Royal Free London NHS Foundation Trust Staff, members and governors’ magazine // July / August 2024 The Oscars heads to the Emirates
Follow our X account @RoyalFreeNHS to see what our patients and staff are saying about us Peter Landstrom Group chief executive to the July/August edition of Freepress, our bi-monthly staff, members and governors’ magazine. Every year staff across the trust take time out from our busy schedules to recognise the achievements of colleagues at the RFL Oscars. We’ve celebrated your incredible contributions at local site events, and recently held our overall group awards, which you can read all about on pages 4 and 5. I want to take this opportunity to recognise once again everyone who was nominated or won an award this year. It’s a privilege to shine a light on your work and I hope that you all enjoyed the celebrations. It’s been almost two months since the launch of our clinical strategy, with work ongoing every day to bring it to life. This edition includes more stories about what this means for our patients, such as quicker access to diagnostic scans thanks to new training for radiographers and a new vaccine that protects against urine infections for kidney transplant patients. These are just two stories showing how everyone has a part to play in providing the best patient care. I’m delighted that the chaplaincy-spiritual care team are featured in our meet the team story on pages 6 and 7. They play an invaluable role in caring for patients regardless of their beliefs, while supporting staff through sometimes difficult situations. Have a read of it, as it is a great example of work that takes place in the NHS which can go unnoticed but is so important. Thank you for all of your ongoing work. Remember to look out for one another and I hope you can find some time for a well-earned rest over the summer. Key to abbreviations: Barnet Hospital: BH Chase Farm Hospital: CFH Royal Free Hospital: RFH Royal Free London: RFL 2 Hello and welcome
James Lawton and his friends who took on the cycling challenge James and the RFH team A ride to remember 3 A patient who received a liver transplant two years ago took to the road to make a special return trip to the hospital where he received his life-saving treatment. James Lawton, 45, from Oxford, cycled 60 miles with two friends through the night. The trio travelled from his home to the RFH to raise awareness and funds for PSC UK, a charity for people with primary sclerosing cholangitis (PSC), a chronic liver disease in which bile ducts inside and outside the liver become inflamed and scarred, and eventually can narrow or block. James wanted to commemorate the journey taken by the ambulance which collected him in the early hours for his transplant the following day. transplant operation, to the various nurses who cared for me in ICU and on the ward, to Nati who chatted with me while she cleaned my room, to Dr Patch and all the hepatology team – everyone provided me with excellent care in those early days. But the biggest thanks go to the transplant co-ordinators who were, and continue to be, a great support for me – special thanks to Michael and Emma who were with me and helped me through each of the days when I had received a call for transplant.” He added: “I wouldn’t be here today if it wasn’t for my donor – for the decision they made, that their family honoured. I’m so grateful that my wife Bex and I get to watch the kids grow up together. I can’t thank my donor enough for their generosity and all the life that I now enjoy because of it.” Organ failure and transplantation I wanted to do something that would push me “ “ On arrival at the hospital, this time on two wheels, James visited some of the staff who had supported him before, during and after his transplant. James, a software developer, said: “I wanted to do something that would push me to train and encourage me to stay healthy so I came up with this plan.” James was diagnosed with PSC back in 2006 but was mostly symptom-free until 2019 when he developed jaundice and fatigue. He had a transplant assessment, but his health improved and he managed to hold off needing the transplant before going downhill again in December 2021. He was finally put on the transplant list in March 2022. On his first attempt to receive a donor James tested positive for COVID-19 and wasn’t able to go ahead as doctors didn’t want him fighting an infection while he was on immunosuppressants. A more urgent case which came in at the last minute meant he missed out at the second attempt, but the third time the call came the transplant went ahead. Since then James has made a steady recovery. He paid tribute to the staff who supported him during his transplant journey. James said: “I’d like to say a huge thank you to everyone who cared for me. From Mr Iype who performed my
4 Staff across the trust were recently recognised for their stellar achievements over the past twelve months at the group RFL staff Oscars. The night was the culmination of site celebrations, with the group awards at the Emirates stadium, kindly supported by the Royal Free charity, announcing the group-wide winners in 14 categories. Speaking at the event, which was attended by over 300 staff, chair of the RFL, Mark Lam said it was a privilege to be a part of the trust. “There were over 900 nominations from across the trust for the Oscars awards this year, which was the highest number of nominations ever received and it’s so special to be here to recognise everything you have achieved this year.” Chief executive Peter Landstrom reflected on the past year for the RFL, and touched on the recently launched five-year trust clinical strategy. “Every single one of us at every site and in every department has a part to play – whether we’re booking patients into their appointments, welcoming them when they arrive at our buildings, offering them vital care and treatment, ensuring we stick to our budgets, or checking in on our colleagues. “The RFL Oscars is an opportunity for us to take time out to say thank you to all our staff – not just the winners from our site awards who join us this evening – who make this organisation a wonderful place to work.” Each year the Royal Free Charity supports the awards, with chief executive of the charity Jon Spiers saying: “We sponsor these awards every year because it’s really important to us that you are recognised for the extraordinary work you do. “We know from the response to our fundraising appeals that these things are also really important to our local communities. It’s thanks to our supporters’ generosity that we can do what we do to help you, your colleagues and your patients.” Winners of the group clinical team of the year award: BH and CFH paediatric diabetes team Celebrations at the Emirates for our group Oscars winners
5 The charity also invites a special guest to attend the awards every year, with this year’s being actor and comedian Stephen Mangan. “What you do, and the service you provide impacts people enormously,” Stephen said. “Every aspect of the hospitals, every department, from the people that we meet as the general public to the people that we never see – you all make a huge impact on our lives. I am delighted to be here tonight to celebrate your success.” What you do, and the service you provide impacts people enormously “ “ Nominees were made up of winners from each of the site events for BH, CFH and group clinical services, RFH and corporate services colleagues, with the winners being decided by a panel of judges. Visit Freenet for the stories of all the winners: • Group clinical team of the year: BH and CFH paediatric diabetes team • Group outstanding contribution to education award: nurse education team • Group clinician of the year: Brooke Reeve, emergency imaging manager • Group non-clinical team of the year: the outpatients appointment centre and central admissions • Group non-clinical employee of the year: Taran Mandair, ward administrator, 11 South • Group shining star award: Margaret O’Connor, rota manager • Group outstanding contribution to patient safety: RFH health services for the elderly MDT • Group outstanding contribution to research award: Professor Marianna Fontana, professor of cardiology • Group quality improvement and efficiency award: Mimoza Qoba, CAMHS clinical lead • Group celebrating diversity award: Withstand programme project team • Group volunteer of the year: the infant feeding support volunteers • Royal Free Charity group supporter of the year: Professor Julian Gillmore, professor of medicine and head of the National Amyloidosis Centre • Group chairman’s leadership award: Louise Gillard, senior matron • Group living our values award: Deborah Kirby, matron Winners Actor and special guest Stephen Mangan
6 ‘We’re here for everyone’... meet the spiritual care team breaking barriers Imam Rashid preparing for Friday prayers at RFH Sitting at the very heart of the trust, the chaplaincyspiritual care team provides support and care for our patients, staff, volunteers, and visitors across all our sites. The team shared how there’s more to their work than meets the eye, from challenging expectations to championing patient and staff needs. What it means to be an RFL chaplain “My role as head of chaplaincy-spiritual care is incredibly diverse,” said Reverend Claire Carson. “I’ve worked as a healthcare chaplain for over 17 years across London and I often use the phrase ‘expect the unexpected’. “Chaplaincy-spiritual care is all about connection, being human, being alongside people at often the toughest moments of their lives and respecting who they are. It’s about holding space for people to tell their stories, express their emotions or sit in silence. We do this by encouraging compassionate, non-judgmental care whilst being respectful of diversity.” “I’m motivated by a strong desire to help people and my community,” said Imam Rashid Ayyub. “I’ve been working in education and religious and spiritual care in the NHS for 40 years and joined the Royal Free London in 2001. Having spent much of my career supporting my local Muslim community, I believe nothing is as helpful as providing spiritual care to those who are suffering.” Zahrah Awaleh, Muslim chaplain, added: “I wanted to work in spiritual care to support marginalised people in the healthcare system and help close the ethnic minority health disparity – and I think that’s what chaplaincy can do.” “The chaplaincy-spiritual care team is a special environment in which to work,” said Catholic chaplain Andrew Brookes, who began working at the RFH in 2022. “There’s a common commitment to patients and human values such as respect, compassion, listening and love. We’re very respectful of each other and often have interesting discussions about our work and our faiths.” Rabbi Indigo Raphael has worked in the NHS almost 20 years and says the chaplaincy-spiritual care service can be prone to myths: “People can think we’re only here to support people of faith but we’re here to support everyone on their unique journeys. Each chaplain brings their own background, traditions and culture. I think we create a model for society reflecting how to work collaboratively and respect one another. It’s so enriching.” “I still get surprises every day,” said Claire. “You can’t predict what will come up – whether that’s responding to emergency calls or marking a significant life event. But the pure joy and delight about my role is that I get to meet and be a part of every department in the trust.” The team provides many rituals and ceremonies, including baby funerals, baptisms and marriages. Last year, the team officiated around 15 weddings and over 100 funeral services. Claire said: “Chaplains hold a lot of emotion in the work we do. Creating open and safe spaces where people can talk about death and dying is so important, for staff and patients. If we as healthcare professionals can talk about death and dying, it can really transform how we care for patients at the end of life.” We’re here to support everyone on their unique journeys “ “
7 Chaplains Andrew and Claire in the chaplaincy office something to be celebrated, not feared – we celebrate all diversity amongst our patients, their families, staff, volunteers and community.” Andrew said: “We do what is asked of us as we’re led by the patient’s needs. People sometimes ask for support from a chaplain who is not part of their faith, or ask for human, generic support. Contact the team BH: 020 8216 4355 ext. 64355 CFH: 020 8375 1078 ext. 51078 RFH: 020 7830 2742 ext. 33096 You know you are making a difference “ “ The team’s varied work often sees them spending time on the wards. Last year, they made over 12,000 visits to patients across the trust. “My days are varied but always involve visiting patients, both Muslim and non-Muslim,” added Rashid. “The most important part of my job is the opportunity to provide comfort and solace to patients by listening to them, providing spiritual advice and seeing them smile.” Indigo, who is based at BH, said: “No day is like the previous one. We receive referrals from patients, staff, family members and even a patient’s faith network. When we’re on the wards, people can often stop us and ask for our support.” Zahrah works with renal patients at Tottenham Hale dialysis unit. She said: “When I’m with a patient, we could be chatting about anything – their latest appointment or what they’re up to at the weekend. I try to make space for patients to speak freely about what’s at the forefront of their minds.” The team champions staff wellbeing by organising weekly mindfulness, art therapy and yoga for staff across the trust. They also provide one-to one sessions, debriefs after difficult scenarios and teaching sessions for teams. Defying expectations “You can never make assumptions about people you’re going to see,” Indigo explained. “We can’t assume what someone’s faith means to them until we ask them. We visit with a listening heart and see diversity as “Being with people at a time of need and helping them in some way is always worthwhile and it’s a great privilege. You know you’re making a difference in a personal way.” Staff networks Zahrah and Indigo are involved in RFL staff networks and have found being a chaplain brings lots of skills to the table. “I’m co-chair of the Royal Free London BAME network. |As a chaplain, I’m always curious about people and I bring that curiosity to the network, too,” said Zahrah. Indigo is part of the LGBTQ+ and friends staff network and chair of the transgender and non-binary working group. “Being part of these networks and the chaplaincyspiritual care team is about providing a safe space and creating an environment which allows people to share their stories.” ‘Come and ask’ “We offer a listening ear in a supportive environment, whatever your worries or concerns. We are here for you,” said Rashid.
8 Patients are receiving access to diagnostic scans sooner thanks to the introduction of new safety training for radiographers. A contrast scan is one where a substance is injected into an intravenous (IV) line and enables organs or tissue to be seen more clearly. These scans are often used to diagnose serious conditions, such as cancer. Normally on-site medical presence is required due to the potential risk of a patient having a severe allergic reaction to the fluid. But radiographers at the community diagnostic centre (CDC) based at Finchley Memorial Hospital have undergone intensive training, enabling them to respond and administer adrenaline if a patient has an adverse reaction. This has been a game-changer for the service. Previously the contrast scans could only be delivered for six hours a day Monday to Friday, corresponding to when medical cover was available. Now the scans can be delivered 10 hours a day seven days a week, enabling faster turnaround times for diagnosis and starting treatment. Chloe Goodman, the operations manager at the CDC who led on the project, worked alongside the RFH resuscitation team, Resuscitation Council UK and the Society of Radiographers, to put the new safety policy in place and introduce a comprehensive training plan. Chloe was supported by Dr Ash Saini, clinical director for imaging and Mary Emerson, nurse consultant for critical care and the patient at risk and resuscitation team. Chloe said: “This has been a really satisfying piece of work for everyone involved. Staff have embraced the chance to increase their skills and scope of practice. We now deliver twice as many contrast scans each week across CT and MRI than we did previously, which ultimately means patients can start their treatment sooner. “Patient safety is our absolute priority. We expanded the hours over time to ensure staff were comfortable with their new responsibilities and we receive ongoing support from the NCL Imaging Academy with Chloe Goodman was awarded an outstanding contribution to patient safety award from Dr Ash Saini, for her work at the CDC at Finchley Memorial Hospital Staff from the radiography team Radiographers step up to deliver improved service for patients simulation training and additional training from the resuscitation team. Staff can also practice as much as needed, under nursing supervision, with a phantom kit for needle placement to ensure their training becomes muscle memory. We have already experienced one adverse reaction since this new system was introduced but staff took prompt action and the patient made an immediate recovery.” Patient safety is our absolute priority “ “ Early equitable diagnosis Mary said: “Anaphylactic reactions to intravenous contrast are rare but life-threatening and require prompt life-saving treatment. This is a good example of how staff from any professional background can be prepared and supported to manage a clinical emergency swiftly and safely. It has been a pleasure working with the CDC team in training and simulations and great to see how well they all performed in real life.”
A vaccine which protects against urine infections is providing a boost to the health of kidney transplant patients, according to new data from the RFH. Due to the immune suppressing medication that transplant patients take, they are vulnerable to bugs and those with recurrent urine infections can spend an average of three extra days a year in hospital. Persistent infections can lead to a loss of transplant function and may sometimes cause the new organ to fail. In addition, because the treatment for urine and kidney infections is antibiotics, frequent use increases the chance of antibiotic-resistant bugs emerging. But new data from kidney consultant Professor Alan Salama has revealed that the number of infections could be cut dramatically thanks to the use of a vaccine called Uromune which protects against the four most common bugs, that cause 95% of urine infections. As part of Professor Salama’s quality improvement project, a total of 21 people were given the vaccine, with 17 showing a significant drop in the number of infections. Before having the vaccine, this cohort of patients had spent 78 days in hospital due to urine infections. Following the vaccine, there were just four days spent in hospital. Vaccine boost for transplant patients The retired lawyer from Wiltshire who had a kidney transplant two years ago, says she is now able to go horse riding, swimming and travel – all because of the vaccine. She said: “Even though the operation went well, right from the start I started experiencing urinary tract infections (UTIs). At one stage I was getting UTIs once a week and I lost 10kg. The nurse said to me, ‘you’re not thriving are you?’.” Her frequent infections meant that she was too unwell to follow her usual exercise routine and she could no longer travel abroad. However, all that changed when she started taking the vaccine last April. “I noticed the difference within a few weeks,” she said. “I started putting on weight and I am back riding my horse, swimming and travelling – I couldn’t have done any of that before I had the vaccine.” Hilary is taking part in the British Transplant Games and will be swimming the 50m backstroke and 100 metres freestyle in Nottingham. “I would recommend this vaccine to others – I feel much better. Without doubt it’s made a huge difference to my life,” she added. I noticed the difference in weeks “ “ 9 Organ failure and transplantation Professor Salama said: “This vaccine has been available for a while, but we didn’t know how well it would work in transplant patients who are taking immune-suppressing medication. “We’re really pleased that it has shown a dramatic improvement for this small number of patients who have received it.” Professor Salama estimated that it could save the trust £32,000 per year, because of the reduction in hospital admissions. It will also mean beds becoming available for other patients who need to be in hospital. He said the next step would be a larger study, involving patients from across the country. Hilary Gerlis, 76, said taking the vaccine has “made a huge difference to her life”. Hilary Gerlis
Children on 6 North ward got the giggles when visited by a team of ‘laughter specialists’. Equipped with spinning plates, colourful handkerchiefs and musical instruments, the laughter specialists bring smiles to patients going through a difficult time. The charity has begun regular visits to the children’s and elderly care wards at BH and the RFH, coordinated by the Royal Free Charity. Annie Aris, founder of The Laughter Specialists charity, said: “Laughter has such a positive impact on the body, and our work is about connecting with a child during the hardest time for them to laugh. “We also see how we can work with staff by distracting the children during situations like having a cannula put in or helping them get used to using a wheelchair. We act silly so that they feel confident – we make them important people.” To become a laughter specialist, team members train for a year completing practical days and a theory Patients at BH are benefitting from a new minimally-invasive treatment option for recurrent superficial bladder tumours. Trans urethral laser ablation (TULA) allows for small bladder cancers to be removed under local anaesthetic using a flexible cystoscope and a laser. The procedure is carried out in an outpatient clinic and takes just 15 minutes, freeing up theatre space, and allowing the patient to go home within minutes of completion. If necessary, a biopsy can also be taken and sent for further analysis. Dimitrios Volanis, consultant urologist, said the treatment offers many benefits to both patients and the trust, and feedback from patients has been positive. “At Barnet we have an ageing population, often with complex healthcare needs so being able to treat them safely in a short period of time is a huge benefit,” he said. “Patients avoid general anaesthesia and don’t need to stop any of their regular medications, including blood thinners. Following the procedure patients can return to their normal daily activities within a few hours.” 10 Laughter is the best medicine Laser treatment targets bladder cancer course to prepare them for their working environment. Annie said: “It has its highs and lows, like any work, but to be part of a child’s journey or a patient with dementia and give them a good time is the best job in the world.” Play specialist Siobhan McCurry, who works on 6 North, said: “The children really appreciate the laughter specialists – it distracts them from what’s happening. The parents enjoy it as well because they can relax and see their children having a bit of fun.” Malcolm Ozin, from Hendon, received the treatment after a small recurrent bladder cancer was identified. “I didn’t know it was going to be a laser treatment, and it really didn’t hurt at all, it just felt like a pin prick,” said Malcolm. “I came into the hospital and within 45 minutes I was finished and ready to leave. “I enjoy going to the gym, yoga and swimming and I’ve been told I can do all of that again from tomorrow!” Mr Dimitrios Volanis (right) and the urology team at BH Martin Ozin said the procedure felt just like a pin prick The laughter specialists determined to bring smiles to the wards Cancer Ageing well
Governors’ update Register to attend our Annual Members’ Meeting Join us at our Annual Members’ Meeting to celebrate the incredible achievements of our staff over the past year. You will hear all about our plans including our new five-year clinical vision and the incredible work of our teams will be on display. This will be a chance to speak with staff, share your feedback and learn more about our services. The meeting will take place on Tuesday 10 September from 6 to 7.30pm at the RFH. To register, please email rf.membership@nhs.net 11 Illuminating the breast cancer fight Meet our new governors Our latest Medicine for Members’ event, ‘Breast cancer at the Royal Free London: early diagnosis, research, and support’, featured the crucial work of our breast screening and cancer teams. Watch the recording on our website. Leading clinicians discussed the important role breast screening plays in early diagnosis and highlighted the most common signs of breast cancer and how you can check for them. Ground-breaking research being carried out at the trust includes the A-BRAVE clinical trial, testing the effects of a new drug, Avelumab, on patients whose cancer is not completely treated with chemotherapy. One of our patients was the first in the country to be recruited to this trial and the results have shown that the drug gives patients a better overall chance of survival. Speakers also shared information about the vital support on offer for patients and their families after a breast cancer diagnosis. Cancer is a key part of the trust’s clinical strategy and is one of our three group wide clinical priorities. Medicine for Members’ events are hosted by our governors and focus on topics important to patients, staff and the local community. Alex Craggs (staff governor) Alex qualified as a doctor in 2023 and joined the trust the same year. Alex supervises University College London medical students, educates trainee pharmacists, and is helping run a national teaching programme across several medical schools. Vivien Finch (public governor) Vivien was a senior manager in a large state school and has a particular interest in how the trust’s public profile is managed beyond the local community. She is a volunteer at the Medical Detection Dogs charity and a magistrate in London. Caroline Kniaz (public governor) Caroline is a qualified medical doctor and has worked in the health technology sector. She is passionate about leveraging technology to improve care and outcomes. Caroline is committed to improving patient experiences with a focus on diversity and inclusion. Tatiana Votinova (patient governor) Tatiana has a diverse background in medicine and business which fuels her enthusiasm for healthcare improvement, patient advocacy, and accountability.
12 Think before you glove… do I need to wear them? Only use gloves following a risk assessment and if you anticipate: Always perform hand hygiene before putting on and after removing gloves. Search ‘gloves off’ on Freenet for more information. 60 seconds with… Terry Molyneaux Housekeeper based on 6E at RFH What does your role involve? It’s a very busy job. I order the food for patients and restock the ward with everything from catheters to syringes and specialist equipment. Essentially I do whatever needs to be done! I see my job as keeping the ward flowing, making sure trays and cutlery are ready for patient meals and ensuring everything is in working order. That means dealing closely with the estates team and medical electronics to get repairs done as quickly as possible. This job requires common sense, energy and good observational skills. If I see a job that needs doing I do it. What does a typical day look like for you? I work flexible hours which means technically I start at 6.45am and finish at 2.45pm but most days I’m here by 5am. I’m a very early riser, don’t need much sleep and I like to keep busy. That way by the time handover takes place with the nurses coming in for their day shift I’ve already got everything shipshape. What’s the strangest request you’ve ever had? I do get the occasional patient asking for me to take them back home with me! I think they just appreciate that I try and have a word for them. You do sometimes get asked if you’ll get them a McDonalds and I do have to explain that’s outside my job description. How long have you been at the RFH? In my early twenties I worked in a successful business making bespoke protective cases for bands so they could take their instruments and sound systems on tour. My clients included Elton John and Spandau Ballet and I was doing really well. But when I was 23 I developed neurosarcoidosis, which inflamed my brain and caused me to suffer from a lot of seizures. I spent a lot of time in hospital and ended up having to learn how to do everything again, including how to walk. It would have been all too easy to give up but I didn’t. Yes I walk with a limp and it gets worse as the day goes on but I’m proud of being disabled and working hard. I still have a brain and for the past 20 years or so I’ve been putting it to good use being a housekeeper here. I think my attitude impresses patients – they think if I can do it so can they and it gives them hope. What support do you need? On a ward we need to remember we’re a team. For instance just because I’m off for a couple of days doesn’t mean you can’t raise a ticket if there’s a job for estates. We all need to take responsibility instead of letting things pile up. As far as being disabled goes I would say my job helps me in mind, body and spirit. I keep my head held high. • contact with blood, bodily fluids, mucous membranes or non-intact skin • contact with harmful chemicals • caring for a patient in isolation or with signs of infection
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