the

issue 20 October 2010

Stroke service rated

best in the country
!""#
$%&'()$*'+,*$-.$*/)$0)&'
!contents
2 National award for rare cancer care
2 Electronic rostering programme (eRP)
3 A word from David
3 End unnecessary pathology tests
3 Cancer teams lead peer review
4 Foundation trust update
4 Acute Pain Management Service
5 Nurse honoured for Afghan rotation
6 Spotlight on Dr Andy Rhodes
7 View from the top
8 The patient experience
9 AAA screening programme
9 Clinic celebrates five successful years
10 Stroke service rated best in the country
10 State-of-the-art scanner goes live
11 Informing patients
11 Choose and book improvements
12 Wheels in motion
12 Integration stakeholder event
12 Procument update
13 Greener healthcare is no waste of space
13 Health and safety hazards
14 Lunchtime snack turns into attack
14 Benjamin Weir past and present
15 Art – the heart of a healing environment
15 State-of-the-art breast diagnostic unit
16 Charity news
Front page picture shows stroke consultant
Barry Moynihan with patient John Davies
the gazette is written and published by the
communications unit, with contributions from
Charles Whitney. The opinions expressed do
not necessarily represent those of St George’s
Healthcare NHS Trust. The next edition will be
published in December 2010. If you are a staff
member with a story for the gazette, please
email: communications@stgeorges.nhs.uk
Electronic rostering programme (eRP):
a safer staffing programme
A new system is increasing patient
safety by ensuring the right staff with
the right skill mix are in the right place
at the right time. eRP, an electronic
rostering staff bank and payment
system, is expected to generate
savings of £5m over the next two
years. It was rolled out to nursing staff
at the end of August, after a pilot
introduction on the general intensive
care ward proved to be a great
success.
The system will reduce time spent on
administration and payroll errors, providing
greater transparency of staffing and
reduce spend on bank and agency staff. It
will also allow for greater flexibility, as an
online self-service function allows nursing
staff to plan their working lives, for example,
requesting shifts and annual leave.
2 the gazette
GOLDEN AWARD: (l-r) Mr Derek Fawcett, president of BAUS; Mr Nick Watkin and
Mr Richard Greenhalgh, Urology Business Manager of Karl Storz
National award for rare cancer care
Nick Watkin, consultant urological
surgeon at St George’s, was awarded
the coveted Karl-Storz-Harold Hopkins
Golden Telescope at the 2010 British
Association of Urological Surgeons
Annual General Meeting held in June.
The award is in recognition of Nick’s
work in male genital reconstruction
and penile cancer.
St George’s is a specialist centre for
penile cancer, a rare condition affecting
around 400 men in Britain every year.
The trust takes referrals from across the
South of England, and is working to
improve the treatments available for
this distressing condition.
Speaking about the care provided at
the trust Nick Watkin said: “In the
majority of cases, surgery can be
offered which preserves the penis. This
obviously has a huge impact on the
The eRP project team will train staff on the
systems and provide support as they
become familiar with the system. This will
be followed, at a later stage, with the
implementation of time and attendance
which will ensure payroll errors are
minimised.
The initial rollout is across eight wards –
Amyand, Richmond, A&E, Nicholls,
Vernon, McKissock, delivery suite, cardiac
intensive care unit as well as community
midwives.
A system for junior doctors will be
introduced by the eRP team towards the
end of the year.
Steve Loveridge, eRP project manager,
said, “This is an exciting project which will
make a real difference to staff and
management.”
quality of life for patients.”
Anne Bishop, chief executive of the
British Association of Urological
Surgeons, said: “The award is given to
urologists who have made a significant
and lasting contribution to urology.”
Rebecca Porta, chief executive of the
male cancer charity Orchid, said: “It is
encouraging to see the important work
at St George’s being recognised and we
congratulate the team on their success.
Penile cancer is a rare illness, and one
of the most emotionally difficult for
men to deal with.
“The research carried out by Mr Watkin
and his team will undoubtedly help the
overall wellbeing of patients who are
diagnosed with this disease and give
them the encouragement and support
they need during their treatment.”
The trust’s 2009/10 annual
report and summary
accounts is out now. It
contains a review of some of
the key areas of work from
the last financial year.
The report also includes an
awards section, which
celebrates the success that
St George’s staff have had
during 2009/10.
Please contact the
! communications unit on
ext 2717 or via email if
you would like a hard copy. An
electronic copy is available on
the website
www.stgeorges.nhs.uk
A word from David
Success is
something I
am pleased to
say we are
getting very
familiar with here
at St George’s.
However I am
acutely aware
that it does not
come without a
lot of hard work
and dedication
David Astley, chief executive
from our staff.
In August the trust came out top in a
national stroke audit, which assessed
more than 200 trusts in England, Wales
and Northern Ireland. The audit assessed
quality of care by looking at the process
of care in place for patients and how the
service is organised. St George’s achieved
the highest overall score and my
congratulations go to the stroke team on
this outstanding achievement.
October’s edition of the gazette is filled
with other examples of the great work
that goes on around the trust in clinical
and non-clinical settings.
As the gazette goes to print, our plans for
integration with Community Services
Wandsworth are being finalisied. Our
Foundation Trust plans also continue to
gather pace; the consultation came to an
end in August and I’d like to thank those
who took the time to respond.
This month the gazette focuses on the
importance of clinical leadership at St
George’s. In view from the top we speak
to Val Thomas, one of our divisional
chairs, while the spotlight falls on Andy
Rhodes, consultant in general intensive
care unit.
In the last issue of the gazette we
launched the trust’s new values which
are aimed at improving the trust’s culture
for staff and patients. Look out for the
values special logos introduced in
this edition.
kind
responsible
respectful
excellent
"technology
Plea to end unnecessary
pathology tests
Unnecessary tests are delaying patient care and wasting money. That’s the
message from the pathology service as it calls on clinicians to think
carefully about whether tests are really required before requesting them.
Paul Collinson consultant, chemical pathology, from clinical blood sciences, said:
“There are three types of inappropriate testing that we need to reduce.
“The first is when tests are re-ordered despite already having been carried out that
day. For example you might have a patient
admitted to A&E who has a series of tests,
then exactly the same tests are ordered at
the medical assessment unit and again when
the patient is on a ward, all within 24 hours.
“The second is when tests are repeated too
closely together and there is no way of
determining meaning from the results.
Sometimes thyroid function tests are carried
out within a few days of each other but the
international guidance is clear, there should
be a six week interval between tests.
“The third is tests that are clearly
inappropriate for the patient. I’ve seen A&E
patients being screened for cancer by blood
testing and even male patients being tested
for breast cancer, all at St George’s.”
Cancer teams lead peer review
Cancer teams at St George’s Allen, who leads on peer review at
demonstrated excellence in the St George’s, said: “This shows the
latest round of assessments fantastic work which is going on
conducted under the National within these teams. The other cancer
Cancer Peer Review Programme. teams scored extremely well and we
Out of 30 teams from the South are looking forward to more teams
West London Cancer Network, six achieving Earned Autonomy next year.
were awarded Earned Autonomy this
means they have improved on or “Everyone within cancer has worked
maintained excellent performance for extremely hard to achieve and
two consecutive years and will not maintain such high compliance
need to be internally verified during against the peer review measures.”
next year’s review. June Allen and Steve Powell, cancer
Three of those six were teams from and neuro auditor, would like to
St George’s. The breast, lung and thank the teams involved for all their
upper gastro-intestinal teams all hard work and commitment to
gained Earned Autonomy. patient care, making St George’s a
Macmillan lead cancer nurse June leader in cancer treatment.
Congratulations to Helen Jarvis, practice educator,
who is the lucky winner of our July competition. The
answer to the question Arthur Smith is a regular guest on
what BBC2 programme was Grumpy Old Men.
Helen wins a signed copy of Arthur Smith’s book
My Name is Daphne Fairfax.
the gazette 3
#FT status
Foundation trust update
The health white paper Equity and excellence: liberating
the NHS, published in July, made it clear that the
government expects all NHS trusts to become Foundation
Trusts (FTs) by 2013. FT status is therefore vital if St
George’s is to stay in control of its future.
St George’s 12-week public consultation on its plans to become
a FT ended in August – a big thank you goes to those who
responded.
Overall there was strong support for our plans and, from a staff
perspective, we have learned more about how we need to
increase engagement to ensure staff can contribute fully to our
future plans.
We held two staff FT open forums during the summer, led by the
trust chair, Naaz Coker and chief executive, David Astley, and
there was good attendance at both meetings.
The FT team is now established in its new office on the ground
floor of Grosvenor Wing, giving more prominence to this
important stream of work. If you would like someone to attend
your staff meeting to talk about our FT application, please
contact the team. The next staff open forum will be on Thursday
11th November at 3pm in the Hyde Park room and we look
forward to seeing you then.
The FT membership office launched a major membership
recruitment drive at the beginning of September to recruit
several thousand members. It is hoped that staff will help with
membership recruitment by encouraging family members and
friends to sign up. For more details contact the FT membership
officer on 020 8266 6132 or email
adrienne.long@stgeorges.nhs.uk
Expanding role for acute pain management service
HIGH PRAISE: Sophie Mayo (right) and the acute pain management team
Patient Sophie Mayo knows St George’s Hospital better
than most of its staff, having had 20 abdominal operations
for Crohn’s Disease since 1999, and spent around six
months on the wards during a recent stay.
She is one of the 3,000 patients treated by the acute pain
management service last year, and is full of praise for the team.
Sophie said: “They’re really helpful, they give you advice about
the best use of drugs, like morphine, at hospital and how to
switch to less powerful drugs when you go home.”
4 the gazette
FT TEAM: (l-r) Adrienne Long, Esther Corcoran and Wilfred Carneiro
Who’s who in FT
Wilfred Carneiro is the trust’s equality and FT membership
manager. Wearing his FT hat, Wilfred is responsible for
the delivery of the wider membership strategy, which
includes linking with our local communities, preparing for
the election of governors and planning for a regular cycle
of membership engagement and information events.
As FT membership officer, Adrienne Long is responsible
for the implementation of the membership recruitment
strategy and for the day-to-day liaison with FT members.
Esther Corcoran, senior communications officer, focuses
on internal and external communication of the trust’s FT
plans and membership recruitment.
The FT membership office also benefits from the work of
two volunteers, Wendy Gaynair and Jasmine Taylor, who
assist with membership database administration and
office work.
After her operation Sophie uses patient controlled analgesia, a
machine that contains a syringe of morphine connected to a line
and button, which she can press when she feels she needs it, to
receive a controlled dose of painkiller.
Jeremy Cashman, consultant anaethetist, who leads the team,
said he is seeing more patients than ever since St George’s was
designated one of four major trauma centres for London.
He said: “The team is made up of anaesthetists, nurses and other
health professionals, and 94 per cent of patients said they had a
positive experience of the service during 2009.
“We are developing ways of delivering the safest, most effective
pain management possible, while reducing the risk of patients
becoming tolerant of medicines.”
The service also evaluates and refines practice for specific
conditions, to ensure pain management is taken into account
throughout the patient pathway. For example, procedures in
place for patients being treated for a fractured pelvis have
improved.
Trainee clinical nurse specialist Tanya Butt said: “I’ve been with
the team for about nine months now and it has taught me a lot.
I don’t think people realise exactly how important the team is to
patients, and how much work we do.“
$military connections

Nurse honoured for Afghan rotation

A St George’s nurse has been honoured for spending three Safe Return, as way of
months at the British military hospital at Camp Bastion in thanking the trust for
Afghanistan. releasing staff nurse Emma
Officers from the Territorial Army Medical Services visited St O’Reilly during her three
George’s during July to present a limited edition war print called month rotation.
Emma was mobilised in
October 2009 and over the
winter she was dealing with
casualties from the war.
She said: “It was a real eye-
opener, and it has benefited
my practice at St George’s. I
was in a lot of situations that
I wouldn’t usually encounter.
I’d consider going again.”
Emma’s commanding officer, Colonel Gerry McBride, met trust
chief executive David Astley, when he presented the hospital with
the print. He said: “Territorial Army medics are a vital part of the
medical support provided by the army medical service, and the
support of NHS trusts such as St George’s has been absolutely
fundamental to the continued running of the world-class field
MILITARY HONOURS: (l-r) Emma O’Reilly, David Astley and Colonel
Gerry McBride hospital at Camp Bastion.”

St George’s Hospital Charity

welcomes new chief executive
Martyn Willis joined the charity as chief executive in
May this year. The gazette caught up with him to find
out more about his role and his vision for the future of
the charity.
What does your role involve?
The primary function is one of governance. This means that it
is my job to ensure that the trustees have in place proper
policies and procedures to manage our resources effectively. It
is my job to keep them updated on changes to legislation and
Charity Commission guidelines. It is also my responsibility to
oversee that expenditure is within the rules of individual
funds.
Additionally, I have been tasked with increasing our
fundraising capacity, in light of the country’s current
economic situation and the impact it is having on all walks of
life, charities included.
What is your experience so far of the charity and
St George’s as a whole?
As a former cardiac patient I am the grateful recipient of
excellent care and treatment from staff at St George’s and from
what I have witnessed since I have been here, there is
immense pride and dedication permeating right across the trust.
However what I do feel is that there is a distinct lack of
awareness of the role of the charity and the important and
rewarding work that we do. It is my job along with Liz Woods
and her team in the fundraising office, to change that.
Could you clarify the role of
the charity for us then?
The role of the charity is to provide
maximum benefit to patients and
staff of St George’s by supplementing
and not substituting funding of the
core services of the NHS.
Martyn Willis
What is your vision for
St George’s Hospital Charity?
It is my intention to spread the word about our work. I want
to grow our database with details of people willing to support
us. Our trustees are determined to increase the funds
available to enable them to provide grants for the trust to
turn adequately funded schemes into five star projects
wherever possible. But it is not just grand designs that we
support, the trustees also wish to provide for the smaller
things that improve the welfare of patients and staff.
My vision is that staff and the community who rely on
St George’s for their healthcare join us and help expand the
work that we do in support of services and provisions outside
the mainstream provision to make a significant difference to
the widest number of patients.
Anyone wishing to support us should either call in to our
office in the main entrance or call one of the team, Liz, Sheila
or Maribel on 020 8725 4522.

the gazette 5
%spotlight

Meet Andy Rhodes,

general intensive care unit consultant
Andy, who has been clinical
director of critical care at
St George’s since 2009, talks
about the team effort made to
stamp out hospital acquired
infections among some of the
most vulnerable patients at
St George’s.
He said: ”The general intensive care
unit has achieved an impressive and
sustained reduction in infections
such as MRSA and Clostridium
difficile (C diff), despite the fact that
ICU patients are among the most
vulnerable to infections in the
hospital, due to the majority of them
being old, frail and seriously ill.
”This has not always been the case.
Three years ago, the ICU had a
major problem, with more than 20
MRSA bacteraemia cases being
recorded in a single quarter.
“St George’s patients are seen by
more healthcare professionals on
ICU than on other wards, often with
many interventions taking place
every hour. This makes it easier for
an infection to spread from one
patient to the next if hygiene
standards are not maintained.
“In 2007 we had a big problem with MRSA and C diff on Staff throughout critical care are building on these
the ICUs, especially on the general unit, and it took a joint achievements by taking part in a project to reduce the risk of
effort from everybody in the critical care team to tackle central venous catheter blood stream infections (CVC-BSI),
the problem. called Matching Michigan.
“We took it very seriously and adopted a zero tolerance Andy said: “The three adult ICUs and PICU are now part of an
approach to hospital acquired infections. This included a National Patient Safety Agent project, led at St George’s by
concerted effort to improve hand hygiene as well as a series consultant nurse in critical care Deborah Dawson, to
of other infection control practices and interventions. reproduce the success achieved by hospitals in Michigan, USA.
He said: “ICU nurses and doctors have worked enthusiastically
The reduction in infection numbers came to ensure that CVC insertion and care practice is of the
about towards the end of 2007 and we’ve highest standard.”
maintained the improvement ever since. This involves the daily surveillance of all central lines ensuring
We see MRSA much less frequently now, that they are required, are appropriately dressed and show no
which shows that we are doing something signs of infection.
right, but that does not mean we can relax. “In conjunction with Dr Peter Riley from microbiology, each of
Infection control is nowadays far more a the units review every bacteraemia against the definitions for
CVC blood stream infection to identify a monthly rate of
part of everyday life on ICU, and something infection for each unit. Since starting this project in December
that we have to remain vigilant about. 2009 we have seen a further decrease in CVC-BSI rates.”

6 the gazette
&view from the top
Val Thomas is the
divisional chair for the
children and women,
diagnostics, therapeutics
and critical care division
and a cellular pathology
consultant. She talks to
the gazette about how
she balances her roles.
What does your role as
divisional chair involve?
Perhaps unsurprisingly, this is a very
difficult question which I am still finding
the answer to! Each of the divisions is
working towards a model where each is
essentially accountable and responsible
for all the clinical and support activities
within the division, rather like three
parallel healthcare businesses. In order
to do this, the first part of my role has
been to really get to know the clinical
services within the division; how they
work and how they fit together with the
rest of the trust. I work closely with our
divisional director of operations, to
review each service’s strategy and
business plan to ensure that they not
only fit with the trust’s overall strategy
but strive to deliver excellent services to
our patients.
Another key aspect of my role is to work
with our divisional director of nursing,
head of midwifery and governance lead
to ensure that the services within the
division are safe and comply with
national standards. In the background, I
sit on consultant appointments
committees, help facilitate job planning,
chair SUI panels and sit on a variety of
trust committees as a clinical
representative.
How long have you been at
St George’s and where did
you start out?
I trained as a student at St George’s
Medical School and was in the second
year of students to begin undergraduate
training on the Tooting site. I undertook
an intercalated BSc and then a PhD in
developmental biology before going
back into clinical medical training.
During my PhD studies, I was lucky
enough to spend some time in the USA
with the research team I was attached
to, at Harvard and MIT. I enjoyed basic
research but for me it felt too far from
my original intent when I embarked on
medical training. After I qualified in
medicine, I was in a dilemma about
which medical specialty career to
pursue. Pathology won narrowly over
psychiatry and I spent five years in leafy
Hampstead training in cellular
pathology before successfully applying
for a consultancy back at St George’s
where I have been since 1992.
What benefits do you think
&
the three divisional chair
roles have brought to the
structure of the trust?
St George’s is enormous and due to get
even bigger with the integration of
Community Services Wandsworth into a
fourth division. The sheer size makes it
very difficult for a single medical
director to really get to know people
across all services and to understand
how they work.
Each division is the size of a small
hospital giving the divisional chairs the
opportunity to help develop a closer
sense of identity and community and a
better understanding of the roles and
needs of each of the teams in their
division. There is the opportunity for
better communication between the
clinical teams and the board via the
divisional chairs, as we meet regularly
with members of the division and the
executive and can keep everyone up to
speed with ongoing changes and
developments.
How do you balance this
with your role as a cellular
pathology consultant?
Cellular pathology largely involves
reviewing biopsies and cytology
specimens down a microscope and
writing reports giving diagnostic and
prognostic information so that physicians
and surgeons can plan a patient’s
treatment. This can be fitted in quite
flexibly as there are few fixed sessions a
week. The problem then is that I find
myself with too many management
commitments as my diary seems
attractively empty to those who have
access, so I have learnt to pace the
number of meetings and other
commitments and to say no!
What do you do to relax?
Rather dull hobbies by today’s standards,
though I did recently learn to scuba dive.
I am a member of a book club and read
novels voraciously and fairly
indiscriminately. I belong to Streatham
Choral Society which practices at St
Leonard’s Church (Monday evenings
7.30 – new members always welcome).
Unlike many of my friends, I never intend
to run a marathon!
the gazette 7
The patient experience –
it’s everyone’s
responsibility
respectful
The gazette spoke to Sarah Duncan,
patient experience manager, to find
out more about her role and how
staff can help improve the patient
experience.
What does the patient experience
manager do? I oversee PALS and the
health information centre, complaints and
improvements, voluntary services,
bereavement services and patient and
public involvement in the trust. I am very
lucky to manage such hard working and
passionate teams, who are committed to
making a real difference to the patient
experience.
What is the difference between PALS
and complaints? Whenever I ask staff
what PALS do, they say “deal with
complaints”. To this I respond – no! PALS
staff help to sort out any problems or
concerns that patients may have about the
trust’s services by liaising with relevant
staff, as well as providing information to
patients and listening to their views and
comments.
They also provide advice on how to access
interpreters, signers and other services. In
addition, PALS staff provide customer care
training to staff throughout the trust.
Although PALS staff can offer advice on
the complaints process, they do not deal
with complaints.
Some staff are great at responding to PALS
queries quickly, but many do not
understand how important this is. An
unresolved PALS query can develop into a
formal complaint – this results in a
frustrated patient and a lot of work for the
manager who has to investigate.
What if a patient wants to make a
complaint? If a patient expresses, either
verbally or in writing, that they want to
make a complaint about something that
8 the gazette
SARAH DUNCAN: The trust’s patient experience manager
PALS TEAM: (l-r) Catherine Jones, PALS
manager; Joely Hampton, Peter Martin and
Glenn Webb, PALS officers
COMPLAINTS AND IMPROVEMENTS: Eliot
Maunder, Jacqueline Ewers, Louise O’Connell;
administrative officer and Ilse Vandenput,
complaints and improvements coordinators
has happened to them, this is dealt with
by the staff in the complaints and
improvements (C&I) department.
Every complaint is logged onto our
database and acknowledged within three
working days. C&I staff then email the
complaint to the general manager for the
relevant area for action and investigation.
They co-ordinate the sign-off and sending
of complaint responses via the chief
executive.
The team also provides various training
sessions about responding to complaints
and give advice and guidance to staff, as
well as dealing with compliments.
Tell us about the compliments? During
2009/2010 the trust received 270 letters
of thanks centrally. In addition to this,
almost 4,000 forms of thanks were
received locally by trust staff, such as
cards, flowers and chocolates. We know
that good news is under reported so staff
should always let the complaints and
improvements department know, so these
can be recognised. You don’t have to send
the flowers and the chocolates themselves
(unless you want to!) just the number
received will be fine.
What can staff do to stop a concern or
complaint developing? It’s about taking
responsibility for concerns when they are
raised with you, even if you have to do
some running around to get the answers
that are needed – I can recite a story to
illustrate this.
A patient went to the reception of a clinic
to check in for his appointment and the
clerk informed him that the clinic was

cancelled. The patient was very upset
and asked the clerk why he was not
informed. The clerk said “well, we must
have tried to contact you. Go to PALS!”
The patient then walked all the way to
PALS where staff had to contact the
same clinic clerk to get the information
the patient needed. He had been sent a
letter which hadn’t been received. An
apology was offered and a new
appointment arranged.
What a waste of everyone’s time – all
of this could have been sorted out at
the clinic reception in the first place.
Many complaints and concerns would
never be raised if staff would simply
take responsibility for issues when they
occurs.
Why is good complaints handling so
important the trust? Successful
businesses are all judged by their
reputation. We want people to choose
to come to St George’s. It is a fact that
if someone receives a good service and
good customer care from a shop,
restaurant or hospital, they will mention
it to their friends and family. However, if
someone receives a poor service they
are even more likely to tell people. The
same applies with handling complaints
and concerns. Nobody expects us to
get it right every time, but it is how we
deal with the complaints and concerns
that do arise that defines us.
PATIENT FEEDBACK
A patient who referred himself to a
screening programme is so grateful to
the staff for saving his life that he
wanted to “shout from the rooftops”
to encourage more men to take part
in the programme.
Terence McCarthy, of New Malden,
decided to refer himself to the trust’s
abdominal aortic aneurysm (AAA)
screening programme in 2009, after
his close friend died of an aneurysm.
The 79-year-old grandfather was
placed under surveillance in
November, and in May this year was
rushed into hospital for surgery after
his aneurysm swelled to nearly 6.5cm.
He said: “There is no question at all
how close this was – two or three
doctors said how lucky I was. I am so
grateful to everyone involved in the
screening programme, I would like to
say thank you to them all. I am going
to tell all my friends to have the
screening done.”
'in the news
AAA screening programme
hits the headlines
In August St George’s was featured
on ITV London Tonight in a report
highlighting the trust’s abdominal
aortic aneurism (AAA) screening
programme.
The programme is aimed at men aged
between 65 and 74, an estimated
80,000 of whom are affected by AAA,
a condition which is caused when the
main blood vessel in the abdomen -
the aorta - weakens and starts to
expand.
People suffering with AAAs often don’t
experience any symptoms and, if it
remains undetected, it can be fatal. On
average around 6,000 men every year
die from AAA.
Clinic for high-risk pregnancies
celebrates five successful years
A service set up to provide
anaesthetic support to pregnant
women at high risk of
complications celebrates its fifth
anniversary this year.
The high-risk obstetric anaesthetic
clinic was established in October
2005, and is staffed by consultant
anaesthetists Renate Wendler and
Frank Schroeder and two
obstetricians, Amar Bhide and Ingrid
Watt-Coote. It is supported by
midwives from the fetal medicine
unit, cardiologists, haematologists,
surgeons and radiologists within St
George’s.
The clinic is held every Thursday,
providing a multidisciplinary approach
to tackling the most complex cases
among the 5,000 women who give
birth at St George’s every year.
Patient numbers are rising year on
year, up 12.1 per cent during 2009
and 50 per cent over the past five
years. The most common conditions
were haematological (blood) diseases,
followed by cardiac disease in
pregnancy.
The London Tonight report featured
patient Terence McCarthy (see patient
feedback, left) whose life was saved by
the programme, and an interview with
consultant vascular surgeon Ian Loftus,
lead for the NHS AAA Screening
Programme for St George’s and
southwest London.
The clinic provides advice and
assessments for women who have
had previous difficulties with
analgesia and anaesthesia and help
for those with medical conditions
before and after conception.
This includes regular assessments of
women as they progress through
pregnancy, with a robust
management plan for labour and
delivery. All high-risk women are
treated at a specialist high-
dependency unit on the delivery
suite.
Consultant obstetric and cardiac
anaesthetist, Wendler, said: “Our
experience shows that careful
planning in a multidisciplinary team
will lead to successful maternal and
neonatal outcomes in high-risk
patients.”
The team also provides training for
senior anaesthetic and obstetric
trainees who have an interest in high
risk pregnancy and maternal
medicine. A yearly report on clinic
activity and outcome can be found
on the St George’s intranet
anaesthetic page.
the gazette 9
Stroke service rated best in
the country
excellent
St George’s has been rated the best in
the country in a stroke national audit
released in August. The National
Sentinel Audit for Stroke, organised
by the Royal College of Physicians,
assesses quality of care by looking at
the process of care in place for
patients and how the service is
organised.
More than 200 trusts in England, Wales and
Northern Ireland were assessed across eight
categories and the stroke service at St
George’s achieved the highest overall score.
In July St George’s began operating one of
eight specialist hyper-acute stroke units
TEAM EFFORT: The stroke service achieved top marks for organization of care and the
(HASU) in London, providing expert
coordination of team meetings and the range of specialist staff working on the unit
emergency care to stroke patients, including
access to CT scans and clot-busting drugs which is not provided by over half of unit and a TIA (mini-stroke) service. In the
which save lives and reduce long-term stroke services across the country. next twelve months we are expecting to
disability. increase our bed capacity and the number
Hugh Markus, professor of neurology and
The stroke service achieved top marks in of TIA clinics so that we can continue to
one of five consultants in the stroke team,
the audit for organisation of care for provide the very highest quality care for
said: “These results are a marvellous
patients, the coordination of team increasing numbers of patients.”
achievement for the team here. The
meetings and the breadth of specialist The service was recently selected as one
staff working on the unit. The service also service has been ranked among the top
of only eight hyper acute stroke research
scored very highly for its communication ten in the country in the last few audits,
units in the country, securing funding for
with patients and carers and the so quality has been consistently high for
advanced research into stroke care, which
multidisciplinary approach to patient care. some time now. The fact that we are now aims to help increase understanding of
The audit also recognised the service for placed top is a tribute to a huge amount stroke and develop innovative treatments
coordinating closely with a specialist of effort and enthusiasm from a large and for the condition.
community rehabilitation team for longer- diverse multidisciplinary team. This story hit the news during August,
term care of both stroke and general “We now provide all three tiers of stroke featuring on GMTV, BBC London News,
neurology patients – a care package services at St George’s – a HASU, a stroke BBC Radio London and Radio Jackie.

State-of-the-art scanner goes live

Patients are benefiting from the latest technology at St George’s
where the next generation of MRI scanner has been installed.
The 3 Tesla MRI scanner (3T), housed in the Atkinson Morley Wing, is a
joint £2.5million purchase between the trust and St George’s University
of London.
Tesla is the unit of measurement quantifying the strength of a magnetic
field. Conventional MRI scanners operate at 1.5 Tesla, but the 3T operates
at twice that, and this is up to ten times the strength of low field or open
MRI scanners.
The increased image clarity revealed by 3T is particularly beneficial for pathological conditions involving the brain, spine, and
cardiac system. It takes extra slices when creating an image, allowing for a more detailed picture.
The hospital has access to five sessions per week, three for cardiac patients and two for neuro patients. The remaining sessions
will be used by the university for research into neurological and cardiac diseases. The new scanner will allow researchers to
investigate the structure, function and chemical changes in the brain that occur with diseases such as stroke and dementia.

10 the gazette
Multi-disciplinary
approach to informing
patients
responsible
A team of pharmacists, nurses,
doctors, pharmacy technicians and
educators is working to improve
patients’ understanding of their
medicines. At the same time
clinicians and nurses are gaining a
better understanding of what
information they should provide to
patients.
The patient experience task group was
set up after a survey in August 2009
showed that patients were not being
given enough information about their
medicines, how to take them and what
side effects to look out for.
Along with regular meetings, the group
works to train clinicians and nurses
about the information they should give
to patients, and spend time on the
wards helping to explain prescriptions.
Assistant chief pharmacist, Wendy
Pullinger, said: “We have trained more
than 150 ward staff so far and covered
three medical and six surgical wards. The
group’s multidisciplinary approach is
GREATER UNDERSTANDING: Matthew Boardman, a member of the patient experience task group,
talks Gladys through her medicine
bringing about great benefits, as we are
able to address the need for better
information and provide support on the
ward, throughout the patient pathway.”
Pharmacy technician Marina Timofeeva
said:“Research shows that the better we
communicate with patients, the more
likely they are to take their medicines
correctly and have a more successful
recovery.
“We know that sometimes patients
don’t read all the notes that come with
their medicine. They end up paying
more attention to the advice of their
friends or neighbours rather than
clinicians, so it is important to make sure
they have as much information as
possible when they are at hospital.”
Kendra Caesar, discharge co-ordinator
on Cavell Ward, said: “The group has
made a real difference on the ward,
helping to reinforce best practice among
nurses and clinicians.”
Gladys Ada Maria Francis, 83, a patient
on Cavell Ward, said: “I’ve had a good
experience at St George’s and they have
been very helpful explaining my
medicines to me.”
St George’s
recognised
for choose
and book
improvements
Patients are benefiting from
easier access to
appointments at times that
suit them, according to
figures gathered by the
choose and book service at
St George’s.
The trust has consistently met its
target of having fewer than four
per cent of patients unable to
secure an appointment at a
convenient time. This figure is
down from an average of 20 per
cent per month during 2009.
Jo Derbyshire, choose and
book manager, said: “There is a
growing number of GPs using
choose and book to refer
patients, and it is an easier
process for everybody involved if
patients can get the right
appointment the first time they
come into contact with the
service. Therefore have increased
capacity and added new
services”.
In December 2009 an ambitious
project started to ensure all
outpatients’ clinics that were not
open to choose and book were
identified and included on the
system.
As a result, an additional 40
clinics are now available,
including rapid access for the
elderly, the rapid access chest
pain clinic, restorative dentistry,
the foot and ankle clinic and the
hand clinic.
Patients are using the service
from across southwest London
and beyond, with the majority
able to book their appointment
straight away.
For advice and
" information about choose
and book call assistant
service manager Buddhi Pant on
020 8725 4985.
the gazette 11
Wheels in motion
Every day the patient transport
service at St George’s carries around
350 passengers and covers more
than 2,000 miles.
The service has improved dramatically
since the transport assessment and
booking (TAB) team was set up three
years ago, with a mission to ensure
fairness in the way patient transport is
allocated.
The team provides a single point of
contact for patients wishing to book
transport for outpatient appointments.
THE TAB TEAM: (l-r) Dawn Gregory, Daisy Allchurch, Jade Costan, Sonia Bryan and Victor Ayuko
Procurement update
New agency balances staffing
needs
The trust’s new agency staffing group
brings together colleagues from human
resources, divisional directorates,
procurement and nursing. The aim of the
group is to get the right balance between
permanent, bank and temporary staff
across the trust; implementing an
electronic rostering system; ensuring use
of the the right agencies and value for
money.
Significant progress is already being made
in the procurement of temporary staff
from external agencies. Examples include
improved control and coordination of
spend on medical locums; a new
collaborative deal in south London for our
allied health professionals and further
efficiencies on our administrative and
clerical expenditure.
12 the gazette
Patients can call the team with
questions they have about the service,
have a medical assessment carried out
over the phone and, if appropriate,
arrange their transport. Once the team
agrees to provide transport a
confirmation letter is sent to the patient
with a transport time.
Since the TAB team launch there have
been fewer complaints about patient
transport, and most journeys are now
completed on time.
To contact the TAB team, call 020 8725
0808.
In keeping with the procurement
programme as a whole, the strategy is to
deliver all of these improvements without
compromising patient care.
The agency staffing group is an example
of how the trust is coordinating staff
efforts to improve a key area of
expenditure. For more information,
contact Rebecca Coppock at
rebecca.coppock@stgeorges.nhs.uk
Improving medical records
storage
In another procurement initiative St
George’s is working with the storage firm
Iron Mountain, which holds 69,000 boxes
of historical medical records for the trust.
The firm is looking at ways of linking up
with the hospital’s electronic patient
records system, so that requests for the
retrieval of old records can be automated.
Integration
stakeholder event
Around 80 stakeholders including
GPs, local councillors and patient
group representatives attended an
event at the trust in July to learn
more about the plans for St George’s
integration with Community Services
Wandsworth. Attendees were told
about the integration process so far and
were asked about their views on how
plans to progress should be taken
forward.
Suzanne Marsello, programme director,
said, “The event was a great opportunity
for stakeholders to hear more about this
exciting development and also provided
an important platform for us to seek
everyone’s views.”
The proposed plans will bring community
and acute services together to provide
improved care for local residents.
Following integration it is expected that
St George’s will be responsible for
providing services including: district
nursing, health visiting, community
specialist nursing, school nursing and
many of the services provided at Queen
Mary’s Hospital, Roehampton.
As the gazette went to print, final
approval for intregration from the boards
of St George’s, NHS Wandsworth and
NHS London was being determined.
Deals save time and money
Better procurement is saving time for
clinicians while improving patient safety
and saving money, in a pilot project where
a new type of urinary catheter is being
used on two wards. Instead of ordering
parts from different suppliers, complete
packs are provided, which saves time for
staff and, if rolled out across the trust,
could save £20,000 a year in costs. To
provide feedback on the new catheters,
download the feedback form from the
procurement page on the intranet.
The procurement team has also slashed
the cost of cochlear implants by
negotiating a better deal with its supplier,
saving £86,000 per annum.
For information about the
! programme to modernise our
supply chain, email
procurement@stgeorges.nhs.uk
a hospital
Greener healthcare is no waste of space
Staff took the chance to find
out more about the trust’s
green initiatives at the Waste
Awareness Day in July.
The Hyde Park room was filled
with stands from partners and
providers including the trust’s
health and safety and infection
control teams, Veolia domestic and
recycling waste, GW Butler, which
deals with clinical waste, and the
10:10 campaign. The total amount
of waste produced by the trust in
2009/10 was 2,960 tonnes –
enough waste to fill the Tooting lido
twice each week.
Our comprehensive recycling
scheme saw the trust recycle more
than 333 tonnes of plastic, paper,
cardboard, cans and glass in
2009/10, a vast improvement on
the 35 tonnes we recycled in
2004/5.
All domestic waste is now recycled and
goes towards providing power to 48,000
homes across London.
Almost 80 per cent of the trust’s
alternative treated waste (orange bag
Eyes open for health and safety hazards
Carcinogenic fumes, blocked fire exits,
Legionnaires’ disease and cramped
workspaces aren’t topics that usually
spring to mind during the average
working day.
But this is exactly what Peter McDermott,
health and safety manager, is confronted
with on a daily basis.
As the gazette went on a walk-around the
trust with Peter, it was only a matter of
minutes before we were tripping over
health and safety hazards. These hazards
affect staff, patients, contractors and
public on a daily basis. Trust-wide we
declare three slips, trips and falls a day –
thankfully the vast majority of these do not
result in any serious injury.
The key to preventing incidents is
awareness of hazards and risks; taking
notice of the people, spaces, work
equipment, the ward or working
WASTE AWARE: Amelia Floresca, infection control nurse,
demonstrates what waste should be placed in the orange
bin bags
waste), once shredded, is used as fuel for
the cement industry.
These developments, along with staff
awareness and knowledge about where
trust waste goes is the key to meeting
environment and generally things around
you; learning to envisage and assess any
potential hazards before they happen,
and then, most importantly, taking
responsibility to manage those risks which
are identified.
Peter said: “Health and safety is everyone’s
job – you need to look out for yourself,
your team, patients and visitors too.”
To increase awareness, the health and
safety team at St George’s is offering staff
the chance to take part in a one-day
course, which provides junior and middle
managers, nurses and supervisors with
the right tools to undertake risk
assessments.
The next courses are on Friday 15th
October or Monday 6th December, from
9am-4.30pm.
There is also a four-day course, entitled
Managing Safely, for middle and senior
three objectives: ensuring we comply
with waste legislation; reducing costs
through recycling and segregating
waste and support St George’s being a
green organisation.
The continuing work also supports our
10:10 commitment, to cut carbon
emissions by ten per cent by the end
of 2010.
Mary Prior, general manager for
facilities, said: “The trust has in a
number of initiatives aimed at
improving sustainability. Staff wanting
to get involved or those with and ideas
for how we can be greener should
email Think.Green@stgeorges.nhs.uk“
In addition the bi-monthly waste
project group is looking for new
members to generate ideas about
making the way we handle waste safe
for our staff.
Look out for the next instalment of the
10:10 campaign in the December
edition of the gazette, featuring an
article about the trust’s green
developments.
To learn more about recycling at the
" trust, contact waste manager Alan
Hall on ext 3169.
staff and managers, which aims to link
statutory health and safety requirements
with the work of the trust. On completion
of a written exam and work-based
project, attendees will receive an Institute
of Safety & Health (IOSH) certificate
recognising their training.
If you want to know what you can do to
make your workplace and team healthier
and safer, look out for the monthly health
and safety calendar checklist themes,
circulated via eG. You can also request a
copy of the calendar.
For more information about risk or safety
issues call the health and safety team on
ext 2487.
! To book, complete the registration
form on the intranet and return it
to the risk management office, Room 41,
Fountain Suite, Knightsbridge Wing.
the gazette 13
%staff news

Benjamin Weir past and present

As part of a new series the gazette
will dig deeper into the history of St
George’s and its people and wards.
This month we look at Benjamin Weir
and find out about his association
with St George’s, and learn more
about the work of the ward named in
honour of him today.
Benjamin Weir was a resident of south
London and was known for his generosity
in helping the less fortunate in
Wandsworth and Streatham. He was born
in Southwark in 1809, and became
wealthy through land and property
investment. When the Bolingbroke was
bought for the development of a hospital,
Benjamin Weir not only provided a
generous donation to help purchase the
NEW FACES: Ben Weir, the class of 2010
property, but also promised to financially
support the maintenance of the hospital ward; caring for patients pre and post care for all the patients. Benjamin Weir
until his death in 1909. heart surgery. The ward also looks after ward runs extremely efficiently, the staff
cardiology patients and patients who have work to ensure patients are discharged by
In his will he requested that his house be
just had heart attacks and interventions 11am and have just started on the
turned into a healthcare facility and be
and investigations into their cardiac productive ward project.
called the Weir Hospital. However, the
disease. “The senior sister ensures staff all have
property was not suitable for this so a
annual individual performance reviews
Weir Hospital was eventually established Kimberly O’Hara, matron on Benjamin
(IPRs) and they have an excellent team
in Weir Road, Streatham. The hospital Weir ward, has been working on the work approach to patient care. When I do
was opened in 1913 and over the years ward for two and a half years and finds it my weekly matron rounds the patients are
evolved into a maternity hospital, until it extremely rewarding. She said, “I work all extremely complimentary of the staff
was closed and its services moved to the with a wonderful team of staff to ensure and how hard they work. The ward is
current St George’s site in 1978. that patient safety and quality is our always clean and free of clutter and a
Today, Benjamin Weir ward is located in priority. I am involved with all very sick welcoming place for patients and their
Atkinson Morley Wing and is patients, attend the cardiac arrests to visitors and a lovely environment for staff
predominantly a cardiothoracic surgical support the teams and ensure planned to work in.”

Lunchtime snack turns into attack

Medical secretary Sue Wichard had
a hair raising experience in August
when she nearly choked to death
at her desk as she munched on her
lunchtime salad. Sue said: “I took a
bite of lettuce and as I bent over to
pick up something I felt the lettuce
get lodged in the back of my throat.
I knew it was really serious as I
could not breathe at all.”
Alone in the office, Sue went running
out in search of some assistance and
found respiratory nurse Karen Wright.
Together with Yee Ean Ong, consultant
in chest medicine, the pair attempted
to assist Sue. A combination of Sue
trying to manually dislodge the lettuce
herself, back slaps and the
Heimlich manoeuvre finally
succeeded in dislodging the
offending vegetable after a
frightening two minutes.
“I was seconds away from
passing out, so was very
relieved when it worked!”
Sue says.
Sue has survived the ordeal
relatively unscathed (she has CLOSE CALL: (l-r) Yee Ean Ong, Sue Wichard and Karen Wright
suffered a broken rib from the
Heimlich manoeuvre) and is very grateful has also sworn off lettuce since the
to her colleagues. “I would like to extend incident. She said: “Salads were part of
my sincere thanks to Karen and Yee Ean a diet I was on, but I will now have
for their help. Had it not been for their buttered buns instead any day of the
assistance I would not have survived.” Sue week!”

14 the gazette
Art – the heart of a
healing environment
kind
It’s often easy to ignore the importance
of the arts in a hospital environment,
but as the gazette speaks to the trust’s
art director, Belinda Harward, and
advocate for performing arts Sarah
Weatherall, we find out there is more
to healing arts than meets the eye.
“I would describe my job as taking stress
out of spaces,” says Belinda, who has built
the trust’s collection up to 450 works since
she joined in 2002.
“I consider the use of volume, daylight,
colour, texture and art, bringing all these
elements together so that they serve the
function of the space, either internal or
external building projects.
“People walk into hospital loaded with
expectations – their emotional responses
tend to be about apprehension, fear and of
course hope. My job is to recognise that
and to address it in how I approach the
space.”
Belinda, who hails from the west country,
gained a masters in design at Brunel
University and has worked in marketing,
communications and strategy at British
Airways and in private sector advertising
and design, managing major national
campaigns.
“Well-designed spaces communicate at a
visual level, leading people to believe the
care will be good. This is particularly
important here as people feel vulnerable
and find illness difficult to grapple with.
“There is lots of research to prove that art,
St George’s to build state-of-the-art breast diagnostic unit
The trust has announced that it is set
to build a new breast diagnostic unit,
which will screen women from across
southwest London. St George’s hosts
the South West London Breast
Screening Service and the St George’s
National Breast Screening Training
Centre, as well as providing breast
services for symptomatic local women.
The antisoma building on the trust’s
perimeter road will house the modern
facility, which will provide state-of-the-art
equipment for the diagnosis and treatment
of breast cancer and other breast diseases.
design and performance all
contribute to reducing stress
levels and aid recovery, so it is
a real privilege that I can use
my expertise to help this
process.”
Belinda is guided by the arts
committee, (AfTHE Arts for the
Teaching and Healing
Environment) of 18 members,
which identifies projects and
discusses how the budget,
which like her role is funded
by St George’s Hospital
Charity, will be spent. It hopes
ARTS GURUS: (l-r) Belinda Harward, art director and Sarah
to make the trust’s art, Weatherall, advocate for performing arts are working to
including the popular gallery in transform St George’s into a top-notch healing environment
the Ingredients restaurant,
widely available.
Future plans include expanding the
performing arts programme, a role fulfilled
with the appointment of Sarah Weatherall,
an advocate for the performing arts, who
brings theatre, comedy and music to the
bedside.
Sarah’s focus is on patients with long
lengths of stay, or frequent inpatients. She
said: “Studies have shown good outcomes
for patients requiring, for instance, less
analgesic or shorter stays in hospital. I
hope to be working with doctors and
nurses to reach patients most in need.”
A programme of performing arts will rely
heavily on volunteer actors, entertainers
and musicians. “We are on the hunt for
talented individuals to come forward to
give around three afternoons a year. This
way I hope to build a programme on
Clinical results at the trust for breast
screening are among the best in London.
By becoming fully digital the service will
offer more rapid access to diagnostic tests
and all tests will be able to take place in
the same session.
“This announcement is really positive for
women in southwest London.” Says Dr
Louise Wilkinson, director of screening at
St George’s. “Early detection of breast
cancer is the key to successful treatment
and this unit will provide all the tests
women need in one place at one time, and
give them their results quickly. This will
limited resources.”
Sarah is also setting up a choir, along with
medical school students, so the hospital
can benefit from its own musical talent. It
will be led by Christopher Killerby who
founded the 75-strong community choir,
Colliers Wood Chorus. Rehearsals will
take place every Wednesday lunchtime.
Everyone is welcome, regardless of ability
or experience.
Sarah continued: “The idea is that
rehearsals will take place in four week
blocks, so no-one will need to commit to
a long period of time, and every four
weeks there will be a small concert on the
wards.”
Email performingarts@stgeorges.nhs.uk
to find out more about the choir and to
discuss ways performing arts might
improve patients’ experience, wellbeing
and mood.
help reduce anxiety for women and allow
the team to fully investigate any problems
more efficiently.”
“This is going to be a sophisticated unit,
providing women with a comfortable,
modern, high-quality and efficient
screening and diagnostic service in a calm
and caring environment.” Louise explains.
“The quality of care at St George’s has
always been of the highest standard and
the new environment will ensure that
women benefit from the best possible
services in a building designed for the
purpose.”
the gazette 15
 (fundraising

St George’s Hospital Charity news

( Four members of staff took
part in the British 10k London run
in July raising money for St
George’s Hospital Charity. The 10k
route starts at Hyde Park Corner
and takes in Piccadilly, the
Embankment, Tower Bridge,
Westminster Bridge and Whitehall.
Congratulations to Abi Changer,
Penny Neild, Niki Giatras and Chris
Burke who took part and raised
(l-r) Martyn Willis,
chief executive of
£2,000 between them.
St George’s Hospital
Charity; Marilyn Palmer-
Williams; Kally Umanee;
Floral affair Fiona Chisholm; Araxi

St George’s Hospital received a visit from local

Kaskanian and Amy
Lyddall-Fell CEDA conference
family run firm, Nelsons, in July, when it donated
vases of arranged flowers.
donates £4,500
By way of marking its 150th anniversary, Nelsons, based in Wimbledon,
to renal unit
donated eight vases of flowers arranged by its staff members. The
flowers were presented to Martyn Willis, chief executive of St
George’s Hospital Charity, and were displayed across the trust.
Bridget Streatfeild-James of Nelsons said: “We’re delighted to be
able to make this donation to St George’s during our 150th
anniversary year. We have many talented flower arrangers on our
staff and they felt strongly about wanting to support their local
hospital and its charity. This is a wonderful example of Nelsons in
the local community.”

Dragons on fire

(
GENEROUS DONATION: (l-r) Iain MacPhee,
consultant nephrologist; Jonathan Doughty FCSI;
David Oliveira, consultant nephrologist; Stuart
Coombe; Ray Coombe; Helen Gregson, lead renal
transplant nurse; Mohamed Morsy, consultant
transplant surgeon; Nicos Kessaris, consultant renal
and transplant surgeon; Joyce Popoola, consultant
nephrologist; Liz Cording, clinical nurse specialist

St George’s Hospital Charity was one of

two charities to receive a donation from
money raised at the 2010 catering
equipment distributors association (CEDA)
conference. CEDA chairman Peter Kitchin
chose the charity, following an inspirational
story of father and son Ray and Stuart Coombe.
Back row:
Ray’s son Stuart had suffered complete kidney
(l-r) Tac Hau; Kevin
Wedderburn; Silvan failure and required a transplant. Ray
Koterba; Tak Pang; Philip immediately volunteered to be the donor and
Murray; Michael Armour both operations were successfully carried out at
Front row: (l-r) Junes St George’s Dragons took on the cream of
St George’s. Ray recovered quickly, but Stuart
‘Nutmeg’ Mohamed; London’s NHS finance departments in a five-a-
Samuel Ridge
suffered complications, which were only
side tournament at Wembley in July. Despite
overcome by the skill and dedication of the
crashing out controversially in the group stage, the team team at St George’s. Stuart is now back to full
earned some valuable exposure for St George’s Hospital Charity health, enjoying life and study at the University
on what turned out to be the hottest day of the summer. of Manchester.

16 the gazette