Royal Free London NHS Foundation Trust Staff, members and governors’ magazine // March / April 2025 There’s no place like home Caring for patients in the community
Follow our X account @RoyalFreeNHS to see what our patients and staff are saying about us Peter Landstrom Group chief executive to the March/April edition of our staff, members and governors’ magazine. I’m delighted so many of you took the opportunity to share what it’s like to work at the Royal Free London in the NHS staff survey. Our participation rate was well above the national average, which helps provide a real insight into what we’re doing well and what we can do better. Thank you to everyone who took the time to complete the survey. The results show continued improvement across several key areas, which is great to see, as well as areas we can do more. See the results on page 5. I recently attended the official opening of the refurbished urgent treatment centre (UTC) at Barnet Hospital. It was fantastic to see the centre open after months of redevelopment and we know the reconfiguration is already having an impact, improving patient flow and reducing waiting times for our patients. Read the full story on page 10. Community care is vital in helping our hospitals work efficiently and ensuring patients receive treatment in the best place for them. On pages 6 and 7, the work of one of our district nursing teams, who deliver care to patients in their own homes, is highlighted in the latest ‘Meet the team’. Physiotherapists at Chase Farm Hospital also hosted their first community appointment day in Enfield. This is another example showcasing how our incredible staff are providing exceptional care for our patients outside of a traditional hospital setting and the benefits that can bring, so please do take a look on page 9. Thank you again for your commitment and dedication in the face of what proved a very challenging winter. I do hope you manage to enjoy the start of spring and please take care of yourselves. Key to abbreviations: Barnet Hospital: BH Chase Farm Hospital: CFH Royal Free Hospital: RFH Royal Free London: RFL 2 Hello and welcome
3 Martha Myers and Alba Gaughan Inaugural award in honour of former patient goes to kidney care nurse A nurse has been honoured for consistently going above and beyond for her patients. Alba Gaughan, an assistant phlebotomist at Edgware Kidney Care Centre, has become the first recipient of the inaugural David Myers Award for Excellence in Kidney Care, after being nominated by her patients. Alba, who has worked at the RFL for 24 years, told assembled guests she was “humbled and grateful” to receive the new award. She said: “This award motivates me to work even harder because of the impact I know it has on patients’ lives.” The idea to create the award came from Martha Myers, the widow of David Myers BEM, (pictured left). David, who died last year, had been a kidney transplant recipient twice over and spent more than 30 years as a renal patient of the RFH. He campaigned tirelessly on behalf of RFL patients, helping to lead the charge locally to raise awareness of organ donation, especially among ethnic minority groups. The award was presented at the end of an evening where David’s work as part of the RFH Kidney Patients’ Association (RFHKPA) and his three terms as hospital governor was celebrated. From championing patient representation on committees related to their care, improving patient transport, putting in successful grant bids for education events, fundraising for equipment, as well as ensuring renal dialysis centres remain at the heart of communities, David’s legacy lives on. Dr Mark Jesky, consultant nephrologist and service lead, reminded the 100-strong audience gathered on World Kidney Day, that they should never lose sight of the people behind every kidney disease statistic. Speakers included Professor David Wheeler who discussed the management of chronic kidney disease and treatments currently available and on the horizon. Professor Danny Gale also shared how patient data is being used in the fight against kidney disease. Transplant patient Patricia Gooden took part in a discussion led by Dr Anamika Adwaney, consultant nephrologist, and Emma Dunning, a renal transplant clinical nurse specialist. The focus was on enabling patients to live their very best lives and Patricia shared “ “ Thank you David for showing us the way how she refused to let her condition stop her from her great love of travel and her commitment to the RFHKPA. Nii Plange, chairman of the RFHKPA, spoke of David’s unwavering dedication and compassionate heart. He said: “I’m full of gratitude for the time we had together and though, I wish we’d had more time, I’m comforted by the memories we created. Thank you David for showing us the way.” The event, which took place at the RFH, also included a tribute to David from his godson, Marc Abraham, who shared memories from David’s family. Going forward, the award will continue to be presented annually to a member of staff from the RFL renal service who goes above and beyond. The award will be displayed in the RFH’s renal unit.
4 L-R: John O’Hare-Price, lead critical care nurse technologist, Sara Santos and Sumeet Khubchandani, critical care nurse technologists Pumped to be world first Hundreds of new medicine pumps have been successfully installed in the RFH’s intensive care unit (ICU) as part of a ‘world first’ project. The 460 pumps deliver vital medicines and fluids to ICU patients and switching from the old models without a glitch was crucial to patient care. What made it more complex was a trust-wide software upgrade needed to be implemented so the new pumps would work – and the upgrade affected all medical devices that linked to the trust’s electronic patient record (EPR). Thanks to the meticulous planning and hard work of a group of staff, the change-over went smoothly. Lead critical care nurse technologist John O’HarePrice said that changing over the pumps which ‘talk’ directly to EPR had never previously been attempted by any ICU department. “It was an incredibly complex job and one that no other hospital has done before,” he said. “Because many of the medicines delivered by the pumps can’t be paused at all, there was a huge risk to patient care if the upgrade didn’t go smoothly and the pumps didn’t work immediately. We had nurses on standby to deliver medicines in case that happened.” Critical care nurse technologists, pharmacists, medical electronics and the digital team, as well as nursing and medical staff played a crucial part in the project. John added: “We did a massive amount of testing and preparation before the go live – testing out different scenarios and developing workarounds which meant that thankfully the change-over went to plan.” There was a huge risk to patient care if the upgrade didn’t go smoothly “ “ The new pumps have a number of benefits for patients including reducing the likelihood of errors occurring because the prescriptions are loaded directly on to EPR, which warns clinicians if the medicine dose falls outside normal parameters. The pumps are also connected to Wi-Fi, which means they continue collecting data even when a patient is being moved, thus reducing documentation errors. Because the software upgrade affected other trust sites, BH and CFH were also involved in the project. John added: “Pharmacy played a huge part in the project – going through our medicines library and checking everything was entered accurately. We’ve got a library of 274 drugs with a range of different prescriptions for each so that was a really big job for our pharmacists. “But I would like to say thank you to every single team who was involved – it was a multidisciplinary team effort!”
5 Staff survey: what our staff shared about working at the RFL More colleagues than ever said they would recommend the RFL as a place to work, according to the annual staff survey. The latest results also showed more than three quarters of staff said they would be happy with the standard of care provided by the trust if a friend or relative needed treatment. A record-breaking number of colleagues took part in the 2024 survey, helping provide an accurate picture of what working at the RFL is like; 57% of staff at the RFL and 64% of staff at North Mid shared their feedback, response rates well above the national average. The NHS staff survey helps identify areas where the trust is performing well and where improvements need to be made. The 2024 survey took place before the merger of the RFL and North Mid, meaning results are separate this year. Results are in At the RFL, over 89% of staff feel trusted to do their job and believe their role makes a difference to patients and service users. Compared to 2023, more RFL staff said they feel valued by their teams and that teams across the trust work together to achieve their objectives. 80% of staff said when errors, near misses or incidents are reported, the trust takes action to ensure they do not happen again. There was also a 4% improvement in staff feeling secure to raise concerns about unsafe clinical procedures. At North Mid, almost 60% of staff said they often or always look forward to going to work. Compared to last year, there was an increase in staff saying their appraisals helped improve how they do their jobs and feeling that there are enough colleagues for them to do their jobs properly. More staff also said they did not experience abuse from patients, service users and the public, and less said they completed unpaid additional hours per week. More work to be done Despite some improvements, more still needs to be done to improve the experience of staff in the areas of discrimination, bullying and harassment, and morale. RFL group chief executive Peter Landstrom said: “I’m pleased to see continued improvements across several key areas in this year’s NHS staff survey results. Thank you to all staff who completed the survey. Our high participation rate, well above the national average across all our health units, gives us a great insight into what working at the RFL is like. “We recognise there’s still work to be done. We’re committed to addressing areas that need improvement, particularly in reducing harassment, bullying, and discrimination experienced by our staff. Work has already started in this area, and we have shared the actions we are taking to improve sexual safety across the trust. “These results provide valuable insights that will guide our efforts to make the RFL an even better place to work.” Next steps Thank you to all our staff who took the time to complete the survey. Following the results, we will be taking steps to act on feedback to improve the experience of working at the RFL. We will continue to listen and encourage you to share your feedback through a variety of forums. Keep an eye out for further updates on Freenet. 6,760 staff at RFL completed the 2024 survey.
6 Meet the district nurses bringing care into communities Not all our patients are able to come into hospital to receive the treatment they need – whether that’s because it’s not safe for them to move around outside their home, or they aren’t able to get out of their bed. Enter our dedicated district nurses, who bring the hospital to them. Part of North Mid community services, the team of more than 100 specialist nurses operate a 24/7 service delivering world-class care in the homes of hundreds of housebound patients across Enfield. The service works closely with local authorities, GP surgeries and community services to bring care into the community, helping to reduce hospital admissions and appointments. They receive between 450 and 500 referrals each month from hospitals, GPs and patients themselves. From wound dressing to medication administration, the wide range of care these nurses can provide means patients receive support in the best place for them: their own home. The six divisions of the district nursing team are based in various centres across Enfield, including St Michael’s Primary Care Centre, Highlands Practice, Arnos Grove Medical Centre, Eagle House Surgery and Lucas House. The Rowan Court district nurses, based at Pine Lodge at St Michael’s Primary Care Centre, shared with us the peaks and surprising challenges that come with providing treatment outside the hospital setting. Forging bonds and giving holistic care When starting their shift at their base, the nurses and healthcare workers receive their list of patients to visit. Mercy Amoako-atta, advanced community nurse practitioner, started her career in district nursing as a healthcare assistant in 2013. Explaining what the team’s work involves, she said: “We treat patients with long-term conditions; diabetic patients who need help administering their insulin; palliative care patients who have chosen to die in their own home; patients needing wound therapy or wound dressing. Most of our patients are over the age of 65 and housebound. “When we visit them, we do a holistic assessment. You might see a patient for one thing but treat them for something else too once you observe them. If we find something that we can’t manage, we escalate this and call an ambulance if needed.” Healthcare support worker Marta Zelzik said: “Apart from the clinical care, we also support patients. Some patients don’t have anyone else visiting them, so are happy to see us. We end up becoming like their family.” “ “ We end up becoming like their family L-R: healthcare support workers Marta Zelzik and Kelly Petro They see around 10 to 12 patients a day in their sector, and each has an allotted visit time. They also have an on-call service for emergency visits, which can come at any time. Ama Arthur, caseload manager, is the team lead for the Rowan Court nurses. She explained how some people can misunderstand their line of work: “We can be seen as an emergency service and receive requests to see patients there and then, but that isn’t how we work. We prioritise emergency visits that come through via our on-call service, but we usually have a time slot in which to see each patient.” In total, the district nurses travel up to 10,000 miles every week visiting patients across Enfield.
7 “ “ It can be very challenging but I love my job Pet peeves and pythons Visiting patients’ homes comes with its own unique set of challenges such as unexpected pets and locked doors. Adisa Adam is one of the newest district nurses in the team, joining three months ago after university. Explaining one of the challenges she’s already experienced, she said: “Some patients don’t want to be seen and initially don’t open the door to you. You have to have patience and explain that they need care.” Nurse Margaret Nanyongn shared her personal challenge with felines. She said: “I have a fear of cats which I have to conquer every single day!” But that pales into insignificance as the team recall a visually impaired patient who hadn’t realised their pet python had escaped until their district nurse visited and came face to face with the reptile! Healthcare support worker Yevdokilya Shkar, known as Victoria, has worked in the district nursing team for seven years. “You never know what you’re going to be facing each day,” Victoria said. “You have to work alongside families, sometimes in cluttered environments and you have to do it under pressure. It can be very challenging, but I love my job.” Honing skills Margaret worked on hospital wards before making the move to community nursing. She said: “It’s totally different and you get to acquire a lot of different skills on the job.” Practice development nurse, Becky Balakrishnan, said: “There’s a lot of variety in the role which people enjoy. We help our nurses perform at their best and train them with a wide range of skills.” Chinwe Iwuagwu, caseload manager, explained the additional pressure they can be under: “District nursing means lone working. You’re travelling alone and have to make clinical decisions by yourself.” L-R: caseload managers Carmella Craig, Ama Arthur and Chinwe Iwuagwu Continuity of care in the clinic As well as going out to visit patients, the team also manage a clinic four days a week at St Michael’s for patients on the community care caseload who can make it into the clinic for an appointment. Carmella Craig, caseload manager, has worked at North Mid for 15 years and has led the clinic since its inception in 2018. She shared: “The importance of the clinic is that it provides that continuity of care – you see the same patient and you can notice any deterioration and act on it. I’ve got a lot of rapport with patients that come here. They get to know me and get more comfortable.” A passion for community care The passion the district nurses have for their work shines through. Adisa shared why she chose community nursing: “I get to spend more time with patients and build a relationship with them.” Ama said: “We all make life better. We have an impact on patients and our presence at home makes the families feel safe. Some families find solace in us.” Mercy added: “Seeing patients in the comfort of their own home and making them feel well is fulfilling. I especially enjoy working with the elderly – the little things you do, which you see as a job, mean such a lot.”
8 More patients at BH are receiving care from the comfort of their homes thanks to a new ‘virtual ward’. The service, which launched in December, has already seen more than 60 patients. It aims to help patients recover faster and ensure only those who need to be in hospital are. Inpatients and patients in our emergency department with a range of conditions including hypertension, pneumonia and flu, are assessed and if considered suitable, can be referred to the virtual ward. They are then sent home with a blood pressure monitor, finger pulse oximeter and electronic tablet device to measure their vital signs which they then input into an app. If needed, the virtual ward team can also provide patients with equipment to monitor their heart rate and weight. A clinician in the adult assessment unit reviews the results in real time and if they do not receive them or there are any concerns, the patient will be contacted immediately. In addition, enhanced care can also be arranged where the patient receives a visit at home from one of our nurses. The patient can be moved seamlessly on to the hospital @ home service instead of having to come back to hospital. Hema Patel, 42, (pictured left), was one of the first patients to go into our virtual ward. She’s being treated for breast cancer at another hospital and was rushed into BH’s emergency department with an increased heart rate and high blood pressure after missing a chemotherapy session due to illness. She said: “When I was offered the chance to go home instead of stay in hospital for a week, I said yes as I knew I would be much more comfortable. “I absolutely loved being on the virtual ward – it felt like my doctors and nurses were with me at all times. They called immediately if I missed a reading or if something did not seem right. I had total confidence in them. I would tell anyone who is given the opportunity to do this to go for it.” Dr Lauren Farber, clinical director for acute care and medical staffing, said: “Before we introduced this virtual ward, patients would stay in hospital for up to two weeks for monitoring but now this can be done while they are at home where we know they recover better. “This approach is helping us reduce the time our patients are waiting for a bed in our emergency department and helping these patients get better more quickly.” Home sweet home care I would tell anyone who is offered this opportunity to go for it “ “ Staff involved with the adult assessment unit (AAU) virtual ward
Physiotherapists at CFH swapped the hospital’s clinic rooms for the sports hall of a local leisure centre as part of the team’s first community appointment day. The event took place over two days with the aim of empowering patients to take ownership of their health and meet various community and health teams. Two hundred patients who had self-referred to the service were provided with an hour-long slot to attend the event at Southbury Leisure Centre in Enfield, where they had a conversation with a physiotherapist, followed by an assessment. Once finished, patients were then invited to speak to other teams about health issues, with dietitians, respiratory, long COVID, heart failure and bone health teams, among others, all having stalls in the hall. Ryan Clarke, the physiotherapist who led the organisation of the event, said its aim was to provide high-quality patient care outside of a hospital setting. “With a day like today, patients have the ability to access a number of different health and community services which would otherwise be separated in a hospital setting,” he said. “One man spoke about having heart palpitations which he hadn’t done anything about, and was able to leave here today with some advice which will hopefully prevent something more serious developing later on.” Alison Martyn, service manager for musculoskeletal (MSK) physiotherapy, also spoke about the benefits. “We know that bringing patients into a healthcare environment makes them quite passive,” she said. “Bringing health to a community setting encourages patients to manage their own care and introduces them to a place like a leisure centre which they may not have engaged with before.” Physiotherapists transform leisure centre into health hub The success of the event is evident in the attendance across both days. Typically, 10 to 20 per cent of the service’s patients would not attend their appointment. The community appointment day had a turnout of 95%. “This will hopefully be beneficial towards our waiting list,” Ryan added. “Our number is currently above 2,000, and we saw over 200 patients in the two days, which is four times what we would have seen in the same time at Chase Farm Hospital.” Kenneth Ibe was self-referred to the physiotherapy service by his GP after he fell from a ladder, injuring his knee and later developing arthritis. “I was really positive about coming here as I am keen to get active again,” Kenneth said. “My physio today explained everything clearly and gave me practical tips and explanations that I can take away.” 9 Alison Martyn, MSK physiotherapy service manager and Ryan Clarke, physiotherapist The physiotherapy, community and health teams who took part in the community appointment day Kenneth Ibe was assessed on the day by physiotherapist Alex Gran Following the event, all patients continue on a patientinitiated follow up pathway. “We’re moving that control on to the patient, and similar days run in other trusts have shown a reduction in patients rebooking, or having less follow-up appointments, which we hope to see in our data in the coming weeks and months,” Alison said.
10 Take on the ultimate urban challenge Mayor of Barnet and MPs celebrate our staff Elite Royal Marines are swapping jungle treks and Arctic survival for the ultimate urban challenge – delivering the first-ever charity abseil down the Pears Building on the RFH campus. This May, in partnership with the Royal Free Charity, thrill-seekers will don harnesses and helmets to brave new heights from the top of the 70-foot-tall building, under the expert guidance of these world-class commandos, raising vital funds for the RFL. Lieutenant Colonel Gary Veacock, whose wife Heidi received life-saving treatment for a neuroendocrine tumour at the RFH, said: “We are your Royal Marines – the nation’s Royal Marines – and it’s a privilege to deliver this event with the Royal Free Charity in gratitude for the exceptional care given to our families. “We’re lending our expertise, honed through global challenges, to ensure participants have an unforgettable and safe experience abseiling down the Pears Building.” Funds raised will support RFL’s 17,000 NHS staff and the two million patients they care for each year. Gary added: “The care my family received here has been nothing short of extraordinary. The teamwork and dedication of the staff remind me so much of my time Mayor of Barnet, Councillor Tony Vourou, and MPs, Catherine West, and Dan Tomlinson, officially opened BH’s new UTC. They congratulated staff on achieving this significant milestone and thanked them for their hard work and dedication. The Mayor of Barnet said: “These centres are really important for our community – thank you to you and your teams for everything that you do.” The new space helps ensure patients are cared for in the right place at the right time. Over 8,000 patients have walked through its doors since the UTC opened in November 2024 and it is already delivering a better experience for patients. In January the emergency department was the eighth Gary Veacock and his wife Heidi Staff and guests celebrate the official opening of the new UTC in the marines; it’s never about the individual but the whole team.” Money raised from the abseil will help the charity to continue providing a range of services supporting RFL staff and patients. The abseil takes place on Friday 9 May and Saturday 10 May from the roof of the Pears Building – home to the Royal Free Charity and UCL’s Institute of Immunity and Transplantation. The Royal Free Charity is urging people to sign up fast and secure their spot on this unique adventure. Visit the charity’s website to find out more: royalfreecharity.org/abseil best performing in the country for the number of patients discharged, admitted or transferred within four hours. Deborah Sanders, chief executive of BH, said: “Our staff are amazing and they should be very proud of what they have achieved. “Our new UTC is really making a difference to patient experience and is a much better environment for our staff to work in. We have more to do to make things even better for the communities we serve but this is a significant step in our journey. “Thank you to the Mayor of Barnet, Catherine West and Dan Tomlinson for joining us to mark this moment.”
Governors’ update 11 Your feedback in action At the RFL, we are committed to improving how we communicate and engage with you, our members. Last year, we invited you to share your thoughts on what we are doing well and areas where we can do better. Over two months we surveyed staff, patient and public members. We received almost 900 responses – a huge thank you to everyone who took part. Your feedback has given us meaningful insights into how we can better connect with our membership from north central London and beyond. Below, we’ve highlighted key findings from the survey and the steps we’re taking to strengthen our engagement based on your feedback. Survey highlights Medicine for members’ events These events give our members, and the public, a chance to learn more about the RFL’s services. Over a third of members who responded to our survey had attended at least one of our medicine for members’ events. Respondents said they wanted to hear about cardiology, oncology, research and innovation at future events. Annual members’ meeting These events are an opportunity to reflect on the incredible achievements of our staff during the previous year. Attendees receive updates on our operational and financial performance and can have their questions answered by executive directors. Respondents said they wanted to hear how we are managing waiting lists, how our trust is promoting health and wellbeing and more about new research. Monthly membership update This newsletter includes the latest updates from across the RFL. Preferred topics are development and service changes and research. Members are also interested in campaigns, feedback from patients and human-interest stories. You said. We’re listening! • The world-class research taking place at our trust took centre stage at our latest annual members’ meeting. Attendees heard from Nicole Matthew, a RFH patient, about how research into a vaccine that protects kidney transplant patients against urinary tract infections has made a significant difference to her quality of life. • You let us know that our annual members’ meeting should be no longer than an hour and a half and we implemented this for our most recent event. • At least one medicine for members’ event in 2025 will focus on one of your top three preferred topics, which are cardiology, oncology and research and innovation. • Ground-breaking research taking place across the trust is spotlighted in every monthly membership newsletter. We are always looking for ways to improve the way we communicate and engage with members. If you would like to share any feedback, please email rf-tr.governors@nhs.net Become a member of the RFL and help make a difference Encourage your friends, family, colleagues and patients to become a member of the RFL and get more involved with their local hospital. From sharing feedback about our services to being able to stand for election as a governor, they will have a chance to make a real difference. Our members receive information about our trust’s developments directly into their inbox and are invited to join events. They have the opportunity to elect representatives to serve on our Council of Governors and stand for election as a RFL governor. Following our merger with North Mid, we are expanding the council, with new elections in the coming months to ensure the voices of North Mid’s local communities are included. Becoming a member is free and open to those who live in England and are aged 16 or over.
12 60 seconds with… Kaljit Kaur, urology nurse consultant Tell me a bit about your role I’ve been a urology nurse consultant at the RFL for two years. I am the first to take up the role in the trust, which has been very exciting. I am responsible for delivering expert clinical practice, drive education and research within the department and provide leadership. It is an extremely diverse role with a lot of autonomy and flexibility which provides opportunity to represent urology nursing at the RFL regionally and nationally. Clinically I deliver and teach prostate cancer diagnostics alongside supporting the development of all the sub-speciality services within urology to enhance nursing. I’m also involved in NCL-wide work where I can influence change. I have recently helped set up a NCL urological nurses association as part of this work. I have also joined The British Association of Urological Nurses as a co-opted trustee and deputy education lead, where I can drive education to urology nurses at a national level. How did you get into urology? I thoroughly enjoyed my placement on a urology ward during my nurse training and was offered a job – 24 years later I am still here! Urology has enabled me to grow and develop my skills given its diverse and everchanging landscape. I have held roles including staff nurse, ward manager and nurse practitioner, learning the breadth and depth of urology, initiating service improvement and enhancing patient experience along the way. I have loved my career to date and advise anyone considering their career path to find your passion and remain with it. Do you have any personal career highlights? I relocated from Durham to work in urology in London eight years ago seeking a new challenge. Not knowing anyone in London was a risk which has paid off. It stands out as a pivotal moment which then opened so many more opportunities for my urology journey. Sub-specialising in prostate cancer diagnostics and being involved in a national diagnostic project in this field, and then implementing a nurse-led prostate cancer diagnostic service have all been highlights too. What are the most significant challenges of your role? Achieving targets (i.e cancer performance), clinical nurse specialist recruitment and retention, and supporting financial improvement whilst embedding change and enhancing patient experience are all challenging aspects. How do you like to unwind away from work? I am a foodie, so you will often find me eating my way around London! I have a live list on my phone of restaurants ‘to visit’ and another of restaurants ‘visited and would return to’! I am often described as a social butterfly since I like to make the most of the city by attending events and enjoy spending time with family and friends. Fitness is important to me so I go to the gym regularly and hike the hills when I can! Taking care of your wellbeing Every day, our staff go above and beyond to care for our patients. Please take the time to also look after your own wellbeing: • 24/7 helpline (out of hours) contact Care First on 0800 174319 (24/7) service) for emotional and psychological support or access online via carefirst-lifestyle.co.uk; login details can be found on Freenet • Contact the Samaritans (on 116 123), NHS Helpline (111) or your GP • Cost of living worries can have a huge impact on our mental health – visit our financial wellbeing page on Freenet • Visit Freenet for a range of resources, information and other wellbeing tips
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