LGBTQ+ and friends network 10th anniversary Decade of dedication to equality and inclusivity Staff, members and governors’ magazine // March / April 2024 Royal Free London NHS Foundation Trust
L-R: Yemisi Osibote, head of workforce and staff experience, Alisha Ali, RFH deputy director of nursing and Peter Landstrom, RFL group chief executive Jon Spiers, chief executive of the Royal Free Charity was thanked by Stephen Downer, co-chair of the network Follow our X account @RoyalFreeNHS to see what our patients and staff are saying about us Fulfilling our mission of equality and inclusivity 3 Hello and Peter Landstrom Group chief executive welcome to the March/April edition of our staff, members and governors’ magazine. I’m delighted to be able to share with you the positive progress we have made in our NHS staff survey results. We have made improvements across every key area, thank you to the record number of you who shared your experiences and insights. We want to make the Royal Free London the best place to work, and of course there are always areas in which we can improve, with work already ongoing to address this. Read the results on page 5. I was lucky enough to attend the celebrations for the tenth anniversary of the LGBTQ+ and friends staff network which has made our magazine’s front cover. It was fantastic to see so many colleagues in attendance. It is so good to hear how the new planned eye surgery hub at Edgware Community Hospital is already enabling us to see more patients and reduce waiting times. Key to its success is the excellent relationship built with primary care and I commend all the efforts to embed the hub within our local communities. I have visited various departments in recent months, including staff at Enfield Civic Centre, some of whom are featured in this issue’s ‘meet the team’. All the staff there do extraordinary work to keep services running, and it was great to meet so many of you on my visit. As always, thank you for your hard work. Your commitment does not go unnoticed. Key to abbreviations: Barnet Hospital: BH Chase Farm Hospital: CFH Royal Free Hospital: RFH Royal Free London: RFL 2 Staff came together for a special event to celebrate the last 10 years of the LGBTQ+ and friends network. The network was established in 2014 with a simple yet powerful mission: to provide a platform for sharing experiences, discussing issues, and fostering a supportive environment for our LGBTQ+ staff. Over the past decade the network has been on an amazing journey, marked by various initiatives and events. From its participation in Pride in London events since 2015 and joining hands with the BAME network in UK Black Pride events since 2019, it has continuously advocated for the rights and visibility of the LGBTQ+ community within the trust. The anniversary event was an important opportunity to reflect on these achievements and also recognise colleagues and organisations that have supported the network’s mission. Yemisi Osibote, head of workforce and staff experience, was praised for the dedication, support and advice she has provided to the network’s co-chairs over the years. The Royal Free Charity was recognised for the generous funding it has provided for Pride events, and the network’s allyship training which ensures colleagues have the tools to listen and promote inclusion. Peter Landstrom, RFL group chief executive, attended the event and reflected on the network’s achievements. He said: “While I have only been part of the Royal Free London for about two of those years, I can say with certainty that the work being done by the network is vital to our mission of being an inclusive and equal organisation. “Let us not forget the challenges and struggles that the LGBTQ+ community has faced throughout history, both in the UK and globally. It is through our collective efforts and determination that we continue to pave the way for a more inclusive and accepting workplace. “I want to express my thanks to all those involved in the network, and to the co-chairs past and present including Stephen Downer, Hazel Wright and Adrian Burns. The passion of you and your network colleagues have made a deep impact within our trust and broader community, and I am sure there will be many more achievements coming. Thank you, and here’s to many more years of progress and celebration!” “ It is through our collective efforts and determination that we continue to pave the way for a more inclusive and accepting workplace.”
5 4 Welcoming international doctors of the future Dozens of international medical graduates (IMGs) are set to benefit from a new clinical attachment programme which will see them spend two weeks in a RFL department. The programme is open to graduates who complete their education in medicine abroad, and provides them with a first step into the NHS, an opportunity to interact with teams and meet other people in a similar position to them. Zarina Khan, head of quality, postgraduate medical education, said the programme fills a gap in London. “My inbox gets at least three or four requests a week from doctors overseas or who recently moved to the UK who are looking for an attachment or an observership, and consultants in the trust also let me know they’ve had similar requests,” Zarina said. “A lot of senior doctors in the trust want to give back and help others into the system so we thought it would be a good idea to create a coordinated scheme to offer that.” The programme was piloted in February and saw over 580 applications for just 20 places on the programme. Those who were chosen to participate were matched with their area of interest as much as possible, ranging from general surgery, neurology, oncology, to obstetrics and gynaecology, epidemiology and trauma and orthopaedics, amongst others. Wahidul Khan, from London but educated in Bulgaria, took part in the pilot. He spent two weeks in general surgery with a focus on colorectal surgery. “When I came in I was expecting to just be shadowing doctors, but Where can we improve While the results are positive overall, they also show that work is still needed to address areas such as discrimination; raising concerns; bullying and harassment; and engagement with our bank staff who continue to feel their voices need to be heard. Other areas that require improvement include staff morale and appreciation; health and wellbeing; and unwanted behaviour and sexual harassment. RFL group chief executive Peter Landstrom said: “It’s great that we have heard from more of our staff than ever in the latest annual NHS staff survey. This is not about hitting a percentage; it’s genuinely wanting to hear from as many of you as possible, ensuring feedback reflects the experience of everyone who works at the trust. “There are some really clear messages in this year’s results. Colleagues feel like there are more staff around and some of the big vacancy gaps have improved. We also know that staff are feeling like they can contribute to the organisation and feel supported to reach their potential. there was a full introduction on the first day with presentations about what to expect,” he said. “While we can be proud of this progress, there’s still important work to do in other areas, such as discrimination experienced by staff; speaking up; unwanted behaviour and sexual harassment. “We will focus our efforts on these areas going forward, and build on the initiatives already underway, such as our Freedom from Racism programme, health and wellbeing support, and our efforts to ensure staff feel confident to speak up when they have concerns.” Next steps We will be taking steps to act on your feedback and improve your experience of working at the RFL. This includes identifying areas that performed particularly well and encouraging the sharing of best practice across the organisation. We will continue to listen to staff feedback throughout the coming year and work with you to address areas that can be improved. The detailed results can be read on Freenet. Staff survey: progress made but work to do The staff survey results are in The results of the 2023 NHS staff survey have been published and show we have made improvements across every key area compared to last year and we need to do more to address your feedback. The staff survey identifies areas where the trust is performing well and where improvements need to be made, providing a valuable snapshot of what it’s like to work at the RFL. Wahidul Khan who took part in the pilot Mahnoor Bokhari, who found the pilot “really helpful” Participants and staff involved in organising the pilot “On the ward I really enjoyed getting to know the first year junior doctors as they are on a similar level to me. Everyone made me feel as if I was part of the team which has helped me build confidence in applying for a role in the NHS. I was also in theatres for a six-hour abdominal reconstruction surgery, and as a junior doctor that is amazing to witness. “There are lots of us who are born and raised in the UK but graduate from abroad and an opportunity like this is very special to learn more about the NHS. We sometimes feel imposter syndrome, but once here you realise you are more than capable of working in the NHS. The RFL is definitely somewhere I can see myself working in the future.” Mahnoor Bokhari, also took part in the programme, being placed in cardiology. “The NHS is really different to what I’m used to in Pakistan, particularly the digital systems so the two weeks have been really helpful. I now know more about the structure of the NHS and how everything works, and what is required of a junior doctor in applying for future jobs. “It was also quite a social experience,” she said. “I met a lot of people in the same boat as me. During lunch breaks we would meet up and discuss the wards and how things were going.” Application details for the first official cohort of the programme will soon be shared on our website. “ The RFL is definitely somewhere I can see myself working in the future”
6 7 Meet the unsung heroes in the outpatient appointments centre Before a patient even gets to meet with a consultant, an allied health professional from the fracture clinic or perhaps a clinical nurse specialist, their journey within the RFL has already begun. Every month thousands of patients need to be registered, appointments booked and clinics scheduled to ensure care is delivered in a timely way by the correct speciality. That’s the work of the 140-strong teams which make up the outpatient appointment centre (OAC), many of whom are based at Enfield Civic Centre (ECC). These unsung heroes are dealing with unprecedented volumes of referrals and helping services to manage their often challenging waiting lists. For many patients speaking to someone from the OAC will be their very first experience of the RFL and the focus is on making it the best it can possibly be. rescheduled. We get approximately 2,300 cancellation requests a month which translates into approximately 4,000 patients being affected and needing to be rescheduled. In the February industrial action 350 clinics were cancelled. Staff worked extra hours at weekends and did overtime to make sure those cancellations were rebooked.” The whole system is geared towards ensuring the patient can manage their booking in a way that suits them. From an out of hours voicemail service which enables people to be called back in office hours, to an SMS reminder service, the aim is to ensure patients can get an appointment that they can attend. It’s now also possible for patients to cancel and rearrange for themselves – via the patient portal. Empathy towards the patient and great communication skills are key to being successful in all the roles. Kebera Baptiste, co-ordinator for the team’s automated service, said: “I used to work for the civil service and prison service but now I’ve got this job I’m never leaving, I love it. You need to put yourself in a patient’s shoes. I’m contacting people who’ve requested a call back. They might be anxious and frustrated that they are struggling to get an appointment and you need to work through it with them.” Another vital part of the jigsaw is the clinic template team. Shirley Jacome, template service manager, leads the 15 strong team. She said: “We have 36 different templates for clinics. From annual leave and study leave to industrial action or sickness there are lots of reasons why clinics may need to be cancelled and Chanelle Lubrun, assistant operations manager, who oversees the OAC and who started out in the call centre herself, said: “We’re the service provider for the whole trust when it comes to booking, cancelling or moving outpatient appointments. We’re the team that help services manage their patient waiting lists and meet their targets. We are also the experts and gatekeepers for services when it comes to systems such as Cerner and e-RS. We hold a lot of knowledge.” There is also real passion and excitement around the OAC’s commitment to wellbeing. There’s a monthly newsletter for the whole of the ECC and an emphasis on wellbeing champions and mental health first aiders. Chanelle said: “We listen to staff and they tell us what they want and we do our best to help support it. We’ve got a knitting club and bake club and this year we’re focusing on fitness so now we’ve got several groups undertaking a step challenge. Staff also work together to support charities of their choice and we’ve also got a wellbeing room on the 10th floor with a The template team Working together for patients: (L-R) seated: Chanelle Lubrun, assistant operations manager and Pat Archibald. (L-R) stood: Shirley Jacome, template service manager, Nicola Churchill, service manager for the outpatients appointments service and Migena Cupi, service manager for the bookings team Nicola Churchill and colleagues Kebera Baptiste, co-ordinator for the team’s automated service The outpatient appointment team “ We’re the service provider for the whole trust when it comes to booking, cancelling or moving outpatient appointments” “ The team are brilliant at getting the answers our patients need” virtual reality (VR) machine and other relaxation aids. “The pandemic had a profound effect on everybody working here and things have changed for ever — from more flexible working to a recognition of how important wellbeing is. But we know there is still so much more we could do such as working alongside other teams to develop improved systems. We definitely want to be part of those conversations.” Migena Cupi, is service manager for the bookings team, which at 69 is the largest team. They manage 36 specialities and on a monthly basis process 24,000 first outpatient referrals, but before booking there is also validation work to be done to ensure that patients who are getting an appointment really need one. The team also manage and ensure that follow up appointments are booked. “We do have to make sure that everything is completed and monitored properly so that patients don’t find themselves lost in the system,” she said. Migena added: “We’re currently working alongside the transformation team and the services to digitalise as much as possible of the patient’s journey, to give more patients the ability to rearrange or cancel their own appointments. It’s really exciting to see how things could develop going forward.” From start to finish the numbers involved are mindboggling but it is clear that these teams never forget that each one of those numbers is a patient who needs a helping hand. “We receive around 2,000 calls a day so we’re busy but the team are incredibly committed, answering approximately 100 calls a day each,” explained Nicola Churchill, service manager for the outpatients appointment service. “A patient might be calling because they’ve been given an appointment date which doesn’t work for them so we will need to help them navigate getting a new one. Although patients are encouraged to use our automated services, the bulk is still done over the phone. Patients could also be querying their waiting time or outcomes of test results – both of which might mean us reaching out to the relevant service to check. It’s not necessarily straightforward but the team are brilliant at getting the answers our patients need.” Even before getting a patient booked in it is the job of the registration team to interrogate the referral form to ensure all the necessary information is available as a missing medical record number (MRN) or NHS number could lead to problems further down the line. “We have to be detectives and piece together the information,” said Pat Archibald, who manages the four-strong team. “It’s vital we get the right information to ensure there are no identity mix-ups.”
8 9 Staff at the new hub for planned eye surgery at Edgware Community Hospital are excited about their innovative vision for providing local eye care. The new hub, with two theatres running alongside each other, is set to contribute towards an additional 3,000 procedures carried out every year across the sector, reducing waiting times for some patients who need sight-saving operations. Run by the RFL, the hub primarily provides treatment for adults who have common, low complexity conditions such as cataracts. The hub additionally has the facilities to manage corneal, glaucoma and oculoplastic conditions. Rohit Jolly, clinical service lead for ophthalmology at the RFL, said: “We are proud of this hub. We provide a high standard of care to patients in welcoming surroundings, being mindful of not overcrowding the clinical space and maintaining a calm environment. The consultant surgeon will meet the patient before, during and after surgery and the same nurse accompanies the patient from arrival to discharge, providing a personalised approach to care.” Following several years of closer working between North Middlesex University Hospital NHS Trust and the RFL group, we are now looking at how we could come together as one organisation. We believe it would enable us to go further and faster in improving services for patients and improving the health of our local community. North Mid has been a clinical partner with the RFL group since 2017 and we have been in a formal partnership since 2021. Our experience has shown that we can achieve more together than we can apart, delivering better care for local people and more opportunities for our staff. Over the coming months we will be developing plans for North Mid to merge into the RFL group alongside BH, CFH and the RFH. Our hospitals would continue to provide the same local services. However, by coming together as one, we expect to be able to deliver: Merger with North Mid Non-clinical staff also play a vital role within the unit, ensuring patients navigate the pathway seamlessly. From the receptionists to waiting list co-ordinators everyone is highly valued. The team’s hard work is clearly paying off as theatre utilisation has risen significantly. Staff have the flexibility to accommodate urgent cases and the co-ordinators go to great lengths to fill any slot that might suddenly become available. Another string to the bow for the team is their strong relationship with the community. Rohit added: “We’ve made sure we are firmly engaged with our GPs and optometrists in the primary sector, running education events and providing feedback. It’s really important for us that they know the level of service we offer and that patients will be treated within a few weeks of referral.” Helen Richards, 65, from Potters Bar, attending for her second cataract operation, said: “My son is getting married in the summer and I want to see it all properly so that’s been a big incentive for me, as well as being able to read again for pleasure. The team here are wonderful and I’m very relaxed coming back today six weeks on from my first procedure, which took just 15 minutes in theatre. If I had a third eye that needed doing I’d come back here!” • reduced waiting times • improved access to specialist care locally • better joined-up community services • greater opportunities to benefit from the latest medical research and trials of new treatments • more coordinated action to help people stay healthy, with screening and early intervention services tailored to our different communities. The plans we are developing will form a business case which will then need to be approved by both trusts’ boards and NHS England. We are working to have the business case completed by summer 2024 and to bring the organisations together in autumn 2024. We’re talking with our staff, patients and local communities to explain our plans so they can help shape the improvements made possible by our new shared future. Find out more on our website – royalfree.nhs.uk/about-us#NMUH-merger Rohit (pictured right) with colleagues from the eye surgery hub Yvonne Goddard (pictured centre) and organisers Each patient is re-checked prior to surgery A clearer future for patients A wellbeing week held at BH culminated with staff taking centre stage to reveal hidden talents in a very special event dubbed ‘Barnet’s Got Talent’. The talent show featured several singing, acting and dancing acts from across the hospital who performed in front of a packed crowd in the lecture hall. The show was hosted by Yvonne Goddard, divisional director of nursing for medicine and urgent care (MUC). Yvonne was supported by her MUC colleagues, Karen Kirwilliam, Kathleen Riley, Susan Ball, Kelly O’Sullivan and Goreti Duarte. Bev Thomas, BH director of nursing, Dr Sarah Fowler, consultant geriatrician and clinical lead for BH’s acute assessment unit and Ife Akinyemi, BH head of quality governance, had the tough job of judging the acts and picking a winner. Despite strong competition, including ED consultant Russell Durkin’s much praised rendition of the aria Where’er you walk, by Handel, it was dementia lead Doris Ajayi who scooped first prize for her impressive and moving acting. Karen Kirwilliam, head of nursing for medicine and Barnet’s Got Talent urgent care, said: “Doris made a huge impact. She played an elderly woman with dementia who was lost in the hospital and there was lots of audience interaction. The story she told encompassed all the values of the trust and was extremely heartwarming. “Everybody who took part in the show deserves a massive thank you because they were instrumental in making the event the success it was.” Consultants Radhika Rampat and Zine El-Housenni Anne Marie Williams, the sister in charge of the unit, described how the team work to the patient’s needs. For example patients can walk to and from the theatre but equally, if needed, they can be wheeled in and out on a bed. She said: “We don’t talk about ‘routine’ surgery here. Every patient is treated as an individual.” “ We don’t talk about ‘routine’ surgery here” Traditional dancing trio from ITU Doris Ajayi, BH dementia lead, won first prize
Patients receiving chemotherapy at CFH and Finchley Memorial Hospital have been benefitting from a new way to pass time during their treatment in the form of virtual reality (VR) headsets. Funded by the Royal Free Charity, the VR headsets provide patients with immersive calming visuals and settings which they explore while completing their course of chemotherapy. John Ryan is a patient at CFH who has used the Eden virtual reality system, made up of a main control station and handheld headset. The user selects their preferred immersive experience, with options including ‘Mission Mars’, ‘Mountain Vistas’ and ‘Escape to the Islands’, and simply holds the headset to their eyes. “I used it at my very first chemo session, and it was very well explained to me what it was going to be like,” John said. 10 11 Governors’ update MSK stars shine bright Bringing tranquillity to treatment Royal Free Charity for introducing them to the suite.” Jon Spiers, chief executive of the Royal Free Charity, said: “The VR therapy project was made possible because our local supporters responded to our Bring the Future Forward fundraising appeal; it’s thanks to their donations that we were able to fund the VR kits and it’s thanks to our wonderful volunteers that we can offer it to patients as a distraction during their treatment.” Our specialist musculoskeletal (MSK) physiotherapy teams showcased their life-changing work at our latest Medicine for Members’ event, ‘MSK matters – supporting patient health and wellbeing’. Our first speaker, Amanda Michael, outpatient therapy service lead, provided an overview of the MSK physiotherapy service at the RFL and explained how the team’s involvement with MSK patients starts at the very beginning of their treatment journey. She said: “We have a team of first contact practitioners, working in GP surgeries in Barnet and Enfield who support patients with various MSK conditions such as back, neck and joint pain.” Amanda was joined by Emma Brooks, MSK advanced practice physiotherapy team lead and first contact practitioner service lead, and Christopher Surr, MSK advanced practitioner physiotherapist and first contact practitioner. Emma provided more detail about the first contact practitioner service and Christopher talked about his work in our community MSK clinics. Final speaker of the evening, Robert Jones, MSK clinical lead, provided some general MSK health and wellbeing advice. He discussed the physical and mental health benefits of regular exercise as well as the role nutrition can play in reducing the risk of other health conditions such as chronic MSK disorders, type 2 diabetes and heart disease. The event was chaired by Gisela Botelho, an elected public governor. A recording of the event and previous ones are available on our website. Medicine for Members’ events showcase topics which are important to staff, patients, and the local community. You can find out more about upcoming events on our website. Could you be a RFL governor? Governors add huge value to our trust. They are elected to represent your interests, to hold the nonexecutive directors to account, and to support the board of directors who are ultimately responsible for how we deliver patient care. From May, vacancies will become available in the public, patient, and staff constituencies. To become a governor, you will need to be a member of the trust in the constituency you wish to stand and be aged 18 or over. If you are interested in standing, you can find out more about the role and how to put yourself forward as a candidate on our website. The deadline for submitting your nomination is 11.59pm on Thursday 28 March. If you are already a RFL member, you will have received information about to how put yourself forward as a candidate in the post or via email. If you have not received this, please contact MiVoice, our independent election provider, via email: support@mi-voice.com Staff from the BH and CFH MSK team Become a RFL member You can become a member of the RFL for free if you live in England, are 16 or over, or are a carer for a patient that is under 16 years old. Full details, including the benefits of being a RFL member, can be found on our website. Get in touch: Our governors are elected to represent the interests of members and to hear the views of staff, patients, and the public. If you would like to get in touch, please email rf.governors@nhs.net John Ryan using the VR headset in the CFH chemo suite The VR headsets and the immersive experience options “If you are anxious coming in to have chemo, it is very relaxing. I normally bring a book with me or watch something on my phone, so this is a nice addition to have during the three-hour chemo session. The 3D setting might be a little disorienting at first, but it is very user friendly so you quickly get used to them. “The volunteers have been really good here making us cups of tea along with supporting us with the headsets, so I want to give a huge thank you to them.” “We let patients know about any concerns like motion sickness and afterward we ask them to complete a questionnaire to gather their feedback, which has been really positive so far.” said Esther, one of the volunteers. Flore Dohmatob, senior sister, welcomed the initiative in the chemo suite. “The outcome for patients has been very good,” Flore said. “They are more relaxed and the headsets help with reducing stress. “I had one patient tell me he felt as if he wasn’t having treatment. We have TVs here, and some patients decide to read, so this is just another offering to improve patient experience. Thank you to the “ I had one patient tell me he felt as if he wasn’t having treatment”
12 Psychological wellbeing support available We all need the support of our colleagues to provide the best possible care for our patients. If your team is facing challenges, the trust’s team psychology support service may be able to assist: • This service is part of our occupational health and wellbeing offer, and focusses on the psychological wellbeing of all teams across the RFL. • We provide tailored, group interventions to help teams navigate concerns such as burnout, stress, significant changes, communication challenges and more. • Any team at the trust can use this service and staff who are interested can discuss with their manager. • Visit Freenet for further details – team leaders and managers can contact us via rf-tr.teampsychology@nhs.net. 60 seconds with… Donna Hodge Lead upper gastrointestinal (GI) cancer clinical nurse specialist based at CFH Tell us about your role? I manage the upper GI two week wait pathway and the team of nurses who carry out a telephone assessment of the patients referred to us on that pathway. Patients are then referred for appropriate investigation and of the 5% that have cancer it will be myself or another colleague who will share the news with them in clinic and order further investigations to get them into a treatment programme. The other part of my job involves helping support the oncology clinics throughout the trust with three other upper GI specialist nurses. Patients will see a consultant but we are there to help in other ways. I see us as the hub at the centre of a wheel able to refer on to other agencies and help patients navigate their diagnosis. What does that involve? Sadly 80% of patients for the cancers we look after – oesophogeal, gastric, pancreatic, bile duct and gall bladder – will be on a palliative pathway and oncology management is our focus as those who have curative disease and are undergoing surgery will be treated off site. We are able to improve their quality of life and lengthen survival. There is a lot on offer and it’s our job to make sure patients get the help they need so we can signpost them to psychological support, benefits advice, help with their heating bills as you need to keep your house warm or hospital car parking exemptions. What do patients want to know? It really comes down to asking patients what is important to them. For some it is about knowing that their pet is going to go to a good home or if they can get someone to help them get their shopping. We also refer patients to their local community palliative care teams. People always think hospices only deal with end of life care but actually nurses will go into the patient’s home and can help them with things like pain relief and combatting nausea. What are you excited about for the future of cancer care? New treatments are coming online all the time and immunotherapy has really changed things by offering improved quality of life and increased longevity. When I started in this role eight years ago most of my patients had died within a year and while that’s still a possibility, I now have patients alive two and a half years from diagnosis. It gives people more time to help make memories. What do you love about the job? I work with an incredible team of nurses and I think we are privileged to be working with these patients because we’re helping them achieve what they want. I also want to give a special shout out for our specialist dieticians. They’re a gamechanger for our patients who can have issues digesting their food and swallowing. How do you like to unwind away from work? I’m a real homebody and always have a DIY project on the go in the house. I’m a fan of power tools!
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