowel Problems –direct to test colonoscopy; barium enema, CT colonoscopy Speaker TBC
Coeliac Disease Dr Sohail Butt
GP Ashford
Prescribing Update PCT Pharmacists
Wednesday 5th October Programme TBC
Thursday 10th NovemberSpotting the sick child - managing acute respiratory infections. Dr Bhatti
Paediatric Consultant ASPH
Using Antipyretics PCT Phamacists
Safeguarding Children Dr Tara Jones
PCT lead GP for Safeguarding Children
Wednesday 7th December Dementia - Legal Issues, Consent and Capacity Dr Rejin Dayandanan
Consultant Psychogeriatrician
Prescribing in Dementia PCT Pharmacists and Dr Dayandanan
End of Life care in the community Dr Fiona Bailey
Consultant in Palliative Care ASPH


TUESDAYS 12:15pm – Lunch, 1-2 pm – Meeting
Post Graduate Education Centre, St Peter’s Hospital.

Details will be circulated when available.

“The Contemporary Approach to AF Management” presented by Dr Riyaz Kaba
This event will now take place on Thursday 17th November at 6.30pm in The Lightbox, Woking

Not 21st September 2011 as previously advertised.

To reserve a place please contact at or 01932 723716

This seminar is kindly sponsored by AGA Medical Ltd


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,
01932 722420

Debbie Beesley,
CAB Manager
01932 723511