Royal Free London NHS Foundation Trust Staff, members, and governors’ magazine // September / October 2026 Every voice matters Staff survey and Speaking Up
The ENT team who completed the first patient list Maricel Natal Peter with North Mid staff on Pearl ward New treatment offers alternative to thyroid surgery 3 Patients are now benefitting from radiofrequency ablation (RFA), a minimally invasive treatment for selected patients with benign thyroid nodules which can reduce symptoms without the need for conventional surgery. Benign thyroid nodules are non-cancerous lumps that develop within the thyroid gland. Up to 50% of adults develop them, and while many do not cause symptoms, larger nodules can lead to a visible swelling in the neck, discomfort, swallowing difficulties or pressure on the windpipe. Treatment may be recommended when symptoms become troublesome or affect a patient’s quality of life. The first patients underwent RFA at BH following the introduction of the new service by the trust’s ear, nose and throat (ENT) thyroid team. The ultrasound-guided procedure uses a thin needle probe to apply controlled heat to targeted areas of a nodule. Over the following months, the body’s natural immune system cleans away the treated tissue, with most patients seeing a significant reduction in the volume of the nodule. Conventional thyroid surgery usually requires a general anaesthetic, an incision in the neck and an inpatient hospital stay. For some patients, particularly those with other health conditions that increase the risks associated with general anaesthesia, this may not be the preferred or most appropriate option. RFA offers a less invasive alternative and typically preserves the surrounding thyroid tissue, reducing the likelihood of patients needing lifelong thyroid hormone replacement. RFA is generally performed under local anaesthetic, with the procedure taking between 30 and 90 minutes. Patients remain awake during the treatment, while the clinical team uses ultrasound to position the probe and protect the healthy thyroid and surrounding structures. After a period of observation, patients can usually return home the same day. Maricel Natal, a carer living in Colindale, was one of the first patients to undergo RFA in the trust. She first noticed swelling in her neck four years ago, which led her to visit her GP. “With the nodules, I often have palpitations and I sometimes have difficulty swallowing,” she said. “When this new procedure was explained to me, it felt like the right option. As a carer, I want to get back to work quickly. I arrived at 7.30am in the morning and went home before midday. The team were so amazing so I want to say a big thank you to them.” James Rudd, consultant ENT, head and neck and thyroid surgeon, said: “We’re delighted to have successfully introduced RFA for some patients with benign thyroid nodules. We expect around 20 to 30 patients each year could benefit from this treatment.” Although this is a new application within the trust’s thyroid service, radiofrequency technology is already used elsewhere at RFL, including in procedures targeting tumours in the liver and other parts of the abdomen. Introducing it for benign thyroid nodules has involved close collaboration between colleagues in ENT surgery, interventional radiology, endocrinology, nursing and supporting services. Hello and welcome to the September/October edition of our bi-monthly magazine for staff, members and governors. Peter Landstrom Group chief executive Care with compassion Act with integrity Champion inclusion Deliver excellence Key to abbreviations: Barnet Hospital: BH Chase Farm Hospital: CFH Royal Free Hospital: RFH Royal Free London: RFL North Middlesex University Hospital: North Mid As we head into autumn, I’m very aware of how busy the summer has been across our trust. I hope many of you managed to take a well-earned break. You should be incredibly proud of everything you have achieved for our patients. Thanks to your hard work, we are treating more patients than ever before in our emergency departments, while more patients are receiving faster cancer diagnosis and treatment across the RFL. These achievements have helped make us one of the top performing trusts in the country. We also know that, for you to do your best work, it’s vital you have the support you need to thrive. That’s why it’s so important that you take part in this year’s staff survey. the experts in your area, and every voice matters. Turn to page 4 to find out more and have your say. I also encourage you to read about the important work of our Freedom to Speak Up Guardians (see page 8) and how colleagues are using the service. Creating a culture where people feel safe to raise concerns, share ideas and speak openly benefits us all. When we take the time to listen to one another and learn from different experiences, we can make meaningful improvements for our staff, patients and communities. On that note, I recently visited North Mid, where I toured the new UTC, due to open towards the end of this year. I want to say a big thank you to the staff who have had to completely change the ways they are working while the building work is in its final stage. It was great to see and hear the enthusiasm about the difference it will make when it opens. I also met with colleagues in the pre-operative assessment unit and on Pearl ward, hearing first-hand about the fantastic work taking place across the hospital. Follow us on social media @royalfreelondonnhs @RoyalFreeNHS Royal Free london 2 We want to hear your views “ “ Now the survey has launched, it’s your opportunity to tell us about your experience at the trust and help shape our workplace for the future. Whatever your role and wherever you work, we want to hear your views on what’s going well and where we should focus our efforts. After all, you are
5 4 Staff feedback helps us understand what it is like to work at the RFL, what supports colleagues to do their best work and where change is needed. We listen in many ways, including through the NHS Staff Survey, conversations with teams, staff networks, Freedom to Speak Up and other feedback channels. Here are some examples of group-wide work shaped by what colleagues have told us. For changes specific to your health unit, take a look at the news section on Freenet. What we’ve heard and how we’re responding Creating a culture where everyone feels valued Our shared commitments reflect what colleagues have told us matters: feeling valued, respected and included at work. Teams are now discussing what caring with compassion, championing inclusion, acting with integrity and delivering excellence mean in practice. Supporting inclusion and development Almost 400 colleagues have taken part in Freedom from Racism programmes over the past two years. We have also introduced reciprocal mentoring, while programmes including WITH:STAND continue to support colleagues’ development and progression. Helping colleagues feel safe to speak up We have strengthened our Freedom to Speak Up service by investing in dedicated support and increasing its visibility. More colleagues are now coming forward for advice and to have their concerns heard. Every day, colleagues across the RFL help people through some of the most important moments of their lives. We want your experience of working here to reflect the amazing experience of care you provide. The NHS Staff Survey is your opportunity to tell us what it is like to work at the RFL – your feedback helps us understand what supports colleagues to do their best work and where things could be better. No matter your role or location, add your voice to the mix. Search for ‘NHS Staff Survey’ on Freenet to learn more. You make the difference. Share your experience. 15 minutes to share your experience on life at the RFL. Completely anonymous – nobody in the trust can see your responses. Search for ‘IQVIA’ in your inbox to find your personalised link. Turn to page 8 to meet our Freedom to Speak Up Guardians and find out how they can support you. Search for ‘IQVIA’ to complete your survey.
6 7 Children’s community nursing and special school nurses While the vast majority of RFL nurses provide care for patients on hospital wards – one team are out in the community braving all weathers, traffic and the unknown, to look after children in need of care. Dozens of nurses make up the children’s community nursing and special schools nursing service – providing care to children of all ages within their homes, schools and outpatient clinics. The teams have a base at each of our hospital sites, as well as at Cedar House in Enfield and provide a variety of services, including supportive care following a hospital discharge, nursing care for children receiving chemotherapy or continuing care for children with more complex health needs. The teams also provide education for staff based in schools and to parents so, where appropriate, they can take ownership of their child’s care. The community children’s nursing team based at the RFH look after children living in Camden, Islington and south Barnet. They have around 250 children on their case load, from newborns to 17-year-olds, with their needs ranging from intravenous antibiotics for a few days to something much more long term, such as chemotherapy. Madina Ahmed, clinical lead for children’s community and complex nursing services, said there are huge benefits to being based at an acute hospital. “You develop a close working relationship with ward staff, which really benefits the child,” said Madina. “It means we have fewer failed discharges, because we can intervene at the earliest stage if something isn’t in place, preventing the child making an unnecessary return to hospital.” The team also train staff, who may need to administer some emergency care to children while they are at school. For instance, a child who might need urgent seizure medication or a child with a serious allergy. Two members of the team provide nursing care to 270 students at Swiss Cottage School – a school for children with special educational needs aged from four to 19. Madina says her upbringing in Mauritius gave her a love of looking after children. “I grew up around lots of kids and I was often babysitting them,” she said. “So I have always loved kids and that is what drew me to paediatric nursing.” Madina added that the key to children’s nursing is understanding the patient who is in front of you. She said: “You could be looking after a baby, you could be looking after a teenager and that is completely different. You need to be adaptable.” According to Ray Bywater, children’s community nursing manager for BH and CFH, it takes a particular kind of person to excel in the job. “You have to be confident making quick decisions by yourself,” he said. “The members of my team have a lot of clinical responsibility, albeit they will have support from managers where needed. But you are outside, navigating traffic and weather, it’s a completely different role from being on the ward. You have to go into someone’s home and you never know what to expect.” The children’s nursing team based at BH and CFH look after around 230 children living in north Barnet and north Enfield. There are just over six whole time equivalent nurses within the team, looking after children aged up to 16 or 19 for those with a disability. You have to be confident making quick decisions by yourself “ “ The beautiful thing about children’s nursing is that a child can really bounce back “ “ Ray has been a paediatric nurse for 27 years and has managed the children’s community nursing team since 2010. He said the service had grown a lot during this time. “Some of it is because the population has grown but also because the role has expanded,” he added. “We now carry out more procedures which used to be done by other teams, such as gastrostomy – feeding-tube – care. It really is one of the best nursing roles out there. “For the children you look after, you become part of the family – it’s incredibly rewarding. We are helping patients stay out of hospital.” Ray and his team also help parents deliver some aspects of their child’s care. “It wouldn’t be for every family and that’s OK,” he said. “But some families are happy to do it and where we can, we help them take ownership.” The nursing team based at Cedar House in Enfield also provides care for children in schools as well as continuing care for children with longer-term health conditions. Madina said: “The team help keep children with medical needs in education so they don’t miss out on schooling. They might provide care in their homes which means they don’t need to spend time going to the GP or to hospital and can continue with their schooling instead. We do home visits and sometimes clinics within schools.” Additionally, the Cedar House team supports Enfield’s seven special needs schools based across 16 separate sites and they provide continuing care to children who have more complex health needs. Madina said: “The nursing teams make a huge difference, allowing children to go to school and stay in education. They have developed great working relationships with our partners in social services, in education and of course with the families. “It can be a really challenging job but it’s also so rewarding when you see the difference it makes to children’s lives.” L-R: Matron Malvina Benitez-Castillo, children’s community nurses Danielle Gordon, Rachel Koshy, Arlene Clarke, Roshni Barber and children’s community senior health worker Antoinette Fisher Ray Bywater One of the most important qualities a children’s community nurse needs is empathy, according to matron Malvina Benitez-Castillo, who manages the team at North Mid. “We are caring for a family with an unwell child and that can be highly stressful,” said Malvina. “People might not behave as they normally would and as a nurse you have to be understanding and compassionate. “Children’s nurses also often to be patient. You need to be a little bit of a child yourself – it might be best to play with them for 10 minutes first and then you can give them their treatment.” At North Mid, the community children’s nurses team looks after around 150 children living in south Enfield and Haringey. They have a total of six whole time equivalent nurses who provide care for children in their own homes. Malvina added: “Our job is to allow for family life to go on for these children. We give them some normality and as little disruption as possible to their home life and their education. “The beautiful thing about nursing children is that they bounce back. Sometimes you think they seem so unwell, and you worry about how they will pull through. Then the next day they are doing really well. Being a part of that moment with their family is a real privilege.”
8 Jill Eastmond and Aisha Hanif are already familiar faces across our sites, making it their priority to get out to meet as many staff as possible face-to-face. Lead Freedom to Speak Up Guardian, Jill, joined the RFL eight months ago taking up the mantle from outgoing Guardian, Jim Mansfield. In taking on the role Jill also became guardian for North Mid, who had previously used an external guardian service. To develop the service further, Aisha was recruited as Jill’s deputy, enabling them to increase access and support for all who need it. Their role is to ensure that anyone who works at the trust can raise concerns safely, confidently and in confidence. This includes healthcare professionals, non-clinical staff, volunteers, contractors, bank staff, students and former employees. Jill said: “We make sure concerns are heard and addressed, so that as an organisation we can learn from every case and foster an inclusive culture where everyone is treated fairly and equally.” Jill is responsible for keeping relevant policies up to date and Aisha is focused on recruiting and increasing the number of Speaking Up Champions as well as increasing engagement with them. She said: “Aisha and I walk the floors regularly to visit clinics and departments, attend huddles and audit meetings. That interaction has resulted in a significant rise in the number of cases recorded in the first six months of the refreshed service. I’m also pleased that the number of anonymous concerns raised to us has been minimal, which indicates that colleagues feel safe speaking with us.” Supporting managers is an important part of the FTSU Guardian’s role as it encourages concerns to be resolved informally and locally wherever possible. This could help avoid lengthy and stressful formal processes, while reducing the risk of work related stress and long term sickness absence. Empowering staff to share their voice 9 L-R: Jill Eastmond and Aisha Hanif Gloria’s insights You don’t always need to have an answer before you speak up – sometimes you just need someone who will listen. Speaking up isn’t necessarily about complaining – it can be about seeking clarity, it can be about challenging something respectfully, it can be asking whether there is a better way of doing something and it can be about supporting someone else who may not be confident enough to speak for themselves. If a member of my team comes to me with something that they are uncomfortable with, or they feel that they haven’t been heard, I can listen to them and support them. But I also know I don’t need to be the person who has all the answers. I can say: “Have you considered speaking to Jill?” – that’s because I know from my own experience that the conversation is approachable, supportive and non-judgemental. Leadership isn’t about creating an environment where everyone agrees with you. It’s about creating an environment where people feel safe enough to disagree with you. If people are afraid to challenge decisions, raise concerns or tell us when something isn’t working, then we don’t have the full picture. In healthcare that can have serious consequences. “Feeling safe to have a conversation” Gloria Lewis, ward manager of the emergency department at North Mid has been supported by the FTSU Guardian service and shares her story: “I’ve never personally raised a formal Freedom to Speak Up concern but the service is so much more than that. It’s about having someone you trust, knowing where you can go, feeling safe to have a conversation, and knowing your voice matters. I met Jill through the WITH:STAND programme and I began to understand what the role was really about and, importantly, that you don’t necessarily have to wait until something becomes a serious problem before you speak to someone. Jill created an environment where I felt comfortable having conversations, asking questions and exploring situations and that has been really valuable to me. Jill is someone I can go to when I need to talk something through. Sometimes it’s been about understanding a policy. Sometimes it’s been about seeking advice. Sometimes it’s simply about getting another perspective before deciding how I want to approach something.” Gloria Lewis Contact us In addition to Jill and Aisha the trust has several site-based Speaking Up Champions. To contact the Champions, Speaking Up Guardian or if you would like to become a Speaking Up Champion email rf-tr.speakingup.nhs.net. You can also call Jill or Aisha on MS Teams. You can find more information by typing ‘speaking’ into Freenet.
Governors’ update From guiding hospital visitors to providing pet therapy, Royal Free Charity volunteers find many ways to make a difference across the RFL. Now, the volunteer service is supporting the endoscopy team at CFH thanks to a new role designed to give patients extra support before and after their procedures. Anne Liddiard joined the department after more than a year volunteering elsewhere in the hospital. For patients waiting for an endoscopy, a procedure that uses a tube with a camera to look inside the body, a friendly face and someone to talk to can make a difficult moment feel that little bit easier. Anne said: “Waiting for the procedure is often a very worrying time for patients and distraction or someone to sit and listen to them is of great benefit.” After a career as a medical secretary, including at CFH, Anne wanted to stay involved with the NHS after retirement and support busy clinical teams. In the endoscopy unit, that support takes many forms, from helping staff with administrative tasks to chatting with patients before and after procedures. 10 11 Celebrating remarkable progress in cancer care Book your place at our Annual Members Meeting Give flu the cold shoulder this winter The power of kindness Janadean Mills-McDonald, senior nurse in CFH’s endoscopy unit, said: “Having Anne as a volunteer in endoscopy is invaluable.” One encounter has stayed with Anne. She spent time with a young woman experiencing mental health difficulties, listening as she shared her worries before treatment. “I was literally a shoulder to cry on,” she said. For anyone considering volunteering, her message is simple: “There is a role for everyone.” Royal Free Charity volunteers make a direct and meaningful contribution to patient experience. Visit royalfreecharity.org or pop into a charity office to find out more. More than 100 trust members heard how the RFL has transformed cancer services to become one of the best performing trusts in the country for waiting times, delivering faster diagnoses and treatment for patients when it matters most. At our latest Medicine for Members event, group director of cancer, Laura Morrison, interim lead cancer physician, Professor Joerg-Matthias Pollok, and group lead cancer nurse, Jemma O’Reilly, shared the story behind one of the trust’s most significant improvement journeys in recent years. Through the dedication, expertise and teamwork of colleagues, the trust has driven a major turnaround in cancer performance, improving access to care and helping more patients start treatment sooner. For patients, the results speak for themselves. More people are receiving cancer treatment within the national 62-day standard than a year ago, placing the trust among the top quartile of performers in England. Earlier diagnoses are also helping patients access treatment more quickly while reducing the stress and uncertainty that often accompany a cancer referral. These achievements have been recognised nationally, with the trust shortlisted for a prestigious HSJ Award for performance recovery. If you missed the event, you can watch a recording on our website. Join us for an evening of celebration, insight and conversation at our 2026 Annual Members Meeting on Wednesday 4 November from 6 to 7.30pm. This special event is your opportunity to hear about the difference our staff, volunteers and partners have made over the past year, discover how we are improving care for patients and communities, and find out what lies ahead for the RFL. On the evening you will be able to: • c elebrate some of the trust’s key achievements from the past year • h ear about the challenges we have faced and how we are responding to them • g ain insights into our operational and financial performance • e xplore interactive displays showcasing the breadth of services we provide • m eet governors, staff and fellow members of our local community • p ut your questions directly to our trust board during a live Q&A session Anyone can catch the flu and colder, drier days means the virus spreads more easily – protect yourself, your colleagues and our patients by getting vaccinated. All RFL staff can get their vaccine for free from October at one of our vaccine clinics. Our friendly vaccinators will be on hand across sites to administer the vaccine and help shield colleagues from flu. The vaccine works by using inactivated fragments of a flu virus to help your body produce the right antibodies to fight off a real infection – there’s no live strain involved, so you can’t get the flu from the vaccine. If you catch the virus after getting vaccinated, symptoms are often much milder and it can help you get back on your feet quicker, reducing the chances of passing it on to others. The virus changes every year, and so does the vaccine, to make sure you’re as protected as possible against the latest strains. It’s important to get your vaccine every year, and as early as possible, to help reduce flu cases and keep our services running smoothly. Search ‘flu vaccine’ on Freenet for details on your local vaccine clinic and how to book an appointment. Help shield your colleagues from flu Share your views: take part in our membership survey We are committed to improving how we engage with you and enhancing your experience as a RFL member. In previous years, we have surveyed our membership as a whole. This year we are taking a more tailored approach by introducing constituencyspecific surveys. This will help us better understand the needs, experiences and priorities of our staff, patient and public members. All trust members will have received the survey by email, and it will remain open until Friday 27 November. Please take a few minutes to complete it. This is your opportunity to tell us what we are doing well, where we can improve, and how we can better support and engage with our members in the future. Your feedback is invaluable and will help shape our membership programme going forward. Laura Morrison, group director of cancer Professor JoergMatthias Pollok, interim lead cancer physician Jemma O’Reilly, group lead cancer nurse
12 60 seconds with… Nicola Henawi nurse consultant palliative care Tell us about yourself I’ve worked at the RFL since 2005 and before that I was at St Bart’s Hospital and the Christie Hospital in Manchester. My background is in oncology and haematology and, during that time, I developed a passion for ensuring there was high quality palliative and end of life care available to everyone, regardless of diagnosis. I was drawn to the RFL because it has a really varied cohort of patients, not just cancer, and because of the collaborative nature of the work, which spans hospital and community. I’ve been very lucky during my career to have worked alongside inspiring people and their compassionate leadership and communication has impacted my approach. What matters to you? I enjoy the diversity of the role including developing and shaping services, as well as supporting and educating others. This in turn improves the experience for our patients and those important to them. I teach at degree and master’s level and lead the nursing teams for BH, RFH and North Camden Community Services. Last year we had approximately 3,200 palliative care referrals between the three. It’s a seven-day service with staff working across hospital and community settings. What are some of the challenges you face? One of the key challenges is recognising opportunities to identify patients early enough to have meaningful conversations about what matters most to them and their future care. We encourage staff to embrace these discussions openly and confidently, recognising their role to facilitate discussions and provide people with the opportunity to express what is important to them. With an ageing population and increasing frailty, demand is growing faster than resources, making collaboration and innovation essential. Earlier this year a partnership was established with Marie Curie clinicians working in the emergency department at the RFH. A similar initiative is in place at North Mid, although the model differs slightly. We have also developed specialist palliative nursing roles for renal and liver disease. While, as nurses, our instinct is often to respond immediately and address the problem in front of us, it is equally important to take a step back and think strategically about how we can improve care more broadly. That’s why audits like the National Audit of Care at the End of Life are so valuable, helping us identify opportunities for further improvement. What should we never lose sight of? Ultimately, it’s about listening to patients and their family and treating them with kindness, empathy, dignity and respect. The importance of this to the end-oflife experience should never be underestimated. The incredible emails we receive from families praising the care and support provided by the ward teams during a patient’s final days or weeks are powerful reminders of the lasting difference compassionate care can make, and we are always pleased to share this feedback with the staff involved. How do you like to unwind outside of work? After five years on a waiting list, I have finally got an allotment. It’s very much a work in progress as I’m starting from scratch but I find it really rewarding, including the prospect of eating my own vegetables. I also enjoy running and, together with some members of our team, we take part in the London Winter Run in February. Taking care of your wellbeing Every day, our staff go above and beyond to care for our patients. • 24/7 helpline contact Optima Health on 0800 174319. The team are available 24 hours a day, 365 days of the year. It’s confidential and free • 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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